Core Interpersonal Skills for Health Professionals - Literature review Example

Assignment Title: Analysis of Interview Unit Code and Title: NSP1104D Communication in Health Care Lecturer: Student Name: Student Number: Date of Submission: Table of Contents Table of contents………………………………………………………………………………………………………………………..1 Introduction...................................................................................................2 Analysis: Interviewing theories..........................................................................2 Analysis: Questioning theories.........................................................................................................5 Conclusion........................................................................................................................................8 References........................................................................................................................................9 Table of Contents 1 Introduction 2 The assignment will look at interviewing and questioning theories relating to health care. It will analyse an interview between two students, one acting as the nurse and the other one as the patient. It aims at looking at the mistakes that occur during health care interviews and how they can be eliminated. There will be theories and suggestions in support of the examples as quoted from the recordings. The assignment looks at communication as the mother of interviewing and questioning. The assignment will provide recommendations to be put in place to improve communication in the health care sector. 2 According to Kenworthy, Ellis and Gates, (2003) communication is a mode of interaction between two or more parties by exchange of messages; sending and receiving of messages (Kenworthy et el, 2003, pp. 3). Another definition is that communication is a mode of creating beneficial relationship among people. It explains how this relationship affects behaviour of each other, which is extremely crucial in improving nursing interventions in the health care field (Balzer, 2012, pp. 5). 2 Analysis 2 Part A: Interviewing theories 2 Introduction The assignment will look at interviewing and questioning theories relating to health care. It will analyse an interview between two students, one acting as the nurse and the other one as the patient. It aims at looking at the mistakes that occur during health care interviews and how they can be eliminated. There will be theories and suggestions in support of the examples as quoted from the recordings. The assignment looks at communication as the mother of interviewing and questioning. The assignment will provide recommendations to be put in place to improve communication in the health care sector. According to Kenworthy, Ellis and Gates, (2003) communication is a mode of interaction between two or more parties by exchange of messages; sending and receiving of messages (Kenworthy et el, 2003, pp. 3). Another definition is that communication is a mode of creating beneficial relationship among people. It explains how this relationship affects behaviour of each other, which is extremely crucial in improving nursing interventions in the health care field (Balzer, 2012, pp. 5). Analysis Part A: Interviewing theories Interview can be defined as communication of ideas and thoughts between people or a group of people for the benefit of the involved parties. In health care, it is to benefit patients, health professionals or that benefits all of them (Price, 2004, pp. 45). According to Stein (2009) there are two types of interviewing, planned and spontaneous exploration. To Stein planned exploration is where the nurse takes control by asking direct questions to help them get information from the patients. Spontaneous exploration is unplanned form of the interview where the patient takes control. In this kind of interview a lot of information is given out by the patient, this helps enhance the relationship between the patient and the nurse. This form of interview helps the patient bring out his or her feelings so that the nurse can act with empathy and probe the patient with open questions that will help in solving the patient’s problems (Stein, 2009, p. 174-175). According to Price (2004) interviews in health care have different purposes such as taking patients history so as to understand his or her condition, diagnosis explanation, to help the patient cope with the situation and give a prescription (Price, 2004, pp. 44). The purpose of an interview is not limited to its medical purpose only because it is aimed at developing a positive relation between the nurse and the patient, which help health care provision. To Arnold and Boggs (2007) there are four phases of interviewing, namely preparation, initiation, exploration and termination. Preparation is the planning stage of an interview where one determines what to ask in an interview. Initiation is the phase where therapeutic relationship is created, and reason for interview is explained. Exploration is where the problem is looked at in depth considering the patient’s feelings. Termination is the final phase of the interview where proper plans are put in place to end the interview if all the patient’s issues are understood. Interviewing is a complex communication process which is more than asking and answering questions (Stewart and Cash, 2011, pp. 18-19). This is due barriers such as mistrust, language barrier where the patient gives out incomplete information to the nurse (Stewart and Cash, 2011, pp. 376-378).   Example of an interview between a nurse and a patient The following is an example of a health assessment interview between a nurse and patient where two students acted these roles one as a nurse and the other one as the patient it is found in the recording. This quote is located at 10 minutes 17 seconds (10:17) of the recording. Interviewer: “Do you have any problems with constipation or diarrhea?” Patient: “Diarrhea? No. even if my appetite is not really good, but still I eat some kind of food that helps me keep my appetite firm, so I don’t have any problem with diarrhea”. Interviewer: “Now I have to move to personal questions eeh?”             Relating the above example to the interviewing theory, the interviewer ask the patient abrupt question which puts the patient off guard, and the patient seems confused and does not answer question fully, and it in a defensive manner. The interviewer should not have left the question half unanswered, but should have prompted for answers, so as to know why the patient jumped to self defense. The interviewer ought to have asked a question like “what kind of food do you eat?” The interviewer should have used the prompting when interviewing the patient, and ask the question in a light manner so as not to make the patient get confused.  According to Stewart and Cash (2009, p.377), the approach used to interview or the way a question is asked can bar effective communication between a patient and a nurse, hence the correct or important information not obtained. In the future, the interviewer ought to ask the question lightly to avoid a defensive climate (Stewart and Cash, 2011, p.90-91).  B. Questioning theory Questioning is a communication skill, which is, applied when a person need to obtain information from another person (O’Toole, 2008, chapter 4). The origin of the word question is Latin, and it means seek. Seeking is the same as searching, and in nursing context, searching for answers and information is very essential for effective communication. The need to gather information in the nursing is what triggers questioning (O’Toole, 2008, chp4).  Asking questions as a form of communication is a chief cornerstone of excellent nursing, and it is the initial step in establishing effective interpersonal relationship between patients and health practitioners (Balzer-Riley, 2012, p. 143). This is because; nurses in their practice question and communicate with many people in the line of their duty, and communication is inevitable. According to Stein-Parbury (2009, p. 180), questioning involves various skills like probing and prompting. These questioning skills aid in acquisition of information, where the patient may not be willing to give the information directly, or clarification is needed. The basis for questioning is to obtain information from patients and establishing an effective working relationship between nurses and the patients (Morrison, 2008, p.7). The information obtained ranges from the history of the patient which includes previous illnesses, current symptoms, social and family relationships, or even previous relationships.   According to Morrison (2008, p.16), questions fall in two categories; and nondirective questions. Directive questions guides the patient on what is being needed, that is, the questions are specific on what is expected.  Nondirective questions are not specific, and they give the patient or person being asked the freedom to give any information a person choose to present. Directive questions are also referred to as closed questions, and they require specific or direct answers. Nondirective questions are also referred to as open-ended questions, and they do not require specific or even direct responses. An open-ended question requires more explanations, which creates a strong rapport between the patient and the nurse (Morrison, 2008, p.16). Open-ended questions also yield more and reliable information. Specific questions provide less information, which may not even be reliable. When questioning or interviewing a patient, the first question asked should be specific, as this makes the person know what the nurse wants to know (Morrison, 2008 p.17). However, the early part of the questioning should be dominated by open ended questions, in order to create a working relationship as well as knowing the patient’s uppermost feelings and problems. Both Stein-Parbury (2009) and Morrison (2008) argues that the two questioning skills (specific and nondirective questions) are essential while obtaining information, and when used together, the best results are achieved. The skill applied depends on the information sort after, and when creating an excellent working relationship, and during the course of the nurses’ line of duty. The example below took place in a health assessment interview conducted between a student acting in the role of a nurse and another student acting in the role of a patient. The quote in this example is located at 5 minutes and 8 second (5:8) of the recording. Interviewer: “Do you smoke?” Patient: “No I don’t smoke.” Interviewer: “You don’t smoke?” Patient: “No.” Interviewer: “Have you ever smoked in the past?” Patient: “Sorry?”             When the above example is related to the questioning theory, it is clear that the interviewer is asking pretty specific questions on the same topic. Specific questions, according to Morrison (2008, p.16), are good when asking the first question, but should not be used a lot in order not to bore or confuse the patient. In future, therefore, the interviewer should avoid repeating the same questions especially if they are closed, but rather use a closed skill for the first question and open-ended for the other following questions. Repeating of the same question using the same questioning skill can make the patient have doubts or even lose concentration, and this may lead to more repetition, and waste time. Therefore, many closed questions should be avoided while asking patient questions, as open-ended questions are better according to Morrison (2008). Conclusion In conclusion, the assignment explains interviewing and questioning theories in relationship to the health care assessment. There is an example of health care assessment interview where one student played the role of a nurse and another one playing the role of a patient. It is clear in the assignment that interviewing and questioning theories are very important if there have to be a positive relationship between a nurse and a patient. The examples of interviews show the mistakes that occur during interviews between a nurse and a patient. Recommendations have been suggested in the assignment to eliminate these problems so as to improve the quality of interviewing in the health care sector. References Arnold, E., & Boggs, K. U. (2007). Interpersonal relationships: Professional communication skills for nurses. St. Louis, Mo: Elsevier Saunders. Balzer-Riley, J. W. (2012). Communication in nursing. St. Louis, Mo: Elsevier/Mosby. Kenworthy, N., Ellis, R. B., & Gates, R. J. (2003). Interpersonal communication in nursing: Theory and practice. Edinburgh: Churchill Livingstone. Morison, J. (2008). The first interview. 3rd ed. New York: The Guilford Press. N.S.W: Churchill Livingstone Elsevier. O’Toole, G. (2008). Communication: Core interpersonal skills for health professionals. New York: Churchill Livingstone Elsevier. Price, B. (2004). Conducting sensitive patient interviews. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 18(38), 45. Stein-Parbury, J. (2009). Patient & person: Interpersonal skills in nursing. Chatswood, N.S.W: Churchill Livingstone Elsevier. Stewart, C. J., & Cash, W. B. (2011). Interviewing: Principles and practices. New York, N.Y: McGraw-Hill Higher Education.                                                Read More