In Partial Fulfillment of the Requirement In

NCM 201 Health Assessment

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Submitted by:
Aila Kye B. Hinlog

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February 11, 2019

 Marjorie Gordon's 11 functional health patterns

Marjorie Gordon proposed functional health patterns as a guide for establishing a

comprehensive nursing data base of pertinent client assessment information (Jones,
2013). These 11 categories make possible a systematic and standardised approach to
data collection, and enable the nurse to determine the following aspects of health and
human function in order to plan required nursing care for their clients.

Consider the questions that you will need to ask your client to collect relevant and
pertinent information for each of the 11 functional health patterns. Once you have the
information, you will need to either type it directly onto this page, or type it into a
separate document and up-load that to this page.

Health perception and health management: Data collection is focused on the person's
perceived level of health and well-being, and on practices for maintaining health. Habits
that may be detrimental to health are also evaluated, including smoking and alcohol or
drug use. Actual or potential problems related to safety and health management may be
identified as well as needs for modifications in the home or needs for continued care in
the home.

Nutrition and metabolism: Assessment is focused on the pattern of food and fluid
consumption relative to metabolic need. The adequacy of local nutrient supplies is
evaluated. Actual or potential problems related to fluid balance, tissue integrity, and host
defences may be identified as well as problems with the gastrointestinal system.

Elimination: Data collection is focused on excretory patterns (bowel, bladder, skin).

Excretory problems such as incontinence, constipation, diarrhoea, and urinary retention
may be identified.

Activity and exercise: Assessment is focused on the activities of daily living requiring
energy expenditure, including self-care activities, exercise, and leisure activities. The
status of major body systems involved with activity and exercise is evaluated, including
the respiratory, cardiovascular, and musculoskeletal systems.

Cognition and Perception: Assessment is focused on the ability to comprehend and

use information and on the sensory functions. Data pertaining to neurological functions
are collected to aid this process. Sensory experiences such as pain and altered sensory
input may be identified and further evaluated.

Sleep and rest: Assessment is focused on the person's sleep, rest, and relaxation
practices. Dysfunctional sleep patterns, fatigue, and responses to sleep deprivation may
be identified.
Self-perception and self-concept: Assessment is focused on the person's attitudes
toward self, including identity, body image, and sense of self-worth. The person's level
of self-esteem and response to threats to his or her self-concept may be identified.

Roles and relationships: Assessment is focused on the person's roles in the world and
relationships with others. Satisfaction with roles, role strain, or dysfunctional
relationships may be further evaluated.

Sexuality and reproduction: Assessment is focused on the person's satisfaction or

dissatisfaction with sexuality patterns and reproductive functions. Concerns with
sexuality may he identified.

Coping and stress tolerance: Assessment is focused on the person's perception of

stress and on his or her coping strategies Support systems are evaluated, and
symptoms of stress are noted. The effectiveness of a person's coping strategies in
terms of stress tolerance may be further evaluated.

Values and belief: Assessment is focused on the person's values and beliefs (including
spiritual beliefs), or on the goals that guide his or her choices or decisions.

Health Care according to Dorothea Orem

Major Assumptions And Concepts Of The Theory

1. People should be self-reliant and responsible for their own care and others in
their family needing care
2. People are distinct individuals
3. Nursing is a form of action – interaction between two or more persons
4. Successfully meeting universal and development self-care requisites is an
important component of primary care prevention and ill health
5. A person’s knowledge of potential health problems is necessary for promoting
self-care behaviors
6. Self-care and dependent care are behaviors learned within a socio-cultural
context
A. Theory of Self-Care

This theory Includes:

Self-care – practice of activities that individual initiates and performs on their own
behalf in maintaining life, health and well being

Self-care agency – is a human ability which is "the ability for engaging in self-care" -
conditioned by age developmental state, life experience sociocultural orientation health
and available resources

Therapeutic self-care demand – "totality of self-care actions to be performed for some

duration in order to meet self-care requisites by using valid methods and related sets of
operations and actions"

Self-care requisites - action directed towards provision of self-care. 3 categories of

self-care requisites are:

1. Universal self-care requisites

a) Associated with life processes and the maintenance of the integrity of human
structure and functioning
b) Common to all , ADL
c) Identifies these requisites as:
d) Maintenance of sufficient intake of air ,water, food
e) Provision of care association with elimination process
f) Balance between activity and rest, between solitude and social interaction
g) Prevention of hazards to human life well-being and
h) Promotion of human functioning

2. Developmental self-care requisites

a) Associated with developmental processes/ derived from a condition or

associated with an event
E.g. adjusting to a new job
adjusting to body changes

3. Health deviation self-care

a) Required in conditions of illness, injury, or disease .these include:--

b) Seeking and securing appropriate medical assistance
c) Being aware of and attending to the effects and results of pathologic conditions
d) Effectively carrying out medically prescribed measures
e) Modifying self-concepts in accepting oneself as being in a particular state of
health and in specific forms of health care
 f) Learning to live with effects of pathologic conditions

B. Theory of self-care deficit

a) Specifies when nursing is needed

b) Nursing is required when an adult (or in the case of a dependent, the parent) is
incapable or limited in the provision of continuous effective self-care. Orem
identifies 5 methods of helping:
c) Acting for and doing for others
d) Guiding others
e) Supporting another
f) Providing an environment promoting personal development in relation to meet
future demands
g) Teaching another

C. Theory of Nursing Systems

a) Describes how the patient’s self-care needs will be met by the nurse , the patient,
or both
b) Identifies 3 classifications of nursing system to meet the self-care requisites of
the patient:-
c) Wholly compensatory system
d) Partly compensatory system
e) Supportive – educative system
f) Design and elements of nursing system define
g) Scope of nursing responsibility in health care situations
h) General and specific roles of nurses and patients
i) Reasons for nurses’ relationship with patients and
j) Orem recognized that specialized technologies are usually developed by
members of the health profession
k) A technology is systematized information about a process or a method for
affecting some desired result through deliberate practical endeavor, with or
without use of materials or instruments.

Orem’s Concept

The person (or patient) is the central focus of nursing care. According to Orem,
the person's health state is mediated by his/her environment. A person, who is healthy,
is capable of self-care. When there is illness in the person's health state, the person is
not able to complete all self-care requisites. When this occurs, nursing care is needed to
assist the person in completing his/her self-care. Nurses must assess the person's
ability to provide his/her own self-care and the environmental context of the person in
order to overcome health-associated limitations.
 Health Assessment according to Callista Roy

In nursing care, according to Roy (1984) as recipients of nursing care are

individuals, families, groups, society is seen as a "Holistic adaptive system" in all
aspects of a single entity.

A system is a unity which connect because of its function as a unit for some
purpose, and the interdependence of each of its parts. System consists of the input
process, output, control and feedback (Roy, 1991), with the following explanation:

Input

Roy identifies the input as a stimulus, a unity of information, materials or energy

from the environment which may cause the response, which is divided into three levels,
namely stimulus focal, contextual and residual stimuli.

Focal stimulus is a stimulus that directly deal with a person, the effect is immediate,
such as infection.

Contextual stimuli are all other stimuli experienced by a person both internal and
external influence and the situation can be observed, measured and subjectively
reported. Stimuli appear simultaneously which may cause a negative response to the
focal stimulus such as anemia, social isolation.

Stimulus residuals are additional features available and relevant to the situation
but it is difficult to observe include the belief, attitude, develop according to the
individual nature of past experience, it gives the process of learning to tolerance. For
example, the experience of pain in the waist there is a tolerance but there is not.

Control

Process control by reason Roy is a form of coping mechanisms in use. This

control mechanism is divided into regulator and kognatoryang a subsystem.

Subsystem regulator

Subsystem regulator has these components: input-and output processes. Input

internal or external stimulus. The transmitter regulators are chemical systems, neural or
endocrine. Autonomic reflex is the response of neural systems and brain and spinal
cord which passed the behavioral output of the regulator system. Many physiological
processes that can be considered as a behavioral regulator subsystem.
 Subsystem kognator

Stimulus for kognator subsystem can be external or internal. The behavior of the
regulator output subsystems can be stimulus for kognator feedback subsystem.
Kognator process control-related brain function in information processing, judgment and
emotions. Perception or process information related to the internal process in selecting
attention, noting and remembering. Learning correlated with the process of imitation,
reinforcement (reinforcement) and insight (insight). Problem solving and decision
making is internal processes associated with assessment or analysis. Emotion is the
defense to seek waivers, use judgment and compassion.

Output

The output of a system is the observed behavior DAPT, can be measured or

subjectively reported both from within and from outside. This behavior is a feedback to
the system. Roy output categorize the system as an adaptive response or a response
that is not mal-adaptive. Adaptive response can improve the overall integrity of the
person that can be seen when a person is able to carry out the objectives with regard to
survival, development, reproduction and excellence. While the mall adaptive response
behaviors that do not support this goal.

Roy has used a form of coping mechanism to describe someone as an adaptive

process control system. Some coping mechanisms inherited or genetically inherited (eg
white blood cells) as a defense system against bacteria that invade the body. Another
mechanism that can be studied such as the use of antiseptic to clean the wound. Roy
introduced the unique concept of nursing science is the control mechanism called
Regulator and Kognator and mechanisms are part sub-system adaptation.
 Maslow Hierarchy of Needs

Self-Actualization

Self-actualization is the summit of Maslow's hierarchy of needs. It is the quest of

reaching one's full potential as a person. Unlike lower level needs, this need is never
fully satisfied; as one grows psychologically there are always new opportunities to
continue to grow.

Self-actualized people tend to have needs such as:

1. Truth
2. Justice
3. Wisdom
4. Meaning

Self-actualized persons have frequent occurrences of peak experiences, which are

energized moments of profound happiness and harmony. According to Maslow, only a
small percentage of the population reaches the level of self-actualization.

Esteem Needs

Once a person feels a sense of "belonging", the need to feel important arises. Esteem
needs may be classified as internal or external. Internal esteem needs are those related
to self-esteem such as self respect and achievement. External esteem needs are those
such as social status and recognition. Some esteem needs are:

1. Self-respect
2. Achievement
3. Attention
4. Recognition
5. Reputation

Maslow later refined his model to include a level between esteem needs and self-
actualization: the need for knowledge and aesthetics.

Social Needs

Once a person has met the lower level physiological and safety needs, higher level
needs awaken. The first level of higher level needs are social needs. Social needs are
those related to interaction with others and may include:

1. Friendship
2. Belonging to a group
3. Giving and receiving love
Safety Needs

Once physiological needs are met, one's attention turns to safety and security in order
to be free from the threat of physical and emotional harm. Such needs might be fulfilled
by:

1. Living in a safe area

2. Medical insurance
3. Job security
4. Financial reserves

According to the Maslow hierarchy, if a person feels threatened, needs further up the
pyramid will not receive attention until that need has been resolved.

Physiological Needs

Physiological needs are those required to sustain life, such as:

1. Air
2. Water
3. Food
4. Sleep

According to Maslow's theory, if these fundamental needs are not satisfied then one will
surely be motivated to satisfy them. Higher needs such as social needs and esteem are
not recognized until one satisfies the needs basic to existence.

Applying Maslow's Needs Hierarchy - Business Management Implications

If Maslow's theory holds, there are some important leadership implications to

enhance workplace motivation. There are staff motivation opportunities by motivating
each employee through management style, job design, company events, and
compensation packages.

Physiological Needs: Provide lunch breaks, rest breaks, and wages that are sufficient
to purchase the essentials of life.

Safety Needs: Provide a safe working environment, freedom from threats, and relative
job security.

Social Needs: Create a feeling of acceptance, belonging, and community by reinforcing

team dynamics.

Esteem Needs: Recognize achievements, assign important projects, and provide

status to make employees feel appreciated and valued.
Self-Actualization: Provide challenging and meaningful work which enables innovation,
creativity, and progress according to long-term goals.

Sources

https://sites.google.com/site/mirandadowding3/client-health-assessment/marjorie-
gordons-11-functional-health-patterns

https://www.scribd.com/document/299216519/Dorothea-Orem

https://www.scribd.com/document/121899389/Callista-Roy-Adaptation-Theory

https://www.scribd.com/doc/14026251/Maslow-Hierarchy-of-Needs
 Narrative

My Grandfather on my mom's side died because of kidney disease. However, before

that happened they were able to build a family that i can't compare to anything and that
includes my mom. My mom met my dad because of the love that my grandparent's on
his side had but my grandmother passed due to a respiratory disease which was
inherited by my uncle which also caused his death. It's very sudden to say that my
auntie whom his wife also passed away after a month because of hypertension. As of
now, I have two siblings since my older twin brothers were both a "blue baby". It has
been hard for our parents but now together with my cousins, we live and strive hard for
the whole family. Being in line with the medical professions is an honor for our family
since it assures as a chance of living a healthy life as time goes by.