NUR 2065 Physical Assessment in Healthcare Exam 1 Study Guide

CHAPTER 3: THE INTERVIEW • Physical Environment Considerations: o Ensuring privacy: Aiming for “geographic” privacy, as well as ensuring “psychological” privacy. o Avoiding interruptions: Concentrate and establish rapport. Inform colleagues of interview and the need to minimize interruptions. o Physical environment: “Equal status” seating (sitting at the same level), placing client 4 to 5 feet away from you. o Dress: Client should remain in street clothes for interview. Gown causes power differential and may make client feel exposed. Build rapport before asking client to change into gown. Your appearance should be professional and avoid extremes. Promote professional image for self. o Note taking: Keep to minimum; offer focused attention. Jot notes down, but also keep non-verbal communication up to par. • Non-Verbal Communication o Physical appearance: Image as initial perception. “First impression”. o Posture: Interpretation of body language can impact engagement with client. o Gestures: Gestures send messages so be aware of your own, as well as the client’s. o Facial expression: Reflects emotion and culture. Pay attention to your own facial expressions as well. o Eye contact: Maintain within the realm of interest, but be mindful of cultural diversity. Lack of eye contact may show the client may be shy, withdrawn, confused, bored, intimidated, etc. o Voice: Be aware of tone, intensity, and rate of speech. o Touch: Interpretation is influenced by age, gender, cultural background, past experience, and current setting. • Verbal Communication  Patient Perspective (Reaction—Patient leads): o Facilitation: Encourages patient to say more and shows them you are interested. o Silence: Directed attentiveness; provides chance to observe client and note non-verbal cues. o Reflection: Echoing patient’s words to help elaborate problem. o Empathy: Names a feeling and allows its expression. o Clarification: Asking for confirmation and summarizing patient’s words.  Interviewer Perspective (Your thoughts—Nurse leads): o Confrontation: Clarifying inconsistent information. o Interpretation: Makes association to identify cause or conclusion. o Explanation: Informing person by sharing factual and objective information. o Summary: Provides conclusion based on verified information which in turn identifies that the interview process is closing. • Therapeutic Responses: o Build rapport and continue therapeutic relationship and using therapeutic touch. o Use therapeutic touch to provide empathy. • Language Barriers o Potential exists for language barrier to be a key element in health care interactions due to cross-cultural communications.