|
1. Introduction and orientation (name and role, explains purpose of
interview, confirms patient agreement) (2=does well 1=adequately, 0=poorly
or not done)
|
2
|
1
|
0
|
|
2. Rapport (shows interest,
concern and respect, )
(2=does
well, 1=adequately, 0=poorly or not done)
|
2
|
1
|
0
|
|
3. Listening skills (attentive listening, responds to answers, picks up
on patient cues) (2=does well, 1=adequately, 0=poorly or not done)
|
2
|
1
|
0
|
|
4. Questioning skills (appropriate open and
closed questions, avoids leading or multiple questions, avoids jargon)
(2=does well, 1=adequately, 0=poorly or not done)
|
2
|
1
|
0
|
|
5. Structure - demonstrates
a logical approach without interrogating the patient (2=does well,
1=adequately, 0=poorly or not done)
|
2
|
1
|
0
|
|
Establishes:
|
|
|
|
|
6. COPD 20 years (1)
|
2
|
1
|
0
|
|
7. Cough worse last 6 months (1) Increasing short of breath 3 months
(1)
|
2
|
1
|
0
|
|
8. Occasional haemoptysis
|
|
1
|
0
|
|
9. Recurrent exacerbations over winter
|
|
1
|
0
|
|
|
|
|
|
Effect on life
|
|
|
|
|
11. Stopped work (1) Breathless on flight of stairs
|
2
|
1
|
0
|
|
Affected mood (1) Lack
of enjoyment (1)
|
2
|
1
|
0
|
|
PMH
|
|
|
|
|
17. Diabetes- 5 years
|
2
|
1
|
0
|
|
Medication
|
|
|
|
|
19. Braltus and
salbutamol (copd) Metformin diabetes
|
|
1
|
0
|
|
20. Antibiotics for exacerbations
|
|
1
|
0
|
|
Social history
|
|
|
|
|
21. Lives alone, Dog main exercise
|
2
|
1
|
0
|
|
22. Stopped smoking 2 months ago (1) 40 pack years (1)
|
2
|
1
|
0
|
|
Expectations
|
|
|
|
|
23. Hoping to get CXR (1) Would like to be able to garden (1)
|
2
|
1
|
0
|
|
24. Thanks the patient and will relay information to the GP (1 mark for both)
|
|
1
|
0
|
|
|
|
|
|