Introduction
In order to ensure better data collection from patients, Marjorie Gordon developed a system that assessed functional health aspects of patients. This system is referred to as the Gordon’s Functional Health Patterns and it’s a very comprehensive approach of collecting information from a patient so that nurses and doctors can use the information for diagnosis of the problems from a range of perspectives. This system is sometimes used as a standard for assessment even though it does not have any theoretical model and it is adaptable to the existing theories where it’s used for diagnosing communities, families and individuals. This system assumes that health and wellness is because of the body function being in harmony with the surrounding environment. Eleven patterns are included in the system and the nursing diagnosis is founded on the principle that the nurse evaluates the patient (individual or family) for each of the 11 elements by assessing behavior patterns and the consequent physiological response that are connected to a certain functional health group. Through these guidelines, the evaluations are then compared to the family’s baseline physiologic results and with socio-cultural and religious norms as well as the healthcare and dietary practices. Evaluations of each of the 11 patterns reveal the interaction of patient or the family with the environment and it’s therefore also called biophysical integration because no single health pattern can in essence be understood as single entity without vivid understanding the related pattern. This therefore means the assessments and descriptions of the family patterns with help a great deal in identification of the functional and dysfunctional features hence assisting the nurses to easily develop an accurate nursing care plan for that particular family. It’s the information from all the 11 elements that can help to divulge information concerning the family’s usual pattern of life, reveal recent changes and hence help in determining the physiologic and pathologic implication of the noted changes.
Family Profile
The family consists of a 54-year-old mother, a 23-year-old daughter and a son aged 19 years. The two children are in normal health while the mother suffers from diabetes type II and episodes of hyperglycemia.
Case scenario
Mrs. Mary O’Brian was taken ill after a medical diagnosis of type II diabetes mellitus and emesis. This medical condition was diagnosed 6 years ago. MO is a white female who was born and brought up in Houston Texas. She later married and moved to live in Seattle Washington with her husband. Her husband died in a car crash five years after the birth of their son and she has remained unmarried since then, she sought medical attention after feeling extremely weak, vomiting and nausea. Her family history source is reliable
Background Information
Treatment
With a blood sugar level of 400mg/dl, she was prescribed to receive Glucaphage (an anti-diabetic) twice a day. She has not taken any over the counter prescriptions.
Previous Illness and hospitalization
She was diagnosed with type 2 diabetes 6 year ago and started treatment. She has also suffered mild peripheral vascular disease.
Allergies
MO is allergic to morphine and some opioid-type drugs causing generalized rash on her skin. She denies being allergic to any food and environment allergens.
Development
MO says that as a child, she never had enough to eat while living in Texas because her family was poor and they were six children. She was not a social child and regrets not having gone out to play or party. She begun smoking to satisfy her social needs like taking ways stress in early 20s but that escalated so much when her husband passed on to up to two packs a day. She however stooped following diagnosis of diabetes. She goes to Baptist church frequently with her children.
The 11 Functional Health Pattern Assessments
Health Perceptions
MO rates her current medical position at 5, which is drop from 8 some six years ago. This is because vomiting has gotten worse. However, she hopes to become healthier at 8 again. She says she does not drink or use any drugs. She admits she does not understand how to manage her condition despite knowing she has diabetes. Sometimes she forgets to take her medication amounting to poor compliance. She hopes to be discharged soon.
Nutrition and Metabolism
MO is 5’3’ in height and weighs 192 pounds. At the ideal weight for her would be between 125 and 130 lbs. she has good appetite and eat three meals a day and intermittent takes some snacks between the meals. Her temperature is 980F. She good hair texture and no loss. She does not complain of itching but does not like hot temperatures. Her nails are smooth and hard and not dry skin or mouth.
Elimination
She says she experiences some rectal bleeding but could and consistency of her stool is constant. She has two bowel movements a day on average. Has been voiding very often in the past two days a condition described as nocturia.
Activity and Exercise
She states she wakes up at 0530 and she helps her daughter to prepare family breakfast, does her domestic chores and takes breakfast and her family at 0700 before leaving for work – a high school teacher. She at times forgets to take her medication or sometimes she runs out of prescription. She has no regular exercise schedule and likes relaxing in her office or surfing the internet. Has been feeling very week in the past two days and stayed at home.
Sexuality-Reproduction
Obstetrics – para 3, gravida 2, no abortions. She has two children living with her.
Sleep-Rest
She sleeps at 2200-2300 and wakes up at 0530. Sometimes she feels she cannot fall asleep because of discomfort in her feet but does not use sleeping pills or other sleep aids. She feels breathlessness at night and wakes up feeling tired.
Sensory
She sometimes uses glasses when her vision gets blurred. She says she does not feel itchiness, redness or has not had trauma to her eyes. Her hearing is fine. She has not experienced decrease in smell perception; she is not allergic to inhalants and denied experiencing nasal discharge or nosebleeds. She says, sometimes her feet feel numb and both legs pains at times. Her salt taste is poor and she has recently been adding more salt to her food.
Cognition
Her speech is clear with good vocabulary choice proper to her education and upbringing. She examines idea keenly and precisely and follows verbal cues in a conversation. Her memory of past events is very clear.
Role-relationship
She was been married for 12 year and her husband died and house has been single. She has two grown up children and lives with them. The two children are very caring and often do most of the domestic chores. She is second born of six.
Value-Belief
She is very religious and goes to church often, her orientation is Baptist church.
Coping and Stress
She says she feel embarrassed to be overweight. She is stressed and she says her facial muscles feel tight.
Two Main Diagnoses
The clients is diabetic and this was previously diagnosed and still it was evident by her increased urination after failing to take her medicine causing her condition to be aggregated. Her blood sugar level was recorded to be 400mg/dl.
The second problem is that, Mary is obese. She eat three meal a day and snack throughout, meaning that her consumption is more than what her body probably needs for normal function (Jack et al, 2004, p. 964). Her behavior can be described as erratic eating, deficient understanding of diabetes or noncompliance because she fails to take her medicines. She weights 192lbs which is about 20% more than optimum weight (Jack et al, 2004, p. 964).
Family health Promotion Strategy
There are several intervention strategies that can help in this assessment process and intervention. Community based intervention and resources are very crucial and they respond to community needs (Edelman & Mandle, 2010, p. 121). These strategies have the support if the community resources, cause local action to increase and encourage feelings of community unity. Educating families about diabetes is the fast strategy. Mary O’Brien can be advised to be visiting community centers on public heal for the classes. The community members have to be reminded constantly that diabetes could result into complication if the patients do not adhere to their medication (Jack et al, 2004, p. 964).
The strategic plan should mainly address the major health elements like high risk people and intervention measures. Furthermore, the program should be based on issues of advocacy, increasing awareness, developing resources and enhancing the health skills (Jones et al, 2003, p. 732). Lifestyle intervention is a major strategy to promoting good health though it’s difficult for patients to cope or sustain the change. Restructuring or changing the surrounding is a strategy that ensures compliance and when the patients are given the motivation, the skills, facilities, access and awareness, then compliance will be high. In a nutshell, community based intervention emphasizes individual effort like nutrition and weight control as well as exercise (Jones et al, 2003, p. 732). They also increase awareness or risk factors, noncompliance risks and consequences. There are also professional who offer counseling and programs for lifestyle change.
Reference List
Edelman, C., & Mandle, C. L. (2010). Health Promotion Throughout the Life Span (7th Ed.). St. Louis: Mosby
Gordon, M. (1994). Nursing Diagnosis: Process And Application (3rd Ed.). St. Louis: Mosby
Jack, L et al. (2004). Understanding the Environmental Issues in Diabetes Self Management Education Research: A Re-Examination of 8 Studies In Community-Based Settings, Ann Intern Med, 140(11), 964
Jones, H et al. (2003). Changes in Diabetes Self-Care Behaviors Make a Difference in Glycemic Control: The Diabetes Stages Of Change (Disc) Study. Diabetes Care 26 (3), 732