{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Is partner in not recipient of medical care 6

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: r 4. Patient satisfaction an appropriate outcome measure. 5 . Patient is partner in, not recipient of, medical care 6. Ultimate goal: a good death (when no cure) D Handout: Learning the Patient's Story How is onset of serious illness 1. Threat of loss of control. often interpreted by patient and/or 2. Threat of impending dependency. the family? 3. Threat of interpersonal closeness. 4. Threat of separation from home, friends, and family. 5. Threat of loss of love. 6. Threat to efficacy (failure to maintain personal health) 7. Threat of pain. 8. Threat of loss of body parts. What are initial responses to 1. Self-treatment. serious illness? 2. Help from non-medical source. 3. Denial or avoidance. 4. Desire to tell story of illness. iat rot ropic st imulus That which moves the patient toward the physician. CHAPTER 5: THE CHIEF CONCERN AND HISTORY OF PRESENT ILLNESS Lecture: Chief Concern and Tuesday, August 30, 2005 History of Present Illness What are the 8 dimensions for Patient’s attributions - ideas and concerns (FIFE) evaluating a patient's symptoms? Chronology - time, duration, course of symptoms Location Quality - feeling of symptom Quantity - degree of symptom Setting - context of illness Aggravating/Alleviating Associated symptoms - concurrent problems List conversational devices other Orientation statements than questions. Paraphrasing Reflection Directive Request for clarification Empathic statements Time management Facilitating body language Facilitating Utterances Silence What do you need to know as a Who is the patient? + FIFE physician? Expectations: What does the patient want from the physician? Function: How does this patient experience this illness? Ideas: What are the patient’s ideas about the illness? Feelings: What are the patient’s main feelings about the illness? Coulehan: p. 4 5 - 60 present illness Wh quest ions direct ive quest ions summariz at ion confront at ion Remedy for dealing with the reticent patient. Remedy for dealing with the rambling patient. Remedy for dealing with the vague patient. A thorough elaboration of the chief complaint and other current symptoms starting from the t ime the patient last felt well until the present. Where What When How - how is it altered, how are you affected Why - why do you think... Who - who is affected... Close-ended questions that provide detail. Technique by which the clinician feeds back to the patient the main points of what has been s aid thus far. Frequent summaries help ensure that the interviewer has the story straight, provide focus, serve as transitions from one topic to another, and keep the interviewer organized. An attempt to clarify inconsistent statements. Guide the reticent patient without asking leading questions. Direct the patient back to the task at hand without appearing to be rude or disinterested. Provide a choice of useful descriptors without leading the patient. CHAPTER 6: PAST MEDICAL HISTORY, FAMILY HISTORY, AND PATIENT PROFILE Lecture: PMH, FH, and Patient...
View Full Document

{[ snackBarMessage ]}

Ask a homework question - tutors are online