Case history taking

Special Challenges

• Silence # overly talkative patients
• Patients with multiple symptoms
• Anxious patients
• Anger and hostility
• Crying & depression
• Confusing behavior or histories
• Limited intelligence
• Developmental disabilities

Barriers to Communication

• May result from:
• Social or cultural differences
• Sight, speech, or hearing impairments
• Attempt to find assistance to aid in communication

Patient encourages

• Let patient continue talking
• FACILITATION
• “Tell me more about it”
• “ Please go on”
• “I’m interested to hear about it “
• Rocking: “Yes, Uh huh, umm, I see”
• Repeating: ”It usually happens at night?”

Confirmation

• Clarifying
• Ex: “What do you mean by fretful?”
• “Do you mean this . . . . ?”

Finally

• Explain to the patients what is going on
• Encourage patient to ask questions
• Next plain
• Thank the patients
• Date & signature

Do not

• False quick diagnosis
• Malignancy
• Debilitating disease
• False reassurance
• May be tempting
• Avoid early assurance or “over reassurance”
• Unless it can be provided with confidence

Thank you….!

• Thank you….!

• Any Questions