MUSC Acute Care Speech Practicum: Patient Interview Comment

Saturday, September 15, 2007

Patient Interview Comment

Christie wrote:

Also, I read the chapter portion on patient interview and enjoyed it. Here are some snippets of what I found most interesting/helpful:

-A poorly conducted historical data collecting session can misdirect the entire assessment process before it begins.

-Allowing for open-ended conversation and using fewer leading and canned querstions are associated with more accurate diagnosis

-A completely open-ended question that allows the patient great latitude in his/her response (such as, "what brings you here"?) is most appropriate

-Ask the patient why they think they are having problems swallowing

-Coughing or choking on swallowing exclusively with thin liquids is a strong indicator of laryngeal penetration of swallowed materials. By itself, this complaint may indicate a poor coordination of airway protection and bolus propulsion often associated with pharyngeal delay. When combined with complains of excessive saliva or mucus, one can infer that there is a weakness in the propulsion of secretions during spontaneous nonbolus swallows.

-The frequency should be characterized with respect to the number of times the symptom occurs during the meal

-Odynophagia (pain on swallowing) should be characterized as burning, sharp, dull, aching, gnawing, or throbbing. The patient should provide an exact location by pointing to the area that hurts. An exact description of the onset of the pain also should be obtained.

-sudden onset of odynophagia could indicate the presence of infection or recurrence of cancer. Patients who recently have been trached or orall intubated often complain of pain on swallowing.

-Globus: lump in throat linked to hypertrophy of lingual tonsils, sinusitis, spondylitis with cervical osteophytes, and gastroesophageal reflux.

Table 1-21 on page 27 was very helpful as well.