Introduction
Frameworks are used to accurately gage a patients health. They are a systematic way of collecting objective and subjective data to establish a plan of care for the patient. Health care professionals must continually observe the patient’s subjective and objective data in order to recognise any changes in the patient’s health so that they can act upon them to achieve the best possible outcome for the patient’s wellbeing.
Gordon’s functional health patterns framework was developed by Marjorie Gordon. It provides a sequence of recurring behaviour from eleven different aspects (Luxford, 2012). These include; health perception and management pattern, nutritional-metabolic pattern, elimination pattern, activity-exercise pattern, sleep-rest pattern, cognitive-perceptual pattern, self-perception/self-concept pattern, role-relationship pattern, sexuality-reproductive pattern, coping/stress-tolerance pattern and value/belief pattern (Gordon, as cited in Luxford, 2012, pp. 225-226). The patient’s health is believed to be influenced by biological, developmental, cultural, social and spiritual factors. Because Gordon’s functional health patterns framework considers each of these factors, it will provide health care professionals utilising it with a comprehensive assessment of the patient’s health (Fulton & Baird, 2010).
Dorothea Orem (as cited in Broadbent, 2012, pp. 47-48) developed a nursing framework based on three related concepts. self-care, self-care deficit and nursing systems. Self-care theory consists of four concepts. The first of these concepts are self-care, which refers to those activities the patient should perform without assistance that promotes wellbeing, for example, intake of air, food and water, elimination process, balance between activity and rest, balance between solitude and social interaction, hazard prevention and promotion of normality within social groups. The second concept is self-care agency, which refers to the patient’s ability to carry out self-care activities and whether or not they require assistance. The third concept is self-care requisites, which refers to the actions taken to provide self-care. Finally, therapeutic self-care demand, which refers to all the activities required to meet existing self-care requisites (Orem, as cited in Broadbent, 2012, pp. 47-48). Self-care deficit comes into play when self-care agency is not able to meet the self-care demand. This means that if the patient is unable to perform any activity of daily living they will not meet the requirements that are essential for them to survive, hence, a health care professional must assist them. The self-care deficit indicates that nursing is required to assist the patient and suggests five different nursing systems that can be used depending on the patient’s ability (Orem, as cited in Broadbent, 2012, pp. 47-48).
Health care professionals should provide care that is considerate of and reactive to unique patient preferences, needs and values. They must ensure that patient values guide all clinical decisions (Krumholz, 2010). To successfully achieve this, when conducting a health assessment it is imperative that health care professionals make professional, ethical and legal considerations. Health care professionals must be mindful of the patient’s comfort and not assume that they are aware of what the health care professional is doing nor assume that the patient is consensual. Kerridge, Lowe & Stewart (2009) stipulate that upholding the patient’s right to autonomy is relevant to a health care professional legally, ethically and professionally. It means that before each procedure the health care professional must ask the patient if they consent to the having the procedure performed on them. The patient can give consent by verbal, written or implied communication. The patient’s right to autonomy must be respected at all times (Kerridge et al., 2009). It is the patient’s legal right to choose what happens to them, even if the patient refuses to have lifesaving medication or procedures performed on them that results in their further ill health or even death (Eburn, 2010).
For both professional and ethical reasons health care professionals must adhere to a code of conduct at all times. Due to the patient’s probable vulnerability, health care professionals have a specific duty to conform to extremely high ethical standards both in their professional and private lives (Johnstone, 2012). Saunders (2012) explains that health care professionals must only perform duties that dwell within their scope of practice. If they do not adhere to this policy they would be failing to uphold ethical standards and also breaking the law. This could lead to the health care professional losing their job and or legal action being taken against them. In order for the health care professionals to maintain professionalism and uphold ethical and legal standards they must consider their scope of practice before performing any duties (Saunders, 2012).There are ethical considerations that health care professionals must be mindful of when documenting a patient’s information. For instance, to be conscious of who will be reading the notes, use official abbreviations and clear language, be specific, objective and protect privacy at all times. Breeching professional, ethical or legal responsibilities could lead to ramifications that are detrimental to the health care professional’s career, health care institution’s reputation and patient’s health (Jeffries, Johnson, Nicholls & Lad, 2012).
Gordon’s functional health patterns framework is a common and excellent way to build a picture of the patient’s health (Newfield, Hinz, Scott-Tilley, Sridaromont & Maramba, 2007). It can be utilised for patients of all ages and in all areas of health speciality. Health is dynamic and ever changing and Gordon’s functional health patterns framework caters for this. Unlike other frameworks, Gordon’s uncovers patterns of both function and dysfunction (Gordon, as cited in Luxford, 2012). It considers the patient’s health from eleven specific aspects providing a broad range of information for health care providers to notice emerging patterns. The titles of the patterns are self-explanatory hence, they are easy to use (Newfield et al., 2007). These eleven categories provide a systematic and standardized approach to data collection and enable the health care professional to determine many aspects of health. Though it has few weaknesses, like most other frameworks, the data collected for Gordon’s functional health patterns framework is based on much subjective data. This means that some data collected can be manipulated by the patient in order to depict an inaccurate assessment of the patient’s health. For this reason is must be used alongside the objective data such as the patient’s vital signs and physical examination in order to ensure an accurate health assessment.
While Orem’s self-care framework appears to be a useful resource for health care professionals to use, Gordon’s functional health patterns framework proves to have strengths that far outweigh its weaknesses. One can understand why it is so commonly used within health care institutions.
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