Practice Consideration
The greatest amount of information will usually be generated by using open-ended questions followed by reflections of what the patient has shared. Open-ended questions require more thought and more than a simple one-word answer. Often this creates a gateway to conversations.
| CLOSE ENDED QUESTIONS |
If you can answer a question with only a "yes" or "no" response, then you are answering a closed-ended type of question.
Examples of closed-ended questions are:
- Do you drink milk?
- How much milk do you drink?
- Do you eat out often?
- Do you exercise?
- How many times per week do you exercise?
- Who does the cooking at your house?
- Who does the grocery shopping?
- Has your doctor told you about your medical condition?
Closed-ended questions should not always be thought of as simple questions that anyone can quickly answer merely because they require a yes or no answer. Closed-ended questions can also be very complicated.
For example, "Which of these 4 formulas will provide 2500 kcal, 120 g protein in less than 1500 ml?
| OPEN-ENDED QUESTIONS |
Open-ended questions are ones that require more than one-word answers. The answers could come in the form of a list, a few sentences or something longer such as a speech, paragraph or essay.
Here are some examples of open-ended questions:
- How do you include milk in your diet?
- Tell me what happens when you eat out?
- What do you do to keep active?
- How would you describe your level of physical activity?
- Tell me about cooking in your house?
- How do you plan meals at your house?
- Describe your grocery shopping?
- What do you know about your medical condition?
Although open-ended questions require lengthier responses than closed-ended questions, open-ended questions are not always more complicated.
For example, asking "What are you planning to have for supper this evening?" may simply require the respondent to read off of a list.
| WHEN TO USE QUESTIONS |
Either type of question can be used in a wide variety of scenarios. Sometimes you really just need a yes or no question. However, if you want a full picture of the situation, for example, dietary intake, you will generally want more open-ended than closed-ended to avoid peppering the patient with Yes and No questions. See the two examples below that show how to elicit basically the same information using primarily open-ended or close-ended questions.
1.Describe what and how much you usually have for breakfast (open-ended)
Response: I generally have one egg, a slice of toast, juice, milk and coffee
2. How is your egg prepared (open-ended)
Response: usually hard boiled
3. What do you put on your toast (open-ended)
Response: a small amount of jelly
4. Describe the amount and type of beverages you drink (open-ended)
Response: usually have one 8 oz glass of either skim or 1% and one same size glass of juice
5. Do you use cream or sugar in your coffee (close-ended)
Response: just enough milk to lighten the coffee
OR
1. Do you have meat or eggs for breakfast? (close-ended)
Response: Yes, usually eggs not meat
2. How many eggs do you have? (close-ended)
Response: Usually one
3. Are the eggs/meat prepared with fat? (close-ended)
Response: No it is hard-boiled
4. Do you eat any cereal products? (close-ended)
Response: Yes, toast
5. How much toast do you have? (close-ended)
Response: 1 slice
6. Do you put anything on your toast? (close-ended)
Response: Just a little jelly
7. Do you drink whole fat milk? (close-ended)
Response: No, usually skim of 1%
8. Do you have fruit or fruit juice for breakfast? (close-ended)
Response: Yes about 8 oz juice
9. How much milk do you drink? (close-ended)
Response: One 8 oz glass
10. Do you drink coffee? (close-ended)
Response: Yes
11. Do you put anything in it? (close-ended)
Response: Yes, a little milk, just to lighten it
You will notice that the when using mostly close-ended questions you often have to ask more questions to get the same information as shown in the example above.