Component Task: Interviewing the Psychiatric Patient on Admission

This is the face to face interaction between the nurse and a patient 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 psychiatric patient. This procedure can also be used to interview the hypoactive patients (e.g. severely depressed, catatonic stuporous patients etc.). These patients demonstrate very slow interaction and thus require extended periods to answer even simple questions. The nurse must understand that the slow responses of these patients is not intentional and he/she should not be frustrated by the slow progress of the interview.

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

·         Give treatment

·         Promote healing and rehabilitation

Types

·         Structured

·         Semi-structured

·         Unstructured

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

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

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

13.    Give broad opening or ask opened ended questions

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

15.    Give patient enough time to express him/herself

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

17.    Restate patient’s statement by rephrasing or paraphrasing

18.    Use appropriate questioning techniques

19.    Ask patient to clarify statements

20.  Use silence to listen to patient

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

22.  Record salient point and close the session

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

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

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


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