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Open-Ended Inquiry and Paraphrasing in Nursing Case Study

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Updated: Nov 23rd, 2021

In the introductory meeting, your client says that they are there to see you because their primary care provider told them they needed to change their lifestyle.

Your open-ended inquiry

Why have your primary care provider recommended you to alter your lifestyle, and what changes were offered?

A follow-up visit with a client whose goal for last week was to increase his walking from 15 minutes to 20 minutes. How would you find out if the client accomplished his goal?

Your open-ended inquiry

How many additional minutes have you spent walking this week? Have you experienced any challenges associated with the increased walking time?

In one of your coaching sessions, your client says, “I just don’t know what this health coaching is supposed to do for me.”

Your open-ended inquiry

How do you understand “health coaching” and its purpose in general? What issues made you attend these health coaching sessions?

During the appointment with your client, your client says, “I don’t know if I can give up sweets.”

Your open-ended inquiry

What you believe to be the most important thing in your life? If you do not stop eating sweets, you are likely to have no opportunity to enjoy them anymore. Does it worth it? What are the positive and negative influences of eating sweets experienced by you currently and expected in the future?

During the appointment with your client, your client says, “Why should I change how I eat? I feel fine, and I am not overweight.”

Your open-ended inquiry

Overweight is not the only reason that makes healthcare professionals recommend their clients to alter their eating habits; what exactly dissatisfies you in your new diet? What health issues made you consult a physician? Can you perceive any connection between them and your eating habits?

Perceptive Reflections Exercises

Client: I’ve tried exercise programs in the past, and they don’t work.

Your perceptive reflection

I realize that you have already tried exercising, but it did not lead to any visible results.

Client: It’s frustrating to exercise and not lose any weight.

Your perceptive reflection

I know that you feel disappointed because your attempts to lose weight are not fruitful yet.

Client: I try really hard to avoid fast food but find that I am in a time crunch when I need to go from work to one of my kids’ events.

Your perceptive reflection

Yes, it is difficult for you to avoid fast food when you have little time between your work and one of your kids’ events.

Client: My cholesterol has improved, so I guess I can go back to eating the way I use to.

Your perceptive reflection

I realize that the positive changes in your cholesterol level make you willing to return to your previous diet.

Client: I know I should eat healthier, but I just can’t afford to buy fresh fruits and vegetables.

Your perceptive reflection

It is wonderful that you realize the necessity to eat healthy food even though your ability to buy them is limited because of the high prices of fresh fruits and vegetables.

Reflection

Nurses must focus on their patients in order to provide them with the needed services. Thus, it is vital for these professionals to ensure that patients understand the information they perceive because clients’ answers can have an enormous influence on health outcomes. Focusing on my personal experience, I managed to realize that the use of open-ended questions and perceptive reflections can not only simplify communication with clients and ensure their understanding of the discussed issue but also affect their intrinsic motivation.

It was rather difficult from the very beginning to ask open-ended questions because sometimes a short answer (“yes” or “no”) was also needed. However, I managed to receive additional information that was valuable for future treatment. Moreover, I could understand a patients’ perception of the discussed issue and their attitudes towards it, as clients’ answers were rather explicit. In fact, it was more complicated to paraphrase what I have heard from clients than to ask questions because it was critical for me not to include additional or biased information in my statements. I had to change sentences as much as possible for patients not to consider that I could not understand them. With the help of paraphrasing, I also managed to clarify some information not only for myself but also for my clients.

The use of open-ended questions and paraphrasing provide professionals with an opportunity to affect patients’ intrinsic motivation, so these techniques benefited my practice as well (Flannery, 2017). My clarifications and repetitions made clients realize the fact they initially considered to be not very critical. As a result, they became eager to follow provided recommendations and even believed that it was their initiative to act this way.

During my practice coaching sessions, I used both techniques (open-ended questions and paraphrasing) frequently. For instance, I asked a patient, “How do you understand “health coaching” and its purpose in general?” With the help of this question, I managed to understand what dissatisfied my client and why he lacked motivation, as he revealed how he treated these sessions and what effect he expected to see. Rephrasing Jane’s words with “Yes, it is difficult for you to avoid fast food when you have little time between your work and one of your kids’ events,” I made her consider food alternatives. In her answer, she said she realized that these products could be limited and used along with other products so that she still had a possibility to keep to a healthy diet.

Reference

Flannery, M. (2017). Self-determination theory: Intrinsic motivation and behavioral change. Oncology Nursing Forum, 44(2), 155-156. Web.

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IvyPanda. (2021) 'Open-Ended Inquiry and Paraphrasing in Nursing'. 23 November.

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