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12. Medical Interview

The medical interview is the most important tool of thephysician. There are 3 main functions of the Interview for a better

execution of it: gathering information; developing and maintaining

a therapeutic relationship; and communicating information. All

these functions will improve the physician`s wor. All these

functions need to be integrated together.

!y collecting information we can determine the nature of the

problem. The simple sills needed for an e"cient conversation

are: open#ended $uestions %tell me about your concerns&;facilitation %tell me more&; direction %this information is important

and I would lie to hear more about it&; summari'ing and checing

for other worries.

The interaction between the patient and doctor gives the

patient freedom to tal openly and in more details about him. The

patient needs support( partnership( respect( empathy( avoidance

of shame. The doctor should chec if the patient understands the

cause of his problem( the diagnosis( the treatment( should avoidcomplicated medical terms.

The structural elements of the interview: )ptimi'ing the

environment %eliminate distractions( comfortable position&; the

opening %preliminary evaluation&; *reparing to listen %focusing(

leaving behind worries and other thoughts&; greeting %it sets the

initial tone of the conversation&; the introduction %discussion

about the reason of the presence of the patient&; identi+cation of

the barriers to communicating %especially is the patient is death

or if he is in pain&; survey %sonda,& all the problems %asing more

and more $uestions&; negotiate a priority problem ; establish

narrative thread % a longer discussion&; developing the life contest

of the patient and illness.

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-oa doctor should show interest( respect and to listen

carefully.