6635-W2-D2

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Fazaia Degree College, M.R.F, Kamra, Attock *

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6635

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Nursing

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Nov 24, 2024

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The psychiatric interview is the most important component when establishing a rapport with the patient. During my clinical rotation this week I was able to gain a better understanding of how to engage more one on one with a patient in a more intimate setting. At the bedside in the ICU I am used to barely speaking with a patient due to them being on a ventilator. The family I speak with is either over the phone or at the bedside and their emotions are always high. I am learning how to take time to sit down and listen to someone at their most vulnerable moments. The psychiatric interview is a time to establish rapport and understand that each patient presents with their own illness. When you begin to ask your patient questions you are obtaining psychiatric history and build up to a formal treatment plan/diagnosis. “Studies show that up to 30% of patients drop out of treatment prematurely, and many never return after the first appointment. The reasons for treatment drop out are many” (Carlat, 2024 p. 3). Most patients will stop seeing certain providers if they don’t feel comfortable or feel like they aren’t included in the plan process. “In contemporary psychiatry, patient assessment is guided by the classification of mental disorders. In psychiatric interviews, the clinician's goal is to evaluate the patient's problems and provide an evidence- based treatment grounded on symptom-oriented diagnostic ICD10/DSM-5 categories” (Savander et al., 2021). We rely so heavily on communication within the healthcare system. During my clinical I learned that this is how we evaluate and diagnose patients. We can only go off what they tell us and the symptoms that they describe. Setting a comfortable and respectable environment can help ease the patient's mind. Tools help guide the plan/diagnosis phase. There are many different types of mental health algorithms and tools. The rating scale I was assigned is the global assessment of functioning (GAF). The GAF is a tool used to rate how serious a mental health illness is and how much it is impacting a person's day to day life. This scale has been used by psychiatrists since 1962. The strongest component about the scale is it helps to gauge how well a person can do everyday activities and to see how well the treatment plan is working. The scale numbers can be obtained from a patient interview or questionnaire, medical records, or information obtained from a close family member. The scale is simple, the higher the number the more someone is able to function in everyday life. The GAF scale can be very helpful when trying to gauge how serious a patient's mental health issue is. I would personally use this scale during my initial interview with a new patient. After establishing a good rapport in the beginning, I would then try to gain as much information as I can to formulate the best plan for the patient. “GAF has a wide range of applications. For example, it can be used in research and in the clinic to determine how well a treatment is working; improve the ability to link daily clinical work to empirical research; compare treatment results across diagnoses; allocate resources; and measure case- mix in mental health care” (CurrPsychiatry, 2014). As with any information obtained from a patient or outside source, credibility can always change how well a tool assessment works and treatment. The interview process is mostly subjective data. I believe that with practice I will find the best mental health tool that fits the individualized needs of the patient. References Carlat, D. J. (2024). The psychiatric interview. Lippincott Williams & Wilkins. Savander EÈ, Hintikka J, Wuolio M, Peräkylä A. The Patients' Practises Disclosing Subjective Experiences in the Psychiatric Intake Interview. Front Psychiatry. 2021 May 10;12:605760. doi: 10.3389/fpsyt.2021.605760. PMID: 34040547; PMCID: PMC8141629.

I H MA. Collecting Information for Rating Global Assessment of Functioning (GAF): Sources of Information and Methods for Information Collection. Curr Psychiatry Rev. 2014 Nov;10(4):330-347. doi: 10.2174/1573400509666140102000243. PMID: 25598769; PMCID: PMC4287015.

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