In 1987 Marjorie Gordon proposed a functional health pattern as a guide to establish a comprehensive nursing data base. A comprehensive family assessment provides a foundation to promote family health (Edelman and Mandel, 2001).There is 11 categories that provide a systematic and standardized approach to determine the aspects of health and human function. By interviewing the entire family it becomes possible to determine the functional and dysfunctional (or risky) behaviors for the individual and well as the family as a whole.
I began my interview by first creating and then asking two open-ended questions from each of the eleven functional health patterns. This tool was utilized in helping me to develop a nursing diagnosis and guide the family with an appropriate intervention for the entire family to have a healthier lifestyle. The family selected was a nuclear family of four and also friends of mine.
The father was 50 years old and worked for the state as a fire fighter and instructor with his department. The mother was 49, and a full time nurse. They had two children, a 21 year old daughter and a 19 year old son. They both lived at home. They couple has been married for 25 years this month. My assessment began with the health management and perception pattern. The family did have different views in health management. The two children thought it was less important to get regular health exams at this time in their life due to their age.
The father did smoke an “occasional” cigar but everyone in the family strongly opposed tobacco products. The 21 year old daughter did admit to drinking alcohol frequently since her 21st birthday but concluded that everyone drinks at her age. The remainder three family members avoid any alcohol consumption and think she has a drinking problem. For the nutrition and metabolic question the family reported they all eat healthy.
The parents taught them from an early age about the importance of nutrition. They prefer to eat at home together at least three times a week. The children try to avoid fast food but admit with their busy work and school schedule it is not possible. The mother and father take home prepared food to work. They also enjoy a night out alone twice a month and eat off the healthy menu. They all drink plenty of water. When it comes to sleep patterns they are all very different.
The father sleeps like a “rock”. The mother is a light sleeper and wakes up frequently though out the night. She worries periodically about her children, finances and ill parents. The son sleeps well and takes regular one hour naps after work. The daughter seldom gets more than six hours of sleep due to her after work social life. The entire family denies and bowel or urinary issues. The have regular and daily bowel movements and understand the importance of a high fiber diet and water intake to promote intestinal health.
They do not have any issues with hematuria, pain or difficult urination. It was obvious when asking the family about the importance of exercise how crucial it was to their daily routine. The daughter however has become less involved again due to her social activities. They all belong to a gym and the mother and father have been regular competitors in various events over the course of their marriage. The mother, father and son spend at least one hour every day exercising by doing a variety of cardio classes, yoga, weight training and outdoor sports.
They are very active at work, in their community and with church activities. In the cognitive and perceptual pattern the parents and children have no problems with memory or ability to focus. They are both excelling in their careers and able to process and implement any new policies or procedures required at work. They both are educators at work. He is an instructor and she is a nursing preceptor for new employees and new nursing graduates. They both devote time for continuing education for each of their own state licensure.
They all love to read for pleasure and knowledge. The mother is in school to get a higher degree. Both of the children are in college, convey a yearning for knowledge and able to maintain a B average. They all create time to stay current on political, local and national news. The parents and children are all capable of making independent and responsible decisions. The roles of each family member are very traditional.
The father is the leader and primary financial provider. He does all the yard work and repairs on the house and cars. Most family decisions are made jointly. The mother works part time and does the majority of the housekeeping and cooking. This works well for them. The primary role for the children is to work and pay their own private social ventures but most important while they live at home for free they must attend school full time and achieve a B or better average.
They have many friends, attend church, volunteer and are active in their community. They are all very confident in their self- image. They all are lean, well defined and athletic looking in appearance. They express no insecurities regarding body image issues. Out of respect for the parents and children the questions about their sexuality were done in private. They are a Christian family and believe in abstinence until marriage. They are satisfied with their sex life and admit is much better now that the kids older and not at home as much.
The mother had a tubal ligation after the second child which also contributed to a more satisfying intimate life without the worry of pregnancy. The entire family is very close and primarily leans on each other in times of stress. They have a loving extended family as well. The father teaches critical incident debriefing and stress management at work and is able to use that knowledge and skill at home. The mother is very supportive of her children. She understands they must make mistakes in order to learn about life. Both parents encourage hard work and to love your neighbor.
The love, commitment and strength of the father and mother are the reason this family is such a success in so many ways. They get their ultimate strength from their faith and devotion to God’s word. When finishing our interview the couple quoted my favorite verse. Philippians 4:13, “I can do all things through Christ which strengthens me”. The first wellness nursing diagnosis according to the Functional Health Patterns is readiness for enhanced sleep due to the mother’s inability to get a restful night of sleep. The second wellness nursing diagnosis I chose was health seeking behaviors.
The daughter was at risk for ineffective health maintenance .This was in response to the daughter’s inability to recognize and take control her excessive drinking problem. In conclusion, even though this family seemed to be healthy in so many ways this assessment too is to assist a family in developing a wellness diagnosis or diagnosis’s to achieve the maximum level of wellness possible.
- http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing%20diagnoses%20grouped%20by%20functional%20health%20patterns.pdf, Retrieved October 5, 2012
- Edelman, C. L., & Mandle, C. L. (2010). Health Promotion Throughout the Life Span (7th ed.). St. Lous, MO: Mosby