Nurses, in order to practice effectively, must assess consciously and unconsciously to determine the needs of the client (McCain, 1965, pg. 82). The functional abilities of the patient are selected based on the assessment. Marjorie Gordon proposed functional health patterns as a guide to provide a comprehensive nursing assessment of the patient (Gordon, 1994). Gordon’s health patterns are categorized into 11 possible approaches to collect data and assist the nurse to determine aspects of health and human function.
Its intension is to assist with utilizing the nursing process. The functional health patterns categories capture the holistic, spiritual, emotional and social aspects of the whole person. Health perception and health management pattern is relative to the patient’s perceived health status and practices used to reach his/her current level to well-begin. Nutritional-Metabolic pattern describes nutritional intake relative to metabolic needs.
Elimination patterns focused on bowel, bladder or skin assessment and function. Activity and exercise pattern assessment centers on activity level and energy levels needs to perform activities of daily living. Cognitive-perceptual pattern focuses on the patient’s ability to follow and understand directions, ability to comprehend and use information. Sleep and rest pattern describes pattern of sleep, rest and relaxation. Self-perception, self-concept patterned assessment of body image and self-worth. Role-relationship pattern is focus on the patient’s role within the family and relationships.
Sexual-reproductive assessment is focused on sexual relationships and reproductive history. Coping and stress tolerance assessment describes general coping patterns and effectiveness of the pattern in terms of stress tolerance. Lastly, value-belief pattern assessment includes religious beliefs and value system (Edelman, 2010). The family assessment of the Filipino client proved uneventful and interesting.
The questions asked from the functional health patterns address health beliefs-perceptions, nutrition and role relationships. Filipinos spend a lot of the time working. Preventive health care usually take a backseat. They live to self-diagnosis, self-medicate and seek alternative care.
Home remedies in the form of medicinal herbs are believed to heal common aliments (Ordonez, 2004, pg.25). This practice prevents early treatment and diagnosis. Some believe in “soul loss” and that sleep related to the wandering of the soul out of the body known as “bangungot” of nightmares after a heavy meal may result in “death” (Ordonez, 2004, pg.25). Health prevention among the Filipinos almost always begins with self-monitoring of the symptoms.
This is done not to cause an economic or emotional inconvenience to the family. Severe symptoms such as pain or physical impairment would motivate one to seek advice from a trusted friend or family member in the healthcare field (Becker, 2003, pg.113.). Screening programs such as mammograms, pap smears, blood test for cholesterol and glucose maybe delayed or rejected in fear of “external forces”(Ordonez, 2004, pg. 25).
Older women who are active in the church tend to participate in promotional programs and screenings. The answer to questions about health belief and perception from the client was generalized. She felt that her “health could be better”. The second question asked addressed nutrition. Nutrition in the Filipino culture has strict eating patterns.
They eat three meals a day and snacks two time between the day meals. Nutrition pattern assessment of the client revealed a typical cultural diet that could cause weight gain and health problems. Food is seen as gift from God. Watching one’s diet is viewed as an important component of healthy living. Food is very important to the Filipino culture as it symbolizes sharing and reciprocity.
Relationships are developed at the dinner table (Ordonez, 2004, pg.26). Meals are always served to guest, refusal to eat is a form of rejection. Rice is viewed as proper, complete and healthy even though it is high in carbohydrates. This poses a problem since diabetes is a very common among within the culture.
They view rice as “energy” (Ordonez, 2004, pg. 26). Vinegar, coconut milk, lime, tamarind, garlic, ginger, onion and pepper are key ingredients. In the United States, Filipino’s frequent at fast food chains and take-out restaurants that are usually reserved for the wealthy in their county. Obesity is visual evidence of good economic status.
Being fat means one is healthy and financially able to care for your children. Others may view it as begin “lazy and fat” (Ordonez, 2004, pg. 26). The third question addressed the role of relationship pattern was typical of the Filipino family. The client stated that she was the principle breadwinner of the family but her husband is the head of the household.
Filipinos highly value the presence of family and remain the basic unit of their society (McBride, 2000, pg.10). The father is considered the head and provider. The mother takes responsibility of the domestic chores, growth and values formation of the children. The children view the mother as calm and soft. Father is regarded as eminent figure in the family (McBride, 2000, pg.10). Parents would prefer adult children stay at home for fear of letting go. There is a strong respect for elders and are given the highest respect from children. Disrespect for one another is not tolerated (McBride, 2000, pg.11).
Divorce is prohibited in the Philippines. It is seen as an infringement of a woman’s liberty to get out of a bad marriage or as a protection against abandonment and loss of support. Filipino women in particular hold important positions in their country such as judges, administrators, and heads of companies. Financial statuses vary greatly, but the structure remains the same. The grandparents live in the same household in order to care for their grandchildren. The client, in the interview, allowed her parents to stay for long periods of time to assist with child care. She had 2 young children, age 2 and 4.
The wellness diagnoses focus on the client’s readiness to advance from the current health status to a higher level of well-being. To have a wellness diagnosis, two cues are present: a desire for increase wellness and effective present status or function (Carpenito-Moyet, 2008, pg.17). Interventions focus on attainment of a new health behavior.
The wellness diagnosis identified with health perception-health management pattern is health seeking behavior. It indicates that the client expressed a desire to learn more disease prevention. Ways to access more health information could come from the physician, wed sites, brochures, and/or other people with the same conditions. She verbalized a desire to manage diabetes and hypertension with conventional therapy. The second wellness diagnosis is associated with nutritional-metabolic pattern: readiness for enhanced nutritional metabolic pattern.
She expresses a desire to change her nutritional choices and choose adequate foods to promote a better well-being. Referral to web sites associated with nutrition and diabetes requested. The final wellness diagnosis is associated with role-relationship pattern: Readiness for enhanced relationship. She expresses a desire to show a greater appreciation and respect for her parents. They live in the same household, provide childcare and cook for the family.
In conclusion, functional health patterns provide a guideline for initial assessment and date base of nursing diagnosis. We learn skills to intergrade into every interaction with each family. By asking questions, listening, and observing cues from the patient, one can help determine what he or she knows, what to know and need to know. What we learn through listening and observing promotes family-centered care.
The assessment process of a patient’s functional abilities includes physiological, psychological and social behavior. The Filipino family is a very strong unit. Good health is highly valued and associated with the ability to present a public picture of well-being and youthfulness. Assessment of the whole person will present the true picture of well-being. As with any individual or family structure, understanding of the culture attitude affects how patients view their bodies and health. Gordon stated “knowledge in health care can change over the course of a few years, but cognitive abilities last a life time (Hanink, 2012, pg.2).
ReferenceBecker, G., (2003) Cultural Expressions of bodily Awareness among Chronically Ill Filipino Americans, Annals of Family Medicine. 1(2) 113-118. Carpenito-Moyet, L., (2008) Nursing Diagnosis: Applications to Clinical Practice: 12th edition, Philadelphia: Lippincott, Williams & Wilkins. Edelman, C. L. &Mandle, C .L. (2010)
Health Promotion throughout the Lifespan. Missouri: Mosby. Gordon, M., (1994) Functional Health Patterns: Nursing Diagnosis and Application. 3rd ed.: St Louis: Mosby. Hanink, E., (2010) Profiles in Nursing: Marjorie Gordon, Pioneer of the Medical Record. 15, 2010 from http://www.workingnurse.com/articles/profiles-in-nursing-marjorie-gordon-pioneer. McBride, M., (2000)
Health and Health Care of Filipino American Elders. Standard Education -25. Retrieved March 9, 2012 from http://www.standofrd.edu/group/ethnoger/Filipino.html McCain, F.A., (1965) Nursing by Assessment –Not Intuition. The American Journal of Nursing, 65(4) 82-84. Ordonez, R. & Gandeza, N., (2004) Integrating Traditional beliefs and Modern Medicine: Filipino Nurses’ Health Beliefs, Behaviors and Practices. Home Health Care Management & Practice, 17(1). 22-27. Weber,J. R., (2005). Nurses’ Handbook of Health Assessment, 5th e.d., Philadelphia: Lippincott. Williams & Wilkins
Functional Health PatternQuestionsHealth Beliefs- Perception and Management1.How do you describe you current health?2.What are you doing to improve your health?
1.What is your typical food intake?
2.What is your appetite?
1.What is your family structure?
2.What relationship are most important to you presently?