Reflective questions in health counseling

This study explores questions that nurses ask patients in order to awaken reflection on their health behavior in health counseling. Thirty-eight counseling situations were videotaped in a hospital. The data were analyzed using conversation analysis which was adapted for the purpose of this study. Nonverbal communication supported speech and was interpreted alongside it. This study found that nurses used only a few reflective questions, most of which were future-oriented or introduced hypotheses. In a nonreflective discussion, nurses used only check-up and alternative questions to get information about patients' illnesses and health care measures. Findings indicated that reflective conversation began with check-up questions about patients' immediate situation, followed by questions about patients' feelings in the past, present, or future. On the third level of questioning, the structure might vary between embedded questions, check-up, alternative, or feeling questions. Nonverbal communication supported the discussion. Reflective questions tended to ensure patient-centered conversation and might improve the effectiveness of health counselling.