What role (if any) would motivational interviewing have for the patients you have described
All you have to do is answer two questions
(Question 1) What role (if any) would motivational interviewing have for the patients you have described? The patient that I had describe was an Adolescent client who is reluctant to answer questions. YOU HAVE TO PROVIDE TWO PARAGRAPHS WITH ONE REFENCE. WHEN YOU ANSWER THIS QUESTION
(Question 2) all you have to do is read this paragraph that I’m going to provide below and WRITE ONE PARAGRAPH RESPONDING TO THE POST. REQUIES ONE REFERENCE. Talkative Patient
Scenario: A 76-year-old male DH is in your office for his annual physical exam. He is healthy for his age except for taking Coumadin for a mechanical mitral valve replacement several years ago. DH lost his wife to a slip and fall accident 8 months ago and you have not seen him in one year and have never seen him without his wife being present at the appointment. DH is very talkative during the exam, you let him talk for several minutes while listening attentively (Bickley, 2021), and are able to assess that although he is sad about the loss of his wife he is not depressed, having any mental issues, and is able to care for himself, including taking his medications as prescribed.
Approach to address the behavior and communicate with the patient: I would courteously tell the patient that I feel he is more talkative than I remember from past interactions. It is common for patients to view the physical examination with a little anxiety (Bickley, 2021), I would ask the patient if he feels uneasy at this appointment because his wife is not there with him. He talks to you about being concerned because she always took care of things for him, and he was not exactly sure what to do at this appointment because she always prepped him on what to talk to you about. I would direct the visit by asking the specific questions I was concerned with during the physical exam while reassuring him that he can relax, and we will work through the appointment together. The skillful clinician examines the patient, and at the same time assesses the whole patient, and shares information that calms, explains, and reassures (Bickley, 2021). I would assure the patient that he appears to be adjusting to the change in his life well and offer talk therapy if talking about his circumstance helps him feel better. In this case, he states he has a good family support system and begins to calm down. I would ask him to call me if his feelings changed or if he ever feels he needs help. I would tell the patient that when he is seeing a provider to relax because we want to work together with him to ensure his health. I would tell him to write a list of his concern in order of importance for future appointments to make him feel more comfortable. Most importantly at the end of the appointment, I would reassure him he did great on his own, to make him feel comfortable and ensure he would not be anxious to see providers in the future. The effectiveness of medical treatment depends on the quality of the patient-provider relationship. It has been proposed that this depends on the extent to which the patient and clinician build a shared understanding of life situations (McCabe & Healey, 2018).
Documentation: I would document the encounter by stating that initially the patient was very talkative, but stated he was situationally anxious since this was his first appointment since he lost his wife. I would document that I feel he is managing his situation well, has a good support system, and declines the offer for referral for talk therapy. I would document that I offered reassurance that was well received, and that the patient was more relaxed and conversed appropriately by the end of the appointment.
Reference
Bickley, L. S. (2021). Bates’ Guide to Physical Examination and History Taking Twelfth, North American Edition Kindle Book (12th ed.) [E-book].
McCabe, R., & Healey, P. G. T. (2018). Miscommunication in Doctor-Patient Communication. Topics in Cognitive Science, 10(2), 409–424. https://doi.org/10.1111/tops.12337
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