How to implement inclusve dialogue with your patient?
Engaging in an inclusive dialogue with the patient, their relatives and other health professionals is key to ensuring that the patient's needs are fully considered and to improving continuity of care. Ask the right questions to establish history and identify the patient’s expectations and treatment goals.
When assessing a patient with a chronic wound, it is important to gather as much information as possible by asking the right questions and listening to the patient. It is also important to use the first consultation not only to holistically assess the patient but also to start involving and empowering them:
1. Assess the patient’s understanding and obtain consent
If the patient is not able to give consent, explore consent issues with their family or relatives
2. Identify the patient’s goal and objectives
- Ask the patient what aspects of their life are most important to them
- Explore their short and long-term treatment goals
- Discuss a potential timeline in which to achieve these goals
3. Identify the patient’s priorities about treatment
- Discuss their ideal outcomes
- Explore manageability: what can the patient realistically do to help their ulcer to heal?
- Ask the patient about the levels of support they have or require
Questions you can use to elicit the patient’s history and goals
- What can you tell me about your wound?
- How long have you had it?
- What do you think caused the wound?
- What is the worst thing about your wound?
- What makes your wound better?
- What makes your wound worse?
- How does your wound affect your day-to-day life?
- How often are you able to leave the house?
- How often do you meet your family and friends?
- What do you enjoy doing?
- Does your wound your wound stop you from doing anything?
- How is your general health?
- What medications do you take?
- Who helps you out with your wound care?
- Do you have any worries about your treatment plan?
- What helps would you like with your wound?
- Bianchi J,Flanagan M, King B. 3D: a framework to improve care for patients with legulcers. Implementing person-centred diagnosis, evidence-based treatmentdecisions and inclusive dialogue with the 3D framework. J Wound Care 2020; 29(11 Suppl a):S1–S66