Hospitalization,Giving,History health Hospitalization - Giving a History

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The interview is likely to be lengthy, andmany of the questions will be reviewed by other members of the staff.The patient must cooperate to the best of his or her ability and shouldnever insist that, because the family physician has already taken allof the details, repetition is unnecessary. Often, the patient forgetsto tell his or her own physician about something, and this comes tolight only during the interview at the hospital. This medical historyis the most important single factor in helping the physician to make adiagnosis. It is more important than the physical examination, thetests, or the X rays, even with the sophisticated equipment availablein today's hospitals.An intern usually comes to see you after you have settled into your room. He or she writes down all the details of your illness.Giving a History. The resident physician begins the interview byintroducing himself or herself and explaining who he or she is.Residents vary in interview technique, but commonly the resident beginsby discussing the patient's main symptoms, because obviously this iscausing the patient the most concern. When the resident asks you whatis wrong, you should explain the most prominent symptom or symptoms,such as shortness of breath or abdominal pain. The resident does notwant your estimated diagnosis.The questions that follow relate to the presenting symptom. Forexample, if you are complaining of abdominal pain, the resident willask questions such as: has the pain changed position at all; has thepain become localized (concentrated in one area) or has it spread toother areas of the abdomen; and what type of pain is it (sharp,burning, spasmodic, or a dull ache).The resident will ask questions relating to the intensity of thepain. A question commonly asked of mothers is whether the pain is asintense as labor pains. The resident will also want to know if anythingmakes the pain worse, such as moving a limb, or whether anything easesthe pain, such as sitting up or lying down. The resident will ask ifyou notice any other symptoms as the same time as the pain, forinstance, gas or flatus.After the questions concerning the main complaint, the residentwill probably ask about your past medical history. The questions willcover areas such as: have you had any major illnesses (do not forget tomention any childhood illnesses you have had); have you had anyoperations (you should mention even the most minor ones, such as havinga mole removed); and have you ever been treated for a disorder(remember to mention minor disorders such as indigestion). The residentwill ask a female patient about her menstrual and obstetrical history;how many children she has had; whether all the pregnancies and laborswere normal; and if there were any postnatal complications. A femalepatient must remember to mention any blood pressure problems duringpregnancy or complications, such as forceps delivery or induced labor.If you have ever been hospitalized, you will be asked the year and yourhome address at the time, the name of the previous hospital, and thephysician whose care you were under.The resident will ask you what job you do and whether it exposesyou to any particular hazards or emotional tension. A patient's socialhistory plays an important part in the diagnosis.The physician will ask if your mother and father are stillalive. If they're not, he or she will want to know of what they died.If your grandparents lived into their eighties and both parents arealive and well at the age of seventy, there is a likelihood that youwill live to the same age. If you are an adopted child, you shouldmention it. The resident may also ask direct questions about conditionsand illnesses in the family: is there any incidence of tuberculosis orhas any member of the family suffered from a stroke or heart attack.The resident will want to know about your drinking and smokinghabits. This is not an opportunity for the resident to criticize or pryinto your habits, but it is essential that you answer the questionsaccurately. The resident has no wish to censure you, but he or she musthave accurate information in order to reach a correct diagnosis.The resident will then probably move on to questions related todrugs and medications. A patient often denies taking drugs regularly,only to admit, after closer questioning, that he or she has been takingantacids for indigestion for the past forty years or a laxative everymorning for the past month. It is most important that you thinkcarefully before giving your answer. The accuracy of the diagnosiscould depend on it. A good example of this is the contraceptive pill.Many women do not regard this as regular medication, but during majorsurgery it can encourage the formation of blood clots that could provefatal. The resident will also want to know about any allergies, such asone to adhesive tape.Many residents make a habit of running through all of the body'ssystems at the end of the interview, asking direct questions abouteach. This is a sort of screening that gives the patient a last chanceto remember anything that may be important. The questions about thechest may include: how much do you smoke; do you ever have pain in thechest; are you ever out of breath after walking up the stairs; and doyou ever cough up mucus. Questions about the bowels may include: howoften do you have a bowel movement; have you ever noticed blood in thestool; or do you feel bowel discomfort at any time. Questions about thebladder may include: how often do you urinate; do you ever feel pain orburning on urinating; have you ever noticed any blood or cloudiness inthe urine; have you ever suffered from stress incontinence orfrequency; and have you ever had trouble urinating. A female patientwill be asked questions about her menstrual cycle: is it regular; isthe bleeding heavy or light; does she suffer from painful menstruation;or does she ever bleed in mid-cycle. Article Tags: Female Patient, Questions About