- \n
- Family initials__________________Date_______________<\/li>\n
- Ethnicity________________<\/li>\n
- Age of family members______<\/li>\n
- Gender of family member________<\/li>\n
- Occupation____________<\/li>\n
- Community involvement______________<\/li>\n
- Family health history________________________<\/li>\n
- Neighborhood information_______________<\/li>\n<\/ul>\n
Health Perception\/Health Management<\/h2>\n
<\/i><\/strong><\/p>\n
- \n
- Describe any health problems in your family.<\/li>\n
- If a family member indicates a current or past illness, ask the individual the following questions:\n
- \n
- What is the cause of the illness or health problem?<\/li>\n
- How is the illness managed?<\/li>\n
- Has the illness affected the family\u2019s daily activities?<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
- \n
- Does any member use alcohol, tobacco, or drugs?<\/li>\n
- Has each family member seen a doctor in the past year? ____ Past 5 years? _____Past 10 years? ___________<\/li>\n
- Is any family member allergic to a substance?<\/li>\n<\/ul>\n
<\/strong> <\/p>\nNutritional-Metabolic Pattern<\/h2>\n
- \n
- What is a typical meal plan?\n
- \n
- Breakfast<\/li>\n
- Lunch<\/li>\n
- Dinner<\/li>\n
- Snack<\/li>\n<\/ul>\n<\/li>\n
- Are you on a special diet? Are there any restrictions on your diet?<\/li>\n<\/ul>\n
- \n
- Do you experience any problem with eating such as nausea, vomiting, weight gain or loss, difficulty swallowing?<\/li>\n
- Do you experience infections frequently? Does the wound take time to heal?<\/li>\n
- Do you have any problems with your hair, skin, or nails?<\/li>\n<\/ul>\n
Elimination Patterns<\/h2>\n
- \n
- What is your bowel pattern (frequency, discomfort, characteristic stool)? <\/li>\n
- Do you use laxative, suppositories and enemas?If yes, how many times a week?<\/li>\n
- How often do you urinate?Is there any discomfort or loss of control?<\/li>\n<\/ul>\n
Activity-Exercise Patterns<\/h2>\n
- \n
- Describe your daily routine.<\/li>\n
- When you engage in physical activities, do you experience fatigue?<\/li>\n
- Identify your functional level by the following codes?\n
- \n
- Level 0:Full self care<\/li>\n
- Level 1:Require special equipment such as a wheelchair, a walker, etc.<\/li>\n
- Level 2: Require assistance while dressing<\/li>\n
- Level 3:Require assistance while bathing<\/li>\n
- Level 4:Is totally dependent <\/li>\n<\/ul>\n<\/li>\n
- Are you able to do the following independently?<\/li>\n<\/ul>\n
<\/i><\/strong><\/p>\n
Sleep-Rest Pattern<\/h2>\n
<\/i><\/strong><\/p>\n
- \n
- Do you nap frequently?<\/li>\n
- Describe your sleep patterns.<\/li>\n
- Do you follow a bedtime routine?<\/li>\n
- For how many hours do you sleep?<\/li>\n<\/ul>\n
Cognitive-Perceptual Pattern<\/h2>\n
- \n
- Are you experiencing any discomfort or pain? If yes describe its duration, location, intensity, and the relief measures you use?<\/li>\n
- Do you use a hearing aid?<\/li>\n
- Do you wear glasses or contacts?<\/li>\n
- Do you experience numbness or tingling?<\/li>\n
- Are there changes in your memory or ability to learn?<\/li>\n
- Are you able to smell?<\/li>\n
- Are you able to taste?<\/li>\n<\/ul>\n
Self Perception – Self Concept Pattern<\/h2>\n
- \n
- Describe yourself.<\/li>\n
- How do you feel about your body image?<\/li>\n
- What are your strengths\/weaknesses?<\/li>\n
- Has your body image been affected by a recent illness or health change?<\/li>\n<\/ul>\n
Role \u2013 Relationship Pattern<\/h2>\n
- \n
- Describe your family.<\/li>\n
- Whom do you live with?<\/li>\n
- Has your family been affected by an illness?<\/li>\n<\/ul>\n
Sexuality-Reproductive Pattern<\/h2>\n
- \n
- Are you sexually active?<\/li>\n
- Has an illness affected your sexual patterns?<\/li>\n
- Are you using any medication to enhance your sexual functions?<\/li>\n
- For women:\n
- \n
- Age menstruation began____<\/li>\n
- Last menstrual period_____<\/li>\n
- Pregnancy history_____<\/li>\n
- Menopause? ______ <\/li>\n
- Hormone replacement therapy______<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
<\/i><\/strong><\/p>\n
Coping-Stress Tolerance Pattern<\/h2>\n
- \n
- Have undergone sudden changes in your life in the past year or two?If so, describe them.<\/li>\n
- How do you manage stress?<\/li>\n
- How do you relax?<\/li>\n
- Do you utilize support groups or counseling sessions? If so, are they helpful?<\/li>\n<\/ul>\n
Value-Belief Pattern<\/h2>\n
- \n
- Does your family have any religious, spiritual, or cultural practices?<\/li>\n
- When you have been ill, what do you believe will help you recover or heal faster?<\/li>\n
- Would like your clergy to contact you?<\/li>\n<\/ul>\n
Interviewing Techniques \u2022 Select an appropriate environment for the interview. \u2022 Understand the cultural background of the client(s). \u2022 Let the client know how much time the interview will take and what kind of information you will be asking. \u2022 Begin the interview by stating your name and telling the client(s) that you are a nursing student at South University \u2022 Be aware of your body language. Maintain good posture and eye contact. Show the client that you are listening closely. \u2022 When speaking with a client do not challenge or act defensive to any of his\/her responses. The majority of the questions should be openended. Avoid a “yes” or “no” response. \u2022 If the client does not want to answer a question, respect his\/her wishes. \u2022 Only ask a client one question at a time and it may be necessary to clarify the client’s responses if you are unsure of the answer. \u2022 Do not hurry the client. Allow the client brief period of silence to gather his or her thoughts. Encourage the client to expand his\/her thoughts. For example: “Can you provide more detail on that?” or “Then what did you do?” \u2022 Keep the client(s) focused on the topic you are talking about. \u2022 At the end of the interview, ask the client(s) if they have any questions for you. \u2022 Thank the client(s) for their time. <\/p>\n
Tasks:<\/strong><\/strong>
<\/span><\/p>\nAfter you have interviewed the family, compile the data obtained from the GFHP.<\/p>\n
Discuss the strengths and weaknesses of your assessment. Did the assessment tool you used prove to be appropriate for your assessment? Analyze the data gathered, and identify four unhealthy patterns for the family. Present your analysis in the form of a paper.<\/p>\n
In a 2- to 3-page paper, present your analysis of the following:<\/p>\n
- What is a typical meal plan?\n
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