Question

Student nurses are often reminded to use open-ended communication techniques with patients.

Why might open-ended questions and interview techniques not always be the most effective approach with a patient who has a possible personality disorder?

Does this mean nurses should stick with “yes” or “no” questions when interviewing these patients? Or does the text suggest ways to adapt open-ended interviewing to elicit more objective responses from these patients? (Hint: Think about perspective.)

What are some example questions you would ask a patient with a personality disorder?

Answer 1

A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people.

As personality disoder is an unhealthy pattern of thinking and peception, patient can be easily deviated from the answer for open eneded questions.

so patients with this disorder should be asked with both open eded and close ended questions to reach tot he conclusion. If the patient replies "yes" to either question, the clinician can ask further questions. ... Primary care providers should ask specific screening questions for the disorder.

There are various methods—techniques and instruments—for diagnosing personality disorders in clinical practice. There are psychometric self-report scales and projective tests as well as structured, semi-structured, and open-ended interviews.

Establish initial rapport

Elicit specific information, including a history of the presenting problems, pertinent medical information, family background, social history, and specific symptom and behavioral patterns. Formally test mental status.

Ask if the patient has any questions or unmentioned concerns. Initial recommendations are then made to the patient for further evaluation and/or beginning treatment.

The here and now is the place to begin all interviews. Any one of a number of simple questions can be used: “What brings you to see me today? Can you tell me what has been troubling you? How is it that you decided to make this appointment?” For anxious patients, structure is useful: early inquiry about age, marital status, and living situation may give them time to becomecomfortable before embarking on a description of their problems. If the anxiety is evident, a simple comment about the anxiety may help patients to talk about their worries.

The interviewer should use language that is not technical and not overly intellectual. When possible, the patient’s own words should be used. This is particularly important in dealing with intimate matters such as sexual concerns. People describe their sexual experience in language that is quite varied. If a patient says that he or she is gay, use that exact term rather than an apparently equivalent term such as homosexual. People use some words and not others because of the specific connotations that different words carry for them; at first, such distinctions may not be apparent to the interviewer.

Example of questions

• Do you have long-term feelings of sadness?
• Do you have long-term feelings of anger?
• Do you find that your relationships usually get very difficult and end abruptly?
• Have you had episodes in the past where you tried to hurt yourself, not to kill yourself but simply to cause yourself pain or distract you from something?
• How do you feel after these episodes? (Patients often respond that they feel a sense of release or relief.)
• Do you often feel empty inside?
• Do you find that you can be feeling okay then suddenly feel angry, or you can be feeling okay and suddenly feel sad? Does this happen a lot during the course of a day?