Family Health Assessment
Historically, most nursing and health care activities have dealt with the treatment of disease or responses to disease. Although community health nurses have worked with clients in areas of health promotion for a number of years, access to these clients has been through referrals focusing on illness, tertiary care, or prevention of further disease. In the past decade, interest in health promotion and wellness has soared. There has been a flurry of articles related to fitness or development of healthy lifestyles found in lay magazines, videotapes on physical fitness abound, and the professional literature contains articles describing the wellness, health, or freedom from illness. By definition, health can be described as a vibrant state of being in which the behavioral and developmental potential of an individual are achieved to the fullest extent possible (Weber, 2009). Therefore, health is not merely the absence of disease. The wellness literature is prolific with definitions of wellness and health. A paradigm shift has not yet taken place since health promotion behaviors are used merely to achieve the goal of disease prevention rather than high level of wellness and self actualization. Diagnoses for wellness nursing do not include related factors. Inherent in these diagnoses is the family that understands higher-level of functioning is available. This paper aims to analyze and summarize Gordon’s 11 functional health patterns by interviewing a family on its family health assessment.
Pattern of health perception and health management
Health is a core concept in any family. This concept is modified with quantifiers based on a variety of factors. These factors may include gender, age, race or ethnic heritage, current health or physical condition, comparison group, geographic location, social or economic situation, and the demands of various roles in society (Moyet, 2008). In this pattern, the family was concerned with various factors such as the family’s general health, concerns about illness, health practices, and responsibility for health restoration and maintenance. However, the family’s health status is uncompromised as all of the family members are practically healthy. Furthermore, in order to ensure that the family is protected against diseases, the family’s members are required to be maintain a healthy life such that they are not exposed to common-day diseases.
Nutritional- Metabolic pattern
Many families in the third world countries have been affected by a lack of adequate nutrition; while too much intake of calories often leads to obesity a trend that has become prevalent western societies of affluence. The family in question which is mindful of its health is aware of the need of taking supplements and eating good food. As such, the family is often conscious with its nutritional and metabolic pattern since it would want to enjoy a continued or better state of health. However, stumbling blocks are many as a good number of the family members do not comprehend their own peculiar dietary or supplementary needs. Hence, this is the basis for the revolutionary theories of personalized metabolic nutrition, or metabolic typing. Different metabolic types require different fuel, and varying qualities within each of the metabolic types. This may suggest further modifications of the essential foods and supplements recommended for that type (Gordon, 2010). The family’s food intake is considered as normal because all family members consume the required amount of food. Hence, the family classifies itself under the category of healthy eaters. Not one family member is over or under weight as it is often the case with other families.
Pattern of Elimination
Assessment of one’s health pattern facilitates synthesis and analysis of data collected on other functional health patterns. The pattern of elimination helps to explain the guideline, control and removal of by-products and wastes in the body. The family often consults a nurse who helps to determine the family’s usual or previous pattern of elimination and compare it with the current situation to determine the family’s readiness for improving elimination patterns and/or how the pattern can be improved. Furthermore, it would be prudent to observe current voiding pattern and time, color, and amount voided in order to be able document normalization of elimination. In order to promote a predictable voiding pattern, it would be prudent to regulate liquid intake at prescheduled times (Newfield et al, 2007). The family described itself as having a healthy pattern of elimination based on the fact that none of its family members has complained of an irregular elimination pattern be it regular bowel or regular urinary.
Pattern of activity and exercise
The largest percentage of the population that is inactive is of concern because lack of regular physical activity or exercise is a catalyst for heart disease and other related ailments. Since the family often participates in physical activities, this has been contributed to a reduction in risk for all-cause mortality, diabetes, cardiovascular disease, and depression and anxiety as well as improved mental health. Prescriptive exercise programs are often used in conjunction with weight-management program. Hence, in order for the family to gain overall improvements in functional capacity and reduce risk factors associated with the disease state, both aerobic and resistive modes of exercise are prescribed. In order to keep themselves fit, most of the family members engage in physical activities that help them to not only maintain a healthy body, but also shed off some extra weight. The family members often engage in physical activities on a daily basis.
Cognitive perceptual pattern
The ability of the family members to retain information, solve problems, make decisions, use language appropriately, and to understand and follow directions is often considered to be part and parcel of the cognitive patterns. Olfactory, auditory, visual, tactile, gustatory, and kinesthetic feelings and opinions determine perceptual and sensory patterns. Compensation for cognitive-perceptual difficulties ensures safety. More often than not, health requires a balance between individual and the environment. According to the family members, decreased levels of cognition or perception required increased levels of environmental control. Assessing cognitive-perceptual patterns includes evaluating cognitive skills, language capabilities, and perception related to required or desired activities (Edelman et al, 2007). Not one member of the family has developed hearing difficulties, but there are two members who have a long-term problem with their eyesight.
Pattern of sleep and rest
In the case of nursing diagnosis, it is important to assess usual sleep patterns and rituals for all the family members who are being admitted to a hospital or seeking help for a sleep problem. Perhaps the most significant single factor assessed in the sleeping-rest pattern is the relaxation and sleep adequacy perception. Subjective reports of fatigue or energy levels provide some indication of the individual’s satisfaction. It is evident that most family members often make assumptions about the roles that sleep and rest play in preparing them for the required or desired daily activities. This pattern becomes extremely important when sleep and rest are perceived as insufficient. Sleep serves as a restorative function for most individuals. Sleep deprivation studies provide vivid demonstrations of the need for different types of sleep: light, deep, dream and rapid eye movement sleep. The objective, when assessing the sleep-rest pattern among the family members, is to analyze the pattern effectiveness, from each individual’s perspective. More often than not, family members are advised to get enough sleep as this helps them active throughout the day. None of the family members has registered the need of sleeping as all the family members have a natural sleeping habit.
Pattern of self perception and self-concept
The pattern of self perception follows the cognitive pattern particularly well because mental status measures include feelings and perceptions of the family members. Cognitive perceptual ability greatly influences the ability to function or manipulate within the family setting. The self perception-self concept pattern encompasses the wisdom of an individual’s goals, personal identity, emotional feelings and patterns about their personality. The family’s worthiness and self image are often derived from their competencies, personal appearance, and limitations awareness, not to mention the family’s self perception and other perceptions. As a result, the nurse will examine the nonverbal, physical and verbal cues. Family climate and relationship patterns provide the environmental impact that influences the self-concept pattern. Most people care about what others think of them; hence, the support of significant others affects the self-perception-self-concept pattern. In the course of interview, it was evident that all the family members have a good rapport amongst each other such that they feel good for each other to the extent that they are willing a supporting hand if one of them is in need. None of the family members has ever felt as if they lack a sense of direction if the good relation amongst the family members is anything to go by.
Roles-relationship pattern
The roles-relationship pattern describes the position assumed by the family as well as the associations that the family is involved in which might have a close relation to that position. The perception of the family members is a major constituent of exploration, and assessment which includes each individual’s relationship and roles satisfaction levels. The concept of health as the harmonious balance between the family and the environment indicates the major role that relationships play in health status. The objective of the roles-relationships pattern assessment is to describe an individual’s pattern of family and shared circumstances, with the associated responsibilities. Assessment centers on communal roles, communal relations, work and family. The relationships among the functional health patterns are clearly apparent in light of the developmental stages. Hence, it is apparent that family relationships have an effect on individual family members; hence, problems may arise and be evident in other aspects of live. None of the family members has moved out to live on their own; hence, all the family members live under one shed. Other than having good relations amongst themselves, this also happens to be the case with other people outside the family circle.
Sexuality-Reproductive pattern
The sexuality reproductive pattern describes the family’s sexual self-concept, methods of intimacy, sexual functioning, and reproductive areas. Sexuality is the behavioral expression of sexual identity. The importance of the sexual-reproductive pattern to the family’s life and health is closely related to the self-perception and the relationships patterns. This concept of sexual self and individual’s relationships pattern indicate the level and the perceived satisfaction of sexual functioning. Reproductive patterns are equally significant to this pattern assessment, the whole individual, family and community. In the case of the parents, they described their sexual relationship as perfect, and one that is devoid of problems. Furthermore, the female members of the family have had a regular menstrual cycle and they are yet to detect any irregular patterns.
Pattern of coping and stress tolerance
The coping-stress tolerance pattern is a representation of the family’s ability to cope and manage stress in an effective manner. This pattern involves the ability of the family members to overcome crises in life and to defy features responsible for important resource accessibility, manipulating stress management, and conflict resolution modes. For purposes of assessing this pattern, coping, which is considered the family’s behavioral response to stress, includes both problem solving ability and use of defense mechanisms. The perception of stress and ability to manage it depends on personal development, amount of stress previously experienced, current level of stress within the environment, and sources of social support. Stress tolerance patterns elicit the amount of stress efficiently processed in the past. Not a major change has gone through the lives of any of the family members. The family describes most of these changes as normal. In addition, none of the family members has ever abused drugs or is in a constant use of drugs or medication.
Patterns of values and beliefs
These patterns describe value including the family’s goals, beliefs and spiritual values. This pattern also includes the perception of good, perception of bad, as well as the conflicts that result due to values and beliefs. The objective in assessing this pattern is to determine the basis for health-related decisions and actions among the family members. Dimensions of assessment include the individual’s values and beliefs that are related to health (Yacoub & Ammar, 2004). The family describes itself as a religious family that has its trust in God. All the family members are active churchgoing members. The family members do not have major plans ahead, but this does not stop them from predicting a bright future ahead.
Furthermore, the family also listed two wellness nursing diagnoses patterns that would help to enhance their level of wellness. To begin with, the family vouched for improved safety precautions by increasing home fire prevention. Residential homes fire protection standards rely on a number of principles that combine certain operational and construction features. These features are a manifestation of the cognitive and mobility limitations of many disabled and elderly residents who cannot be easily withdrawn from the scene of the fire. These guidelines include; correct design and building of the house, particularly to contain both fire and smoke; and provision of fire detection, alarm, and extinguishment. Another wellness diagnoses pattern that will improve the family’s level of wellness is the potential for an improved state of health by quitting smoking. Since one of the family members is an ardent smoker, he needs to face some of the tough, hard facts that may sound a bit strong. More often than not, denial plays a big role in a smoker’s life, and it helps to keep the smoker tethered to tobacco products. Excuses as to, why the smoker cannot quit smoking are often lame and unjustified. As a matter of fact, no person in their correct state of mind would ignore all the warnings, the health risks, and the research that shows that smoking damages their health.
References
Edelman, C. L. et al (2013). Health Promotion Throughout the Life Span. St Louis, Missouri: Elsevier Health Sciences.
Gordon, M. (2010). Manual of Nursing Diagnosis. Sudbury, MA: Jones & Bartlett Publishers.
Moyet, L. J. (2008). Nursing Diagnosis: Application to Clinical Practice. USA: Lippincott Williams & Wilkins.
Newfield, S. A. et al (2007). Cox’s Clinical Application of Nursing Diagnosis: Adult, Child, Women’s, Mental Health, Gerontic, and Home Health Consideration. Philadelphia: F. A. Davis.
Weber. J. R. (2009). Nurses’ Handbook of Health Assessment. USA: Lippincott Williams & Wilkins.
Yacoub, S. M. & Ammar, H. H. (2004). Pattern-oriented Analysis and Design: Composing Patterns to Design Software Systems. Boston: Addison-Wesley Professional.
Appendixes
Questions
Pattern of health perception and health management
- What is your perceived health status?
- What are your current health care behaviors; disease prevention activities and health promotion; medical treatments; and follow-up care?
Nutritional- Metabolic pattern
- How can you describe your family’s daily food intake?
- Would you classify your family as healthy eaters?
- Is there anyone in your family who considers him/herself as over or under weight?
Pattern of elimination
- How would describe your family’s elimination pattern of regular bowel?
- How would you describe your family’s elimination pattern of regular urinary?
Pattern of activity and exercise
- Does any of your family members exercise or engage in physical activities?
- How often do your family members exercise?
Cognitive-Perceptual pattern
- Is there any family member who has developed difficulties of hearing others?
- Is there any family member who has developed seeing difficulties?
Pattern of sleep and rest
- How do you feel when you have rested well and you are able to carry out your daily activities?
- Do you sleep naturally or do you require some aids to help you fall asleep?
Pattern of Self Perception and Self Concept
- How often do you feel good about yourself or your family members?
- Have you ever felt as if you lack a sense of direction?
Role-Relationship Pattern
- Do you live with your family members or do you live alone?
- Other than your family members, how can you describe your relationship with others outside your family circle?
Sexual-Reproductive Pattern
- If you are a parent, would you describe your sexual life as satisfying or is it problematic?
- In the case of female members, how is your menstruation cycle like?
Pattern of coping and stress tolerance
- What major changes has your life gone through in the recent past?
- By any chance, do any of your family members use any kind of drugs or medication?
Patterns of values and beliefs
- Does your family place much value on religion?
- What are your future plans or those of your family members?
