Health Promotion of the Family: The Holistic View Gordon developed the 11 functional health patterns to assist in holistic assessment of the family. (Edeleman, Kudzma, & Mandle, 2014)The functional health pattern format assists nurses in assessment of the family, which lends to development of wellness and family nursing diagnoses. An analysis of the family health assessment made through the use of the functional health pattern framework provided the writer with a holistic overview on the health status of this one particular family. The patterns assessed were: values, health perception, nutrition, sleep/rest, elimination, activity/exercise, cognitive, sensory-perception, self-perception, role relationship, sexuality and coping. Overall the assessed family strives to maintain optimal health by many proactive activities yet there are a few dysfunctional patterns that have the potential to minimize their ultimate health status.
The assessed family was queried about their overall health using the aforementioned patterns. The writer deemed it important to assess their cognitive and sensory-perception patterns foremost in the assessment. The writer first assessed each family member’s level of education. The male family member reported to have a “bachelors degree” and the female family member reported to have a “masters degree.” The family was assessed as to how they preferred to gain information about health as to which they reported use of the Internet and research. The family was then queried if any member had an illness that affected their mental abilities. The female member replied, “I have kidney disease and the medications I take sometimes cause me to have blurred vision, tremors and I have a history of fainting.” The writer then next assessed the family’s sensory perception. They were queried if anyone in the family had any problems with vision, hearing or any of their other senses and if so were they corrected. They both reported that vision was their only deficit and both wear glasses to correct this problem. They were also queried if anyone in the family had a disease that affected the senses to which the female member replied, “Yes, the kidney disease. I have a kidney transplant. The immunosuppressant’s I take sometimes cause blurred vision, cause dizziness and make me lightheaded.” She also reported “I experience headache pain which I feel is attributed to the kidney disease as well.” In relation to health perception and values the family described their health as, “Ok.” The family briefly verbalized understanding of the connection between health status and their way of life by stating, “They are connected.” The family displayed some knowledge of these connections through their nutritional choices. The writer queried the family about their diet as compared to the recommended daily allowance. One member reported, “I eat more calories than the recommended daily allowance” while the other family member stated, “I watch what I eat and I think that I eat what I should as compared to the RDA.” In light of the difference in dietary habits, the family was encouraged to eat meals together, to encourage the member whose eating habits were not ideal to become more health and nutritious conscious. In discussion of nutrition one family member notified the writer of her battle with kidney disease. The writer and family discussed the importance of eating fresh fruits and vegetables, low fat dairy, fish, chicken and legumes. The female family member stated, “I have been suffering with kidney disease for a long time and my doctors and nurses have done a great job educating me on the DASH diet, which I try to follow to stay healthy.” The writer was pleasantly surprised by the knowledge of the family member and encouraged her continued compliance.
After discussion of nutrition the conversation flowed with ease into the topic of elimination. When queried about bowel patterns and urination difficulty or issues affecting the skin, the male family member denied any problems with any of the three. On the other hand the female family member endorsed having constipation at times, using Metamucil, a fiber laxative, and Pepto-Bismol for upset stomach. She reported, “I have had two kidney transplants and eight surgeries, so I have quite a bit of scarring which sometimes makes digestion difficult.” Again the writer applauded the female family member for use of the proper tools to promote her digestive health. They displayed knowledge of healthy urine and stool patterns, by discussing the color, consistency and odor. The family appeared to have a good foundation for maintaining digestive health yet they were unaware of how the skin played a role in elimination. They were interested to learn that, “Perspiration quantity and quality determine excretory skin function” (Edeleman et al., 2014, p. 134).
The family continued to show their knowledge about promoting health through the assessment of their exercise/activity patterns. Both family members reported participation in moderate to heavy exercise programs a few days out of the week. They reported participation in basketball, martial arts and weight training exercise. When queried if they both felt they had energy for exercise, the male family member replied, “Yes, even when I wake up tired, I am able to gain energy throughout the day.” On the contrary the female family member stated, “No I need rest in order to work out.” The writer and family discussed how her kidney disease affects her ability to exercise. The decreased function of the kidney has negative effects on the cardiovascular and respiratory system, which in turn leads to decreased oxygen in the blood.
The conversation naturally proceeded to the topic of rest as they had both previously discussed their energy levels briefly when speaking of exercise/activity. Although the family appeared to have a good grasp on maintaining optimal health in quite a few areas, one aspect that they appeared to struggle with was sleep/rest. They both reported, “Working long days, 7-10 hours per day and sleeping on average 5-6 hours.” It was not surprising that they both denied feeling rested and ready for the day after sleep. When queried what was one thing they would do to improve their sleep the male family member reported simply with a grin, “Get more sleep,” while the female family member replied, “If I could decrease my stress I feel that would improve the quality and quantity of my sleep.”
Since the female family member touched on the topic of stress the writer proceeded to query the family about their coping mechanisms. They both replied that, “Exercise is a coping mechanism we find helpful in stressful situations.” The writer queried the family if they had ever elicited the use of a professional for help in dealing with stress. The female family member reported, “After my surgeries for my transplants I found that talking to a professional was very helpful.”
On the aspect of self-perception the family was asked to identify similarities and differences between their family and others. The male family member stated, “I feel like we are different because of dealing with all the health issues all the time but we are similar in the fact that we deal with the same pressures as other families, for example work, paying bills, and maintaining a relationship.” Each member was then asked what strengths they brought to the household. The male family member replied, “99% of the time I am calm and emotionally consistent no matter what stressors arise.” The female family member additionally replied, “It doesn’t matter what I go through, or what we go through I just keep on pushing through.” During this discussion it was evident that the general tone in the family is peaceful. The writer then asked how each member feels toward one another, to which both expressed feelings of love, admiration and respect.
The interview next addressed role/relationship. The writer asked the family to describe their roles in life from day to day. They both fill many roles, including those of financial providers, husband, wife, partner, friend, son, brother, daughter and sister. Despite having to fill these many roles they both acknowledged that their relationships with each other and with God are of utmost importance. The writer was curious to know if any changes in their lives had affected their roles or relationships as of late. After a long pause they both looked at each other then looked back at me. Finally the male family member replied, “Yes, we have been going through a rough patch lately, we are not really seeing ‘eye to eye’ on things. It has been over a year and things have not been the same as they used to be, I fear we are drifting apart.” This part of the assessment transitioned into the final section of the discussion.
Lastly the family was interviewed about the aspect of sexuality. The first question the writer asked was simple and to the point. The question was posed, are you satisfied with your sex life? Both family members replied no but expanded on their answers in different ways. The male family member replied that the quantity was not enough for him and the female family member replied that she does not engage or initiate acts of intimacy enough. The next natural question was in relation to communication of needs. The male family member stated, “I feel like she is not direct enough, I tell her to just tell me what, how and when she wants what she wants but she doesn’t do that. I have given up communicating in regards to this topic.” The female family member acknowledged not being as direct as her husband has requested yet stated her reason as fear of rejection despite constant reassurance from her spouse. The family reportedly has replaced sexual affection with displays of love in non-sexual ways.
Overall the family appeared to have a good understanding of health promotion. One concern that the writer took note of was in regards to the family’s sleep/rest pattern. They are both busy adults and are not balanced in the time they sleep/rest in compared to work and other activities. Yet they have both expressed the desire to enhance sleep. The Wellness Diagnosis Readiness for Enhanced Sleep is definitely appropriate for them. (Weber, 2005) The family could implement a routine to aid them in developing good sleep habits. This would in turn increase their energy and have a positive effect on their overall health.
Another concern the writer took note of was the dysfunctional sexual pattern present between the couple. This was evident by their comments in relation to lack of fulfillment in this aspect of their relationship. The Wellness Diagnosis Readiness for Enhanced Sexuality Patterns is appropriate for this identified problem. (Weber, 2005) The writer suggested the use of couples counseling since the female family member had acknowledged positive results through individual psychotherapy in the past.
Gordon’s functional heath pattern aids the nurse in gathering a synopsis of the family’s knowledge of health promotion from a holistic standpoint. Through this assessment the nurse gains information he or she can effectively use to create Wellness Nursing Diagnoses for the family and therefore continue to promote health and wellness for families and patients.

References
Edeleman, C., Kudzma, E., & Mandle, C. (2014). Health Promotion Throughout the Life Span (8th ed.). [VitalBook file].
Weber, J. R. (2005). Nursing Diagnoses (Wellness, Risk, and Actual) Grouped According to Functional Health Patterns. In Lippincott, Williams, & Wilkins (Eds.), Nurses’ Handbook of Health Assessment (5th). Retrieved from http://web.archive.org/web/20120526135152/http://jxzy.smu.edu.cn/jkpg/UploadFiles/file/TF_06928152357_nursing%20diagnoses%20grouped%20by%20functional%20health%20patterns.pdf