Psychosocial Midterm Questions With Complete Solutions
ASK-TELL-ASK
-Ask - if they are ready to talk about the test results
-Tell - information in small amounts; build on what they know
Ask - what do they understand; would they like to hear more
-Repeat the cycle as many times as is needed
-Ask- Tell- Ask..... A great way of making sure people know
what's going on
ASK-TELL-ASK CAVEATS
-if you are talking too much stop and ask what is being heard
-if a person seem overwhelmed telling more info is not going to
help
-if the person has no emotional response now, they may later
responding to emotions
-strong emotions often present in medical interactions
-some clinicians are not comfortable with emotions
-basic emotion management skills are easily learned and applied
-responding to emotion is time efficient in the long run
how to respond to emotion
-Acknowledge - "You seem frightened (sad, upset, angry...)"
-Legitimize - "Anyone in your shoes would be (frightened)..."
-Explore - "Tell me more about the most frightening part..."
-Empathize - "That certainly sounds frightening"
-Support - "We will work through this together."
,What underlies an "I wish" statment
Ambiguous statements
--Reframes what is hoped for as a wish
--Acknowledges that what is hoped for will likely not happen
Empathic statement
--Identifies with what the patient is unrealistically hoping for
--Puts that hope in a more realistic frame
Must be followed by
--Emotion management
--Planning for what comes next
The "Tell Me More" statment
-using the patient's own language to deepen understanding
examples:
"Tell me more about the most upsetting part"
"Tell me more about what was worrying you the most"
"Tell me more about what made you most angry"
you can use the info gained from a "Tell Me More" statement to
then
-express empathy
--"Now I really have a sense why it was so (distressing) to you"
--"I can imagine that I would react similarly in your shoes"
-follow through
--"We will work hard with you to find an approach that makes
sense"
--"We will help you sort out next steps"
when involving family members remember
,If key family members were not there, make a plan for
informing"
--How should we go about informing his (children)?"
Who from the family should be with us when we talk to (the
patient)?
--"Who do you think should go with us when we talk to ___ ?"
Evaluate requests that some family members not be told.
--"His grandmother is very frail; I don't think she could handle
it."
--"I don't want his father to be told; he is a severe alcoholic."
when making a follow up plan
Establish a plan for the next steps
--"I would like you to see a cancer specialist."
--"Why don't we meet again later this week."
Ensure the patient has adequate support"
--Is there anyone who can be with you?"
Reassure that patient will not be abandoned"
--We will work together to find the best path."
Assess the patient's safety
What were the top leading causes of death in 2021?
-heart disease
-cancer
-covid-19
Death rates for all causes of death ____ except for ____ disease
and ____ disease which _____.
, -inc
-chronic lower respiratory diseases
-Alzheimer
-dec
life expectancy has ____ for both males and females
dec
Do males or females live longer?
females
What are the top 3 leading causes of death for infants?
-congenital malformations
-low birth weight
-sudden infant death syndrome
What is death?
-breathing ceases
-heart stops/no pulse
what happens to physical comfort in death?
-pain (different for everyone)
-breathing problems "death rattle" (fluids collect in throat of
dying person) - raise head of bed, order o2
-pressure ulcers, skin dryness
-digestion probelms
-fatigue
hospice
ASK-TELL-ASK
-Ask - if they are ready to talk about the test results
-Tell - information in small amounts; build on what they know
Ask - what do they understand; would they like to hear more
-Repeat the cycle as many times as is needed
-Ask- Tell- Ask..... A great way of making sure people know
what's going on
ASK-TELL-ASK CAVEATS
-if you are talking too much stop and ask what is being heard
-if a person seem overwhelmed telling more info is not going to
help
-if the person has no emotional response now, they may later
responding to emotions
-strong emotions often present in medical interactions
-some clinicians are not comfortable with emotions
-basic emotion management skills are easily learned and applied
-responding to emotion is time efficient in the long run
how to respond to emotion
-Acknowledge - "You seem frightened (sad, upset, angry...)"
-Legitimize - "Anyone in your shoes would be (frightened)..."
-Explore - "Tell me more about the most frightening part..."
-Empathize - "That certainly sounds frightening"
-Support - "We will work through this together."
,What underlies an "I wish" statment
Ambiguous statements
--Reframes what is hoped for as a wish
--Acknowledges that what is hoped for will likely not happen
Empathic statement
--Identifies with what the patient is unrealistically hoping for
--Puts that hope in a more realistic frame
Must be followed by
--Emotion management
--Planning for what comes next
The "Tell Me More" statment
-using the patient's own language to deepen understanding
examples:
"Tell me more about the most upsetting part"
"Tell me more about what was worrying you the most"
"Tell me more about what made you most angry"
you can use the info gained from a "Tell Me More" statement to
then
-express empathy
--"Now I really have a sense why it was so (distressing) to you"
--"I can imagine that I would react similarly in your shoes"
-follow through
--"We will work hard with you to find an approach that makes
sense"
--"We will help you sort out next steps"
when involving family members remember
,If key family members were not there, make a plan for
informing"
--How should we go about informing his (children)?"
Who from the family should be with us when we talk to (the
patient)?
--"Who do you think should go with us when we talk to ___ ?"
Evaluate requests that some family members not be told.
--"His grandmother is very frail; I don't think she could handle
it."
--"I don't want his father to be told; he is a severe alcoholic."
when making a follow up plan
Establish a plan for the next steps
--"I would like you to see a cancer specialist."
--"Why don't we meet again later this week."
Ensure the patient has adequate support"
--Is there anyone who can be with you?"
Reassure that patient will not be abandoned"
--We will work together to find the best path."
Assess the patient's safety
What were the top leading causes of death in 2021?
-heart disease
-cancer
-covid-19
Death rates for all causes of death ____ except for ____ disease
and ____ disease which _____.
, -inc
-chronic lower respiratory diseases
-Alzheimer
-dec
life expectancy has ____ for both males and females
dec
Do males or females live longer?
females
What are the top 3 leading causes of death for infants?
-congenital malformations
-low birth weight
-sudden infant death syndrome
What is death?
-breathing ceases
-heart stops/no pulse
what happens to physical comfort in death?
-pain (different for everyone)
-breathing problems "death rattle" (fluids collect in throat of
dying person) - raise head of bed, order o2
-pressure ulcers, skin dryness
-digestion probelms
-fatigue
hospice
