Gordon's Functional Health Pattern (Form)

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Gordon’s Functional Health Patterns Assessment

1. Health Perception Health Management


Before hospitalization:
The patient had regular vitamins and exercises through playing. She received vaccines
right on the given time.

During hospitalization:
The patient takes her medications as prescribed.

2. Nutritional-Metabolic Pattern
Before hospitalization:
The patient has no known allergies. She eats very well – breastfeed, complementary
foods.

During hospitalization:
The patient had a decreased appetite but it slowly turning back.

3. Elimination Pattern
Before hospitalization:
The patient had a normal urinary elimination with diaper changed, 3 or more times per
day. Her fecal elimination happens once or twice a day.

During hospitalization:
The patient has normal urinary elimination. At the start of her hospitalization, she had fecal
elimination every now and then.

4. Activity-Exercise Pattern
Before hospitalization:
The patient plays with her friends with maximum energy.

During hospitalization:
The patient plays but at a minimal level due to hospital conditions.

5. Sleep-Rest Pattern
Before hospitalization:
The patient had enough of sleep everyday, with one naps, one in the afternoon, and sleep
at the evening.

During hospitalization:
The patient had a disturbed sleep pattern due to hospital conditions..

6. Cognitive-Perceptual Pattern
Before hospitalization:
The patient can see, hear, and smell clearly. She communicates well with her parents with
words and sounds that she can do. She remembers faces of her relatives and playmates
very well.
During hospitalization:
The patient can still see, hear, and smell clearly. She still communicates well with her
parents with words and sounds that she can do. She also still remembers faces of her
relatives and playmates very well.

7. Self-Perception – Self-Concept Pattern


Before hospitalization:
The patient had a good posture, maintains eye contact when relaxed, and had a normal
tone of when speaking or making sounds.

During hospitalization:
The patient still had a good posture, maintains eye contact when relaxed, and had a
normal tone of when speaking or making sounds.

8. Roles-Relationship Pattern
Before hospitalization:
The patient has a good relationship with her family and playmates and socializes well with
others.

During hospitalization:
The patient still has a good relationship with her family and playmates and socializes well
with others except healthcare providers.

9. Sexuality-Reproductive Pattern
Before hospitalization:
N/A

During hospitalization:
N/A

10. Coping-Stress Tolerance Pattern


Before hospitalization:
The patient cries when she’s not able to play or when hungry. It is managed through
feeding her and giving her a toy.

During hospitalization:
The patient still cries over hunger and insufficient play and it is still managed through
feeding her and giving her a toy.

11. Values-Beliefs Pattern


Before hospitalization:
The patient is brought by her family to church every other day.

After hospitalization:
Due to hospitalization, the patient can’t be brought to church.

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