Gordon's 11 Functional Health Patterns

1. Health Perception and Health Management.

2. Nutrition and Metabolism
3. Elimination
4. Activity and Exercise.
5. Cognition and Perception.
6. Sleep and Rest.
7. Self-Perception and Self-Concept.
8. Roles and Relationships.
9. Sexuality and Reproduction.
10. Coping and Stress Tolerance.
11. Values and Belief.
Describes the client’s perceived health &
well being and how health is managed.

HEALTH PERCEPTION &

MANAGEMENT
•History (subjective data):

•Client’s general health? What is your opinion about your health?

•Any colds in past year? Do you have any allergies? If yes what type of
allergy?
•If appropriate: any absences from work/school?
•Most important things you do to keep healthy?
Use of cigarettes, alcohol, drugs?
•Perform self exams, i.e. Breast/testicular self-examination?
•Accidents at home, work, school, driving?
•In past, has it been easy to find ways to carry out doctor’s or nurse’s
suggestions?

HEALTH PERCEPTION & MANAGEMENT

• (If appropriate) What do you think caused current illness?
• Are you using any medicine lately?
• What actions have you taken since symptoms started?
• Have your actions helped?
• (If appropriate) What things are most important to your
health?
• How can we be most helpful? done exercise every what?
 This pattern describes food and fluid
consumption relative to metabolic need &
pattern indicators of local nutrient supply.

NUTRITIONAL/ METABOLIC
History (subjective data):

• Typical daily food intake including snacks?

• Use of supplements, vitamins?
• Typical daily fluid intake?
• Weight loss/gain? Height loss/gain?
• Appetite?
• Any food restrictions?
• Breastfeeding? Infant feeding?
• Food or eating: Discomfort, swallowing difficulties, diet restrictions,
able to follow?
• Healing – any problems? Skin problems: lesions? Dryness? Dental
problems?
NUTRITIONAL/ METABOLIC
• Examination (examples of objective data):
• Skin assessment, oral mucous membranes, teeth,
actual weight/height, temperature. Abdominal
assessment.
DIET RECALL
M T W TH F SA SU

Breakfast
(include time of meal)
Snack
Lunch
Snack
Dinner
Snack
ELIMINATION

Describes the pattern of excretory function

(bowel, bladder, skin).
ELIMINATION

History (subjective data):

• Bowel elimination pattern (describe) Frequency, character,
discomfort, problem with bowel control, use of laxatives
(i.e. type, frequency), etc.?
• Urinary elimination pattern (describe) Frequency, problem
with bladder control?
• Excess perspiration? Odour problems? Body cavity
drainage, suction, etc.?
• Are you using any laxative? If yes which?
 ACTIVITY/ EXERCISE

This pattern describes activity level,

exercise program, and leisure activities.
 ACTIVITY/ EXERCISE
History (subjective data):
• Sufficient energy for desired and/or required
activities?
• Exercise pattern? Type? regularity?
• Spare time (leisure) activities?
• Child-play activities?
• Perceived ability for feeding, grooming, bathing,
general mobility, toileting, home maintenance, bed
mobility, dressing and shopping?
Examination (examples of objective data):
 Examination (examples of objective data):

• Demonstrate ability for the following criteria:

• Gait. Posture. Absent body part. Range of motion
(ROM) joints. Hand grip - can pick up pencil?
• Respiration. Blood pressure. General appearance.
• Musculoskeletal, cardiac and respiratory
assessments.
• The do experience any breathing problem with
activities of daily living?
• Any changes in heart beat during exercise?
MONDAY, NOV. ACTIVITIES
7
5:00 am Woke up
5:30 am Ate Breakfast
6:00 am Took a bath
6:30 am Dress up for school
7:00 am Walked to school
7:45 am Reached school
Etc.
Until sleeping
time
ACTIVITY DIARY/RECALL
 SLEEP/REST

Describes patterns of sleep, rest, and

relaxation.
 SLEEP/REST
History (subjective data):
• Generally rested and ready for activity after sleep?
• Sleep onset problems? Aids? Dreams (nightmares), early
awakening?
• Rest / relaxation periods?
• Sleeping Hour/ do you have any naps during the day
• Are you using any medication for sleeping?
Examination (examples of objective data):
• Observe sleep pattern and rest pattern if applicable
• Dark circles around the eyes, eye bags, yawning, inability to
 M T W TH F SA SU

Time went to bed

Approximate time fell asleep

Wake up period/ sleep interruptions (how

long)
Time woke up the next morning

Feeling after waking up

Naps(time slept & woke up; duration)

Activities done before bedtime

Bedtime rituals

SLEEP DIARY
COGNITIVE/PERCEPTUAL

Describes the ability of the individual to

understand and follow directions, retain
information, make decisions, and solve
problems. Also assesses the five senses.
 COGNITIVE/PERCEPTUAL
History (subjective data):
• Hearing difficulty? Hearing aid?
• Vision? Wears glasses? Last checked? When last changed?
• Any change in memory? Loss? Concentration?
• Orientation about time place and person.
• Important decisions easy/difficult to make?
• Easiest way for you to learn things? Any difficulty?
• Any discomfort? Pain? COLDSPA C - Character O - Onset
L - Location D - Duration S – Severity P - Pattern A -
Associated factors (Weber, 2003)
Examination (examples of objective data):
Orientation.
• Hears whispers? Reads newsprint?
• Grasps ideas and questions (abstract, concrete)?
• Language spoken. Vocabulary, level of Attention
span.
SELF PERCEPTION/SELF CONCEPT

Describes client’s self-worth, comfort,

body image, feeling state.
 SELF PERCEPTION/SELF CONCEPT
History (subjective data):
• How do you describe yourself?
• Most of the time, feel good (or not so good) about
self?
• Changes in body or things you can do? Problems
for you?
• Changes in the way you feel about self or body
(generally or since illness started)?
• Things frequently make you angry? Annoyed?
Fearful? Anxious? Depressed?
• Not able to control things? What helps?
• Ever feel you lose hope?
• Examination (examples of objective data):
• Eye contact. Attention span (distraction?).
• Voice and speech pattern.
• Body posture.
• Do you like grooming?
• Are you satisfied with your self-body image?
• Client nervous (5) or relaxed (1) (rate scale 1-5)
Client assertive (5) or passive (1) (rate scale 1-5)
 ROLES/RELATIONSHIP
History (subjective data):
• Live alone?
• What is your role in the family
• Family? Family structure? Any family problems you
have difficulty handling (nuclear/extended family)?
Family or others depend on you for things? How
well are you managing?
• If appropriate – How families/others feel about your
illness?
• If you are in hospital the who will perform your
responsibilities?
• Examination (examples of objective data):
• Interaction with family members or others if present.
• Problems with children?
• Belong to social groups?
• Close friends? Feel lonely? (Frequency)
• Things generally go well at work / school?
• If appropriate – income sufficient for needs?
Feel part of (or isolated in) your neighborhood?
 SEXUALITY/REPRODUCTIVE
History (subjective data):
• If appropriate to age and situation – Sexual relationships satisfying?
Changes? Problems?
• If appropriate – Use of contraceptives? Problems?
• Female – when did menstruation begin? Last menstrual period (LMP)?
Any menstrual problems?
• (Gravida/Para if appropriate)
Examination (examples of objective data):
• None unless a problem is identified or a pelvic examination is
warranted as part of full physical assessment (advanced nursing skill).
• Do you have any sexual problem? Loss of libido?
VALUE/BELIEF PATTERN

Describes the patterns of values, beliefs

(including spiritual), and goals that guides
the client’s choices or decisions.
 COPING/STRESS TOLERANCE
History (subjective data):
• Any big changes in your life in last year or two?
Crisis?
• Who is most helpful in talking things over? Available
to you now?
• Tense or relaxed most of the time? When tense,
what helps?
• Use any medications, drugs, alcohol to relax?
• When (if) there are big problems in your life, how do
you handle them? Most of the time, are these ways
successful?
 VALUE/BELIEF PATTERN
History (subjective data):
• Generally get things you want from life?
• Important plans for future?
• Religion important to you? f appropriate - Does this
help when difficulties arise?
• If appropriate – will being here interfere with any
religious practices?
• Health beliefs/values?
 COMPLETE
HEALTH HISTORY
8 Sections of a Complete Health History

• Biographic data
• Reasons for seeking health care (Chief Complaint)
• History of present health concern
• Past health history
• Family health history
• Review of systems for current health problems
• Lifestyle and practices profile
• Developmental level
BIOGRAPHIC DATA

• Includes information that identifies the client

– E.g. name, address, phone number, gender etc.

– Source of data:
• Client or significant others
 REASON(S) FOR SEEKING HEALTH
CARE
• Also known as Client’s Chief Complaint (CC)

• We aim to determine the following:

– What brought the client to seek health care
– The feelings of the client about seeking health care

• Can be assessed by asking the following questions:

– “What is your major health problem or concerns at this time?”
– "How do you feel about having seeking health care?”
 “What is your major health problem or
concerns at this time?”

• Assist the client to focus on his most

significant concern

• Other questions like, “ Why are you here?”

and “How can I help you?” can also be asked

– Reminder: use holistic approach in phrasing

questions, draw out concerns that are beyond
just a physical complaint and address other
associated factors like stress or lifestyle
 "How do you feel about having seeking
health care?”

• Encourages the client to discuss fears or

feelings about having to seek health care
advice.

• May help in determining descriptions of past

experiences—both positive and negative—
with other health care worker
HISTORY OF PRESENT HEALTH
CONCERN

• takes into account several aspects of

client’s current health concern

• includes questions that provide detailed

descriptions of the client’s health problem
Encourage the client to explain:

• health problem or symptom focusing on onset,

progression and duration
• signs and symptoms and related problems
• what the client perceives as causing the
problem/symptom
• what makes the problem worse
• what makes the problem better
• which treatments have been tried
• what effect the problem has had on daily life
• what is the client’s ability to provide self-care
TIP: USE MNEMONICS

• To gather a comprehensive
history of present concern as a
nurse you may use the following
mnemonic to organize data:

• PQRST or COLDSPA
Precipitating factors
(What brought about the
pain? What do you do to
be relieved?)
Quality/character (What
the pain feels like? Piercing?
Scalding? Crushing?
Unbearable? Killing?
Intense?, How does it look
like?)
Region/Radiation (Where
do you feel the pain?)
Severity (Use rating scale
0-10/ 1-10)
Time/duration ( How long
it lasts?)
Character (how does it feel,
look, smell, sound?)
Onset (When did it begin: is it
better, worse, or same since it
began?)
Location/radiation (Where is it?
Does it radiate?)
Duration (How long it lasts?
Does it recur?)
Severity (use rating scale)
Pattern (What makes it better,
worse?)
Associated factors (What other
symptoms do you have with it?
Will you be able to continue
doing your work or other
activities ?)
 PAST HEALTH HISTORY

• elicit data related to the client’s strengths and

weaknesses in his health history
– Physical, social, emotional or
spiritual
• may also include trends of unhealthy
behaviors
– Vices or lack of physical activity
• data obtained in this section aids the nurse
to identify risk factors that stem from
previous health problems (risk factors may
be to the client or significant others)
Past Health History
includes questions about...
• birth, growth and development
• childhood diseases
• immunizations
• allergies
• previous health problems
• hospitalizations and surgeries
• pregnancies
• births
• previous accidents and injuries
• pain experiences
• emotional or psychological problems
 FAMILY HEALTH HISTORY

• focuses on health problems that

seem to run in families or those
that are genetically based
• should include as many genetic
relatives as the client can recall
• include maternal and paternal
grandparents, aunts and uncles
on both sides, parents, siblings
and the client’s children
 FAMILY HEALTH HISTORY
• drawing a genogram helps to organize and illustrate the client’s family
history
• use a standard format
• provide a key for the entries
– female relatives: circle
– male relatives: square
– deceased relative: marking an X in the circle or square and listing the age
at death
– cause of death noted inside a parenthesis e.g. (heart failure )
– AW (Alive and well) should be placed next to the age
– Straight or vertical lines to denote relationship
– Horizontal doted line to indicate client’s spouse
– Vertical dotted line to indicate adoption