1. How would you describe your family’s current state of health?
2. What are you doing to promote health?
3. Are there any habits that can be detrimental to you or your families health? Nutrition and Metabolism:
1. Is there any diseases or medical complications that affect nutritional or metabolic function?
2. What is a typical family meal, and typical daily fluid intake?
3. Are there any physical complications preventing or making obtaining the proper nutrition or daily caloric or fluid intake? Elimination:
1.Explain your normal bowel, bladder patterns. Have there been any changes in these patterns?
2.Do you have any problems with constipation or diarrhea?
Activity and Exercise:
1. What do you and your family do for physical activity and exercise?
2. How many days/hours of physical activity a week do you do?
1. How does your family acquire information about health diagnosis?
2. Who makes the decisions regarding health care for you and your family?
Sleep and Rest:
1. How many hours of sleep on average per night do you and family members get?
2. Are there any difficulties with falling or staying asleep? Do you feel rested in the morning? Self -Perception- Self-Concept:
1. How does your family feel they integrate into the community?
2. How does the family describe the events that led to a change? Roles and Relationships:
1. How does the family manage daily living and how are household tasks divided?
2. Who is employed in the household and who holds financial responsibility?
Is it shared? Sexuality-Reproductive
1. Individually are you comfortable with your partner in discussing
2. How do as a married couple view marriage, parenthood and relationship as lovers?
1. How does your family cope with stressful life events?
2. What resources do you have access to or use already?
1. Do you as a family identify with any cultural, ethnic, religious, or other organizations?
2. What are your family’s values and beliefs and how do they influence your daily life?