Defense Mechanisms
SOAPE
Nonverbal Communication Observations
Components of the Medical History
Diverse Patients
100

 A patient insists they don’t have a health problem despite multiple abnormal test results. This common behavior shows up in conversations with healthcare providers.

What is denial?

100

A patient begins taking ownership of their health, reporting accurate data and showing improved test results. You evaluate these outcomes in which SOAPE category?

What is the evaluation phase?

100
Patient is observed to be sighing frequently.

What is boredom?

100

The initial documentation from the patient of what may be wrong.

What is the Chief Complaint?

100

This ethnicity believes the head is sacred and will take offense by being touched on the head or shoulders.

What is Vietnamese?

200

This behavior can occur when a patient justifies not following their treatment plan, offering reasons like a busy schedule or family obligations.

What is rationalization?

200

A plan to address a patient’s habit of blaming others for their lack of progress includes creating an accountability tracker. This falls under which phase of SOAPE?

What is the plan phase?

200

Patient refuses to make eye contact, sways side to side, and tends to look down often.

What is anxiety, embarrassment, or worry?

200

Being a chain smoker for 10 years

What is Social History?

200

These actions denote femininity.

What is crying? What is sobbing?

300

You notice that a patient avoids taking responsibility for their poor diet by blaming their family for bringing unhealthy food into the home. This is an example of what coping strategy?

What is projection?

300

A patient avoids answering questions about their health history while visibly anxious and tapping their foot. This behavior is recorded in which part of SOAPE?

What is objective?

300

Patient has furrowed brows, exhibits tension, and continuous movement.

What is anger or frustration?

300

Attended regular physical therapy for 3 months as per physicians request for a  wrist that was operated on 6 months ago. 

What is Past History or Past Medical History?
300

This ethnic groups "yes" may not actually mean "yes" due to the avoidance of conflicts.

What is Laotian's?

400

During a consultation, the patient becomes frustrated about their health but redirects that frustration toward the nurse, claiming they are being “too pushy.” What is this behavior called?

What is regression?

400

 In which phase of SOAPE would you evaluate how a patient’s use of defense mechanisms, such as denial, impacts their overall understanding of their diagnosis?

What is the assessment phase?

400

Patient winces and gasps, struggles to talk normally, and breathes irregularly. 

What is pain?

400

Patients aunt was diagnosed stage 2 cancer 10 years ago, and has since recovered to become cancer free.

What is Family History?

400

These TWO ethnic groups have a less precise time understanding. 

What are Afghans and Mexicans?

500

A patient frequently minimizes their health concerns by saying, “It’s not that bad,” even when symptoms are severe. This consistent reliance on avoidance impacts their care.

What is denial?

500

A patient says, “I’m fine, just a little tired,” when asked about their overall health. This falls into which part of SOAPE?

What is subjective?

500

Patient is frowning, exhibits signs of previously crying, speaks softly, and maintains closed off body language.

What is sadness, fear, or distrust?

500

Physician checks and notes that the patient has difficulty breathing, complains of chest pain, and has an ache in her back.

What is systems review or review of systems?

500

These TWO ethnic groups may not look into the eyes of the person being addressed because long eye contact indicates disrespect and is impolite.

What are Cambodians and Laotian's?

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