GORDON’S FUNCTIONAL HEALTH PATTERNS

● Marjorie Gordon was a nursing theorist and professor who proposed a nursing
assessment theory known as Gordon's 11 Functional Health Patterns in 1987. FHP's
as a guide, used by nurses in the nursing process for establishing a comprehensive
nursing database as a result of nursing assessment of the patient. Gordon's
Functional Health Pattern include 11 categories, which make a systematic and
standardized approach to data collection possible, and enable the nurse to determine
the following aspects of health and human function:

I.HEALTH PERCEPTION- HEALTH MANAGEMENT PATTERN

● Data collection is focused on the person's perceived level of health and well-being,
and on practices for maintaining health. Habits that may be detrimental to health are
also evaluated, including smoking and alcohol or drug use. Actual or potential
problems related to safety and health management may be identified as well as needs
for modifications in the home or needs for continued care in the home.

1. History

a. How has general health been?

b. Any colds in past year? When appropriate absences from work?
c. Most important things you do to keep healthy? Think these things make a difference to
health?
(Include family folk remedies when appropriate.) Use of cigarettes, alcohol, drugs?
Breast self examination?
d. Accidents (home, work, driving)?
e. In the past, been easy to find ways to follow suggestions from physicians or nurses?
f. When appropriate: what do you think caused this illness? Actions taken when
symptoms are perceived? Results of action?
g. When appropriate: things important to you in your health care? How can we be most
helpful?

Examination—general health appearance

II.NUTRITIONAL METABOLIC PATTERN

● Assessment is focused on the pattern of food and fluid consumption relative to

metabolic need. The adequacy of local nutrient supplies is evaluated. Actual or
potential problems related to fluid balance, tissue integrity, and host defenses may be
identified as well as problems with the gastrointestinal system.
1. History

a. Typical daily food intake? (Describe) Supplements (vitamins, type of snacks)?

b. Typical daily fluid intake? (Describe)
c. Weight loss or gain? (Amount) Height loss or gain? (Amount)
d. Appetite
e. Food or eating: Discomfort? Swallowing? Diet restrictions?
f. Heal well or poorly?
g. Skin problems: Lesions? Dryness?
h. Dental problems?

2. Examination

a. Skin: Bony prominences? Lesions? Color changes? Moistness?

b. Oral mucous membranes: Color? Moistness? Lesions?
c. Teeth: General appearance and alignment? Dentures? Cavities? Missing teeth?
d. Actual weight, height
e. Temperature
f. Intravenous feeding-parenteral feeding (specify)?

III. ELIMINATION PATTERN

● Data collection is focused on excretory patterns (bowel, bladder, skin). Excretory

problems such as incontinence, constipation, diarrhea, and urinary retention may be
identified.

1. History

a. Bowel elimination pattern? (Describe.) Frequency? Character? Discomfort? Problem

in control?
b. Laxatives?
c. Urinary elimination pattern? (Describe.) Frequency? Problem in control?
d. Excessive perspiration? Odor problems?
e. Body cavity drainage, suction, and so on? (Specify.)

2. Examination- when indicated: examine excreta or drainage color and consistency

IV. ACTIVITY- EXERCISE PATTERN

● Assessment is focused on the activities of daily living requiring energy expenditure,

including self-care activities, exercise, and leisure activities. The status of major body
systems involved with activity and exercise is evaluated, including the respiratory,
cardiovascular, and musculo-skeletal systems.

1. History
 a. Sufficient energy for desired or required activities?
b. Exercise pattern? Type? Regularity?
c. Spare-time (leisure) activities?

Perceived ability (code for level) for: Feeding _______ Dressing ______ Cooking ______
Bathing _____ Grooming _____ Shopping _____ Toileting ______
General Mobility ______ Bed Mobility ______ Home maintenance ________

Functional Level Codes:

Level 0: full self-care

Level I: requires use of equipment or device
Level II: requires assistance or supervision from another person
Level III: requires assistance or supervision from another person and equipment or
device
Level IV: is dependent and does not participate

2. Examination

a. Demonstrated ability (code listed above) for:

Feeding_______ Dressing_________ Cooking________
Bathing________ Grooming________ Shopping_______
Toileting_______ General Mobility__________
b. Gait________ Posture_________ Absent body part? (Specify.)________
c. Range of motion (joints)________ Muscle firmness_________
d. Hand grip________ Can pick up a pencil? ________
e. Pulse (rate)_______ (rhythm)_________ Breath sounds_________
f. Respirations (rate)_________ (rhythm)________ Breath sounds_________
g. Blood pressure__________
h. General appearance (grooming, hygiene, and energy level)

V. SLEEP-REST PATTERN

● Assessment is focused on the person's sleep, rest, and relaxation practices.

Dysfunctional sleep patterns, fatigue, and responses to sleep deprivation may be
identified.

1. History

a. Generally rested and ready for daily activities after sleep?

b. Sleep onset problems? Aids? Dreams (nightmares)? Early awakening?
c. Rest- relaxation periods?
d. Examination
e. When appropriate: Observe sleep pattern

VI. COGNITIVE-PERCEPTUAL PATTERN

 ● Assessment is focused on the ability to comprehend and use information and on the
sensory functions. Data pertaining to neurologic functions are collected to aid this
process. Sensory experiences such as pain and altered sensory input may be
identified and further evaluated.

1. History

a. Hearing difficulty? Hearing aid?

b. Vision? Wear glasses? Last checked? When last changed?
c. Any change in memory lately?
d. Important decision easy or difficult to make?
e. Easiest way for you to learn things? Any difficulty?
f. Any discomfort? Pain? When appropriate: How do you manage it?

2. Examination

a. Orientation
b. Hears whisper?
c. Reads newsprint?
d. Grasps ideas and questions (abstract, concrete)?
e. Language spoken
f. Vocabulary level. Attention span.

VII. SELF-PERCEPTION---SELF-CONCEPT PATTERN

● Assessment is focused on the person's attitudes toward self, including identity, body
image, and sense of self-worth. The person's level of self-esteem and response to
threats to his or her self-concept may be identified.

1. History

a. How describe self? Most of the time, feel good (not so good) about self?
b. Changes in body or things you can’t do? Problem to you?
c. Changes in way you feel about self or body (since illness started)?
d. Things frequently make you angry? Annoyed? Fearful? Anxious?
e. Ever feel you lose hope?

2. Examination

a. Eye contact. Attention span (distraction).

b. Voice and speech pattern. Body posture
c. Nervous (5) or relaxed (1); rate from 1 to 5.
d. Assertive (5) or passive (1); rate from 1 to 5.

VIII. ROLES-RELATIONSHIPS PATTERN

 ● Assessment is focused on the person's roles in the world and relationships with
others. Satisfaction with roles, role strain, or dysfunctional relationships may be further
evaluated.

1. History

a. Live alone? Family? Family structure (diagram)?

b. Any family problems you have difficulty handling (nuclear or extended)?
c. Family or others depend on you for things? How managing?
d. When appropriate: How family or others feel about illness or hospitalization?
e. When appropriate: Problems with children? Difficulty handling?
f. Being to social groups? Close friends? Feel lonely (frequency)?
g. Things generally go well at work? (School?)
h. When appropriate: Income sufficient for needs?
i. Feel part of (or isolated in) neighborhood where living?

2. Examination

a. Interaction with family member(s) or others (if present)

IX. SEXUALITY-REPRODUCTIVE PATTERN

● Assessment is focused on the person's satisfaction or dissatisfaction with sexuality

patterns and reproductive functions. Concerns with sexuality may be identified.

1. History

a. When appropriate to age and situations: Sexual relationship satisfying? Changes?

Problems?
b. When appropriate: use of contraceptives? Problems?
c. Female: When did menstruation started? Last menstrual period? Menstrual problems?
Para?
d. Gravida?

2. Examination: None

X. COPING-STRESS TOLERANCE PATTERN

● Assessment is focused on the person's perception of stress and on his or her coping
strategies Support systems are evaluated, and symptoms of stress are noted. The
effectiveness of a person's coping strategies in terms of stress tolerance may be
further evaluated.

1. History

a. Any big changes in your life in the last year or two? Crisis?
b. Who’s most helpful in talking things over? Available to you now?c. Tense or relaxed
 most of the time? When tense, what helps?
c. Use any medicines, drugs, alcohol?
d. When (if) have big problems (any problems) in your life, how do you handle them?
e. Most of the time is this (are these) way(s) successful?

2. Examination: none

XI. VALUES-BELIEFS PATTERN

● Assessment is focused on the person's values and beliefs (including spiritual beliefs),
or on the goals that guide his or her choices or decisions.

1. History

a. Generally get things you want from life? Important plans for the future?
b. Religion important in life? When appropriate: Does this help when difficulties arise?
c. When appropriate: will being here interfere with any religious practices?

2. Examination: None

Gordon’s Functional Health Patterns

● Gordon’s Functional Health Patterns is a method develops By Marjorie Gordon in 1987

proposed functional health patterns as a guide for establishing a comprehensive nursing
data base. By using these categories it’s possible to create a systematic and
standardized approach to data collection, and enable the nurse to determine the
following aspects of health and human function:

11 Gordon’s Functional Health Patterns

1. Health Perception Health Management Pattern

2. Nutritional Metabolic Pattern
3. Elimination Pattern
4. Activity Exercise Pattern
5. Sleep Rest Pattern
6. Cognitive-Perceptual Pattern
7. Self-Perception-Self-Concept Pattern
8. Role-Relationship Pattern
9. Sexuality-Reproductive
10. Coping-Stress Tolerance Pattern
11. Value-Belief Pattern
1. Health Perception and Health Management.
- It’s focused on the person’s perceived level of health and well-being, and on practices for
maintaining health. Also evaluated Habits including smoking and alcohol or drug use.

● Contamination
● Disturbed energy field
● Effective therapeutic regimen management
● Health-seeking behaviors (specify)
● Ineffective community therapeutic regimen management
● Ineffective family therapeutic regimen management
● Ineffective health maintenance
● Ineffective protection
● Ineffective therapeutic regimen management\
● Noncompliance (ineffective Adherence)
● Readiness for enhanced immunization status
● Readiness for enhanced therapeutic regimen management
● Risk for contamination
● Risk for infection
● Risk for injury
● Risk for perioperative positioning injury
● Risk for poisoning
● Risk for sudden infant death syndrome
● Risk for suffocation
● Risk for trauma
● Risk-prone health behavior

2. Nutritional Metabolic Pattern

- it’s focused on the pattern of food and fluid consumption relative to metabolic need. It
evaluated the adequacy of local nutrient supplies. Actual or potential problems related
to fluid balance, tissue integrity, and host defenses may be identified as well as problems
with the gastrointestinal system.

● Adult failure to thrive

● Deficient fluid volume: [isotonic]
● [Deficient fluid volume: hyper/hypotonic]
● Effective breastfeeding [Learning Need]
● Excess fluid volume
● Hyperthermia
● Hypothermia
● Imbalanced nutrition: more than body requirements
● Imbalanced nutrition: less than body requirements
● Imbalanced nutrition: risk for more than body requirements
● Impaired dentition
● Impaired oral mucous membrane
 ● Impaired skin integrity
● Impaired swallowing
● Impaired tissue integrity
● Ineffective breastfeeding
● Ineffective infant feeding pattern
● Ineffective thermoregulation
● Interrupted breastfeeding
● Latex allergy response
● Nausea
● Readiness for enhanced fluid balance
● Readiness for enhanced nutrition
● Risk for aspiration
● Risk for deficient fluid volume
● Risk for imbalanced fluid volume
● Risk for imbalanced body temperature
● Risk for impaired liver function
● Risk for impaired skin integrity
● Risk for latex allergy response
● Risk for unstable blood glucose

3. Elimination Pattern. It’s focused on excretory patterns (bowel, bladder, skin).

● Bowel incontinence
● Constipation
● Diarrhea
● Functional urinary incontinence
● Impaired urinary elimination
● Overflow urinary incontinence
● Perceived constipation
● Readiness for enhanced urinary elimination,
● Reflex urinary incontinence
● Risk for constipation
● Risk for urge urinary incontinence
● Stress urinary incontinence
● Total urinary incontinence
● Urge urinary incontinence
● [acute/chronic] Urinary retention

4. Activity and Exercise Pattern.

-It’s focused on the activities of daily living requiring energy expenditure, including self-care
activities, exercise, and leisure activities.

● Activity intolerance
 ● Autonomic dysreflexia
● Decreased cardiac output
● Decreased intracranial adaptive capacity
● Deficient diversonal activity
● Delayed growth and development
● Delayed surgical recovery
● Disorganized infant behavior
● Dysfunctional ventilatory weaning response
● Fatigue\
● Impaired spontaneous ventilation
● Impaired bed mobility
● Impaired gas exchange
● Impaired home maintenance
● Impaired physical mobility
● Impaired transfer ability
● Impaired walking
● Impaired wheelchair mobility
● Ineffective airway clearance
● Ineffective breathing pattern
● Ineffective tissue perfusion
● Readiness for enhanced organized infant behavior
● Readiness for enhanced self care
● Risk for delayed development
● Risk for disorganized infant behavior
● Risk for disproportionate growth
● Risk for activity intolerance
● Risk for autonomic dysreflexia
● Risk for disuse syndrome
● Sedentary lifestyle
● Self-care deficit
● Wandering

5. Cognitive-Perceptual Pattern.
- It’s focused on the ability to comprehend and use information and on the sensory
functions. Neurologic functions, Sensory experiences such as pain and altered sensory
input.

● Acute confusion
● Acute pain
● Chronic confusion
● Chronic pain
● Decisional conflict
● Deficient knowledge
● Disturbed sensory perception
 ● Disturbed thought processes
● Impaired environmental interpretation syndrome
● Impaired memory
● Readiness for enhanced comfort
● Readiness for enhanced decision making
● Readiness for enhanced knowledge
● Risk for acute confusion
● Unilateral neglect

6. Sleep Rest Pattern.

- It’s focused on the person’s sleep, rest, and relaxation practices. To identified
dysfunctional sleep patterns, fatigue, and responses to sleep deprivation.

● Insomnia
● Readiness for enhanced sleep
● Sleep deprivation

7. Self-Perception-Self-Concept Pattern
- its focused on the person’s attitudes toward self, including identity, body image, and
sense of self-worth.

● Anxiety
● disturbed Body image
● Chronic low self-esteem
● Death anxiety
● Disturbed personal identity
● Fear
● Hopelessness
● Powerlessness
● Readiness for enhanced hope
● Readiness for enhanced power
● Readiness for enhanced self-concept
● Risk for compromised human dignity
● Risk for loneliness
● Risk for powerlessness
● Risk for situational low self-esteem
● Risk for [/actual] other-directed violence
● Risk for [actual/] self-directed violence
● Situational low self-esteem

8. Role-Relationship Pattern.
- It’s focused on the person’s roles in the world and relationships with others. Evaluated
Satisfaction with roles, role strain, or dysfunctional relationships.
 ● Caregiver role strain
● Chronic sorrow
● Complicated grieving
● Dysfunctional family processes: alcoholism (substance abuse)
● Grieving
● Impaired social interaction
● Impaired verbal communication
● Ineffective role performance
● Interrupted family processes
● Parental role conflict
● Readiness for enhanced communication
● Readiness for enhanced family processes
● Readiness for enhanced parenting
● Relocation stress syndrome
● Risk for caregiver role strain
● Risk for complicated grieving
● Risk for impaired parent/infant/child attachment
● Risk for relocation stress syndrome
● Social isolation

9. Sexuality and Reproduction.

- It’s focused on the person’s satisfaction or dissatisfaction with sexuality patterns and
reproductive functions.

● Ineffective sexuality patterns

● Rape-trauma syndrome
● Sexual dysfunction

10. Coping-Stress Tolerance Pattern.

- its focused on the person’s perception of stress and coping strategies Support systems,
evaluated symptoms of stress, effectiveness of a person’s coping strategies.

● Compromised family coping

● Defensive coping
● Disabled family coping
● Impaired adjustment
● Ineffective community coping
● Ineffective coping
● Ineffective denial
● Post-trauma syndrome
● Readiness for enhanced community coping
● Readiness for enhanced coping
● Readiness for enhanced family coping
● Risk for self-mutilation
 ● Risk for suicide
● Risk for post-trauma syndrome
● Self-mutilation
● Stress overload

11. Value-Belief Pattern

- it’s focused on the person’s values and beliefs.

● Impaired religiosity
● Moral distress
● Readiness for enhanced religiosity
● Readiness for enhanced spiritual well-being
● Risk for impaired religiosity
● Risk for spiritual distress
● Spiritual distress