Directive and Non-Directive Interviews

• Two approaches to interviewing are directive and non-directive.

Directive Interview

• Highly structured and designed to elicit specific information.
• The nurse establishes and controls the interview's direction, particularly at the beginning.
• Clients primarily respond to questions but may lack opportunities to ask questions or discuss concerns.
• Directive interviews are often used in time-sensitive situations to gather and give information.

Non-Directive Interview

• The nurse allows the client to control the direction of the interview, including the purpose, subject matter, and pacing.
• Rapport, involving an understanding between two or more people, is built.
• A combination of directive and non-directive approaches is best for information gathering interviews

Types of Interview Questions

• Closed questions are restrictive requiring "yes," "no," or short factual answers
• Open-ended questions invite clients to explore and elaborate on thoughts or feelings.
• Open-ended questions are associated with nondirective interviews.
• Neutral questions can be answered without direction or pressure from the nurse.
• Leading Questions are closed-ended questions that direct the client's response.
• Leading questions are typically used in directive interviews.

Open-Ended Questions

• Advantages: Enables interviewees to talk freely, facilitating observation and highlighting important topics.
• Advantages: Can reveal the interviewee's knowledge gaps, prejudices, or emotional state.
• Advantages: Provides insights that the interviewer may not have directly asked about and fosters trust
• Disadvantages: Require more time, elicit more information than necessary, and require interviewer control.
• Disadvantages: Documentation is difficult and requires insight and sensitivity from the interviewer

Closed Questions

• Advantages: Provides focused control, requires less effort, and is less intimidating.
• Advantages: Saves time, facilitates quicker information gathering, and easy documenting responses.
• Advantages: Can be used by unskilled interviewers.
• Disadvantages: Might not reveal feelings or allow for volunteering of valuable insights.
• Disadvantages: Risk inhibiting communication and dominating the interview can occur

Neutral Question

• A neutral question is one that can be answered without direction or pressure from the nurse
• Neutral questions are open-ended and used in nondirective interivews
• Examples include “How do you feel about that?" and "What do you think led to the operation?”

Leading Question

• Leading questions don't allow for the client to answer what they really think
• This can lead to the client inaccurately trying to please the nurse by creating inaccurate data
• Examples include "You're stressed about surgery tomorrow, aren't you?" and “You will take your medicine, won't you?”

Planning the Interview

• It is best to plan the interview by taking into account time, place, seating arrangement and distance:
• Time, schedule interviews when clients are physically comfortable while also free from pain and interruptions.
• Place the interview in a well-lit, ventilated room free from noise.
• Consider positioning the nurse at a 45-degree angle to the bed to avoid staring

Interview Distance

• The distance between the interviewer and interviewee must be neither too small nor too great
• Maintaining between 2-3 feet during an interview is ideal

Interview Language

• Communication must be appropriate for the client to understand otherwise it is discrimination
• The interviewer should seek to convert terminology that is complicated into common English usage
• If the client uses a different language an interpreter/translator is needed

Stages of an Interview

• The opening or introduction, the body or development stage, the closing.

Interview Opening

• It the most important part of the interview
• It is important to establish a rapport
• It is important to orient the interviewee

Establishing Rapport

• Establishing rapport is a process of creating goodwill and trust.
• Can begin with a greeting with nonverbal gestures such as a smile, a handshake, and a friendly manner.
• Be careful not too overdo as this could cause anxiety

Interview Orientation

• The nurse explains the purpose of the interview, what info is needed time length and what is expected of the client
• Stating how the information will be used stating the client has a right not to provide data

The Interview Body

• The client communicates their thoughts, feelings, knowledge, and perceptions.
• Nurses should use communication techniques to ensure all parties feel comfortable

Communication during Interviews:

• Listen carefully using all your senses, use appropriate language, plan question sequences and only ask one thing at a time
• Acknowledge the client's right to look at things their way and do not impose personal values on client.
• Respect nonverbally, convey interest and acceptance.
• Maintain awareness of client and personal language
• Be aware of voice inflection, tone, and affect
• Use and accept silence to help the client searching for more thoughts or organize them.

The Interview Closing

• End the interview when you have all the needed information else it is acceptable for the client to end the interview
• The closing is important for the facilitation of future interactions between the client and the interviewer

Common Interview Closing Techniques

• Offering to answer questions is a commonly used closing technique “Do you have any questions?” "I would gladly answer any questions you have.”
• Concluding an interview by saying "Well that's all I need to know for now"
• Thank the client for their time in helping to plan the nursing care
• State you concern for the patient's welfare, "I hope all goes well for you."
• A summary to verify accuracy and agreement should be provided to the client

Directive interviews are highly structured and elicit specific information, while non-directive interviews allow the client to control the direction of the conversation. Combining both approaches is ideal for gathering information and building rapport. Open-ended questions encourage clients to elaborate on their thoughts and feelings.