functional assessments

Functional Assessments

Maria Carmela L. Domocmat, RN ,MSN

Functional Assessments
Gordon’s Functional Health Patterns
Katz Index of Independence
Barthel Index


GORDON’S FUNCTIONAL
HEALTH PATTERNS

Marjorie Gordon (1987) proposed
functional health patterns as a guide for
establishing a comprehensive nursing data
base.


These 11 categories make possible a
systematic and standardized approach to
data collection, and enable the nurse to
determine the following aspects of health
and human function:


1 Health Perception and Management
2 Nutritional metabolic
3 Elimination
4 Activity exercise
5 Sleep rest
6 Cognitive-perceptual
7 Self perception/self concept
8 Role relationship
9 Sexuality reproductive
10 Coping-stress tolerance
11 Value-Belief Pattern


1 Health Perception and Management
2 Nutritional metabolic
3 Elimination
4 Activity exercise
5 Sleep rest
6 Cognitive-perceptual


7 Self perception/self concept
8 Role relationship
9 Sexuality reproductive
10 Coping-stress tolerance
11 Value-Belief Pattern


(1) Health Perception and Health
Management
Data collection is focused on the person's
perceived level of health and well-being, and
on practices for maintaining health


Health Perception and Health
Management
Habits that may be detrimental to health are
also evaluated, including smoking and alcohol
or drug use.
Actual or potential problems r/t
safety & health management
needs for modifications in the home or needs for
continued care in the home.


(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, tissue integrity, and host defenses
may be identified as well as problems with the
gastrointestinal system.


(3) Elimination
Data collection is focused on excretory
patterns (bowel, bladder, skin).
Excretory problems such as incontinence,
constipation, diarrhea, and urinary
retention may be identified.


(4) Activity and Exercise
Assessment is focused on the
activities of daily living requiring energy
expenditure, including self-care activities,
exercise, and leisure activities.
The status of major body systems involved
with activity and exercise is evaluated,
including the respiratory, cardiovascular, and
musculoskeletal systems.


Cognition and Perception. Assessment
is focused on the ability to comprehend
and use information and on the sensory
functions. Data pertaining to neurologic
functions are collected to aid this process.
Sensory experiences such as pain and
altered sensory input may be identified
and further evaluated.


Sleep and Rest. Assessment is focused
on the person's sleep, rest, and relaxation
practices. Dysfunctional sleep patterns,
fatigue, and responses to sleep
deprivation may be identified.


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.


Roles and Relationships. Assessment is
focused on the person's roles in the world
and relationships with others. Satisfaction
with roles, role strain, or dysfunctional
relationships may be further evaluated.


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.


Coping and Stress Tolerance.
Assessment is focused on the person's
perception of stress and on his or her
coping strategies Support systems are
evaluated, and symptoms of stress are
noted. The effectiveness of a person's
coping strategies in terms of stress
tolerance may be further evaluated.


Values and Belief. Assessment is
focused on the person's values and beliefs
(including spiritual beliefs), or on the goals
that guide his or her choices or decisions.


Critical Thinking Exercise 2:
Clustering of Data


On a separate piece of paper, cluster the
following data according to Gordon’s
Functional Health Patterns.
When you organized these data, you have
found that some categories had no data
listed. If this happens to you in the clinical
area, what should you do?


Case history
Age 36
Married, has three small children
Occupation: landscape architect and
homemaker
Religion: Baptist


Case history
Medical diagnosis: Pneumonia
T: 38.3; P: 100; R: 28; :BP: 104/68
States she is concerned about how her
husband is caring for the children, that “it
is tough on him.”


States she feels weak and tired all the
time but can’t seem to rest because she
keeps coughing all the time.
Appetite poor. Has eaten less than half of
regular meals. Is forcing fluids well
(1000ml per shift)


Before illness, she smoked a pack of
cigarettes a day but has not smoked since
hospitalization
States she always has been in good
health and never had to be hospitalized
(even gave birth at home)


States that all of the tests that have to be
done make her nervous; she is worried
about getting AIDS from needle sticks.
Lungs have bilateral rhonchi; she coughs
up thick yellow mucus


Chest x-ray shows improvement over the
last 2 days
White blood cell count is elevated at
16,000.


functional assessments

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functional assessments