GORDON'S FUNCTIONAL HEALTH PATTERNS

Advanced by Marjorie Gordon in 1982 as a guide for establishing and organizing a

comprehensive nursing data base

It is a holistic assessment that provides information from a nursing rather than a

medical perspective.
It has patterns of human function in 11 categories that address physical,
psychological, spiritual and social needs.
The 11 categories facilitate systematic and standardized approach to data collection,
and enable the nurse to determine the aspects of health and human function
Rather than treating the illness or disease, nursing care is aimed at maintaining or
improving the client’s functional status in each of the 11 areas
Clustering of data by functional health patterns helps the nurse identify problems
responsive to nursing intervention and assign appropriate nursing diagnoses to
dysfunctional patterns.
The Functional Assessment Format developed for organizing a complete client
assessment is based on:
1.objective findings,
2.the client’s subjective
3.knowledge of his health problems
4.additional information from related sources.
All human beings have in common certain functional patterns that contribute to their
health ,quality of life and achievement of human potentials
These common patterns are the focus of nursing assessment
Description and evaluation of health patterns permit the nurse to identify functional
patterns
( client' strengths )and dysfunctional patterns(nursing diagnosis)
The format addresses and reflects concepts of holism
What is a health pattern?
A pattern-A configuration of behavior that occur sequentially over a period of
time rather than isolated events.
Health patterns is a manifestation of the whole. Each pattern is
Biopsychosocial-spiritual expression.
They are the data used for clinical inference and judgments
For each pattern, combine subjective and objective data to identify diagnosis
and etiological /contributing factors.
Health is measured by parameters and norms in combination with a subjective
client description.
Health-Defined within the context of functional health patterns is the optimum
level of functioning that allows individuals ,families and communities to develop
their potentials to the fullest

Summary of functional health patterns

1.Health Perception-health Management Pattern
2.Nutritional-metabolic Pattern
3.Elimination Pattern
4.Activity-exercise Pattern
5.Sleep-rest Pattern
6.Cognitive-perceptual Pattern
7.Self-perception and Self-concept Pattern
8.Role Relationship Pattern
9.Sexuality-reproductive Pattern
10.Coping-stress Tolerance Pattern
11.Value-belief Pattern

Advantages
Guides collection of information on client ,client’s family and community
As a format for organizing assessment data and as a corresponding structure for
grouping and leading directly to nursing diagnosis
Encompasses a holistic approach and Incorporates the concepts of client –
environment interaction
FHP can be used as;
a system for organizing clinical knowledge-Courses or curricula using these patterns
have been organized in a number of educational programmes.
a system for organizing clinical literature and as topics for clinical research on health
patterns.

1. Health Perception-health Management:

Data collection is focused on the person's perceived level of health and well-being, and
on practices for maintaining health. 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.
Describes the client’s perceived pattern of health and well being and how her/his
health is managed.
It includes the client’s perception of his/her health status and its relevance to current
activities and future planning
Habits that may be detrimental to health are also evaluated, including smoking and
alcohol or drug use
It also includes the general level of health care behavior
Promotional activities
Self examinations-breast , testicular exams
Preventive practices
Medical and nursing perceptions
Follow up care.
The focus is the individual ,family and community perceived level of health, well-
being and practices for promoting and maintaining health
Assessment of functional health perception-health management patterns
Individual assessment
History
How has general health been
Previous and current health problems and diseases
Activities for promoting and maintaining health
Perceptions on causes of previous and current health or disease status
Examination-General health status

Family assessment
History & Examination

Community assessment
History & examination
Sample NANDA-I nursing diagnosis
Health Maintenance, Ineffective
Infection, Risk for
Injury, Risk for
Risk for injury, Suffocation
Risk for injury, Poisoning
Management of Therapeutic Regimen (Individual, Family, Community), Ineffective
Management of Therapeutic Regimen, Readiness for Enhanced
Surgical Recovery, Delayed

2. 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, feeding difficulties tissue integrity, and host
defenses may be identified as well as problems with the gastrointestinal system.
Assessment objective
to obtain data about typical pattern of food and fluid consumption
Identify gross indicators of metabolic need
Individual assessment
History
Typical daily food and fluid intake
Weight loss/gain
Height
Discomforts with eating ,swallowing
Diet preference or restrictions
 Appetite
Skin problems /lesions and healing of wounds
Dental problems

Examination
Skin
Bony prominences
Oral mucous membranes
Teeth
Actual weight and height
Anthropometric measurements
Temperature
Parenteral /enteric feeding modes

Sample Nutritional Metabolic Patterns NANDA Nursing Diagnoses

Risk for Infection
Impaired Oral Mucous Membranes
Risk for Impaired Skin Integrity
Impaired Swallowing
Ineffective Thermoregulation
Impaired Tissue Integrity
Risk for Aspiration

Risk for Imbalanced Body Temperature

Feeding Self-Care Deficit
Fluid Volume Excess
Risk for Deficient Fluid Volume
Hyperthermia
Imbalanced Nutrition: Less than Body
3. Elimination:
Data collection is focused on patterns of (bowel, bladder, skin) functions. Excretory
problems such as incontinence, constipation, diarrhea, and urinary retention may be
identified.
Individual assessment
History
Bowel elimination-frequency ,character,discomfort,use of laxatives
Urinary elimination-retention
Excessive perspiration
Body cavity drainage-suction
Examination-If indicated-Excreta amount & characteristics

Family & community

Elimination Patterns NANDA Nursing Diagnoses-Examples
 Bowel Incontinence
Constipation
Risk for Constipation
Impaired Urinary Elimination
Functional Urinary Incontinence
Risk for Urge Urinary Incontinence
Toileting: Self-Care Deficit

4. Activity and Exercise:

Assessment is focused on the activities of daily living requiring energy expenditure,
including self-care activities, exercise, recreation and leisure activities.
The status of major body systems involved with activity and exercise is evaluated,
including the respiratory, cardiovascular, and musculoskeletal systems
Individual assessment.
History
sufficient energy for required activities
Exercises
Recreational activities
Perceived ability for ADLs-functional level assessment

Level 0:Full self care

Level 1:Requires use of equipment
Level1:Requires assistance or supervision
Level 11:Requires assistance from another and use of equipment device
Level IV:Is dependant and does not participate
Examination
Demonstrated ability to perform ADLs
Gait
Posture
Range of motion-joints
Muscle strength
Blood pressure
Pulse and respirations
General appearance(grooming, Hygiene ,energy level)
Activity-exercise Patterns NANDA Nursing Diagnoses
Activity Intolerance
Risk for Activity Intolerance
Bathing/Hygiene Self-Care Deficit
Dressing/Grooming Self-Care Deficit
Ineffective Breathing Pattern
Ineffective Airway Clearance
Impaired Gas Exchange
Risk for Peripheral Neurovascular Dysfunction
 Impaired Tissue Integrity
Ineffective Tissue Perfusion
Impaired Spontaneous Ventilation

5. Cognition and Perception:

Describes sensory-perceptual and cognitive adequacy.
Assessmentisfocusedonthesensoryfunctionsandabilitytocomprehendanduseinformati
on.
Data pertaining to functions of the sensory modes, pain and cognitive abilities are
obtained are collected.
Individual assessment
History
Hearing difficulty, hearing aids
Vision-use of glasses
Any change in memory
Ability to make decisions
learning difficulties

Examination
MSE
Hearing tests
Tests of vision
Reading tests
Language spoken
Cognitive-perceptual Patterns NANDA Nursing Diagnoses-examples
Acute Confusion
Decreased Intracranial Adaptive Capacity
Impaired Verbal Communication
Acute Pain
Unilateral Neglect
Risk for Peripheral Neurovascular Dysfunction
Ineffective Protection
Disturbed Sensory Perception
Disturbed Thought Processes
Decisional Conflict

6. Sleep and Rest.

Assessment is focused on the person's sleep, rest, and relaxation practices.
The objective is to describe effectiveness of the pattern from the client’s perspective
Data on sleep characteristics during 24-period is collected include whether the client
feels rested
Dysfunctional sleep patterns, fatigue, and responses to sleep deprivation may be
identified.
Individual assessment
History
Sleep onset problems
Sleeping aids
Early awakening
Rest-relaxation periods
Sleep interruptions-dreams
Generally rested and ready for daily activities
Examination
Sleeping times & presence of sleep pattern reversal
Interruptions during sleep
Prescribed nocte drugs
Sample NANDA nursing diagnosis
Sleep, Readiness for Enhanced
Sleep Deprivation
Sleep Pattern, Disturbed

7. 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.
Individual assessment
History
Clients feelings towards self most of the time
Changes in body or things client can do
Changes in ways client feels about self or image since illness started
Sources of anger, annoyance, fearful
Any hopelessness
Examination
Eye contact
Voice and speech patterns
Body posture
Assertiveness
Signs of identity confusion
Self-perception And Self-concept Pattern-Sample NANDA nursingdiagnosis
Body Image, Disturbed
Death Anxiety
Loneliness, Risk for
Personal Identity, Disturbed
Powerlessness, Risk for and Actual
Self-Concept, Readiness for Enhanced
Self-Esteem, Chronic Low, Situational Low,
Risk for Situational Low
 Self-Mutilation, Risk for and Actual

8. Roles and Relationships:

Assessmentisfocusedontheperson'srolesengagementandrelationshipswithothers.
Includes perception of the current major roles and responsibilities
Satisfaction with roles, role strain, ordysfunctional relationships within the family and
socially may be identified.
Individual assessment
History
Living alone
Family structure
Difficulty inhandling family problems
Feeling of family members about client’s illness
Difficulty handling children
Social group membership and positions held
Income in relationship to needs
Feeling part of the family, friends, neighborhood or isolated
Examination
Interactions-family,relatives,workmates
Sample NANDA Nursing Diagnosis
Caregiver Role Strain, Risk for and Actual
Communication, Readiness for Enhanced
Family Process, Interrupted
Family Process, Readiness for Enhanced
Parent, Infant, and Child Attachment, Impaired, Risk for
Parenting, Impaired, Risk for and Actual
Parental Role Conflict
Parenting, Readiness for Enhanced

9. 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.
Individual assessment
History-consider age and situation
Sexual relationships and whether satisfying, any Changes
Use of contraceptives
Menarche and menopause / andropose
LMP, dysmenorrhea,parity
SGBV

Examination-Antenatal, pelvic examination & genital examination if appropriate

Sexuality and reproduction sample NANDA nursing diagnosis
Rape-Trauma Syndrome: Compound Reaction
 And Silent Reaction
Sexual Dysfunction
Sexuality Patterns, Ineffective

10. Coping and Stress Tolerance:

Assessmentisfocusedontheperson'sperceptionofstressandonhisorhercopingstrategies.
Includes ability to exert a sense of control over threat to integrity

Individual assessment
History
Anybigchangesintheclient’slifeinthelastyearandfollowingpreviouscrisis
The most helpful person in times of stress &Confidants
Use of stress-relieving drugs
Ways of handling stressful issues and their effectiveness
Sampl e NANDA nursing Diagnosis
Adjustment, Impaired
Coping, Readiness for Enhanced
Family Coping, Compromised and Disabled
Individual Coping, Ineffective
Coping, Defensive
Denial, Ineffective

11. Values and Belief.

Assessment is focused on the person's values and beliefs (including spiritual beliefs),
or on the goals that guide client’s choices or decisions.
It includes what is perceived as important in life and perceived conflicts in values,
beliefs or expectations that are health related.
Individual Assessment
History
important plans for the future
Religion important in life
Health actions that contradict beliefs

Sample NANDA nursing Diagnosis Value-belief Pattern

Impaired Religiosity, Risk for and Actual
Spiritual Distress, Risk for and Actual
Spiritual Well-Being, Readiness for Enhanced

REFERENCES AND FURTHER READINGS

FullerJillAyers-SchellerJenipher:HealthAssessmentaNursingApproach.J.B.-
Lippincottcompany
GordonMarjory-Nursing Diagnosis: process & applications Mosby