Introduction

Health assessment means different things to different people. Barkauskas, Stoltenberg-Allen, Baumann and Darling-Fisher (2002) consider health assessment as the systematic collection of data that health professionals, such as nurses, can use to make decisions about how thy will intervene to promote, manintain or restore health.

In this paper, discussion about nursing assessment form of Queen Elizabeth Hospital (figure 1) and Gordon’s functional health pattern (figure 2) are presented, and comparisons between these two assessments on the aspects of structure, comprehensiveness, and applicability will be explained.

Comparison between hospital assessment and Gordon’s functional health patterns

Queen Elizabeth Hospital admission assessment form and the Gordon’s functional health pattern assessment form also can showed the evaluation of Ms Wong’s condition, Ms Wong was admitted to QEH because of slip and fell with left patella fracture. Both assessment forms had clear subjective and objective data on health perception and elimination pattern. It can provide data for us to making nursing diagnosis and care plan. However, there are something difference in terms of structure, comprehensive and applicability of these two assessment.

Structure

The format of Gordon’s Functional Health Patterns Assessment form is simple categories and concise typology. This layout is clustering and is easier to understand and complete. However, hospital assessment forms but not detail to separate category. The Gordon’s Functional Health Patterns Assessment form provides organization framework within which health assessment takes place, so as to clarify and identify client needs, risk factors and specific health problems. The Gordon’s functional health assessment forms including 11 domains in functional health patterns as follows. This is Health perception and management, Activity and exercise, Nutrition and metabolism, Elimination, Sleep and rest, Cognition and perception, Sexuality and reproduction, Self-perception and self-conception, Role and relationships, Coping and stress management, Values and beliefs. A last 4 domains also assess about psychological, social, spiritual. In hospital assessment form to more detail about it.

Comprehensiveness

Gordon’s functional health patterns illustrated a wide scope of assessment themes as a holistic reflection of patient conditions, then more enable prompt nursing diagnosis and implementation. Gordon’s functional health pattern assessment can including to physical, psychological, social, spiritual states were inter-related and inter-dependent. As for Ms Wong’s case, we can know she is suffer from insomnia problems but do not know the reason. However, we can know the reason of insomnia because she is worry no one can take care her husband though Gordon’s functional health patterns assessment. Then, we can provide a holistic care for Ms Wong. For example, refer Community Nurse Service to visit Ms Wong’s home periodically in hospitalization period.

For the hospital assessment, less comprehensive touchdown on patient’s psychological and spiritual details assessed, for example patterns of self- concept sexuality, role relationship, values and beliefs. It let us difficult to set up a holistic care and reduce the chance to set up relationship with our patients.

Applicability

Gordon’s assessment form demonstrates a wider range of health data’s collection as well as a complete history is achieved. It provides informative data and focuses in every daily living, basic health need, cognitive, self-perception, copying stress tolerance and value-belief pattern of the client. Those enhance to set up a conceptual framework for the giving of spiritual care. To make judgment with concerning nursing diagnosis and collaborative problems. They are interrelated and the nursing process can then be easily adopted. The interview is time consuming when using this assessment form. This assessment form pattern suits everyone to read or self -completing. It also contains main components of real health-satisfaction of physical, mental and social-psychology problems.
We can always to build up a good relationship with patient though this assessments.

Hospital assessment form applicability is great but superficial. It suits for the Accident and emergency unit or acute setting hospital. In these hospital or unit, we most important to treat the life threaten problems first. Thought the hospital assessment to have a initial assessment. It is not enough to time to complete a Gordon’s functional health pattern assessment. However, Gordon’s functional pattern assessment is fit for the sub-acute, rehabilitation hospital or psychiatric unit.
To know more about psychological,social, spiritual statues is very important for nurse to decide a personal care plan to help the client to restore a daily life.

At the other side, the open and in depth assessment on psychological and spiritual pattern of Gordon’s assessment tool is difficult to carry out in Chinese culture society. Chinese culture is more traditional, discussion on sexuality reproductive pattern with others was rare. The rectal, breast, genital examination would be odd routine for them because of considering privacy for the areas. Chinese were relatively more reluctant to be examined by nurse than the authorized medical practitioners.

For the detailed psychological and spiritual assessment of Gordon’s functional health patterns, including the deep down exploration on one’s sense of personal identity, view of stressor and defense mechanism. All of the explorations required good trust and rapport relationship was able to be established between nurse and patient, and such really dependent on nurse’s interviewing skills and time invested. Self- reflection of patient was not always possible since these needed certain level of self- awareness or insight.

Conclusion

Holistic health assessment is the foundational skill for the nursing process and uses multiple theory as guidelines in collecting and analyzing data(Grimes & Burns, 1996).

Compare with two different assessment forms, we could recognize the importance of nursing assessment forms that needs an entire structure, comprehensive and applicability, which helps to conduct a good health interview on client. Gordon’s functional pattern is more details in physical, psychological, social, spiritual approach facilitate nurses to get a very comprehensive overview of patient’s health status and identify various possible health problems. In hospital assessment form, it does not include sufficient information about psycho-spiritual side, but the gathered information seemed to be sufficient for the care of emergency or simple case, times and effort was saved. Thereby, different assessment tools is fit for different types of hospital ward setting. *

Reference

Barkauskas, V.H., Stoltenbery – Allen, K., Baumann, L.C., & Darling – Fisher, C. (2002). Health and physical assessment (3rd ed.). St Louis, MO:Mosby.

Grimes, J.and Burns, E. (1996) Health Assessment In Nursing Practice, (4th ed) Little, Brown and company, Bostion.

Contents

Introduction Page 1

Comparison between hospital assessment and Page 1
Gordon’s functional health patterns

Structure Page1 - 2

Comprehensiveness Page 2

Applicability Page 2 - 3

Conclusion Page 4

Reference Page 5

<Compare Hospital Health Assessment and Gordon’s Functional Health Patterns>

Chan Shuk Ying

97028118

TMA 1

Mr. Law Ching Chuen

Submitted in partial fulfillment of the course work for

<NURS S305 Health Assessment and Primary Health Care>

The Nursing Team

School of Science and Technology

The Open University of Hong Kong

25 June 2012

Figure 2

Gordon’s Functional Health Patterns

Name: Ms Wong
Age : 83
Sex: Female
Race: Chinese
Time admitted : 23.6.2012 at 22:30

1. Health Perception – Health Management Pattern

Subjective data: s/f and c/o of left knee pain.

Objective data: General condition: stable, left knee swelling, and decrease range of movement. Temp:37c, BP/P: 154/69mmHg, 90/min, RR:18/min, XR showed fracture of Left patella.

2. Nutritional – Metabolic Pattern

Subjective data: appetite well on low salt full diet. BW55kg with BMI: 21.

Objective data: normal, skin examination normal.

3. Elimination Pattern

Subjective data: bowel and bladder elimination pattern normal

Objective data: may need one assistance to toilet because of left knee pain. Always voiding in bedpan decrease range of movement at left knee. Urine for albumin and sugar: -ve. Abdominal examination, rectal examination and gentoi-urinary examination done:NAD.

4. Activity – Exercise Pattern

Subjective data: c/o left knee to difficult to handle daily activities. Need one assist her to transfer from bed to chair. Objective data: Musculoskeletal system: Left knee swelling and decrease range of movement. Respiratory system and circulatory system normal

5. Sleep-Rest Pattern – rest and relaxation

c/o insomnia, awake at night. Bedtime: 11pm

6. Cognitive-Perceptual Pattern

Mental status assessment: Conscious and alert. Memory intact
Neurological examination done:
RUL5, RLL5
LUL 5,LLL3
GCS 15/15
Sensory examination done: hearing and vision normal. Speech clear with Cantonese.
Pain: c/o left knee pain with pain score 9/10

7. Self-Perception-self-concept Pattern

Feel good

8. Role – relationship pattern Live with husband only, her husband suffer from CVA at last year and mainly homebound now. Ms Wong is a main carer of him. One son in China but not always contact. Ms Wong claimed that she worry about no one take care of her husband. She requested contact MSW for provide meals on wheels service for her husband. She also wanted a nurse will visit her husband.

9. Sexuality-Reproductive Pattern

Gyan state: Menopause
Breast examination : NAD
Genital examination: NAD

10. Coping-stress tolerance Pattern

She always feeling fatigue after her husband suffer from CVA at last year. She cannot to share to her son, because she always cannot contact him.

11. Value-Belief Pattern

No reglious