NRSG139 Health Assessment Interview Report: Analysis and Findings

This report provides an in-depth analysis of a health assessment interview conducted with a 65-year-old woman experiencing an exacerbation of COPD in an aged care setting. The report details the process of establishing and maintaining rapport with the patient, emphasizing the importance of creating a comfortable and private environment, considering communication styles, and respecting cultural values. It highlights the use of active listening, mirroring, and empathy to build trust and connection. Furthermore, the report examines effective questioning techniques, including open-ended and adaptive questioning, paraphrasing, and the application of the clinical reasoning cycle to gather medical information. The report emphasizes the importance of these techniques in facilitating patient communication, obtaining comprehensive health information, and avoiding potential misunderstandings. It concludes by summarizing the key rapport-building and questioning skills employed during the interview and their significance in creating a supportive environment for the patient.

Running head: HEALTH ASSESSMENT
Health assessment
Name of the student:
Name of the University:
Author’s note

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Introduction
Physical examination and health assessment are important professional
responsibilities of nurses and this helps them to interpret key health concern of patients,
identify care priorities and plan appropriate care for patient. The process of health assessment
is facilitated by the use of effective interviewing skills (Forbes & Watt, 2015). This essay
will summarize one such health assessment interview with a patient and explain the process
that was used to complete a good health interviewing using rapport building and questioning
skills. The essay will describe methods that were used to establish and maintain rapport with
the client and engage in effective questioning skills with the client.
Considerations for establishing and maintaining rapport:
The health assessment interview was conducted in an aged care setting with a 65 old
woman named Mrs. White who was suffering from exacerbation of COPD. The health
assessment interview session was arranged to find out about the risk factors, history of the
condition and the efficacy of treatment undertaken. To ensure that appropriate environment
was created for taking the interview, the patient was taken to a separate room to maintain
privacy. Before starting the interview, several considerations were made to develop mutual
trust, build connection with patient and enhance care experience (Lang, 2012). To make the
patient comfortable, the interview was started with general greetings and general questions on
patient’s hobbies and family. While doing this, the communication style and the cultural
values of patient were considered. The first consideration in terms of communication style
was to identify the language in which the patient is comfortable. This was done by asking
simple question ‘Will you be comfortable talking in English?’. This was followed by
considering the cultural values and practice of patient. This involved identifying greeting
styles of patient and level of body contact and gestures that is appropriate for patient. This

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was done by observing non verbal gestures of patient (Estes, 2013). For example, the patient
was found to be comfortable with gesture like touching hands and hence touch gesture was
continued throughout the process. Flickinger et al. (2016) supports that health care providers
must put aside their beliefs and values and learn to control those gesture that patients may
find inappropriate. Frowning or nodding might a sign of patient’s body language too.
Techniques to establish and maintain rapport:
After observing the patient’s communication style and level of comfort by judging
patient’s eye contact, touch, body movement and touch consciousness, the next approach
taken during the interview was to quickly build rapport with Mrs. White (Flickinger et al.,
2016). This was done by innovative communication techniques instead of directly going to
the immediate topic of the health interview. For example, the patient was asked questions like
‘please tell me what brought you here?’ and ‘what medications you had been taking?. Active
listening skill was first employed to build rapport with client. Active listening involves
listening with full attention without being judgmental during the process. This technique was
implemented by patiently listening to Mrs. White and not jumping in with new questions. The
advantage of such conversation was that she got adequate time to express her thought at her
own pace (Anderson & Kirkpatrick, 2016). While the patient was answer, non-verbal signs
were used to show attentiveness such as eye contact, leaning forward and mirroring.
Mirroring is a very important non-verbal gesture as it allows interviewer to establish
coherence by adapting to the body language of the speaker. During the interview, the
patient’s body language was noted to engage in mirroring (Ellis & Abbott, 2018). Another
strategy that was employed to build rapport was to display empathy acknowledgement on his
response during interaction. For example, when asking about patient’s adherence to
medication, the following sentence ‘I understand that taking those medication everyday must
be frustrating’ was used to acknowledge their feelings (Veach, LeRoy & Callanan, 2018).

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Effective questioning techniques:
During the course of the interview, open ended questioning technique was
implemented to explore more about the chief health complaint of patient and her history of
COPD. The open ended question that was used in the interview in the following ways: ‘Tell
me more about the problem you are facing now?’, ‘Do you miss any medication’ and ‘what
medicines have you been taking during exacerbation of symptoms?’. The key advantage of
using such questioning technique is that it allows the staff to obtain most information from
patient and share information in their own pace. This questioning techniques helped to extract
the information that Mrs. White came to the hospital with shortness of breath, she had a
history of COPD and she was using Prednisolone regularly during exacerbation of symptoms
(Veach, LeRoy & Callanan, 2018).
Another therapeutic communication technique that was applied when questioning the
client included use of paraphrasing technique. This involved rephrasing the client’s
comments to further clarify what a client said. For example, the client’s statement related
to ‘I do not miss the medications’ was paraphrased with question like ‘I hope you do not
miss any medications, do you?’ and ‘You mean to say that you do not miss medications,
but this has happened one or two times’. This form of communication technique helped to
prevent misunderstand and seek client’s confirmation indirectly (Fritzsche et al., 2020). In
addition, adaptive questioning technique was applied by starting with general question
first and moving to specific questions. This technique allows client to fully
communication without interrupting the flow of the narrative. This was combined with
non-verbal communication techniques like tuning with patient’s non-verbal gestures,
showing empathy, validation and reassurance. This was necessary as part of developing
trusting relationship with patient and to help her feel relaxed (Quinlan et al., 2017).

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Conclusion:
To conclude, the paper gave an overview of rapport building and effective
questioning skill that was employed during a health assessment interview. Some rapport
building skill that was employed included active listening skills, showing empathy and using
non-verbal strategies like mirroring. Effective questioning skill included use of open-ended
question, adaptive questioning, summarization, empathy and reassurance technique. All the
above techniques can support client to share information without any interruption and avoid
any confrontation or conflict during the process.
References:

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