Comprehensive Health History Assignment

Initiating the session [Joining stage]

• Greet patient appropriately (including verification of name)
• Introduces self, role and nature of the interview
• Gains verbal consent
• Ensures patient is comfortable and ready for the interview
• Asks the patient what brings them in today [chief complaint]
• Listens attentively, leaving the patient space to think before answering
• Confirms the patients concerns and screens for any further problems

Gathering Data [Working stage]

1. Returns to the main concern [chief complaint] and elicits the following information:

• What caused the problem
• What is worrying them the most
• What are they hoping to get out of this interview/visit
• How is the presenting complaint effecting their life

2. Elicits history of present illness including:

• Location, quality / character, quantity / severity
• Timing (onset, duration & frequency)
• Aggravating and alleviating factors; associated symptoms

3. Establishes current medications
4. Identifies allergies medication, foods, pollens, tapes
5. Elicits past medical and surgical history
6. Elicits family history
7. Elicits current social habits and past social history
8. Elicits a complete review of systems

Humanistic and professional skills [Interview technique]

• Shows respect and empathy
• Listens attentively, leaving the patient space to think before answering
• Interviewer posture conveys interest
• Interviewer free of inhibiting mannerisms
• Facilitates patients responses through verbal and nonverbal encouragement such as silence,
• paraphrasing, nodding of the head
• Clarifies patients statements
• Periodically summarises pertinent information for patient
• Adapts to patients level of understanding (avoid / explain jargon)

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