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Gathering information
Initial exploration of the
patient’s problems (disease and illness)
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Patient’s
narrative:
encourages patient to tell the story of the problem(s) from when first started
to the present in own words |
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Question style:
uses open-ended
and closed questions, moves appropriately from open to
closed |
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Listening:
listens
attentively, allowing patient to complete statements without interruption;
leaves space for patient to think before answering or go on after pausing
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Facilitative
response:
facilitates patient's responses verbally and non–verbally e.g. use of
encouragement, silence, repetition, paraphrasing, interpretation |
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Cues:
picks up verbal and
non–verbal cues (body language, speech, facial expression, affect); checks
them out and acknowledges as appropriate |
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Clarification:
clarifies
statements which are vague or need further amplification (e.g. "Could you
explain what you mean by light headed") |
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Time-framing:
establishes when events in history occurred
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Internal
summary:
periodically summarises to check own understanding of what the patient
has said; allows patient an opportunity to correct interpretation and provide
further information |
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Appropriate
use of language:
uses concise, easily
understood questions and comments, avoids or adequately explains jargon
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Further
exploration of the disease framework
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Focused closed
questions:
asks appropriate closed questions to explore facets of the history that have
not emerged from the patient’s account |
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Symptom analysis:
site,
radiation, character, severity, duration, frequency and periodicity, special
times of occurrence, aggravating factors, relieving factors, associated
phenomena |
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Relevant functional
enquiry:
asks questions from the functional enquiry relevant to the appropriate system
being explored |
Further
exploration of the illness framework (patient’s perspective)
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Ideas
and concerns:
determines patient's
ideas (i.e. beliefs re cause) and concerns (i.e. worries) regarding each
problem |
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Effects:
determines
the effects on the patient’s life of each problem |
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Expectations:
determines what help the patient had expected regarding each problem
|
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Feelings
and thoughts:
encourages the
expression of the patient’s feelings and thoughts |
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