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11 Cards in this Set
- Front
- Back
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What are the unique characteristics associated with a family interview that are different from interviewing a single patient?
• Issues making the interview more complex |
o Additional concerns or questions about the patient’s health from the family members
o Ethical dilemmas involving confidentiality and privacy o Legal issues of agency in situations involving a third party who handles financial or legal decisions for the patient o Decreased amount of time that the patient spends talking with physician |
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• Positive aspects of family involvement
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o Valuable resource of information
o Help implementation of and compliance with a treatment plan o Physicians reported that family involvement has a positive influence 95% of the time. |
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What are the core skills needed when interviewing a family?
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1. Greet & build rapport
2. Identify each person's agenda 3. Allow each person to speak 4. Recognize & acknowlege feelings 5. Avoid taking sides 6. Respect privacy & maintain confidentiality 7. Interview the patient separately, if needed 8. evaluate agreement w/ plan |
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How should doctors manage a family who is angry or blamming?
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Reframing- restating a confrontational or demanding position in a way that allows each family member to understand and appreciate others’ viewpoints.
Brainstorming- explore potential solutions after each person’s perspective has been established Decision analysis – considers the perceived problems and benefits of the current situation and the barriers and incentives of the proposed solution Criteria setting Physician may ask patient and family members to write down suggestions for reaching common ground after interview |
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What is SPIKES?
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1. Setting up
2. Patient perception 3. Invitation to breaking news 4. Knoweldge 5. Emotions 6. Stratgy and summary |
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Setting up
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-done in private
-only patient, family, helath team -sit down, make eye contact, use touch, sufficient time to answer q's |
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Patient perception
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What does patient know about illness
correct misinformation tailor to patient's level of comprehension |
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Inivation to b reaking bad news
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get permission to share bad news
Before ordering tests, procedures inform patient of outcomes ask if patient wants detailed info or detailed disclosure |
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Knowledge
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Patient needs enough info to make informed decisions
"spread" instead of "metasaszied" medical jargon Provide small amts of info at a time check for comprhension avoid bluntness or misleading optimisms |
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Emotions
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Acknowledge emotions
Identify and respond to it Have periods of silence |
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Strategy and summary
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Minizime anxiety by summarizing areas discussed
check for comprehension formulate strategy and follow-up plan Provide resources assure availability |
