Scripts for Ideas, Concerns and Dr. Ramesh Mehay, Programme Director (Bradford VTS), 2010 Key points Always explore ALL THREE components – ideas, concerns and expectations Usually, you can explore these three things in that order: ideas concerns expectations (ICE for short). But sometimes, the patient might start off with a concern: ‘I came in because I am worried that these headaches might be a sign of brain cancer’. In that case, as the patient has started with the concern, explore the concerns further and then go onto the ideas and the expectations i.e. CIE. If a patient brings in a third party into the conversation like ‘my wife made me come in to see you’, then explore what her ideas, concerns and expectations are as well as that of the patient. Some trainees get confused over what ‘patient’s ideas’ actually means. It refers to their ‘health belief system’. In other words, what model do they have in their head that makes them think (for instance) that this ‘headache is a brain cancer’. In other words, WHY do they think it is that? Exploring ICE makes the rest of the consultation (like explanation and management) so much easier. In the CSA, the art is to do it quickly but to do it well. So, if a patient’s initial response to your question is ‘nothing really’, don’t just simply accept this and move on. All patients have some sort of ideas, concerns and expectations otherwise THEY WOULD NOT COME TO SEE YOU! So, if they respond in the negative, think about phrasing your question in a different way. The scripts on the next page give you some examples (or scripts) of first and second level questions. To get to the ‘heart of the matter’ sometimes you have to dig deep: but you can’t do that unless you have supplementary questions up your sleeve.

Scripts for Ideas, Concerns and Expectations

Download DOC Report

Upload
ayaantonse
View
212
Download
0

Embed Size (px)

DESCRIPTION

ice

Citation preview

Scripts for Ideas, Concerns and Expectations

Look at the next page for the scripts.

Learn these scripts ‘off by heart’. Practise saying them with patients. You will eventually add your own flavour to them in time.

Dr. Ramesh Mehay, Programme Director (Bradford VTS), 2010

Key pointsAlways explore ALL THREE components – ideas, concerns and expectationsUsually, you can explore these three things in that order: ideas concerns expectations (ICE for short).But sometimes, the patient might start off with a concern: ‘I came in because I am worried that these headaches might be a sign of brain cancer’. In that case, as the patient has started with the concern, explore the concerns further and then go onto the ideas and the expectations i.e. CIE.If a patient brings in a third party into the conversation like ‘my wife made me come in to see you’, then explore what her ideas, concerns and expectations are as well as that of the patient.Some trainees get confused over what ‘patient’s ideas’ actually means. It refers to their ‘health belief system’. In other words, what model do they have in their head that makes them think (for instance) that this ‘headache is a brain cancer’. In other words, WHY do they think it is that?Exploring ICE makes the rest of the consultation (like explanation and management) so much easier. In the CSA, the art is to do it quickly but to do it well.So, if a patient’s initial response to your question is ‘nothing really’, don’t just simply accept this and move on. All patients have some sort of ideas, concerns and expectations otherwise THEY WOULD NOT COME TO SEE YOU! So, if they respond in the negative, think about phrasing your question in a different way. The scripts on the next page give you some examples (or scripts) of first and second level questions. To get to the ‘heart of the matter’ sometimes you have to dig deep: but you can’t do that unless you have supplementary questions up your sleeve.