Student will interview an individual (middle age or older adult). The individual can be a family member.

Biographical Information:
Include items such as age, where they live, employment status,, marital status, source of health care and insurance, advance directives, and family/others living at home

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Health History:
Any childhood illness, chronic illness, hospitalizations or surgeries they have had.
Any medications they are presently taking including OTC and herbal preparations. Any allergies (medications, environment, food).

Family History:
Health problems of immediate family: maternal and paternal. Current ages or age at death. Family structure and interaction. Cultural influence.

Health Promotion Behavior:
Any safety measures implemented at home, environmental exposures, exercise, diet, sun exposure, substance abuse, tobacco and alcohol use, stress, coping measures, and sleep patterns

Psychosocial History:
Relationships, support system, community resources used, financial status, ability to perform activities of daily living, spiritual health and religious practices.

⦁ Student will submit a report containing 4 paragraphs.

a. First paragraph should describe how you conducted the orientation phase of the interview. Summarize demographic information (without actually identifying the interviewee’s name, address and birthdate).

b. Second and third paragraph should discuss information gathered during the working phase of the interview. Summarize health history, family history, psychosocial history and health promotion behaviors.

c. Fourth paragraph should discuss how the termination phase of the interview was conducted, how you developed a trusting relationship with the interviewee, and the therapeutic communication techniques implemented.
( Potter and Perry pages 215-220, ATI page 127).

Note: Data gathered should be factual. Be specific. Do not include your opinion.

⦁ The typewritten report should be double-spaced, font Times New Roman, size 12. Use the APA guidelines for capitalization, punctuations and others.
Minimum word count: 550. This is a writing assignment. Review your report for correct sentence structure, grammar, spelling, capitalization and punctuation. Avoid run-on sentences.

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