Component Task: Interviewing the Anxious Patient

This is the face to face interaction between the nurse and the patient who frequently has intense, excessive and persistent worry and fear about everyday situation for the purpose of obtaining or giving information. It is one of the methods/tools used by nurses to assess the feelings, perceptions, thoughts and attitudes of the anxious patient and to evaluate care given.

Aims

·         Build therapeutic relationship with the patient

·         Gain a better understanding of patient’s problem

·         Obtain useful information in formulating a nursing diagnosis

·         Provide effective nursing care to the patient

·         Reduce patient’s level of anxiety

·         Promote healing and rehabilitation

Requirements

·         Table

·         Two chairs

·         Pen and note pad

·         Recorder

·         Patient’s folder (Electronic/Manual)

·         Serene environment

Steps

1.        Advance Preparation

·         Formulate goals for the interview

·         Determine issues to focus on during the interview

·         Decide on the type to use (structured, semi-structured or unstructured)

·         Prepare patient and physical environment

·         Determine the appropriate techniques of communicating with the patient

2.      Establish rapport (Refer procedure)

3.      Explain procedure and reassure patient

4.      Prepare the interview setting and arrange the chairs as appropriate

5.      Sit patient comfortably facing the interviewer in a serene environment

6.      Seek patient’s consent to record the interview in any form and assure him/her of confidentiality

7.       Sit down avoiding crossing of arms and legs

8.      Initiate the dialogue in a simple language the patient can understand

9.      Maintain composure and speak to patient in a calm, clear and relaxed tone

10.    Employ the use of verbal, nonverbal and therapeutic communication techniques (e.g. maintain eye contact, appropriate use of body language, feedback, use of silence, restating, etc.)

11.      Check frequently on patient’s state of anxiety throughout the interaction

12.    Find patient’s area of motivation and nurture them to gain his/her co-operation

13.    Focus on specifics (i.e. condition, medication, chief compliant etc.)

14.    Arrange and present questions in a hierarchy or ordered basis (description of experience, thoughts about experience, feelings about the experience, etc.)

15.    Give broad opening or ask opened ended questions

16.    Listen and observe for patient’s nonverbal cues (e.g. facial expression, posture, gestures, etc.)

17.    Give patient enough time to express him/herself

18.    Avoid interrupting patient when he/she is speaking (active listening)

19.    Restate patient’s statement by rephrasing or paraphrasing

20.  Use appropriate questioning techniques

21.    Ask patient to clarify statements

22.  Use silence to listen to patient

23.  Summarize with patient what has been discussed during the interview

24.  Record salient point and close the session

25.  Express appreciation to patient and inform him/her on what to do next

26.  Document findings in the nurses’ note/patient’s folder

27.  Report the outcome from the interview to the Charge Nurse


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