KINGDOM OF SAUDI ARABIA

MINISTRY OF HIGHER EDUCATION

UNIVERSITY OF TABUK
FACULTY OF APPLIED MEDICAL
SCIENCE
Nursing Department

Name of Student: __________________________Section: _____ Group:_____

Student no.:________________________ Date: _______________Score:______

COMMUNICATION WITH AN ANXIOUS PATIENT

DIRECTIONS: Below is a list of criteria to evaluate the students performance in
communicating with an anxious patent Indicate your evaluation by placing a
corresponding score on the Raw Score column using the following descriptive scale
of 0-3.
Raw
Score
3

Description of Performance
Performs correctly without
supervision

Performs correctly with minimal

supervision

Performs correctly with maximum

supervision

Unable to perform even under

The student completed and

performed the skill satisfactorily with
no prompts
Performs skill accurately without
prompts from instructor
Criteria of assessment and skill carried
out in correct order/sequence /step-bystep
Completes skill in set time frame
Performs skill accurately
Requires occasional (1-2 ) prompts
during performance of task
Demonstrate coordination, but uses
some unnecessary energy to complete
activity
Complete skill in reasonable time
Criteria of assessment not always
carried out in correct
order/sequence /step-by-step
The student needed minimal
assistance during the skill
demonstration
Performs but not accurately
Requires continuous (3) prompts
Demonstrates lack of skill,
uncoordinated in majority of the
behavior
Skill completed with considerable
delay (or stopped)
Unable to perform

UT-FAMS-CON/1st SEM.,S.,Y.1434-1435 (2014-2015)

Nursing NUR 404
1

Mental Health

maximum supervision

Activity
1. Introduce self appropriately, explained
purpose of interaction.
2. Assess for cues indicating patient is anxious
and factors causing patient anxiety.
3. Prepare for communication by considering
patient goal, time allocation and resources.
4. Prepare quiet, calm area, allowed ample
personal space.
5. Recognized personal level of anxiety, tried to
remain calm.
6. Had patient discuss ways to cope with
anxiety and make discussions about own
care.
7. Evaluate patient ability to discuss factors
causing anxiety.
8. Identify expected outcomes.
9. Document cause of patient anxiety and any
exhibited signs
10. Report methods used to relieve anxiety and
patient response.

Memorize only the step but did not

perform

Total Points: Actual Score X Marks = ___ X Mark (__) = Final Mark_______
Possible Score

Comments:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Students signature over printed name/ Date/ Time: __________________________

Clinical Instructors signature over printed name/ Date/ Time: ___________________

UT-FAMS-CON/1st SEM.,S.,Y.1434-1435 (2014-2015)

Nursing NUR 404
2

Mental Health