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ECU Brain, Language and Aphasia > 5 - Intro to Assessment > Flashcards

5 - Intro to Assessment Flashcards

1
Q

What are the steps to The Clinical Method?

7

A

Gather information (Referral, Hx, exam, etc.)

Evaluate patient’s subjective complaints and objective test results

Determine cluster of symptoms (syndrome)

Look for correlations among symptoms or underlying physical and mental processes

If syndrome exists, what is the prognosis

Use information (Hx, exam, life situation) to determine daily life impact

Use all information to estimate potential effect of treatment

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2
Q

What can be found in a patient’s Medical Record?

8

A

Patient Identification

Doctor’s Orders

Personal History

Medical History

Physical and Neurologic Exam

Specialists Consultations

Progress Notes

Lab Results/Imaging Results

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3
Q

What should you do before the patient interview?

A

Do Your Homework (read chart, medical history, exam reports, etc.)

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4
Q

Where should you conduct a patient interview?

A

In a Quiet Place free from Distractions

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5
Q

How should you initially approach the patient?

A

Tell the Patient Who You Are and Why You are Here

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6
Q

How should you interact with the patient during the interview?

(8)

A

Make the Patient Comfortable

Sit Down

Elicit the Patient’s Story

Be a Patient, Concerned, and Understanding Listener

Talk to the Patient at the Patient’s Level

Treat the Patient as an Adult Who Merits Respect

Prepare the Patient for What Comes Next

Reassure the Patient

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7
Q

Should Family Members/Significant Others be included in the patient Interview?

A

Yes (unless patient expresses otherwise)

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8
Q

Why is Interviewing central to role of diagnostician?

3

A

Gathers data about the individual

Transmits information

Establishes and maintains a working relationship

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9
Q

Interviewing serves as a _______ and a _______.

A

Tool

Relationship

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10
Q

Mastery of interviewing is typically excluded from required ______ and ________ experience.

A

Coursework

Practicum

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11
Q

What four things can be accomplished in a patient interview?

A

Vehicle for giving information

Means of establishing + sustaining a relationship

Tool for gathering data

Medium of therapy

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12
Q

Some clinicians consider interviewing a __________.

A

Secondary process

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13
Q

What are three downfalls of Case History forms?

A

Questions are generic

Questions may be threatening or engender guilt

Answering questions in one particular way, may prevent developing alternative answers

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14
Q

What exactly is the interview process?

A

Verbal and non-verbal exchange between professional and client

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15
Q

Is the interview an ordinary conversation?

A

No

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16
Q

What must the clinician and client become?

A

Co-workers

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17
Q

What do we need to consider when interviewing patients?

6

A

Multicultural considerations

Our own fears (you are a fraud, etc.)

Our own memory failure (learn to write things down)

Emotional barriers

Language gap

What is your specific purpose? (at least act like you have a purpose)

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18
Q

What is the 1st Goal when Interviewing?

A

Obtaining Information

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19
Q

How do we obtain information during an interview?

4

A

Setting the tone

Asking questions

Learn the presenting story

Pay attention to nonverbal messages

20
Q

How do we set the tone during an interview?

4

A

(Think of interview as role-playing situation)

Select relaxed site

Convey sincere interest

Build rapport

Mutual trust and respect (client should feel like you know the answer)

21
Q

How should we ask questions during an interview?

5

A

Use interview guide if possible

Discover how patient sees the problem

Discover when the communication disorder arose and under what conditions

Discover how the communication disorder has changed since its onset

Discover the consequences of the problem

22
Q

What is the patient’s Presenting Story?

What will most patients have done?

What should we do as patient tells their story?

A

Their purpose for seeking help

Many clients will have rehearsed the story

Let the story unravel

23
Q

What should we look for in Nonverbal Messages?

6

A

Eye contact

Facial expressions

Eye gaze

Body movements and postural shifts

Hand movements

Pitch, loudness, vocal quality

24
Q

What should we avoid in an interview?

6

A

Yes/no questions

Phrasing questions in a way that inhibits responses

Concentrating on physical symptoms to the exclusion of client’s feelings

Providing information to soon

Negativistic or moralistic responses

Trusting observations to memory (RECORD INFORMATION)

25
Q

What is the 2nd Goal when Interviewing?

A

Give information

26
Q

What do we do when we give information?

A

Answer client’s questions

27
Q

What sorts of questions might clients ask?

3

A

Requests for information or content

Predetermined opinions

Requests for emotional support/reassurance

28
Q

What is the 3rd Goal when Interviewing?

A

Providing release and support

29
Q

How do we provide release and support?

2

A

Removing discomfort and promote state of comfort and well-being

Demonstrating empathy (capacity to identify ones self with another’s feelings and actions)

30
Q

What are the Behavioral, Cognitive and Emotional Effects of Brain Injury?

(7)

A

Altered Responsiveness

Perseveration

Diminished Response Flexibility

Concreteness

Impaired Self Monitoring

Poor Attention

Emotional Lability

31
Q

What are the Purposes of Testing?

6

A

Determine a diagnosis

Determine a prognosis

Determine nature and severity of communication impairments

Determine appropriateness of treatment
focus

Measure recovery

Measure efficacy of treatment

32
Q

What is the NIH Stroke Scale?

2

A

A clinical stroke assessment tool

It evaluates and documents neurological status in acute stroke patients.

33
Q

What can the NIH Stroke Scale also serve are a measure of?

A

Stroke severity

34
Q

How many items are on the NIH Stroke Scale?

A

15

35
Q

What does the NIH Stroke Scale measure the effects of?

1+9

A

The effect of acute cerebral infarction on the levels of…

  • Consciousness
  • Language
  • Neglect
  • Visual-field loss
  • Extra ocular movement
  • Motor strength
  • Ataxia (lack of muscle control during voluntary movement)
  • Dysarthria
  • Sensory loss
36
Q

How are the items on the NIH Stroke Scale scored?

A

With 3 to 5 grades (0=normal)

37
Q

How long does the NIH Stroke Scale take?

A

Requires less than 10 minutes to complete.

38
Q

What are three Functional Outcome Measures of Stroke?

A

Functional Independence Measure

Stroke Impact Scale

Burden of Stroke Scale

39
Q

What does the Functional Independence Measure (FIM) examine?

6

A

Self-care

Sphincter control

Transfers

Locomotion

Communication

Cognition

40
Q

What does the Stroke Impact Scale measure?

9

A

Physical Problems

Memory + Thinking

Mood

Communication

TypicalDay

Mobility

Hand Use

Participation

Self Assessment of Recovery (0-No Recovery; 100-Full Recovery)

41
Q

What does the Burden of Stroke Scale measure?

8

A

Mobility

Self Care

Communication

Cognition

Swallowing

Social Relations

Energy + Sleep

Mood

42
Q

What are Aphasia Test Batteries?

1+2

A

Tests designed to

  • Identify and describe impairments
  • Estimate severity
43
Q

What are the two input modalities used in Aphasia Test Batteries?

A

Vision

Audition

44
Q

What are the three output modalities used in Aphasia Test Batteries?

A

Speech

Writing

Gesture

45
Q

What are the four Communicative Activities used in Aphasia Test Batteries?

A

Speaking

Listening

Reading

Writing

46
Q

Disability plans usually only cover ___% of original income.

A

60%

ECU Brain, Language and Aphasia (11 decks)

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