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Effective TB Interviewing for Contact Investigation: Self-Study Modules

Return to Module 2 Table of Contents

Patient Education During the TB Interview

Asking Questions

In order to keep focused on the objectives of obtaining accurate and complete information from the patient and building trust, the use of closed and open-ended and focused questions is very important. These concepts are explained below.

Closed-ended questions require a one-word or briefly phrased response, such as “yes” or “no.” While not appropriate in obtaining the most information from the patient, closed-ended questions can be useful in confirming information received and quickly summarizing information that was obtained previously. Closed-ended questions can also move a conversation in a more productive direction if the information that is being sought is not being obtained.

Open-ended questions require more than a one-word response, such as a description or an explanation. Open-ended questions prompt the interviewee to provide information without interviewer biases. These types of questions generally begin with who, what, where, when, why, and how. A statement may also begin with “Tell me about…,” “Describe for me…,” or “Explain to me…”

Table 5. Examples of Closed- and Open-Ended Questions

Examples of Closed-and Open Ended Questions

Closed-Ended Questions:

Open-Ended Questions:

Do you live alone?

Have you had a cough?

Do you work in a large area?

Is your dad’s name spelled J-O-H-N D-O-E?

Did the doctor talk to you about TB?

Who lives with you?

What symptoms have you had?

What is your work environment like?

How is your dad’s name spelled?

What did the doctor tell you about TB?

Examples of closed-ended and open-ended question used in combination

Example 1: Determining the infectious period

Open-ended question: What symptoms have you had?

Patient: Well, I have been kind of run down. Stuff like that.

Open-ended question: What other symptoms have you had besides being tired?

Patient: I don’t really remember. I’ve been on medications, so I’m feeling better now.

Closed-ended question: Have you had a cough?

Patient: Yes.

Open-ended question: For how long did you cough?

Patient: For about a month.

Example 2: Determining basic congregate setting exposure information

Opening interviewer statement: Please describe your work environment.

Patient: I work in a factory.

Open-ended question: How is it set up?

Patient: Well, it’s kind of an assembly line.

Closed-ended: Is it a large factory?

Patient: Yeah, it’s pretty big.

Open-ended: How big would you say?

Patient: Oh, I couldn’t really say.

Closed-Ended: Is it the size of this room?

Patient: No, it’s about three times the size of this room.

Example 3: Physical descriptions

Open-ended question: You said you hang out with Ralph. How would you describe him?

Patient: He’s a little guy; doesn’t say much.

Open-ended question: When you say little…how tall is he?

Patient: Oh, I don’t know his exact height.

Closed-ended question: Is he my height, taller, or shorter?

Patient: About your height.

Focused questions are used if the respondent makes a vague statement or one requiring more specific information. The question may provide limits or boundaries (e.g., time) to direct an answer. Focused questions are not closed-ended questions.

Table 6. Examples of the use of combined open-ended and focused questions

Example 1

Open-ended question: Where do you spend most of your time?

Patient: You know, it’s really hard to say where I spend most of my time.

Focused question: Okay, let’s take yesterday. How did yesterday compare to an average day for you?

Patient: It was pretty much the same.

Focused question: So, what did you do in the morning?

Example 2

Open-ended question: Where do you spend most of your time?

Patient: I guess I spend the most time with some people over at the shelter and then some other people I meet for drinks now and then.

Focused question: Whom do you spend time with over at the shelter?

Patient: Well, there’s this guy Larry…

Example 3

Open-ended question: What is your mailing address?

Patient: I don’t really have a fixed address. I’m living here and there.

Focused question: Can you tell me a little bit more what you mean by here and there?

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