GORDON’S FUNCTIONAL HEALTH PATTERN
HEALTH PERCEPTION – HEALTH MAINTENANCE PATTERN
- Clients description of general health
- Health practices; may include those related to managing a specific chronic illness
- Use of alcohol, tobacco, and other substances
- Home, school, and occupational safety
- Client’s description of the cause of the illness (if present) and actions taken to manage it
NUTRITIONAL – METABOLIC PATTERN
- Does the client seem well nourished and well developed in general appearance?
- Is the client overweight or underweight for the age and height?
- What is the client’s usual dietary pattern? Describe typical daily food and fluid intake.
- Does the client adhere to a special diet?
- How does the client’s skin look? Are there lesions? Is the skin dry?
- What is the client’s body temperature?
- What was the client’s recent cholesterol level?
- Does the client have diabetes or a family history of diabetes?
- Does the client have dental problems? Swallowing problems?
- History of gastrointestinal or endocrine problems?
ELIMINATION PATTERN
- What are your usual bowel and bladder habits?
- What are the frequency, consistency, and color of your stool?
- Do you have difficulty with urination?
- Do you experience incontinence?
- How would you describe your use of laxatives or other aids to elimination?
- D o you have a history of bowel and bladder problems?
ACTIVITY – EXERCISE PATTERN
- What are your usual activities?
- What is your general level of physical fitness?
- Do you have a history of cardiac or respiratory problems?
- What activities give you the most pleasure?
- Do you need help with home maintenance?
- What is your activity tolerance?
- What is your usual pattern of exercise?
- Do you lead a sedentary lifestyle?
- Are you satisfied with your level of activity?
- Do you smoke? How many packs per day? For how many years?
- Are you able to feed yourself, bathe, go to the toilet, groom yourself, and move about in bed?
- Can you do shopping and cooking, maintain your home, and achieve general mobility?
- Do you use a cane or walker or need help for walking?
SLEEP –REST PATTERN
- What is your usual pattern of sleep? Rituals? Reading, teeth brushing, stretching, meditation, watching
TV?
- Do you feel rested in the morning?
- Do you use sleep aids?
- Are you able to sleep through the night?
- Do you have trouble falling asleep?
COGNITIVE – PERCEPTUAL PATTERN
- Do you have any difficulty with vision? Do you need glasses for reading or distance vision?
- Do you have any difficulty with hearing? Do you use hearing aid?
- What is your name? Where do you live?
- What brought you to the hospital? What day is it?
- How long have you been here? Pain/discomfort? Heat/cold intolerance?
SELF-PERCEPTION – SELF-CONCEPT PATTERN
- What can you tell me about yourself?
- How will this hospitalization affect your life?
- How would you describe your support systems?
- Who relies on you?
- Where do you go for moral support?
- What do you do to “take care of yourself”?
- How do you feel about being ill? In the hospital?
- Do you have anxiety? How does it affect you?
- Do you have a history of anxiety disorders? Have you used psychotropic drugs? Alcohol? Street drugs?
ROLE – RELATIONSHIP PATTERN
- Who are the members of your household?
- How would you characterize the strength of your marriage?
- Is your family dependent on you? How are they managing during your hospitalization or illness?
- What are the ages of your children? Where do they live?
- Do close family ties characterize your family?
- When someone is ill, how does your family offer your support?
- Do you have trouble sharing your problems and concerns with others?
- Do you have concerns that this illness will affect your ability to perform in your occupation?
- If you are unable to continue in your present occupation, are you in a position to retire?
- Do you have problems with your children that are difficult for you to manage?
SEXUALITY – REPRODUCTIVE PATERN
- How would you characterize your satisfaction with your sexual relationship?
- Would disruption of your sexual relationship with your spouse be a factor in making a decision about
having this surgery (taking this medication)?
- What was the date of your last menstrual period?
- At what age did you start menstruation? Are your menstrual periods regular?
- Do you use birth control? What method do you use?
- How many times have you been pregnant? How many live births?
COPING – STRESS TOLERANCE
- How are you managing (name the current problem or situation)?
- Have you talked to your (significant other) about (the current situation)?
- Have you informed your family and friends of your (current situation)?
- How would you characterize the level of stress in your life over the past year?
- Do you have someone with whom you are comfortable talking about problems or changes in your life?
- Do you use alcohol or other drugs to relieve stress?
VALUES – BELIEF PATTERN
- Is your life satisfying>? Is your life good?
- What are your plans for the future?
- Do you have a religious affiliation?
- Do you actively practice a religion?
- Is spirituality important in your daily life?
- Will this hospitalization interfere with any religious practices?
