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76 LAYING THE FOUNDATION
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UNIT 1
SHUTTERSTOCK .COM/BRICOLAGE
FIGURE 3.6 Seeing a consumer with sutures or other injuries prompts the nurse to inquire about the events
that led to the incident, as well as past injuries.
Additionally, signicant increases in intimate partner violence were reported during
the COVID-19 pandemic, with many victims unable to seek help due to safety
concerns (Boxall & Morgan, 2021).
PUTTING IT IN CONTEXT
Assessing for domestic and intimate partner violence
You note that Tasha has come to the ED three times in the past 6 months. Six months ago,
she reported falling down the steps and hitting her head. Her old chart documents that she
was seen for a mild closed head injury with concussion. Two months ago, Tasha reported
falling while roller blading and broke her left arm. Her cast was removed two weeks ago.
Today, Tasha presents with multiple facial and mouth lacerations. She tells you that she fell
off her bike. You note multiple ecchymoses on the exposed areas of her skin.
You would need to take into consideration her personal safety when questioning her
closer. For example, many perpetrators of intimate partner violence will not allow the
partner to be alone with a health practitioner when seeking health care. Many health
environments have screening tools and processes in place to protect the safety of the
consumer and health professionals in these circumstances.
> Investigate your agency’s policy on reporting actual and suspected violence or abuse,
asthis will shape your response and actions.
> Investigate your government’s regulations on mandatory reporting of actual and
suspected violence or abuse, as this will shape your response and actions.
Some clues that might alert you to the possibility of domestic and intimate
partner violence are as follows:
> Frequent injuries, accidents or burns
> Previous injuries for which the individual did not seek health care
> Injury is inconsistent with the consumer’s report of how it occurred
> Refusal of the consumer to discuss the injury
> Signicant other accompanies the consumer to the ED, answers questions for
consumer, and refuses to leave the consumer’s side
> Signicant other has a history of previous violence or substance abuse
> Vague symptoms such as chronic pain
THE COMPLETE HEALTH HISTORY INCLUDING DOCUMENTATION 77
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EXAMPLES OF QUESTIONS ASSESSING DOMESTIC AND INTIMATE PARTNER VIOLENCE
Using the communication technique of normalising, the nurse can screen for potential domestic and
intimate partner violence.
Some supportive comments might be:
> ‘Unfortunately intimate partner violence occurs frequently in lots of families who use our services.
Is this what happened to you?’
> ‘Domestic and intimate partner violence occurs very frequently in our community. Keeping this
inmind,
I would like to ask you some questions.’
There are many different ways to screen for
IPV. In Australia and New Zealand, the most commonly
accepted way for non-domestic-violence health professionals to screen includes asking the
followingquestions:
> ‘Within the last year, have you been hit, slapped or hurt in other ways by your partner or ex-partner?’
> ‘Has your partner ever physically threatened or hurt you?’
> ‘Sometimes partners react strongly in arguments and use physical force. Is this happening to you?’
> ‘Does your partner restrict your access to money, social events or friends and family?’
> ‘Do you have children? If so are you worried about your children’s safety with your partner or ex-partner?’
> ‘Are you frightened of your partner or ex-partner?’
If the woman answers ‘NO’ to these questions, screening is stopped there and you can give her a
general information pamphlet then, saying something like: ‘Here is some information we give to all
women about domestic violence.’
If the woman answers ‘YES’ to any question, then continue to ask the following questions:
> ‘Are you safe to go home when you leave here?’
> ‘Would you like some assistance with this?’
A further three questions are also asked if the woman answers ‘YES’ to any of the above:
> ‘Do you have children? (If so) Have they been hurt or witnessed violence?’
> ‘With whom are your children now? Where are they?’
> ‘Are you worried about their safety?’
(RACGP, 2021; NSW Health, 2022; NSW Health 2020)
Answers that make the health professional concerned for the child/ren’s welfare are then required to
ensure their actions are in accordance with child protection notications requirements in their state,
territory or area.
CHAPTER 3
Actions taken may then include:
> Giving information about IPV
> Support given and options discussed
> Report to Department of Community and Family Services
> Notify police
> Refer to community or support services.
Screening is generally not completed if the following circumstances apply:
> Presence of a partner where the partner cannot easily be separated from
theconsumer
> Presence of other family members
> Presence of a child older than three
> Person declines to answer questions.
ADAP TED FRO M NSW HEALT H, 2022; N SW HEALT H, 2020.
It is imperative to document physical violence examination ndings concisely
and accurately. Incorporate drawings of injury locations or use printed anatomical
maps on which injuries can be documented. Many EDs have cameras as a resource,
so that the staff can photograph injuries to document or include in the consumer’s
records. This documentation is important, not only for communicating health
conditions to other health professionals, but also for use by clinicians who are
called to bear witness for police statements and court cases.
Keep in mind that many victims of IPV experience anxiety, depression,
substance abuse and posttraumatic stress disorder after their attack and
these conditions can last for years. Specic healthcare procedures, such as a
gynaecological examination, may invoke memories of the IPV. The nurse needs
78 LAYING THE FOUNDATION
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to be sensitive to the consumer’s needs at these times and must try to make the
consumer feel as safe as possible in this environment.
UNIT 1
Sexual practice histories focus on healthy sexual practices as well as the transmission
of communicable diseases. Various medications can affect sexual function.
Questioning a consumer about sexual practices may be uncomfortable for both
consumer and nurse. The consumer may notice your uneasiness with this topic and
may feel embarrassed to answer the questions. Examine your personal feelings on
sexuality and attain a comfort level that will allow ease in questioning. The health
histories in Chapter 17 provide additional information about female and male
reproductive health.
EXAMPLES OF QUESTIONS ASSESSING SEXUAL PRACTICE
> ‘What term would you use to describe your sexual orientation (heterosexual, homosexual, bisexual,
intergender, transgender, other)?’
> ‘At what age was your rst sexual experience?’
> ‘With how many partners are you currently involved? Has this changed?’
> ‘What method of birth control do you use? Do you have any questions about it? Would you like
additional information on other methods of birth control?’
> ‘What measures do you use to prevent exchange of body uids during sexual activity?’
> ‘Do you engage in oral or anal intercourse?’
> ‘Have you ever had a sexual partner who had a sexually transmitted infection?’
> ‘Do you take any prescription or medications or supplements to help your sexual performance?’
URGENT FINDING
Sexual practice
Risk assessment: Dangerous sexual practices
Be alert for individuals who practise potentially lethal sexual practices that involve
near-strangulation. In adolescents, this practice is often referred to as auto-eroticism or
the ‘choking game’. Individuals literally choke one another with their hands, or they can use
noose-like materials such as belts, scarves and ropes. Adults usually use more sophisticated
techniques to have this auto-erotic experience. The premise of this ‘game’ is to experience
the euphoria that occurs when one is close to unconsciousness or becomes unconscious.
Insome instances, individuals have died during these activities. If dangerous sexual
practices are identied, urgent health education informing the individual of the associated
risks needs to be implemented and documented.
CLINICAL REASONING
Practice tip: Eliciting the sexual history
Be aware that consumers may refuse to answer questions pertaining to sexual history;
tryreturning to these questions later. Ask the consumer whether a nurse of a different
gender would make the consumer more comfortable in discussing sexual practice.
The adolescent consumer may refuse to answer these questions or may provide false
answers if the parent or caregiver is in the room. You could ask the caregiver to leave the
room at the completion of the health history so that you can ask the consumer whether
there is anything else that he or she would like to say.
Be alert for cues that demonstrate the consumer’s desire for sexual education, such as
questions or requests for written information. Answer the consumer’s questions honestly.
> ‘Are you satised with your sexual performance?’
> ‘Do you have any infertility issues? How have you dealt with that?’
> ‘Have you ever been sexually abused? What has transpired since? Have you spoken with
anybody about this before?’
THE COMPLETE HEALTH HISTORY INCLUDING DOCUMENTATION 79
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Travel history
Endemic illnesses may be endogenous to specic regions in the world or to a
single country. Consumers sometimes present with symptoms that cannot or
may not be attributed to routine illnesses. For these reasons, a complete travel
history is warranted when obtaining a health history. As recently seen during the
COVID-19 pandemic, the management of communicable diseases may require
specic vaccinations pre-travel or impact on where consumers can travel from and
to. Checking in with latest border closures, or requirements for travel to and from
different destinations, is essential for the traveller who may ask for assistance in
interpreting latest advice.
EXAMPLES OF QUESTIONS ASSESSING TRAVEL HISTORY
> ‘Where have you travelled either domestically or internationally? Was this a rural or an urban
environment? When?’
> ‘Did you receive any immunisations before you visited that area?’
> ‘Did you need to take any medications prophylactically before or while you were gone?’
> ‘Were you ill when you were there?’
> ‘Was a diagnosis made? What treatment did you receive? Were there any complications?’
> ‘Since returning from this area, have you been ill or not feeling normal?’
Work environment
The work environment can also be hazardous. The nature of employment itself
may present health hazards, whether or not safety measures are used. Carpentry, for
example, is viewed as a relatively safe employment, although over time carpenters
are prone to ischaemia of their ngers from repeated exposure to handheld
vibrating tools. Exposure to toxic substances in the work environment, such as
asbestos, silica dust and lead, is an additional factor to consider.
CHAPTER 3
EXAMPLES OF QUESTIONS ASSESSING WORK ENVIRONMENT
> ‘Describe the work that you do. Is it physically demanding? Is it mentally or emotionally demanding?
Do you sit or stand in one place all day/night? Do you undertake repetitive motions in your role?’
> ‘How many hours a day do you normally work? For how long have you held this position?’
> ‘Do you spend the majority of your work day sitting, standing, walking, running, lifting or biking?’
> ‘Do you work with any chemicals? Raw materials?’
> ‘Are you exposed to radiation or other pollution? Toxic fumes? Hazardous conditions?’
> ‘What safety measures do you practise at work?’
> ‘What is the noise level at your place of employment?’
> ‘Have you noticed that you are sick on the weekend or on your days off?’
> ‘Have you had any work-related accidents or injuries?’
> ‘Do you enjoy your work and are you considering changing your profession? Why?’
> ‘What other jobs have you held in your lifetime?’
Home environment
When assessing the consumer’s home environment, consider both the physical
and psychosocial aspects. The physical examination encompasses a broad spectrum
of topics: physical condition of the house, safety from toxic substances, and the
presence of modern conveniences such as a refrigerator, air conditioner, heater,
telephones and electricity. Older houses may have been painted with lead-based
paint, which poses a health threat to a young child who chews on wooden items
and ingests the paint chips, or have asbestos which can be problematic when
renovating or when this material is exposed.
The psychosocial component of the home environment identies the relative
safety of the neighbourhood.
80 LAYING THE FOUNDATION
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UNIT 1
Physical environment
EXAMPLES OF QUESTIONS ASSESSING PHYSICAL ENVIRONMENT
> ‘How old are your living quarters (i.e. house or apartment building) and in what condition is
thebuilding?
> ‘Do you have electricity, heating and air conditioning? What type of heating do you have?’
> ‘Do you have running water? Do you have a toilet, bath or shower?’
> ‘From what source do you draw your water (e.g. tank, spring, bore, reservoir, town supply)?’
> ‘Do you have access to a telephone?’
> ‘Do you have smoke detectors? Where? Do you inspect the batteries on a regular basis?
Do you have a carbon monoxide detector?’
> ‘How many steps separate each oor? Is there a railing?’
> ‘Do you have any oor rugs? Are they taped to the oor?’
> ‘Do you use a night-light when it is dark?’
> ‘Have you adapted your living quarters to t any special needs?’
> ‘What pets do you have? Do they live inside or outside?’
> ‘What type of transportation do you use?’
> ‘Do you have easy access to a supermarket? Healthcare facility?’
> ‘Where do you store your medications, cleaning supplies and other toxic substances? How are they
secured?’ (if children live in the living quarters)
> ‘Are there any problems with pollution near your home?’
Psychosocial environment
EXAMPLE OF QUESTIONS ASSESSING PSYCHOSOCIAL ENVIRONMENT
> ‘Do you feel safe in your neighbourhood/home environment?’
Hobbies and leisure activities
Acquiring information on consumers’ hobbies and leisure activities is necessary
because some activities can pose health risks. For example, repeated exposure to
glue used in constructing model cars and planes can lead to respiratory ailments.
EXAMPLES OF QUESTIONS ASSESSING HOBBIES AND LEISURE ACTIVITIES
> ‘What hobbies do you have?’ or ‘What do you like to do in your spare time?’
> ‘During or after this activity, have you ever felt sick? What happened?’
> ‘Have you ever given up some leisure activity because of the effect it had on your health?
What happened?’
> ‘Have you ever had an injury from your hobby?’
> ‘Do you nd your hobbies and leisure activities relaxing?’
Stress
Stress is a physiologically dened response to changes that disrupt the resting
equilibrium of an individual. Stress can impact on many systems of the body and
lead to both negative health outcomes and changes in health behaviours that
increase those negative effects (O’Connor, Thayer & Vedhara, 2021). Distress is
negative stress, or stress that is harmful and unpleasant. Eustress is positive stress,
stress that challenges the individual, provides motivation and prevents stagnation.
EXAMPLES OF QUESTIONS ASSESSING STRESS
> ‘What are the current stressors in your life?’
> ‘What do you feel is your greatest stress at the present time?’
> ‘Are there recurring themes with the stress that you experience?’
> ‘Have you ever progressed from the point of being stressed to panic? What were the circumstances?
How did you manage it?’
> ‘Are you able to recognise when you become stressed? What does it feel like in your body?’
THE COMPLETE HEALTH HISTORY INCLUDING DOCUMENTATION 81
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Education
Elicit information on the consumer’s ability to read and write, and tailor your
questions and information to this level.
EXAMPLES OF QUESTIONS ASSESSING EDUCATION:
> ‘What was the highest schooling level that you completed?’
> ‘Describe the type of student that you were.’
> ’What do you do to nd out new information?
> ‘How do you access new information?’
Military service
Knowledge of overseas tours of duty may provide a vital link to current health status.
A consumer may not reveal this information during the travel history because it
was work rather than leisure travel. For instance, military personnel who served in
the Middle East may have been exposed to many chemical agents. Many of them
now have a variety of signs and symptoms collectively called Gulf War syndrome.
Some of the troops who were in the Middle East for the Iraq conict have exhibited
various illnesses such as malaria and unknown respiratory pathology. The full extent
of the impact on these troops may not be known for some time.
EXAMPLES OF QUESTIONS ASSESSING MILITARY SERVICE
> ‘Are you or have you ever been in the military? What was the length of service? Was this active or
reserve duty?’
> ‘To what regions have you been assigned? For how long were you there? When?’
> ‘Have you ever been in combat? Did you have injuries? Do you experience ashbacks?’
Religion
Religion and spirituality can be powerful forces in a consumer’s life. You need to be
aware of and sensitive to implications that spirituality or religious beliefs may have
on the consumer’s health status and healthcare practices.
CHAPTER 3
EXAMPLES OF QUESTIONS ASSESSING RELIGION
> ‘Are you afliated with a specic religion?’
> ‘Do you currently practise your faith?’
> ‘Do your religious beliefs affect your health status? In what way?’
> ‘Are there any beliefs that you feel are compromised by seeking health care?’
> ‘Are there any religious practices that you may need assistance with?’
Cultural background
Closely associated with health and wellbeing is the consumer’s cultural background,
which can penetrate all facets of a consumer’s life. Integrate familiarity with various
cultures into your knowledge base so you will be sensitive to and understand the
consumer’s cultural heritage.
EXAMPLE OF QUESTIONS ASSESSING CULTURAL BACKGROUND
> ‘With what cultural group do you identify yourself?’
> ‘What does this mean for different aspects of your life?’
> ‘Does this impact on what you eat or how you connect with others in your community?’
Roles and relationships
Family roles, work roles and interpersonal relationships provide clues about possible
stressors, areas for health promotion, support systems, and sources of altered
psychosocial patterns.
82 LAYING THE FOUNDATION
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UNIT 1
EXAMPLES OF QUESTIONS ASSESSING ROLES AND RELATIONSHIPS
> ‘What are your home living arrangements? Do you live with others?’
> ‘What type of relationship do you have with these individuals?’
> ‘What is your role within your family (e.g. major caregiver, breadwinner, child, student,
stay-at-home/housebound caregiver)?’
> ‘What responsibilities go along with this role?’
> ‘Who gives you support?’
> ‘Describe the relationship that you have with your friends and neighbours.’
Characteristic patterns of daily living and functional health assessment
Questions about a consumer’s usual lifestyle, or characteristic patterns of daily
, reveal information about the consumer’s normal daily timetable – meals,
living
work and sleep schedules – and social interactions. If the consumer is disabled or
impaired physically or psychologically, you need to perform a functional health
assessment (see Appendix A). The
a person’s ability to perform instrumental activities of daily living and physical
self-maintenance activities. This data serves as baseline information upon which the
effectiveness of nursing interventions can be evaluated.
EXAMPLES OF QUESTIONS ASSESSING PATTERNS OF DAILY LIVING
> ‘Describe a typical day for you, starting from the time you wake up to the time you go to bed.’
> ‘Do you need assistance with any activities of daily living? (If yes) Is assistance readily available?’
> ‘Do you socialise, meet or talk with people outside your house on a daily basis?’
> ‘Does your schedule change on certain days or on the weekend? Describe the change.’
functional health assessment documents
Health maintenance and education activities
Health maintenance activities or health education activities are practices
a person incorporates into his or her lifestyle to promote healthy living. You can
make the transition from the social history to health maintenance or promotion
with the following statements:
EXAMPLES OF QUESTIONS AND COMMENTS THAT ASSESS OR INTRODUCE HEALTH
MAINTENANCE AND EDUCATION ACTIVITIES
> ‘Now I would like to discuss things that you do that improve or maintain your health.’
> ‘There are many things you can do to promote healthy living. I would like us to discuss some of
those practices.’
Sleep
Many illnesses have sleep pattern disturbances as a characteristic. Increased or
decreased hours of sleep or interrupted/changed sleep patterns can both occur. For
this reason, you need to learn about the consumer’s current and usual sleep habits.
A standardised sleep tool, for example the Epworth Sleepiness Scale developed
in Australia (Johns, 2022), can also be used to assess sleep and wakefulness patterns.
General questions about sleep include the following:
EXAMPLES OF QUESTIONS ASSESSING SLEEP
> ‘At what time do you usually go to bed? At what time do you usually awake?’
> ‘How long does it take you to fall asleep? How do you feel when you awaken?’
> ‘Is your sleep undisturbed? Do you have difculty staying asleep? If you wake, is it easy for you to
fall back to sleep?’
> ‘Do you have any discomfort in your legs when you are in bed trying to sleep?’
> ‘Describe the environment in which you sleep (noise level, amount of light, temperature of the room,
sleeping arrangement).’
>>
THE COMPLETE HEALTH HISTORY INCLUDING DOCUMENTATION 83
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>>
> ‘What strategies (also referred to as sleep hygiene) do you use to fall asleep if you are having
difculty (medication, warm milk, other)?
How many times per week do you do this?’
> ‘What is your usual emotional state or mental condition when you go to bed? When you wake?’
> ‘Have you ever been told that you snore loudly or excessively?’
> ‘Do you ever have difculty staying awake?’
> ‘Does the usual time of your sleep–awake cycle change (working rotating shifts)?’
> ‘Do you take a nap during the day? For how long?’
> ‘Do you have nightmares? How frequent are they?’
> ‘Do you walk in your sleep?’
> ‘Do you experience bedwetting?’
> ‘Do you often wake up with dark circles under your eyes? Puffy eyelids? Bloodshot eyes?’
> ‘Do you ever wake in the night because of pain, shortness of breath (dyspnoea), or waking up to
pee at night (nocturia)?’ (
Use non-medical terms wherever possible but document in medical terms.)
> ‘Do you have alcohol, nicotine, high sugar foods or caffeine within 2 hours of bedtime?’
> ‘Do you take any medications or supplements to help you sleep?’
Diet
Refer to Chapter 15 for a more thorough discussion of nutrition and diet history.
EXAMPLES OF QUESTIONS ASSESSING DIET
> ‘Are you on any special therapeutic diet (soft foods, low salt, low cholesterol, low fat, etc.)?’
(
Figure 3.7.)
> ‘Do you follow any particular diet plan (vegetarian, liquid, commercially available diet food,
ricediet, Keto diet, hCG diet, Optifast/Optislim diet, Weight Watchers etc.)?’
> ‘How many meals a day do you eat? At what times do you eat? Do you snack? When?’
> ‘Has your weight uctuated in the past year? Can you explain more about this?’
CHAPTER 3
FIGURE 3.7 Preventing aspirations: thickening liquids
Exercise
Aerobic exercise appropriate to the consumer’s age and physical condition leads to
cardiovascular, respiratory and musculoskeletal tness as well as mental alertness and
general mental wellbeing (Figure 3.8). Combining aerobic exercise with weightlifting
(which increases strength) and calisthenics (which enhances exibility) establishes a
complete physical tness regimen. Non-aerobic activity alsohas benecial effects on
the body, even though the target heart rate may not beattained.
SHUTTERSTOCK.COM/AKIYOKO
84 LAYING THE FOUNDATION
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UNIT 1
SHUTTERSTOCK.COM/ WAV EBREAKMEDIA
FIGURE 3.8 Older adults participating in an exercise class
Australian national guidelines encourage people to be more active and provide
specic advice based on age and other parameters. Current advice for adults aged
18–64 includes being active most days, if possible every day, and states hours
of activity guidelines based on level of activity (vigorous vs moderate intensity)
(Australian Government Department of Health and Aged Care, 2021). New Zealanders
are also encouraged to undertake specic activity levels based on exercise intensity
levels (2.5 hours of moderate or 1.25 hours of vigorous activity) spread over the week
(Ministry of Health, 2021).
EXAMPLES OF QUESTIONS ASSESSING EXERCISE
> ‘Do you participate in a formal or informal exercise program? If yes, for how long have you been involved?’
> ‘What type of exercise do you do?’
> ‘How many times per week do you exercise?’
> ‘For how long do you exercise (in minutes)?’
> ‘What type of warm-up and cool-down exercises do you do?’
> ‘For what period of time do you maintain this elevated heart rate?’
> ‘Have you ever experienced any injuries from your exercise regimen? What type?’
> ‘Does your health impose any restrictions on your ability to exercise?’
Stress management
The assessment of stress management practices is vital. Some commonly used stress
management techniques are exercise, eating, biofeedback, yoga, progressive muscle
relaxation, aromatherapy, imagery, massages, verbalisation, praying, humour,
pet therapy, music therapy, magnet therapy, reexology, art work, journaling,
storytelling, support groups and meditation. For others, stress management
techniques include smoking, drinking, drugs, high-risk sports and violence.
EXAMPLES OF QUESTIONS ASSESSING STRESS MANAGEMENT
> ‘When you become stressed, what do you do to help alleviate the stress?’
> ‘When do you use this skill? Is it effective for you?’
> ‘How do you evaluate the effectiveness of this technique?’
> ‘For how long do you need to perform this technique before your stress is reduced?’
> ‘How many times per day do you use this technique? Per week?’
> ‘Have you tried other stress management skills? How did they work?’
THE COMPLETE HEALTH HISTORY INCLUDING DOCUMENTATION 85
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Use of safety devices
The consumer’s use or lack of use of safety devices on the job, in the home, during
sporting activities and in the environment provides a source for teaching health
promotion skills (
Figure 3.9).
EXAMPLES OF QUESTIONS ASSESSING SAFETY DEVICES
> ‘Do you wear a seatbelt when you are in a car?’
> ‘Do you wear a helmet when riding a motorcycle?’
> ‘Do your hobbies and leisure activities (e.g. cycling) require the use of safety devices (e.g. helmets)?
Do you use them?’
> ‘What precautions do you take when using pesticides or fertilisers?’
Health check-ups
Health check-up information demonstrates patterns of healthcare practices by the
consumer during illness and health, and provides potential sources of health education.
CHAPTER 3
EXAMPLES OF QUESTIONS ASSESSING HEALTH CHECK-UPS
> ‘When was the last time you had the following performed: pulse and blood pressure, complete
physical examination, chest X-ray,
ECG, urinalysis, blood tests, including blood sugar and
cholesterol? What were the results?’
> ‘How often do you see a dentist (Figure 3.10)? For what reason?’
FIGURE 3.10 It is important to ask consumers what other healthcare providers they are seeing,
such as the dentist.
SHUTTERSTOCK.COM/ERMOL AEV ALEXANDER
FIGURE 3.9 Wearing safety equipment is
essential at all ages.
ISTOCK.COM/FS-STOCK
> ‘How often do you see an eye doctor? For what reason? Have you been checked for glaucoma?’
> ‘How often do you have a gynaecological check-up? By whom? What was the date and result of
your last Pap smear?’ (for women)
> ‘Do you know how to perform a breast self-examination? Who taught you? How often do you
perform it? Do you have any questions about it?’ (for women)
> ‘What was the date and the result of your last mammogram?’ (for women over 40 or a woman of
any age with a strong family history of breast cancer)
> ‘Do you know how to perform a testicular self-examination? Who taught you? How often do you
perform it? Do you have any questions about it?’ (for men)
> ‘How often do you have a prostate examination? What was the date and result of your last exam?’
(for men)
> ‘Do you have any other healthcare providers (psychiatrist, psychologist, podiatrist, occupational
orphysical therapist, physiotherapist, chiropractor etc.)? For what reason? How often do you see
this person?’
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