Family Health Assessment
Introduction
A comprehensive family assessment provides a foundation to promote family health (Edelman & Mandle, 2011). Marjorie Gordon developed 11 functional health patterns. They provide a systematic approach for nurses to use during the assessment process. By using this assessment tool the nurse can collect data about functional health patterns. By identifying certain behaviors through this assessment process the nurse can better tailor an appropriate nursing diagnosis, interventions and plan of care. This family health assessment paper has been organized and prepared in the following fashion. First, the questionnaire has been created which includes the 11 functional health patterns. A diagnosis has been presented in “Diagnosis” section, according to questions generated, using course textbook (Weber & Kelley, 2010) and guidelines for specific learning outcomes and conduct of therapeutic conversations by undergraduates from Holtslander & Smith (2013). The proposed list of questions and its format has also been quantitatively evaluated and compared to other documented experiences of family diagnosis using Gordon's 11 functional health patterns (Nettle et al., 1993; Kriegler & Harton, 1992) and their questionnaires used (Nettle et al., 1993). Finally, a wellness family nursing diagnosis has been inferred, based on materials from Weber & Weber (2010).
Discussion
The interviewed family consists of three currently active members – the husband, spouse and their daughter of full legal age. The fourth member, the elder son lives separately now, with his wife and children. The family lives in a private house in the suburbs, the house and its yard has enough space to accommodate all possible needs of the family members mentioned, there are no insects, rodents or other external hazards present. The family pet – a cat lives in the house. The family income is provided by the small family business they run; all three members are employed in the business. Their business and workplace is not involved with hazardous materials or noisy, stressful environments. The family cooking and groceries are done by the spouse and daughter. Moreover, they often take their meals at respectable, healthy restaurants, since it can be afforded by the income. When eating in a restaurant, the daughter usually eats separately, so her choice of meals is independent from the choices of husband and spouse.
Within the health perception-health management pattern, the family believes it consists of perfectly healthy individuals; they are able to afford health insurance. To stay healthy, the husband and spouse do morning runs and attend a gym, moreover the spouse attends fitness classes while the husband works out at home, although irregularly. They own a moderately-sized swimming pool and swim regularly, as well as go to a skiing resort for vacation at least once a year. The daughter practices dancing at a local studio. On the other hand, along with the listed health-seeking behaviors, there is a history of substance abuse in the family. The mother has been smoking for around ten years, but has recently quit; while the daughter is currently a heavy smoker with a daily usage of 2 packs of cigarettes. The husband and spouse occasionally drink alcohol at barbecue or cocktail parties they organize at least once a month while the daughter regularly drinks up to the point of intoxication on every weekend while attending bars and clubs. No heavy drug use has been acknowledged; the daughter admitted occasional use of marijuana. Despite the regularity of their substance usage, none of the family members considers it to be a source of problems or health risks.
Food consumption patterns reported are rather consistent with common ideas about healthy food; the food intake consists of breakfast, lunch and dinner while dinner is usually taken at the workplace. The family diet includes enough protein, a lot of vegetables and spices, including ginger and green-leaf vegetables like onions and parsley. Fats include milk, butter, sunflower and olive oils while the main source of carbohydrates is bread and rice. The family consumes bottled water that is purified through reverse-osmosis, a sufficient amount per day, but usually in the form of black or green tea. All members consider themselves healthy eaters. All family members consider themselves neither under nor overweight, and this can be confirmed through measurements of BMI. The husband has gained some weight recently, for which there is no explanation. There were no abnormalities reported in bowel or urinary elimination patterns. The sleep pattern is traditionally strictly scheduled in the house, although the daughter may stay up later or arrive late from parties, especially at weekends, which also usually includes skipping the supper meal. No sleep-aids or aids against sleepiness during the day are used. The daughter's sleep pattern is more irregular, with certain days of having bad sleep and trouble getting up on time. Cognitive-Perceptual difficulties are absent, which is also indicated by routine eye exams and other checks. The difficulty in learning is hard to estimate since none of the family members continues education or participates in additional job or other trainings. Self-perception is reported by all members as “feeling OK”, although the husband is uncertain about possibilities of expansion for their mutual family business – he is the decision maker; the daughter sees no perspectives for herself in the family business. While she has had some college education, now she is back at her parents’ house with virtually no possibilities of career growth at current job position. Since there has been not much change in the past few years, the everyday coping mechanisms for all family members include the use of stimulants like caffeine (tea and coffee) or nicotine (cigarettes), alcohol and social events like home parties and night clubs. No medications are used. Skiing vacations are also another way of taking off the stress. Some coping and tolerance are also provided by heavy reliance on existing business partnership bonds and existing family resources. Relationships with others, in addition to ones already mentioned are quite limited. The family does not participate in, or hold any social action groups, like charity or local community assistance, are not affiliated with any religious communities, etc. The family values are vaguely defined, because of the absence of religious association; plans for the future and goals from life are also unclear. The values-beliefs pattern is thus incomplete, and regards life as a mean of existence, without higher aspirations. The husband and spouse report complete satisfaction with their sexual life, they sleep together in a single bed and have sex occasionally. The daughter was less willing to discuss her personal matters; while being of legal and fertile age, she does not plan on having children in the near future, and does not see a current suitable candidate for a husband. There were no problems in the women's menstruation cycles reported.
Nursing Diagnosis The nursing diagnoses inferred from the summary above includes energy field disturbances resulting in poor emotional states. There is some impaired physical mobility for the husband; risk for ineffective sexuality pattern and delayed growth and development, risk for sleep deprivation for the daughter; and risk for hopelessness and spiritual distress for the entire family. The wellness nursing diagnoses include health-seeking behaviors, readiness for enhanced nutritional metabolic pattern, readiness for enhanced sleep, readiness for enhanced comfort level and readiness for enhanced self-concept.

List of Questions 1. Health Perception-Health Management Pattern Overall, how is the health of the family? How does the family stay healthy? Do you or anyone in the family drink alcohol or use tobacco products? If so how often and for how long? Do you have regular check-ups with your physician? 2. Nutritional-Metabolic Pattern Describe your Family’s typical daily food intake? Do you consider your family healthy eaters? Describe your family’s typical daily fluid intake? Does anyone consider themself over or under weight? Is there any unexplained weight gain or loss? 3. Elimination Pattern Tell me about the bowel elimination pattern of the familiy? Frequency? Character? Problems? Whats the family’s regular urinary elimination pattern? Frequency? Discomfort? Problems with control? Is there any ecological concerns? Do you sort your household garbage? 4. Activity-Exercise Pattern Dose the family exercise? What type? How often? If not, why? Do the children if any participate in physical activity? What type? How often? If not, why? 5. Sleep-Rest Pattern Dose the family generally feel well rested throughout the day? Does anyone have problems falling asleep? Staying asleep? Does anyone use any aids to help fall asleep? If any, what? For how long? With how much effectiveness? When the family awakens do they feel rested and ready to start the day? 6. Cognitive-Perceptual Pattern Are you aware of any hearing difficulties? Are you aware of any difficulty with seeing? Dose the family get routine eye exams? Are you aware of any learning difficulties experienced by family members? 7. Self-Perception Self-Concept Pattern In general, how do you and other family members feel? Does anyone ever express that you have lost hope? 8. Role-Relationships Pattern Who lives in the home? Who lived in the house when you grew up? What types of social groups do you belong to? What types of interactions with others outside of work or school? 9. Sexuality-Reproductive Pattern Parents: How would you describe your sexual relationship? Do you provide proper sex education to your children? Female: In regards to menstruation cycle. Problems? Last menstrual period? Para? Gravida 10. Coping-Stress Tolerance Pattern Have there been any big changes of events in the pastfew years? Whodo you go to for support? Are the frequently available to you? Do you or other family members use any drugs, medications, or alcohol? 11. Values-Beliefs Pattern Is religion important in your family’s life? Does this help when you are faced with difficult situations? Do have plans and goals for the future. Do you satisfied with how your life is?

References
Weber, J., & Kelley, J. (2010). Health assessment in nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Holtslander, L., Solar, J., & Smith, N. R. (2013). The 15-Minute Family Interview as a Learning Strategy For Senior Undergraduate Nursing Students. Journal of Family Nursing, 19(2), 230–248. doi:10.1177/1074840712472554
Nettle, C., Pavelich, J., Jones, N., Beltz, C., Laboon, P., & Pier, P. (1993). Family as Client: Using Gordon’s Health Pattern Typology. Journal of Community Health Nursing, 10(1), 53.
Kriegler, N. F., & Harton, M. K. (1992). Community Health Assessment Tool: A Patterns Approach to Data Collection and Diagnosis. Journal of Community Health Nursing, 9(4), 229.
Weber, J., & Weber, J. (2010). Nurses’ handbook of health assessment. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Retrieved from http://www.r2library.com/Resource/Title/0781795761