At my current placement (cardio), I have been learning the importance of asking concise and specific subjective questions. This was highlighted especially in patients who have limited English and patients who tend to go off on a tangent.
After consulting my tutor, and applying what she suggested, here are some examples of specific subjective questions I found effective.
- Do you feel SOB now? When you are well, do you feel SOB?
- When you are well, how far can you walk? What stops you?
Over the course of the placement, I had a couple of patients who have limited English. Initially, I found difficulty with this category of patients. This was due to the fact that the subjective exam was usually limited to how much they can understand me and vice versa.
In particular, I had a 76 y/o Chinese male patient, who not only had very limited English, but was also hearing impaired. On the first treatment session, I planned to run through the usual cardio questions. However, found this challenging as the patient could not understand most of what I said. On realizing this, I started using only key words and changing the tone of my voice to make the words sound like a question. For example, cough? Phlegm? When the patient did not understand, I added hand gestures or actions. With coughing, I said cough? Then if needed, I coughed in addition to my question. This proved effective as the patient was able to understand and answered appropriately. With his hearing problem, I found that standing or sitting on his side when talking, allowed him to hear me.
On top of that, I also liaised frequently with his family to gain information, updating them on the patient’s status, and educating them about the different aspects of his physio treatment.
In future, when encountering patients with limited English, I will be patient when discovering what style of communication suits them best. I will also use simple words and shorter sentences when asking questions. Lastly, if able, I could get family members to be present at treatment sessions. This will facilitate a more effective treatment session.
2 comments:
I encountered a similar situation, we actually ended up writing the keywords in english and the chinese translation in a list eg cough, phlegm, SOB ... and when we wanted to ask the patient how he was feeling, we just pointed to the word and he would understand what we are trying to say. I think this is a good and more effective method if the patient is hearing impaired as well.
I thought it was hospital policy that you had to have a translator present if the patient wasn't strong with english? At my womens health placement we had to do this and I also found it hard asking them about their pain levels. I found if you simplify it to "big pain?" or "little pain?" and make big and little hand gestures it is effective also.
Post a Comment