Page 229 - Encyclopedia of Nursing Research

196 n FuNCTIONAL HEALTH PATTErNS

nursing functions, and helped direct nursing reported that findings help predict nurse and
care toward patient responses. patient mix, help identify patient problems,
F Gordon’s (1994) typology of the 11 FHPs link nursing interventions with evidence-
was informed by this work and provided based outcomes, and ultimately help cost out
nurses with a structure for organizing and care more accurately.
documenting patient behavior over time. The Nursing educators have used FHP
FHP framework offered nurses a consistent assessment data to evaluate clinical reason-
framework for identifying human responses ing skills and diagnostic accuracy (Levin,
(nursing diagnoses) that resulted in the artic- Lunney, & Krainovich-Miller, 2005; Lunney,
ulation of autonomous nursing interven- 2008, 2010). Collectively, findings from this
tions and evidence-based patient outcomes. research continue to contribute to the refine-
This focus continues to be consistent with ment of a unified nursing language. Much of
Nursing’s Social Policy Statement (American the ongoing work in this area is published in
Nurses Association, 2003). the International Journal of Nursing Knowledge,
The FHP framework provides nurses formerly the International Journal of Nursing
with an opportunity to know the patient Terminologies and Classifications.
in a unique way. Through a series of semi- Currently, research continues to test and
structured interview questions (Gordon, refine a standardized assessment screening
1994, 2010; Jones, 1986), each of the 11 FHPs tool for use in research investigations. The
is assessed as the individual’s story unfolds. FHP Assessment Screening Tool (FHPAST)
When additional information is required, the originally developed by Barrett and Jones
nurse uses branching questions to elicit new (1999) uses screening questions to evalu-
perceptions. This descriptive approach to ate each of the 11 FHPs. The original tool
data collection is then subjected to analysis was modified from an 83-item tool to a reli-
in which data bits (or cues) are isolated and able and valid three-factor, 57-item, patient-
data are synthesized, leading to the formu- completed tool, with responses to each item
lation of tentative diagnostic statements that organized on a 4-point Likert scale. The
reflect phenomena of concern to nursing. three factors are health risk/threat, general
Internationally, use of the FHP frame- well-being and self confidence, and health
work as a structure for data collection, patient promotion/protection, with α coefficients for
problem identification, and evaluation of care each factor at .97, .93, and .78, respectively.
outcomes has grown. Investigations in many The tool provides a quantitative measure
countries describe high-frequency nursing of the patient’s functional health responses
diagnoses and isolated patient responses to and identifies cues that can be used to guide
phenomena (e.g., eating disorders, sleep dis- further assessment by the nurse. To date,
turbances) and linked intervention strategies the FHPAST has been used in research in
to specific nursing diagnoses. Others have the united States and England in a variety
used the FHP framework to validate cues of populations including healthy adults and
associated with a particular nursing diag- those with chronic illnesses. The FHPAST
nosis. Nurses working in clinical specialties has been translated into several languages
(e.g. ambulatory surgery, oncology, rehabil- including Portuguese, Spanish, and Japanese.
itation, and cardiovascular nursing) have The continued testing and refinement of the
used the FHP framework to identify patient FHPAST will improve the use of a valid and
responses (nursing diagnoses) throughout reliable instrument to measure the patient’s
illness experience and recovery at home functional health over time.
(Flanagan & Jones, 2009). Nurse adminis- Movement toward the use of a stan-
trators, using data from FHP assessments, dardized nursing language and continued