A Simple Guide to Gordon’s Functional Health Patterns for Nurses
Gordon’s functional health patterns is an assessment method that helps nurses understand a patient’s overall health. The scale uses 11 health patterns that reveal a patient’s physical, mental, and emotional status. Nurses can use the outcomes of this assessment to form nursing diagnoses and plan care. Let’s explore where this assessment came from and how to apply it.
Background on Functional Health Patterns
The functional health patterns were developed by Dr. Marjory Gordon. She was part of a league of nursing leaders (including Sister Callista Roy, Dorothea Orem, Margaret Newman, Imogene King, and others) who sought to define and theorize about the profession in the 1970s. What made nursing knowledge different from medical knowledge? What is the nursing process? These are some of the questions that this group sought to answer.
Dr. Gordon was an expert in communication and records, and she was key in developing the clinical reasoning and classification that is specific to the nursing profession. She helped codify the process of applying nursing diagnoses and evaluating outcomes. Her work integrated this nursing language into electronic health records (EHR), giving nurses a voice distinct from medical diagnoses and treatments.
Gordon’s functional health patterns were central to the effort of creating a distinct nursing vernacular. It’s a comprehensive assessment system that helps nurses explore a full picture of symptoms, revealing patterns and areas where support may be needed. The system also helps structure assessment data so that nurses can see how different elements of health overlap.
In 1982, Gordon served as the first president of the North American Nursing Diagnosis Association (NANDA), and was professor emerita at the Connell School of Nursing for 23 years. In 2009, she was named a Living Legend of the American Academy of Nursing, and NANDA International maintains a Gordon Scholars program to continue fostering post-doctoral nursing students across the globe.
Gordon’s Functional Health Patterns Explained
What is the purpose of functional health patterns? These 11 elements are designed to encapsulate the most essential components of health. This system also helps nurses assess patients and efficiently categorize health data.
We broke down Gordon’s 11 functional health patterns and created an example patient to evaluate with this scale, so you can see the assessment in action.
1. Health Perception and Health Management
How does the patient feel about their own health and health behaviors? What current habits do they have that affect their health? Patients may perceive themselves as healthy, unhealthy, or somewhere in between, and these perceptions may be influenced by beliefs that affect self-concept. Some self-reported behaviors may point to potential health problems that warrant investigation.
Example: Claudia, a 48-year-old woman, reports that she isn’t as healthy as she used to be. She has three children at home, as well as a full-time job, and she laments that she feels ashamed that she hasn’t “taken care” of herself in the last several years.
2. Nutrition and Metabolism
How much food and liquids does the patient consume? What are their typical eating habits over the course of a day? Do their intake habits match elimination and their needs? A patient’s emotional status, beliefs, and self-perception can all influence their consumption.
Example: Claudia self-reports that she tries not to drink much water during the day, because she doesn’t have much time to go to the restroom at her job. She relies on “unhealthy snacks” during the day. She doesn’t have time to prepare meals for herself while at work, so she often finds herself eating from vending machines.
3. Elimination
Does the patient have a regular schedule for liquid and solid waste elimination? The nurse may ask the patient about bathroom habits and any factors that may impact them. Elimination is affected by nutrition and metabolism, as well as activity and exercise.
Example: Claudia doesn’t use the restroom during most of the day, but feels that her elimination habits match her intake and denies any discomfort.
4. Activity and Exercise
Can the patient move easily and accomplish functional tasks? Do they have a routine for exercise? Many patients have physical limitations that are not apparent to the naked eye. This question may reveal physical issues that should be investigated and addressed. Activity and exercise can affect self-perception, coping and stress tolerance, and more.
Example: Claudia reports a back injury that sometimes bothers her while exercising. She goes on a walk three times a week, but laments that her workout habits are “not what they used to be.”
5. Cognition and Perception
This element assesses the patient’s cognitive abilities: Do they have any sensory deficits? Are they able to cognitively process the world around them and respond accordingly? Sleep and rest habits impact cognitive functioning, as do nutrition and metabolism.
Example: Claudia is oriented to time, place, and person, and denies any sensory issues. The nurse performs a cognitive assessment and finds no deficits.
6. Sleep and Rest
Rest is an essential element of health. Is the patient getting adequate sleep? What are their sleep habits like, and are there any factors that make sleep or rest more difficult? Sleep impacts cognition, coping and stress tolerance, and other health factors.
Example: Claudia says that her sleep habits have improved now that her children are no longer infants, but she frequently wakes up feeling flushed and has difficulty falling back to sleep. She usually sleeps for seven hours a night, although she reports that back pain sometimes wakes her up early.
7. Self-Perception and Self-Concept
The way a patient views themselves impacts how they care for themselves. What is their attitude about life? Do they exhibit self-esteem? Self-perception impacts health perception, nutrition, exercise, and social relationships.
Example: Claudia exhibits some shame that she doesn’t feel she is “taking care of herself” the way she should. She reports being very focused on her children and family at this stage in life.
8. Roles and Relationships
What is the patient’s social and family life like? What role do they play in the lives of others? Emotional ties influence self-concept, beliefs and values, coping and stress tolerance, and more.
Example: Claudia finds joy and fulfillment in her children, and reports that she loves being a mother. Her husband is also a source of strength. Her parents and siblings live across the country, but she reports that she has a close group of friends whom she sees “every month or so.”
9. Sexuality and Reproduction
Is the patient satisfied with their sex life? If they are within their reproductive years, do they plan on reproducing soon? Do they have a birth control plan? Sexuality impacts roles and relationships and self-perception, and is influenced by activity, beliefs and values, stress, and more.
Example: Claudia reports that her sex life is fulfilling. She obtained an intrauterine device (IUD) after the birth of her last child, and does not plan to have more children. She believes that she is currently in perimenopause.
10. Coping and Stress Tolerance
How does the patient deal with stressful situations? What is their current level of life stress, and what resources are available to them? Coping and stress tolerance influence sleep and rest, self-perception, roles and relationships, and much more.
Example: Due to economic changes, Claudia reports feeling anxious about being let go from her job. Her husband also works, and this brings her some comfort, but she is ashamed of potentially losing her employment. She reports that when she is anxious, she tries to take a walk or “get out of the office.”
11. Values and Beliefs
Beliefs and values underpin behaviors, relationships, self-concept, and much more. This includes the patient’s religious, spiritual, and cultural beliefs. They may also have values around end-of-life care, reproductive care, health behaviors, and much more.
Example: Claudia states that she “grew up Catholic” but does not identify with a religion currently.
How to Use Gordon’s Functional Health Patterns in Nursing
Nurses can use the health patterns, alongside a thorough head-to-toe assessment, to assemble a thorough database on the health of a patient. But you’re probably less likely to use this as an assessment tool, and more as a way to organize health information so that you can see patterns and plan care. (See also: Tanner’s clinical judgment model.)
Gordon’s functional health patterns are not necessarily a formula for nurses to follow when investigating a patient, but a systematic way of viewing health from a holistic perspective. Once you categorize health data this way, you’ll notice how different elements overlap, and how a solution to one problem may solve several others.
Let’s use Claudia, the patient cited above, as an example. Based on the Health Patterns assessment outcomes, what trends do you notice? Claudia reports symptoms of perimenopause, so the nurse may choose to educate her in this area or refer her to a gynecologist. Receiving education on her health status may help improve her health perception, sleep, and stress.
Claudia also reports back pain that affects her exercise habits. The nurse can investigate this pain further to understand its cause and recommend further action. Easing her pain could help Claudia feel better about her overall health, improve her sleep, and lower her stress.
While it may seem abstract, Gordon’s functional health patterns can help nurses gain a more comprehensive perspective on a patient’s health status, so that they can plan interventions with more insight and efficiency.
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