Building health history is the first step to managing the patient because the history contributes a significant role in making the diagnosis and influencing the choice of treatment. A more comprehensive history also directs more relevant investigations and laboratory tests. The process of building a health history requires good communication skills and techniques to collect more comprehensive and accurate information for diagnosis, investigations, and management purposes. My assigned patient case scenario is an adult patient – a 35-year-old male with morbid obesity. He lives in a rural setting. The purpose of this discussion is to present a summary of the interview that I would have with this patient, the best communication techniques to build this health history, and the risk assessment tool that I would apply to this patient’s case.
My interview with this patient would aim at building a comprehensive health history as well as setting up a relationship for future engagement in his care and follow-up. My interview with the patient addressed the reasons for this patient’s visit to the care center, the duration he has been unwell, who else has similar illnesses, which interventions he has sought or taken for his illnesses, and what would have led to him having that illness, and how his environment may have contributed to his reasons for the visit to the care center.
Therefore, this interview seeks to address the etiologies, risk factors, presenting clinical signs and symptoms, management so far, and any other issue relevant to the patient and not necessarily the reason for presentation. The interview addresses the factors leading to the unwellness by seeking to clarify the precipitating factors, maintaining factors, and risks. To acquire these sensitive pieces of information from the patient I would employ certain communication techniques – both verbal and nonverbal.
Effective communication, according to Ball et al. (2022), leads to a positive patient relationship and relies on building confirmation, courtesy, comfort, and connection. According to Diamond-Fox (2021), poor patient communication contributes to poor healthcare quality. Therefore, developing an effective advanced clinical practitioner-patient relationship through communication requires the employment of certain skills that do not work on every patient case. Therefore, patient-centered communication and identification of communication requirements would be an effective first step. There are several communication techniques that I would use to achieve these concepts in my clinical interview.
I would ensure courtesy and connection with the patient by welcoming him to the interview, ensuring he is as comfortable as he could be, and explaining to him the content and purpose of the interview. This courtesy process will also include seeking the patient’s verbal and intended consent before introducing him to the interview. In my interview, I also avoid the use of medical jargon to ensure that the patient understands me with ease. Reassurance to the patient about the confidentiality of our interview will create a rapport and good relationship to allow openness and comprehensiveness of their responses.
Keeping the questions simple and direct will help me avoid overload (Diamond-Fox, 2021). I will also use normalizing questions to avoid or minimize the patient’s sense of embarrassment bearing in mind that this patient is morbidly obese and most likely has developed body image and self-esteem issues (Bouzas et al., 2019; Yazdani et al., 2020). By employing these techniques, I will get a clue about the patient’s risk factors leading to his obesity and the best ways to tackle patient education or other interventions. The use of risk assessment tools would also objectively diagnose this patient’s risk factors.
The patient is at risk of various systemic and organ-specific diseases such as diabetes mellitus, heart failure, dyslipidemia, ischemic heart disease, and stroke. Risk assessment is an objective process and helps the clinician qualify and quality the risks of the patient. In this patient, I would use the body mass index as the initial assessment tool for her risks associated with obesity. The body mass index tool is a product of the division of the patient’s weight in kilograms and the square of their height in meters.
The result of the BMI is expressed as a ratio and there are cutoffs for objectively classifying the severity of his obesity (Crum et al., 2019). Morbid obesity would give a BMI above 40 and this value gives information about the severity of his risk of development of cardiovascular disorders (Good et al., 2021). The value will also
Struggling with online classes or exams? Get expert help to ace your coursework, assignments, and tests stress-free!