Helping patients to express themselves
When people are acutely ill, factors such as pain, medication side-effects, not wanting to bother you or even the person’s levels of self-esteem can get in the way of them identifying and describing what’s going on for them. We’ve all been told about ‘open’ rather than ‘closed’ questions – here’s a quick recap. Open questions are ones which encourage the person to respond freely with their thoughts and feelings. A closed question classically produces a one word answer, whether ‘yes’ or ‘no’ or a fact – ‘Blue’. ‘Horse’. ‘Blue horse’.
- Questions starting with ‘are’ or ‘do’ tend to be closed questions because they generate just ‘yes’ or ‘no’ answers.
- Questions which start with ‘what’, ‘where’, ‘which’, ‘who’ and ‘when’, ‘in what way’ are open questions. These will generate more interesting, fuller answers.
For example, ‘Are you in pain?’ is a closed question. The patient doesn’t have to answer anything more than ‘yes’ or ‘no’. Or they might just deliver a grunt or a shrug of the shoulders. If you want to find out how they’re experiencing the pain, all you need to do is turn it round into, for example, ‘Can you tell me more about the pain?’ and the patient has the opportunity to describe how they feel. Open questions, therefore, are much better at providing information. Open questions are an avenue leading somewhere. Which isn’t to rubbish closed questions; these can give you hard information which we also need sometimes.
Other examples of open questions you could try:
- Please could you tell me more about how you felt about this?
- That’s really interesting. Would you like to tell me a bit more about that?
- What are/were the best things about that? What are/were the worst things about that?
- And then what happened?
- Do you mean that….?
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