Taking an effective history from a patient is an essential skill that can be mastered with practice. Depending on the context of the consultation and the needs of the patient, the history may be brief or more detailed. The taking of a focused history from a patient with new onset pelvic pain will differ in scope from opportunistically enquiring about their sexual health during a cervical screening consultation; however both share the same principles, as outlined below.
It is also important to be aware that patients seeking reproductive and sexual health care may have experienced, or be experiencing, domestic or gender-based violence. Be alert to and aware of cues and indicators of this, which may include psychological and mental health issues as well as physical injuries. The Domestic Violence Toolkit for GPs provides a useful framework for supporting and managing disclosures of domestic violence in the primary care setting (also see section on Safety Planning and Referral in Chapter 16: Management of Sexual Assault and Domestic Violence in Primary Health Care). Be aware that past sexual abuse or sexual violence may increase a patient’s difficulty in seeking help for sexual issues and that ‘routine’ reproductive ...
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Principles of effective history taking
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