GORDON'S 11 FUNTIONAL HEALTH PATTERN (Q'S)

GORDON’S 11 FUNCTIONAL HEALTH PATTERNS

1. Health Perception and Health Management Pattern

 What is your opinion about health?

 Are you immunized about seven target diseases?
 Last immunization?
 Do you have any allergy? If yes, then type of allergy.
 Any surgery in past? What type of surgery?
 Last physical examination and for what purpose.
 Are you using any medicine recently?
 Do you know about these medicines?
 Client’s general health? Any colds in past year? If appropriate: any
absences from work/school?
 Most important things you do to keep healthy?
 Use of cigarettes, alcohol, drugs?
 Perform self-exams, i.e., Breast/testicular self-examination?
 Accidents at home, work, school, driving?
 In past, has it been easy to find ways to carry out doctor’s or nurse’s
suggestions?
 (If appropriate) What do you think caused current illness?
 What actions have you taken since symptoms started?
 Have your actions helped? (If appropriate)
 What things are most important to your health?
 How often do you exercise?
2. Nutrition and Metabolism Pattern
 Ask about their skin, scalp, and nails?

 What is your diet menu?
 Any food restriction regarding disease point of view?
 Any food restriction regarding religious point of view?
 Any food like or dislike?
 Any food allergy?
 Typical daily food intake? (Describe) Use of supplements, vitamins, types

of snacks?
 Typical daily fluid intake? (Describe)
 Weight loss/gain? Height loss/gain?
 Appetite? Breastfeeding? Infant feeding?
 Food or eating: Discomfort, swallowing difficulties, diet restrictions, able to
follow?
 Healing – any problems?
 Skin problems: lesions? Dryness?
 Dental problems?
3. Elimination Pattern
 Urine:
 Color of urine, amount, frequency, odor, and any discharge. Any urinary
problem, Dysuria, Anuria, Oliguria, and Polyuria.
 Defecation:
 Are you using any laxative? If yes which?
 Any problem during passing defecation?
 Bowel elimination pattern (describe) Frequency, character, discomfort,

problem with bowel control, use of laxatives (i.e., type, frequency), etc.?
 Urinary elimination pattern (describe) Frequency, problem with bladder
control? Excess perspiration? Odor problems? Body cavity drainage,
suction, etc.?
4. Activity and Exercise Pattern

 Do you any breathing problem?
In which apnea, hypoxia, hypoxemia, hypercapnia.
 Do you have cough? (Productive or non-productive)
 Any changes in heartbeat during exercise?
 Do you feel pale during exercise?
 What type of exercise you do or any problem during exercise?
 Sufficient energy for desired and/or required activities?

 Exercise pattern? Type? regularity?
 Spare time (leisure) activities?
 Child-play activities?
 Perceived ability for feeding, grooming, bathing, general mobility, toileting,
home maintenance, bed mobility, dressing and shopping?
5. Cognition and Perception Pattern

 Orientation about time place and person.
 Any difficulty in sentence making?
 Loss of memory.
 Hearing difficulty? Hearing aid?

 Vision? Wears glasses? Last checked? When last changed?
 Any change in memory?
 Concentration? Important decisions easy/difficult to make?
 Easiest way for you to learn things? Any difficulty?
 Any discomfort? (COLDSPA, PQRST)
6. Sleep and Rest Pattern

 What is your self-perception about yourself?
 Are you satisfied with your self-body image?
 Do you like grooming?
 How do you describe yourself?

 Most of the time, feel good (or not so good) about self?
 Changes in body or things you can do. Problems for you?
 Changes in the way you feel about self or body (generally or since illness
started)?
 Things frequently make you angry? Annoyed? Fearful? Anxious?
Depressed?
 Not able to control things? What helps?
 Ever feel you lose hope?
7. Self-Perception and Self-Concept Pattern

 What is your self-perception about yourself?
 Are you satisfied with your self-body image?
 Do you like grooming?
 How do you describe yourself?

 Most of the time, feel good (or not so good) about self?
 Changes in body or things you can do. Problems for you?
 Changes in the way you feel about self or body (generally or since illness
started)?
 Things frequently make you angry? Annoyed? Fearful? Anxious?
Depressed?
 Not able to control things? What helps?
 Ever feel you lose hope?
8. Roles and Relationships Pattern

 What is your role in family?
 If you are in hospital, then who will perform your responsibilities?
 All the family members are cooperative with you?
 Who is decision maker in your family?
 Live alone? Family? Family structure?

 Any family problems you have difficulty handling (nuclear/extended
family)?
 Family or others depend on you for things?
 How well are you managing? If appropriate – How families/others feel
about your illness?
 Problems with children? Belong to social groups? Close friends? Feel
lonely? (Frequency)
 Things generally go well at work / school? If appropriate – income
sufficient for needs? Feel part of (or isolated in) your neighborhood?
9. Sexuality and Reproduction Pattern

 When you first notice changes in your menarche (first menses is called
menarche)
 Do you have any sexual problem? (Loss of libido)
 Active sex (direct sex with male and female)
Passive sex (sex without male and female partner)
Digital sex (Artificial dimy etc)
 Reproductive: Infertility
 If appropriate to age and situation – Sexual relationships satisfying?
Changes? Problems? If appropriate – Use of contraceptives? Problems?
Female – when did menstruation begin? Last menstrual period (LMP)? Any
menstrual problems? (Gravida/Para if appropriate)
10. Coping and Stress Tolerance Pattern

 If you have stress, then what is your coping mechanism towards stress?
Crying, angry, violence, (what is your opinion regarding that)
 Any big changes in your life in last year or two? Crisis?

 Who is most helpful in talking things over?
 Available to you now?
 Tense or relaxed most of the time? When tense, what helps? Use any
medications, drugs, alcohol to relax?
 When (if) there are big problems in your life, how do you handle them?
 Most of the time, are these ways successful?
11. Values and Belief Pattern

 What is your religion?
 Do you offer prayer?
 Generally, get things you want from life? Important plans for future?
 Religion important to you? If appropriate - Does this help when difficulties
arise? If appropriate – will being here interfere with any religious practices?

GORDON'S 11 FUNTIONAL HEALTH PATTERN (Q'S)

Uploaded by

Copyright:

Available Formats

GORDON'S 11 FUNTIONAL HEALTH PATTERN (Q'S)

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

GORDON'S 11 FUNTIONAL HEALTH PATTERN (Q'S)

Uploaded by

Copyright:

Available Formats

GORDON’S 11 FUNCTIONAL HEALTH PATTERNS

1. Health Perception and Health Management Pattern

 What is your opinion about health?

2. Nutrition and Metabolism Pattern

 Ask about their skin, scalp, and nails?

 Typical daily food intake? (Describe) Use of supplements, vitamins, types

 Bowel elimination pattern (describe) Frequency, character, discomfort,

4. Activity and Exercise Pattern

 Sufficient energy for desired and/or required activities?

5. Cognition and Perception Pattern

 Hearing difficulty? Hearing aid?

6. Sleep and Rest Pattern

 How do you describe yourself?

7. Self-Perception and Self-Concept Pattern

 How do you describe yourself?

8. Roles and Relationships Pattern

 Live alone? Family? Family structure?

9. Sexuality and Reproduction Pattern

10. Coping and Stress Tolerance Pattern

 Any big changes in your life in last year or two? Crisis?

11. Values and Belief Pattern

You might also like