aaInterviewing Psychiatric Patients（aaInterviewing精神病人）.pdf

Interviewing Psychiatric Patients James Morrison, M. D. The patient interview provides the gateway to the health of the patient. Because it is both a science and an art, the skill of interviewing will improve as you continue your training. Although psychiatric patients differ in some ways from medical and surgical patients, what you read here will apply to nearly every patient you meet. Getting Started When I was in training, students bore the honorific title of Doctor , but everyone, including the patients, knew it was a fraud. Much better to introduce yourself, “I’m Pat Marshall, a medical student.” Ask if the patient is agreeable to the interview, and point out how long you expect to take. Also mention that you’ll probably take some notes. During introductions, show the patient where to sit. Try to sit across the corner of a desk or table from the patient—this gives you room to change the distance between you, as indicated by the patient’s need for space and comfort. (Across the full width of a desk hinders flexibility.) Start off with a brief question that pinpoints where you’d like to go. “What caused you to come for this evaluation?” works for outpatients; the inpatient equivalent is, “Why were you admitted to the hospital?” Some clinicians like to begin with small talk, but psychiatric patients often feel too troubled to care much about ball games, traffic jams, or the weather. Note that the two questions I’ve quoted are open-ended. That means, they can’t be answered “yes” or “no” and you haven’t suggested a multiple-choice answer. Open-ended questions help you establish a working relationship with your patient: • They give the patient the greatest possible latitude in coming up with a response, so you don’t limited the scope of your information.