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Flashcards in Psychosocial Assessment Deck (36)
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1

Basic Interview Stages

1. Opening/Introduction (sets the tone)

2. Body/Development (patient responds to questions)

3. Closing (termination of the interview)

2

Opening/Introduction

-establish rapport
-explain purpose and nature of interview

“MAY I SIT DOWN FOR ABOUT 10 MINUTES TO
TALK ABOUT WHAT BROUGHT YOU INTO THE HOSPITAL?”

“ FEEL FREE TO SAY IF THERE IS ANYTHING YOU DON’T WANT TO TALK ABOUT.”

3

Body/Development: Types of Interview Questions

-Closed
-Open-ended
-neutral
-leading

4

Closed Questions

answer is restricted to few words

5

Open-ended Questions

invitation to explore thoughts/feelings

6

Neutral Questions

freedom to answer without pressure

7

Leading Questions

limits accuracy of response

8

Body/Development Techniques

-listen attentively
-use simple language
-clarify points not understood
-question in logical sequence
-ask one question at a time
-do not impose own values
-avoid using personal examples
-convey respect and interest
-be aware of body language
-be aware of voice
-sit at even level
-use silence to allow patient to organize thoughts
-use eye contact ad be unhurrried

9

Closing Techniques

-offer to answer questions
-offer clear conclusion
-thank the patient
-express concern for future welfare
-plan for next meeting
-provide a summary

10

Considerations

-effective nurse communication
-holistic approach
-interview environment
-patient's developmental level
-patient emotional factors
-patient family factors
-patient culture

11

Goal to the psychosocial assessment

to understand the patient

evaluates:
-mental health and illness
-social well-being
-perception of self
-ability to function in community
-multiple domains of mental status

12

Components of the Psychosocial Assessment

-identify patient
-chief complaint
-history of present illness
-psychiatric history
-med/surg history
-medication list
-alcohol/drug use
-family history
-developmental history
-social history
-violence risk
-mental status exam

13

Social History Components

-social relationships
-living situation
-significant life events
-employment
-education
-legal
-spiritual
-cultural
-financial situation
-coping skills
-interests/hobbies

14

Obtaining Military History

General question: Would it be okay if I asked you about your military experience?


If yes,

-how has military affected you?
-did you see combat, enemy fire, or causalities?
-were you or a buddy wounded, injured or hospitalized?
-do you have a service-connected condition?

15

Mental Status Exam

-analogous to the physical exam
-assessment of brain fx (mental function, emotions, behaviors)
-some aspects obtained by observation
-some aspects obtained by direct questioning

16

Mental Status Exam Components

-general apperance
-motor activity
-speech/communication
-emotional state
-thought content
-thought processes
-perceptual disturbances
-cognition
-abstract reasoning
-insight and judgement

17

General Apperance

-apparent age
-dress
-hygiene/grooming
-posture
-facial expression
-eye contact
-pupils
-general state of health/nutrition
-acute distress

18

motor activity

-rate of movement
-gait
-unusual movements

19

rate of movement

-slowed=bradykinesia
-agitated=hyperkinesia

20

Gait

-freedom
-pacing
-posture

21

Unusual movements

-tics
-tremors
-jitteriness
-hand wringling
-muscle spasms
-lip smacking
-unable to remain still (akathisia)

22

Communication

process of content being expressed

-resistant
-disorganized
-negative
-requires prompting

23

Speech

how content is articulated

-fluency
-rate
-amount
-tone
-volume
-repetition

24

Mood

subjective emotional state

-sad
-angry
-guilty
-anxious

25

Affect

outward expression of emotional state

-flat
-blunted/constricted
-tearful
-euthymic

26

Types of thoughts

-phobias
-hypochondriasis
-ideas of reference
-magical thinking
-obsessions/preoccupations
-thought insertion
-thought broadcasting
-suicidal ideation*
-homicidal ideation*
-delusions

27

Types of Delusions

-grandiose
-persecutory
-jealously
-religious
-somatic
-ideas of reference
-thought insertion
-though broadcasting

28

Thought Process

description of how thoughts are formulated, organized, and expressed

29

Hallucinations

-perceptions in the absence of stimuli to account for them

-may involve any of 5 senses

-auditory most common (command vs. non command)

-do you hear voices when no one is around

30

illusions

misperception of stimuli, mistaking wind for a voice