The Medical Interview Family, Crisis Intervention in the Context of the interdisciplinary task
Posted by Claudio Goldini at April 20, 2010, 12:02 p.m.
Categories: Medicine. Society
Tags: Society Medicine
Serial Murderer of Buenos Aires: INTERVIEW FAMILY MEDICAL, Crisis Intervention in the Context of the interdisciplinary task

Author's note: I considered of interest to publish this article newly

INTERVIEW FAMILY MEDICAL, Crisis Intervention in the Context of the interdisciplinary task
Posted by Claudio Goldini at October 25, 2006, 6:22 PM
Categories: Medicine

The medical interview with the family of a patient with acute onset, in critical condition, requires adequate training of undergraduate and graduate. In 15 years of experience with rotating internship students have observed that during the rotation submitted and for services where mandatory rotations do not provide students the opportunity to train in family interviews. One can imagine because new physicians avoid contact with family, especially when they are relatives of patients in critical condition.

Other conditions that influence the lack of reports and interviews with relatives  of great importance is overload of tasks, the short time that may be available for family members in a public institution of high demand and doomed to emergency tasks, the lack of space in which to meet with family, lack of beds, admissions and high pressure and the burnout of the members of health teams.

In this way the family is often bereft of adequate information and the possibility that the health team lead with his fears and fantasies.

The information provided by doctors are often tinged with exaggerated optimism or pessimism on the contrary, technical expressions incomprehensible to ordinary people, meeting in the hallway or near the patient (we do not know what he hears and understands what), avoidances or aggression towards family members.


Report requires thorough knowledge of himself, interviewing techniques, known elements of psychology and group dynamics, and especially training with experienced professionals.

These professionals can guide future members of the health team.

One way of learning is what can be done in the context of interdisciplinary work. The group must have professionals with experience and knowledge in the interview with the families, knowing the patient's illness, medical history and possible alternatives of their disease, making daily rounds, talks with various specialists, it mean have sufficient knowledge of the patient's illness.

Members should prepare interview guides which should be discussed in the group and followed rigorously.

The interviews should be recorded and the result discussed.

Should be considered also ways to save time and provide comprehensive assistance to the families in daily basis. In this regard has been very useful experiences in the Intensive Care Hospital JA Fernández,  Buenos Aires since 1986 with multi-family groups and, most recently with the families of the victims interned by the tragedy of Cromagnon.

In the context of interdisciplinary group, learning task relationships with family and patients becomes of unsuspected relevant, it is likely that after a training time any of the various specialists of the health team under appropriate supervision is in a position to carry out the interviews with family and patients. In our Neurotrauma Working Group interviews were conducted in the early days of hospitalization of the patient, conducted in groups, coordinated by a team member, objectives are formulated for each family, from the technical point of view we prefer the semi-structured way, lasting between 30 and 45 minutes and then briefly discussed the results. They were quoted later interviews, however, exchanged was almost daily with family members.

If necessary, the interview was carried out individually, especially at the request of family or patient.

After discharge the patients are followed, and rehabilitation oriented.

It should be emphasized that one interview is likely to be insufficient, the patient's history and his family "is putting together" in the course of hospitalization and to the extent that family members will put their trust in the therapeutic team.

Another extremely important aspect of these interviews is the possibility to explore the institutional shortcomings that occur during hospitalization, is a form of learning and correction that will benefit the following patients.

A useful guide for family interviews made by the author can be found in a presentation. .ppt in Argentina Society of Medicine and Surgery of Trauma (in spanish)

Dr. Claudio Goldini
Former Head Intensive Care
Ex Working Group Coordinator Neurotrauma
Former Secretary Emergency Committee
Acute General Hospital Juan A. Fernandez
Coordinator, Central Coordination Committee
of Emergency Hospital, SSIAS, GACBA
Buenos Aires, Argentina
Professor Medical Assistant
Universidad del Salvador, Buenos Aires
claudio@goldini.com

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