Health assessment patterns supporting patient focused care
Mary Aguon, RN
Grand Canyon University: NRS-429V

Introduction As registered nurses, a fundamental objective of the practice is to provide holistic and patient focused care. A diverse population, varying family dynamics, and distinct personal patient preferences serves as a challenge that nurses must overcome on a daily basis. In order to provide the upmost care for patients, nurses must conduct assessments and analyze data to better grasp not only a patients physical state of health, but also to gage their responses mentally and determine what they are capable of doing. One particular method used to aid in providing proper care is Gordon’s 11 functional health patterns, which assist in organizing the assessment aspect of nursing. Incorporating “… this framework for collecting the data base aids in formulating the nursing diagnoses and planning interventions” (Kriegler & Harton, 1992). To better portray the importance of patient assessments in providing greater quality care, the Brown’s were interviewed using Gordon’s functional health patterns touching on all aspects regarding health from spirituality, psychological aspects, life style factors, and more. Assessment One of the essential aspects of the 11 points of the functional health assessment is the perception of health and patterns. Exploration of health perception, “reveal beliefs about health, perceived susceptibility, self-efficacy, and level of knowledge about health status, taking into account the influence of culture” (Edelman, Kudzma, & Mandle, 2014). To Mr. and Mrs. Brown the health and well being of their children and themselves are of upmost importance, more so in recent year. With their three children getting older and a child on the way, the idea of incorporating healthier eating habits is a concept that this family is trying to better implement into their everyday lives. A family medical history presenting many concerns from both maternal and paternal sides of the family causes concern and influences for necessary health changes. The Brown’s recognize that their family’s current eating habits are not as health as they would like. To ensue their goals of healthier eating, the family plans to consume less processed and fried foods and to incorporate more vegetables and fruits of which they have been growing. Sleeping patterns for the Brown’s are consistent with no sleeping difficulties or need of sleep aides. Dependent on levels of tiredness alters how light Mr. Brown sleeps, but he is usually able to fall asleep within 10 minutes of settling down. With a good night worth of sleep, they generally feel well rested besides occasional lazy days. Mr. Brown is the most active member of the household, doing 5 days of physical activity a week with 2 hours daily of cardio and weight training. The children enjoy bicycle riding and playing at the park on a daily basis for their physical activity. The Brown’s who are currently living on Guam are surround by family on a daily basis. With Mrs. Brown being a native of the island it is considered a normal custom to have family over for extended lengths of time especially when those family members are facing hard times. Being in a rather stable state in their life, where family is able to depend on them, the couple shares the financial and authoritative responsibility equally. Living on an islander where Mrs. Brown has grown up, her social group is surrounded by long time friends that she and her household embrace as family. Growing up around the culture of the island, the Brown’s are well adapted despite moving a few times due to Mr. Brown’s previous career. The Brown’s have a strong family connection. As a married couple they are able to communicate effectively in all aspects of life, from sexuality to stress. Marriage and parenting are both important and sacred, as with all relationships it should be highly valued. They have an optimistic outlook on life. With all that life brings, they look to each other for support. Mrs. Brown who is originally from Guam, was brought up with the Catholic faith and her family turns to their faith through blessings and struggles in life. Diagnoses Based on the family health assessment of the Brown family, they appear to be rather healthy, but further assessment regarding the family’s eating habits as well as physical activity should be evaluated. With family history such as diabetes, coronary artery disease, and hypertension, preventative methods should be implemented to enhance a healthier life style. “ Factors that affect weight gain include genetics, sedentary lifestyle, emotional factors associated with dysfunctional eating, disease states such as diabetes mellitus and Crushing’s syndrome, and cultural or ethnic influences on eating. Overall nutritional requirements of the elderly are similar to younger individuals, except calories should be reduced because of their leaner body mass” (Klopp, 2012). To promote a healthier life style, implementation of a patient focused care plan is established. The Brown’s family is at Risk for Imbalanced Nutrition: More than body requirements. Interventions such as consulting a dietician for further assessment and recommendations regarding a weight loss program, establishing short and long-term goals, keeping log of intake, and encouraging patient awareness of nutritional habits. Review and reinforcement of nutritional content and complications associated with disease process should be followed through to provide continuity of care (Klopp, 2012). The Brown’s exhibit Readiness for Enhanced Activity – Exercise Pattern. Assessment of mobility level and nutritional status must be evaluated prior to beginning any activity – exercise program. Establishment of guidelines and goals of activity with the Browns must be set as well as having a support system to motivate and keep the Browns on track with their proposed care plan (Gulanick, 2012).

Reference Brown, D. & Brown, B. (2015). Personal interview. Edelman, C., Kudzma, E., Mandle, C. (2014). Health Promotion Throughout the Life Span. Chapter 7. (8th Edition) [E-Book] Retrieved from http://evolve.elsevier.com Gulanick, M. (2012). Activity Inolerance – Weakness: deconditioned; sedentary. Retrieved from http://www1.us.elsevierhealth.com/MERLIN/Gulanick/archive/Constructor/gulanick01.html Klopp, A. (2012). Nutrition, Altered: More than Body Requirements – Obesity; Overweight. Retrieved from http://www1.us.elsevierhealth.com/MERLIN/Gulanick/archive/Constructor/gulanick37.html Kriegler, N. & Harton, M. (1992). Community Health Assessment Tool: A Patterns Approach to Data Collection and Diagnosis. Journal of Community Health Nursing. Retrieved from http://www.jstor.org/stable/3427199?seq=1#page_scan_tab_contents

Health Assessment Questions:

1. Health perception & Patterns a. What is most valuable to you in regards to yours/and your family’s health? To be a healthy individual as well as ensure my family lives healthy lives. b. How would you describe your family’s current state of health and what are you doing to promote/improve it? Current health is fair. We are trying to incorporate eating healthier (eating less fried foods, more fruits and veggies, quick and healthy recipes, growing our own organic veggies). c. Describe any pertinent family health history? Maternal grandmother diabetic, hypertension, end stage renal disease. Maternal grandfather cardiac issues. Father cancer, hyperthyroidism, and hepatitis C. 2. Nutrition d. Do you consider your family healthy eaters? Please describe typical meal and daily fluid intake? No! Convenient and fast. Whether it would be take out, fast food or frying something quick. e. Are there any disease/medical complications that affect nutritional or metabolic function? No. f. Any physical complications preventing or making obtaining the proper nutrition or daily caloric/fluid intake? No. 3. Sleep/Rest g. Do you feel generally well rested and able to take on daily tasks? Yes. But I can just feel lazy at times. h. Describe your sleep patterns (how well you fall sleep, stay asleep and any sleep aides). No sleep aides, Tend to settle down about 10 mins and dependent on how tired I am also alters how lightly I sleep. i. Do you typically have rest periods or naps during the day? No. 4. Elimination j. Describe your family’s regular bowel elimination pattern? Freq, discomfort, character, difficulty? Typically we all have regular bowel patterns. No unusual discomforts or difficulties. k. Describe your family’s regular urinary elimination pattern? Freq, discomfort, character, difficulty? No issues with urinary elimination. 5. Activity/Exercise l. How many days/hours of physical activity a week do you do? 5 days a week/ 2 hrs daily of cardio and weight training. m. What physical activities (sports or physical exercise) does your family partake in? Bicycle riding, playing at the park on a daily basis. n. Any medical concerns that prevent you or family members from participating in physical activities? No medical concerns. 6. Cognitive & Perception o. Who makes the decisions regarding healthcare in your family? Split decision between husband and wife. p. How do you learn best? (Visual, audio, kinestetics) Kinestetically q. Do you have any problems with vision, hearing, and sensation? No. 7. Values & Beliefs r. What are your spiritual beliefs and does this help when you face difficulty situations? We as a family believe in God. We do not currently attend a place of worship regularly but rather on special occasions/holidays. We welcome prayer and turn to our beliefs when faced with difficult times. s. Describe your future plans and what you find most important in life? Retirement and family. Being able to enjoy life and spend quality time with family and friends. 8. Self-Perception & Management t. How do you describe yourself? (feel good, depressed, ill) Good spirits, outgoing, drop dead gorgeous, friendly, well rounded, reliable, trustworthy, great sense of humor. u. How do you and your family feel they integrate into the community? Just fine, well adapted especially since we’ve moved a few times. 9. Role & Relationship v. Describe your family structure? (nuclear vs extended family, highly depended on) Extended family structure. Coming from an island, we tend to hold family very near and dear. We love having family over for extended lengths especially when they are facing hard times. Given that we are rather stable in life, we are highly depended on. w. How is responsibility divided amongst the family? (Who holds the financial, authoritative responsibility? Shared responsibility?) Shared responsibility, decisions are made collectively. x. Social groups or extracurricular activities? (Strong ties with community, circle of trust worthy friends) Circle of trust worthy friends but embraced as family. 10. Sexuality y. How do you view marriage, parenthood and relations in general? Marriage and parenting are both very important and sacred. You must value every aspect of them. With relationships in general, I enjoy creating bonds that last a lifetime. z. Comfortable discussing sexuality with spouse? Children? Parents? Yes. Sexuality is a normal part of life and I think it’s important to keep an open conversation with all. {. How would you describe your sexual relationship? Very very ACTIVE! Consistent and satisfied. 11. Coping & Stress Patterns |. How do you and your family cope with stressful events? We try to work it out as a family and optimistic about situations. We are supportive of one another. }. How would you describe your support system in place? Strong support system with family as well as peers and friends. ~. Do you have any large stressors in life and what are they? Yes. That is rather personal.