Creating a conducive environment for interviewing adolescents is the initial step, focusing on building comfort and trust. To enhance openness, it may be beneficial to request parents to step out, allowing the adolescent to feel more at ease and willing to share potentially sensitive information. In cases where an interpreter is necessary, ensuring the presence of a professional interpreter is crucial. As highlighted by Ball et al. (2019), the interview setting plays a significant role in communication. Choosing a comfortable space, introducing oneself, explaining the role, and using open-ended questions are essential techniques to establish rapport (Ball et al., 2019).
Communication Techniques:
Once the patient is at ease, employing open-ended questions becomes pivotal. These questions encourage the patient to elaborate, providing more detailed information beyond simple yes or no responses. Allowing sufficient time for responses is crucial, considering that some queries may be sensitive or embarrassing. Effective communication skills are contingent on preparation. Edgemon et al. (2020) emphasize the importance of asking appropriate questions as a sign of interviewee preparedness, facilitating targeted and meaningful answers. Maintaining eye contact and adopting a positive posture fosters trust and enables the interviewer to detect any signs of discomfort or hesitation, affording the patient ample time to respond. Nonverbal cues should be appropriate throughout the interview to promote patient cooperation.
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Risk Assessment Instrument:
The chosen risk assessment tool is the Structured Interview of Family Assessment Risk (SIFAR). Santos & Alberto (2016) describe SIFAR as a structured professional judgment (SPJ) tool tailored for assessing family risk among adolescent offenders. It encompasses evaluations of physical health, mental stability, substance abuse, education, employment, housing/transport, legal issues, violence, ethnic and social dissonance, poverty, social network, and parenting (Santos & Alberto, 2016). This tool aligns perfectly with the targeted questions for adolescents, covering comprehensive information relevant to both medical and psychiatric units.
Targeted Questions:
1. Can you share where you currently reside and with whom?
2. Are you attending school, and what grade are you in?
3. Do you have any existing medical concerns?
4. Have you experienced feelings of sadness more than usual?
5. Do you engage in smoking or the use of illegal drugs?
References
Edgemon, A. K., Rapp, J. T., Brogan, K. M., Richling, S. M., Hamrick, S. A., Peters, R. J., & O’Rourke, S. A. (2020). Behavioral skills training to increase interview skills of adolescent males in a juvenile residential treatment facility. Journal of Applied Behavior Analysis, 53(4), 2303–2318. https://doi-org.ezp.waldenulibrary.org/10.1002/jaba.707
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). Elsevier Mosby.
Santos, D., & Alberto, I. (2016). Developing a Family Risk Assessment Tool in Adolescent Offenders: An Exploratory Study. Child & Adolescent Social Work Journal, 33(2), 103–113. https://doi-org.ezp.waldenulibrary.org/10.1007/s10560-015-0409-1
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
NURS-6052 Critical Appraisal of Research Tool Worksheet Template
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research.
response
I enjoyed reading your post. You have effectively highlighted the importance of communication skills, especially when dealing with adolescents in the age range of 10 to 24 years. Adolescents, at this stage, prioritize social interactions and peer relationships. While sharp assessment skills are valuable, emotional intelligence is equally essential when engaging with adolescents (Emanuel & Gudbranson, 2018).
Research underscores the significance of peer acceptance and influence on adolescents, emphasizing how social deprivation or isolation can disproportionately impact this age group (Orben et al., 2020). Recognizing the importance of social interaction for adolescents, it becomes crucial to focus on questions related to social deprivation during the interview process.
Using an interpreter, if needed, is a practical approach, but cultural competency and sensitivity are pivotal to creating a comfortable environment for the adolescent during the interview.
The Racial Socialization Competency Scale (RaSCS) or RECAST, designed to assess racial socialization competency, is particularly relevant for evaluating stress, skills, and confidence related to racial socialization in adolescents (Anderson et al., 2020). HEEADASSS and PACES, as highlighted by Ball et al. (2019), are effective screening tools for various aspects of adolescent well-being, encompassing home environment, education, employment, activities, drugs, sexuality, suicide/depression, safety from injury, and violence. Additionally, the CRAFFT tool addresses issues such as car driving, relaxation styles, solitary activities, friendships, and troubles adolescents may encounter (Ball et al., 2019).
For Hispanic adolescent boys, health-related risks, including cardiovascular issues, binge drinking, and illegal drug use, have been identified (Assari et al., 2019). Your proposed questions for the young boy are pertinent and crucial. Consider rephrasing some questions to elicit more detailed responses and avoid simple yes or no answers, thereby facilitating more effective communication. This approach can enhance the depth of information obtained during the interview.
References
Anderson, R. E., Jones, S. C., & Stevenson, H. C. (2020). The initial development and validation of the Racial Socialization Competency Scale: Quality and quantity. Cultural Diversity and Ethnic Minority Psychology, 26(4), 426-436. doi:10.1037/cdp0000316
Assari, S., Farokhnia, M., & Mistry, R. (2019). Education Attainment and Alcohol Binge Drinking: Diminished Returns of Hispanics in Los Angeles. Behavioral Sciences, 9(1), 9. doi:10.3390/bs9010009
Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Mosby.
Emanuel, E. J., & Gudbranson, E. (2018). Does Medicine Overemphasize IQ? Jama, 319(7), 651. doi:10.1001/jama.2017.20141
Orben, A., Tomova, L., & Blakemore, S. (2020). The effects of social deprivation on adolescent development and mental health. The Lancet Child & Adolescent Health, 4(8), 634-640. DOI:10.1016/s2352-4642(20)30186-3
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