11 Categories of Gordon's Functional Health Patterns Assessment

Gordon functional health patterns is a method devised by Marjory Gordon to be used by nurses in the nursing process to provide a more comprehensive nursing assessment of the patient. The assessment provides information and understanding on the patients’ perception, meaning and logic using 11 categories to data collection of health patterns. The nursing process uses three types of professional judgement; the diagnostic judgement, therapeutic judgement and ethical judgement. The purpose of the functional health patterns assessment is to evaluate the health status of the patient and to make a judgement based on where a problem or potential problem exists that requires nursing intervention. The assessment also identifies the strengths that are present in the situation such as the patient, their family or their community that can be used to help solve issue.

11 Categories of Gordon Functional Health Patterns

The functional health patterns framework consists of 11 categories or patterns that encompass different aspects of an individual's health and well-being. These patterns include:

• Health Perception-Health Management Pattern: This pattern focuses on the individual's perception of their overall health and their behaviors and practices related to health promotion and maintenance. The following questions pertain to those asked by the nurse to provide an overview of the individual's health status and health practices that are used to reach the current level of health or wellness.

Client’s general health? Any colds in past year? If appropriate: any absences from work/school? Most important things you do to keep healthy? Use of cigarettes, alcohol, drugs? Perform self exams, i.e. Breast/testicular self-examination? Accidents at home, work, school, driving? In past, has it been easy to find ways to carry out doctor’s or nurse’s suggestions? (If appropriate) What do you think caused current illness? What actions have you taken since symptoms started? Have your actions helped? (If appropriate) What things are most important to your health? How can we be most helpful? How often do you exercise?

• Nutritional-Metabolic Pattern: This pattern examines the individual's typical food and fluid intake, as well as their metabolism and nutritional status. Following question asked to take nutritional history.

Typical daily food intake? Use of supplements, vitamins, types of snacks?, daily fluid intake?, Weight loss/gain? Height loss/gain?, Appetite?, Breastfeeding?, Infant feeding?, Food or eating: Discomfort, swallowing difficulties, diet restrictions, able to follow? Healing – any problems? Skin problems: lesions? Dryness? Dental problems?

• Elimination Pattern: This pattern looks at the individual's bowel and bladder function, including patterns of elimination and any problems or issues in these areas. Through this pattern the nurse is able to determine regularity, quality, and quantity of stool and urine.

Bowel elimination pattern Frequency, character, discomfort, problem with bowel control, use of laxatives (i.e. type, frequency), etc.? Urinary elimination pattern (describe) Frequency, problem with bladder control? Excess perspiration? Odour problems? Body cavity drainage, suction, etc.? If indicated, examine excretions or drainage for characteristics, colour, and consistency. Abdominal assessment.

• Activity-Exercise Pattern: This pattern assesses the individual's level of physical activity, exercise routines, and any limitations or barriers to movement and mobility.

Sufficient energy for desired and/or required activities? Exercise pattern? Type? Regularity? Spare time (leisure) activities? Child-play activities? Perceived ability for feeding, grooming, bathing, general mobility, toileting, and home maintenance, bed mobility, dressing and shopping?

• Sleep-Rest Pattern: This pattern explores the individual's sleep patterns, quality of sleep, and any disturbances or disruptions to their rest.

Generally rested and ready for activity after sleep? Sleep onset problems? Aids? Dreams (nightmares), early awakening? Rest / relaxation periods? Sleep routine? Sleep apnea symptoms?

• Cognitive-Perceptual Pattern: This pattern focuses on the individual's cognitive abilities, including their memory, attention, and sensory perception.  Assesses the ability of the individual to understand and follow directions, retain information, make decisions, and solve problems. Also assesses the five senses.

Hearing difficulty? Hearing aid? Vision? Wears glasses? Last checked? When last changed? Any change in memory? Concentration? Important decisions easy/difficult to make? Easiest way for you to learn things? Any difficulty? Any discomfort? Pain? If appropriate – PQRST questions or COLDSPA 

• Self-Perception-Self-Concept Pattern: This pattern examines the individual's self-perception, self-esteem, and body image.

How do you describe yourself? Most of the time, feel good (or not so good) about self? Changes in body or things you can do? Problems for you? Changes in the way you feel about self or body (generally or since illness started)? Things frequently make you angry? Annoyed? Fearful? Anxious? Depressed? Not able to control things? What helps? Ever feel you lose hope?

Eye contact. Attention span (distraction?) Voice and speech pattern. Body posture. Client nervous (5) or relaxed (1) (rate scale 1-5) Client assertive (5) or passive (1) (rate scale 1-5)

• Role-Relationship Pattern: This pattern assesses the individual's roles and relationships, including their family dynamics, social interactions, and support systems.

Live alone? Family? Family structure? Any family problems you have difficulty handling (nuclear/extended family)? Family or others depend on you for things? How well are you managing? If appropriate – How families/others feel about your illness? Problems with children? Belong to social groups? Close friends? Feel lonely? (Frequency) Things generally go well at work / school? If appropriate – income sufficient for needs? Feel part of (or isolated in) your neighbourhood? Interaction with family members or others if present.

• Sexuality-Reproductive Pattern: This pattern explores the individual's sexuality, reproductive health, and any concerns or issues related to these areas. 

If appropriate to age and situation – Sexual relationships satisfying? Changes? Problems? If appropriate – Use of contraceptives? Problems? Female – when did menstruation begin? Last menstrual period (LMP)? Any menstrual problems? (Gravida/Para if appropriate). None unless a problem is identified or a pelvic examination is warranted as part of full physical assessment (advanced nursing skill).

• Coping-Stress Tolerance Pattern: This pattern examines the individual's coping mechanisms, stressors, and their ability to manage stress effectively.

Any big changes in your life in last year or two? Crisis? Who is most helpful in talking things over? Available to you now? Tense or relaxed most of the time? When tense, what helps? Use any medications, drugs, alcohol to relax? When (if) there are big problems in your life, how do you handle them? Most of the time, are these ways successful?

• Value-Belief Pattern: This pattern focuses on the individual's values, beliefs, and spiritual practices that may influence their health-related decisions and behaviors.

Generally get things you want from life? Important plans for future? Religion important to you? If appropriate - Does this help when difficulties arise? If appropriate – will being here interfere with any religious practices?

Conclusion

By using Gordon's functional health patterns, healthcare professionals, particularly nurses, can gather comprehensive and relevant information about an individual's health status. This framework allows for a holistic assessment, taking into account not only physical health but also mental, emotional, and social well-being. It helps identify areas of strength and areas that require intervention or support, guiding healthcare professionals in developing appropriate care plans and interventions tailored to the individual's unique needs.