The Nursing Interview and Health History

In this lesson, you will learn the essential skills of conducting a nursing interview and gathering a patient's health history. You will explore effective communication techniques, learn about different types of health history, and practice asking relevant questions to obtain crucial information for patient care.

Learning Objectives

  • Identify the key components of a comprehensive health history.
  • Demonstrate effective communication techniques used during a nursing interview.
  • Distinguish between subjective and objective data collection.
  • Explain the importance of health history in the diagnostic reasoning process.

Lesson Content

Introduction to the Nursing Interview

The nursing interview is the cornerstone of patient assessment. It's the first opportunity to establish rapport, gather vital information about a patient's health, and begin to develop a plan of care. A successful interview involves active listening, empathy, and clear communication. Remember, you're not just gathering facts; you're building a relationship of trust. Start with a warm greeting, introduce yourself, and explain the purpose of the interview.

Quick Check: Which of the following is an example of subjective data?

Components of a Comprehensive Health History

A complete health history is a narrative of the patient’s past and present health. It guides the nurse to formulate an accurate diagnosis. The key components include:

  • Biographic Data: Name, age, gender, date of birth, occupation, marital status, and source of information (patient, family, etc.). Example: "Ms. Jane Doe, a 65-year-old retired teacher, is the primary source of information."
  • Chief Complaint: The reason for seeking medical attention, stated in the patient's own words. Example: "I've been experiencing chest pain for the past two days."
  • History of Present Illness (HPI): A detailed account of the chief complaint, using the OPQRSTUV method (Onset, Provocative/Palliative, Quality, Region/Radiation, Severity, Timing, Understanding/Impact, Values). *Example: "The chest pain started suddenly (onset) and is made worse by exertion (provocative) and is described as a crushing sensation (quality) located in the center of the chest (region)."
  • Past Medical History (PMH): Prior illnesses, hospitalizations, surgeries, injuries, and allergies (medication, food, environmental). *Example: "Patient reports a history of hypertension and a previous appendectomy."
  • Family History: Health of immediate family members (parents, siblings, grandparents) and any history of significant illnesses. *Example: "Father had a history of heart disease, mother has diabetes."
  • Social History: Lifestyle habits like smoking, alcohol consumption, drug use, diet, exercise, and living situation. *Example: "Patient smokes one pack of cigarettes per day and drinks alcohol occasionally."
  • Review of Systems (ROS): A systematic review of each body system to assess for any current or past health problems. This often involves asking a series of questions about specific symptoms related to each system. *Example: "Do you have any difficulty breathing or cough (respiratory system)?"
  • Medication History: A list of all current medications, including dosage, frequency, route, and over-the-counter medications and supplements. *Example: "Patient takes Lisinopril 20mg orally once daily."

Quick Check: What is the primary purpose of the 'Chief Complaint' in a health history?

Subjective vs. Objective Data

Understanding the difference between subjective and objective data is critical for accurate documentation and clinical reasoning.

  • Subjective Data: Information provided by the patient; what the patient says (symptoms). It cannot be directly measured. Examples: "I feel dizzy," "My back hurts," "I have a headache."
  • Objective Data: Information the nurse observes or measures; signs (vital signs, physical examination findings). It can be measured or observed. *Examples: blood pressure reading, observation of a limp, a rash.

Quick Check: What does the 'P' in the OPQRSTUV method for the History of Present Illness represent?

Effective Communication Techniques

Effective communication is key to a successful nursing interview. Employ these techniques:

  • Active Listening: Pay close attention, use eye contact, and demonstrate genuine interest.
  • Open-ended Questions: Encourage detailed responses and clarify the patient’s experiences (e.g., "Tell me more about...").
  • Closed-ended Questions: Obtain specific information and are useful to clarify information (e.g., "Are you experiencing chest pain?").
  • Empathy: Show understanding and acknowledge the patient's feelings.
  • Clarification: Ask patients to explain what they mean, or rephrase their statement in your own words. *Example: "So, you're saying that the pain started after you lifted the box?"
  • Summarization: Briefly restate what you have heard to confirm your understanding. Example: "Okay, let me see if I understand: You're experiencing chest pain that is worse with exertion, and you have a history of high blood pressure."
  • Avoid: Leading questions, medical jargon, interrupting the patient, and giving personal opinions.

Quick Check: Which of the following is an example of an open-ended question?

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