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RESPONSE

Respond to a colleague who selected a different patient than you, using one or more of the following approaches:

1.Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

2.Suggest additional health-related risks that might be considered.

3.Validate an idea with your own experience and additional research.

(2 paragraphs/2 sources)

POST

Scenario: 76-year-old Black/African American male with disabilities living in an urban setting.

Summary of interview and communication techniques

Patient centered care was found as one of the key elements of high-quality care approach based on patient perspective on illness, understanding patient psychosocial context and reaching shared treatment goals based on patient’s values (Hashim, 2017). Communication skills such as eliciting patient’s agenda with open ended questions, not interrupting the patient; and engaging in active listening are required for patient centered care. Also understanding patient’s perspective of illness and expressing empathy with non-verbal gestures such as respectful silence, touching a patient’s hand or knee if culturally appropriate. Ball, Dains, Flynn, Solomon and Stewart (2019) defined effective communication as positive patient relationship that relies on courtesy, comfort, and confirmation. A clinician must be courteous, ensure both physical and emotional comfort and trust to make sure interaction is clearly understood (Ball et al., 2019).

In my patient’s case, communication may be difficult due to disabilities related to aging such as cognitive impairment, hearing loss, vision impairment and impaired mobility. If this patient is hard of hearing, it is important to speak clearly and slowly, sitting face to face with him when talking or use written interview with large prints and adequate lightening will help with impaired vision.

Risk Assessment instrument

Health risk assessments are an important element of healthy stage and the purpose is to evaluate a patient’s risk of developing common chronic disease (Wu & Orlando, 2015). Several studies found detailed family health history as the key component of health risk assessment and people with family history of a disease have a higher risk of developing the disease than people without a family history (Wu & Orlando, 2017; Lushniak, 2015).

The Groningen Frailty Indicator (GFI) will be an appropriate risk assessment instrument for this patient because it is a type of geriatric screening tool used to identify functional decline in elderly patients. The Groningen Frailty Indicator (GFI) assesses mobility, assistance needed with activities of daily living, shopping, physical fitness, poor hearing and vision, weight loss, and complaints about memory, feeling of isolation, depression and anxiety (Deckx, , Van den Akker, Daniels, Jonge, Bulens, Tjan-Heijnen, Abbema & Buntix, 2015). This risk assessment instrument is very applicable to my patient due to his disabilities and being an elderly patient living in an urban setting. Assessing the patient’s functional status and needs will yield positive patient outcome and improve compliance with treatments. Also provides useful information that encourages providers to consider different aspect of functioning.

Targeted questions

What are your concerns?

Are there anyone in your family with the same disabilities?

Are you taking any over the counter medication or dietary supplement such as herbal remedies?

Are you able to do Groceries or get to pharmacy on your own?

Does anyone else live in your home or you live alone?

References

Ball, J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St Louis, MO: Elsevier Mosby.

Deckx, L., Van den Akker, M., Daniels, L., De Jonge, E.T., Bulens, P., Tjan-Heijnen, V.C.G., Van Abbema, D.L., & Buntinx, F. (2015). Geriatric screening tools are of limited value to predict decline in functional status and quality of life: results of a cohort study. BMC Family Practice, 16(1), 1-2. Doi:10.1186/s12875-015-0241-x

Hashim, M. J. (n.d.). Patient-Centered Communication: Basic Skills. American Family Physician, 95(1), 29–34.

Lushniak, B.D., (2015). Surgeon general’s perspective: Family health history: Using the past to improve future health. Public Health Reports. (1), 3.

Wu, R.R., & Orlando, L.A (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, (1079), 508-513

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