Chapter 4

Copyright © 2009 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Chapter 4: The Interview

 Subjective data
 Results of a
successful interview

Subjective data
-info obtained from the pt
Objective data
-info obtained during physical exam

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Chapter 4: The Interview

 The interview as a contract between patient

and examiner
◦ Time and place
◦ Introduction and explanation
◦ Purpose
◦ Length
◦ Expectations
◦ Presence of others
◦ Confidentiality
◦ Costs

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Chapter 4: The Interview

 Sending
 Receiving
 Internal and external factors

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Chapter 4: The Interview

 Liking others
 Empathy
 Ability to listen

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Chapter 4: The Interview

 Ensure privacy
 Refuse interruptions
 Physical environment
 Dress
 Note-taking
 Tape and video recording

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Chapter 4: The Interview

 Temperature
 Lighting
 Noise
 Distracting equipment
 Distance between you and the patient
 Equal status seating

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Chapter 4: The Interview

 Impedes eye contact

 Attention-shifting
 Interruption of patient’s narrative flow
 Impedes observation of nonverbal
behaviour
 Can be threatening

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 Introducing the  Working phase
interview ◦ Open-ended
questions
◦ Closed or direct
questions

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Chapter 4: The Interview

 Responses—assisting the narrative

◦ Facilitation
◦ Silence
◦ Reflection
◦ Empathy
◦ Clarification
◦ Confrontation
◦ Interpretation
◦ Explanation
◦ Summary

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Chapter 4: The Interview

Ten traps of interviewing

1.Providing false assurance or reassurance
2.Giving unwanted advice
3.Using authority
4.Using avoidance language
5.Engaging in distancing
6.Using professional jargon
7.Using leading or biased questions
8.Talking too much
9.Interrupting
10. Using “why” questions

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Chapter 4: The Interview

 Nonverbal skills
◦ Physical appearance
◦ Posture
◦ Gestures
◦ Facial expression
◦ Eye contact
◦ Voice
◦ Touch
 Closing the interview

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Chapter 4: The Interview

 Hearing-impaired people
 Acutely ill people
 People under the influence of street drugs or
alcohol
 Personal questions asked of the clinician
 Sexually aggressive people
 People who are crying
 Angry people
 People who threaten violence
 Anxious people

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Chapter 4: The Interview

 Cultural perspectives on professional

interactions
 Etiquette
 Space and distance
 Cultural considerations on gender and

sexual orientation

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Chapter 4: The Interview

 Working with (and without) an interpreter

 Nonverbal cross-cultural communication

◦ Vocal cues (and silence)

◦ Action cues
◦ Object cues
◦ Use of personal and territorial space
◦ Touch

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Chapter 4: The Interview

A. Why did you come in today?

B. Where does it hurt?
C. Have you been checking your blood
pressure?
D. When was the last time you were seen
by
a doctor?

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Chapter 4: The Interview

A. Why did you delay coming in when you

noticed the symptoms?
B. What happened between the time you
noticed the symptoms and when you came
in?
C. Did you know you should have come in
right away when you noticed the
symptoms?
D. Explain for me the delay between the onset
of symptoms and the time you came in.

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