Ad hoc interpreter
Using a patient's family member, friend or child as interpreter for a limited English proficient (LEP)
patient.
Animism
Imagining that intimate objects (e.g., a blood pressure cuff) come alive and have human characteristics.
Avoidance language
The use of euphemisms to avoid reality or to hide feelings.
Clarification
Examiner's response used when the patient's word choice is ambiguous or confusing.
Closed questions
Questions that ask for specific information; elicit a short, one- or two-word answer, a "yes" or "no," or a
forced choice.
Confrontation
Response in which examiner gives honest feedback about what he or she has seen or felt after observing
a certain patient action, feeling, or statement.
Distancing
The use of impersonal speech to put space between the self and a threat.
Elderspeak
Infantilizing and demeaning language used by a health professional when speaking to an older adult.
Electronic health recording
Direct computer entry of the patient health record while in the patient's presence.
Empathy
Viewing the world from the other person'd inner frame of reference while remaining yourself;
recognizing and accepting the other person's feelings without criticism.
Ethnocentrism
The tendency to view your own way of life as the most desirable, acceptable, or best and to act in a
superior manner to another culture's life ways.
Explanation
Examiner's statements that inform the patient; examiner shares factual and objective information.
Facilitation
Examiner's response that encourages the patient to say more, to continue with the story.
Geographic privacy
Private room or space with only the examiner and patient present.
Interpretation
Examiner's statement that is not based on direct observation, but is based on examiner's inference or
conclusion; it links events, makes associations, or implies cause.
Interview
Meeting between examiner and patient with the goal of gathering a complete health history.
Jargon
Using medical vocabulary with patient in an exclusionary and paternalistic way.
Leading question
A question that implies that one answer would be better than another.
Nonverbal communication
Message conveyed through body language-posture, gestures, facial expression, eye contact, touch, and
even where one places the chairs.
Open-ended question
asks for longer narrative information; unbiased; leaves the person free to answer in any way.
Reflection
Examiner response that echoes the patient's words; repeats part of why patient has just said.
Summary
Final review of what examiner understands patient has said; condenses facts and presents a survey of
how the examiner receives the health problem or need.
Telegraphic speech
Speech used by age 3 to 4 in which three- or four- word sentences contain only essential words.
Verbal communication
Messages sent through spoken words, vocalizations, tone of voice.
8 Items of information that should be communicated to the patient concerning the terms or
expectations of the interview.
1.) Time and place of interview/ exam.
2.) Intro of self and brief explanation of role.
3.) Purpose of interview
4.) How long it will take.
5.) Explanation of participation from each person.
6.) Presence of any other people (e.g family, students etc.).
7.) Confidentiality and it's limitations.
8.) Any costs that the patient must pay.
Point to consider in preparing the physical setting of interview.
-Room temperature at a comfortable level.
-Sufficient lighting.
-Reduction of noise.
-Removal of distracting objects/equipment.
-Distance between self and patient at 4 to 5 feet.
-Arrange equal status seating.
-Arrange face to face positioning.
9 Types of examiner responses that could be used during an interview.
-Facilitation "mm-hmm, go on."
-Silence
-Reflection pt, "My water was cutting off." me, "Cutting off?"
-Empathy "It must be hard."
-Clarification "Tell me what you mean by ..."
-Interpretation "Could x be because of y?"
-Explanation
-Summary
10 Traps of interviewing.
1.) Providing false assurance/ reassurance.
2.) Giving unwanted advice.
3.) Using authority.
4.) Using avoidance language.
5.) Engaging in distancing.
6.) Using professional jargon.
7.) Using leading/ biased questions.
8.) Talking to much.
9.) Interrupting.
10.) Using "why" questions.
7 Types of nonverbal behaviors that an interviewer could make.
1.) Physical appearance.
2.) Posture.
3.) Gestures.
4.) Facial expressions.
5.) Eye contact.
6.) Voice.
7.) Touch.
List 5 points to consider when using an interpreter during an interview.
1.) Identify the patients language and be aware of cultural differences.
2.) Whenever possible use a trained interpreter.
3.) Be aware of gender differences within cultures.
4.) Be aware of age differences within cultures.
4.) Be aware of socioeconomic differences within cultures.
Useful phrase to use as a closing when ending an interview.
"Is there anything else you would like to mention?"
Special considerations when interviewing an older adult.
-Address the person by last name and title.
-Allow more time.
-Adjust pace comfortably for patient.
-Keep in mind physical limitations.
-Touch is very important.
Ways to modify interview for hearing-impaired.
-Ask preferred method of communication.
-Interpreter is then important for health history.
-If able to read lips, face them.
-Facial hair/ accents make interview difficult.
-Be sure to make sure they understand.
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