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Duran, Fatima Medriza B. - Npi For Rle
Duran, Fatima Medriza B. - Npi For Rle
I. PATIENT PROFILE
Name: Sarah Dada
Age: (not mentioned)
Gender: Female
Civil Status: Married
Diagnosis: Depression
II. SCENARIO
The interaction took place in the morning, inside of Dr. Jad’s clinic, where Sarah, the patient is seated
in front of Dr. Jad. The environment is an area/ room that provides privacy because only the doctor
and the patient is around. Sarah is seated on a chair, as well as Dr. Jad with a table between them.
Therapeutic
Mental Health
Patient Communication Analysis of Behavior
Worker
Techniques Used
*Doctor Jad opens *Sarah steps inside
the door for Sarah* the room*
• It shows that the nurse recognizes
“Good morning, I’m “Good morning ▪ Giving recognition the client as a person, an individual
Dr. Jad, I will be doctor.” ▪ Giving information that gives the client fulfillment of
seeing you today.” his worthiness. This makes the
client feel respected and
comfortable.
• Informing the client of the facts
increases his knowledge about the
topic and what to expect on the
interaction. It also builds trust with
the client.
“Tell me, Sarah. ▪ Broad openings • Broad openings allow the patient
What is troubling to take the initiative to introduce
you?” “I don’t know what’s the topic and talk more. It also
wrong with me. All allows patient to explain more
my body aches. My about what he/she is feeling. For
head, my stomach, Sarah, she has explained what she
has been feeling and her
my knees. And experiences. During the
sometimes I have a interaction, the patient showed
strange tingling little to no emotions and she kept
sensation in my left looking down. Signs of flat affect
cheek.” has also been witnessed. These
signs are commonly seen in
patients experiencing depression.
“Do you mind if I ask ▪ General leads • This gives the patient an
a few questions, to encouragement to continue on
better understand what he is saying. It also indicates
that the nurse is listening and
what you’re going following what the patient is
through?” talking about without taking away
“No, not at all.” the initiative for the interaction. By
asking if the patient is willing to
answer, the nurse makes the
patient feel respected and that
he/she has a say in the interaction.
The patient is also being very
participative by being open to
answering the doctor’s further
questions.
*Doctor provides “I don’t know what is ▪ Encouraging • Helps the client appraise his own
silence, allowing happening. I keep on expression rather than accept the opinion of
others. The patient also complies
Sarah to continue forgetting things.”
well and continues verbalizing.
speaking. *
*Sarah goes back to
her initial thought*
• In this part of the interaction,
“Anyway, they are
Sarah verbalizes about how they
nice people. But their moved from their home to their in-
house is small and I laws’. This indicates that Sarah has
have 3 children. I had a hard time adjusting and was
work all day long and not able to cope up well with the
changes happening around her.
I’m not eating well. I
She also expresses her worries
am also very worried towards her husband, this
about my husband. indicates that Sarah is also having
He is having a hard a social problem and lack of money
time finding a job. to sustain the family’s needs,
which is a very common cause of
Before I knew it, I
depression.
was not eating well,
*Doctor provides or sleeping well and ▪ Silence • Provides limit to put clients’
silence, allowing started having pain actions, thoughts or feeling into
all over my body.” words and shows place of
Sarah to continue interaction. Silence gives time for
speaking. * *Sarah explains with patient to form thought and
continue expressing herself. To
hand gestures as if add with silence, the doctor also
explaining what had maintained moderate eye-contact
happened. * and open posture. This non-verbal
technique allows patient to feel
*Sarah looks at the comfortable in disclosing
information.
Doctor*
“Besides pain, have ▪ Encouraging • Helps the client appraise his own
you noticed anything expression rather than accept the opinion of
others. The patient also complies
else?” well and continues verbalizing.
“Like what?” The patient is also being
participative by seeking
clarification from the doctor.
“Like bleeding or ▪ Giving • Informing the client of the facts
increases her knowledge about
cough or fever for *Sarah shakes her information
the topic and what to expect on
example.” head. * the interaction. It also builds trust
with the client.
“No. Nothing like
that.”
“You said that the ▪ Restating • Restating what the client has said
pain is all over your *Sarah hums* ▪ Exploring allows the client to feel heard and
body. Does it hurt ▪ Encouraging understood. This helps them feel
more in any specific “No. It comes and expression acknowledged and their feelings
respected. Exploring has also been
area?” goes. Especially
used because this allows both the
when I get angry with doctor and patient to delve
my children. I feel further and for the patient to
like my head is going express some more of his/ her
to explode and my thoughts and experiences. Due to
this, Sarah was able to verbalize
hands start shaking.”
that she feels much more pain
when she’s upset. The pain that
she experiences is a common
occurrence in people with
depression. This condition is
called psychosomatic pain. This
refers to a pain that is aggravated
*Doctor hums* by emotional stressors. This
happens due to the hormonal
“Hmm, okay.” imbalance that is happening to
the body.
“So, the pain gets *Sarah cries silently* ▪ Restating
• Restating what the client has said
worse when you are ▪ General leads allows the client to feel heard and
angry. Are you often understood.
angry lately?” ▪ Encouraging
expression • This gives the patient an
encouragement to continue on
what he is saying. It also indicates
that the nurse is listening and
following what the patient is
“Only at my children. talking about without taking away
I feel so bad. I don’t the initiative for the interaction.
*Doctor nods* know what is
happening with me. I • Sarah stated that she feels guilty
was never like that!” as she is always angry with her
children. She stated that she
understands that children are like
“They are children, that, however, she could not
of course. They want control it. Sudden bursts of anger
to play and run and constantly being guilty are
around. My little girl common symptoms among
depressed patients.
*Doctor nods, urging is only one. I hardly
Sarah to continue* feed and clean her. I • She has also stated that she could
don’t talk to her or not do her motherly duties. That
play with her having been said, Sarah is also at
anymore! risk for impaired role and
impaired parenting due to her
condition. She has also been doing
“Not only that!” poorly in terms of her routine
activities or ADLs and feels guilty
“Sarah continues. I because of it.
am not cooking or
cleaning the house
either!”
“When you are “My husband tries ▪ Focusing • Focusing is a technique used to
upset, what to help me but concentrate on a single important
comforts you?” nothing really works. point. And in this case, the doctor
I feel like nothing can is also slowly trying to make Sarah
see that there is something wrong
really get me out of
in random crying spells by asking
this sadness.” her focused questions. The
patient’s answer also indicates
*Sarah pauses and that her husband is a great
continues* support system to her, which is
very important for her to have
▪ Offering Silence
due to her condition. However,
“When I think about she stills feel guilt. The patient has
the future, I feel like I also stated feelings of
have no hope!” hopelessness, which is also a
common occurrence when a
person is depressed. It’s
important that as health workers,
we look closely for the little signs
so that we may prevent a person
from committing suicide or self-
harm. The whole duration of the
interaction, the client showed
little to no emotions, she did not
smile. The only time she showed
emotions was when she cried.
“Sarah, did you talk ▪ General leads • This gives the patient an
with anyone about encouragement to continue on
what he is saying. It also indicates
what you are going that the nurse is listening and
through?” *Sarah shakes her following what the patient is
head* talking about without taking away
the initiative for the interaction. It
“No.” is also vital for the health worker
to ask if Sarah has a support
system. However, she said that
she does not tell anyone about
what she has been feeling.
“We will discuss that ▪ Giving • Informing the patient and letting
soon.” information them know as to what will happen
next implies respect.
*Doctor continues*
“If you don’t mind, I ▪ General leads
• This gives the patient an
still have a few ▪ Exploring encouragement to continue on
questions to ask, what he is saying. It also indicates
then I will do a that the nurse is listening and
physical exam, and following what the patient is
afterwards we will talking about without taking away
the initiative for the interaction.
talk. Is that okay with
• This means delving further into a
you?” subject or an idea. This also
explores the patient to help them
“Sure.” examine the issue more fully, not
only superficially. Sarah has also
been consistently participative in
the interaction.
“It is just a routine *Sarah looks at the ▪ Giving • Informing the patient and letting
them know as to what will happen
question that we ask doctor* information next implies respect.
everyone.”
“I have to ask you *Sarah sighs* ▪ Giving • Informing the patient and letting
more routine information them know as to what will happen
next implies respect.
questions as well.”
• Sources/ References: