The framework guiding nursing practice should maintain a certain level of abstraction, considering that nurses deliver care across various settings and diverse patient populations. Concurrently, a specific framework supporting nurses’ screening assessment is crucial, as it delineates what data need to be collected, the sequence of collection, and the extent of the information required. According to the NANDA®-I Position Statement (2010), the adoption of an evidence-based assessment framework, such as Gordon’s Functional Health Patterns (FHP; Gordon, 1994), is strongly recommended for ensuring accurate nursing diagnoses and promoting safe patient care.
It is important to note that Taxonomy II should not be utilized as an assessment framework. If we were to use Taxonomy II as an assessment framework, we might encounter a format that merely checks for the presence of nursing diagnoses within each domain. However, it is crucial to recognize that this format does not accurately represent the journey from assessment to nursing diagnosis. Although Taxonomy II was developed based on Gordon’s work on Functional Health Patterns (FHPs), resulting in strikingly similar terminology in the two frameworks, their purposes and functions are fundamentally distinct.
The primary aim of Taxonomy II is to categorize nursing diagnoses into domains and their subcategories or classes. Given that each domain and class is precisely defined, this framework assists nurses in identifying appropriate nursing diagnoses among conceptually related diagnoses within the taxonomy. In contrast, the FHP framework was scientifically developed by Gordon in 1974 to standardize the structure for nursing assessment (Gordon, 1982), emphasizing a comprehensive approach to understanding patients’ health responses.
INKA (formerly NANDA International, NANDA-I) supports the use of evidence-based assessment frameworks because accurate nursing diagnoses depend on high-quality nursing assessment.
Holistic nursing assessment is the foundation of safe, compassionate, and effective nursing care. At its heart, nursing assessment is not simply about collecting information or completing forms / computer screens, it is about understanding the person behind the data. Through holistic assessment, nurses seek to understand how individuals, families, and communities experience health, illness, and everyday life, and how those experiences shape their needs, strengths, and goals.
To do this well, nurses rely on assessment frameworks. These frameworks help organize complex information while leaving room for individual stories, cultural values, and personal priorities.
One of the most widely used and internationally recognized frameworks is Marjory Gordon’s Functional Health Patterns. Alongside this approach, nursing also draws on other holistic frameworks that emphasize adaptation, caring relationships, culture, and meaning. Together, these perspectives support truly person-centered nursing care.
Health care often focuses on diagnoses, tests, and treatments. Nursing assessment adds something essential: an understanding of how health conditions affect a person’s daily life, relationships, coping, and sense of well-being. A holistic nursing assessment looks beyond symptoms to explore how people function, what matters most to them, and what helps or hinders their health.
Using a structured assessment framework helps nurses:
It is important to note that assessment frameworks are different from lists of nursing diagnoses. Evidence-based assessment frameworks help nurses gather and interpret the information needed to arrive at accurate diagnoses and meaningful plans of care.
Developed by nurse scholar Dr. Marjory Gordon, Functional Health Patterns offer a practical and holistic way to explore how people manage their health and live their daily lives. Rather than focusing only on body systems or diseases, this framework emphasizes human responses, how people eat, sleep, cope, relate to others, and find meaning.
The framework includes 11 interrelated patterns:
Together, these patterns reflect the whole person, body, mind, and spirit. Because of their strong alignment with nursing’s focus on human responses, FHPs are endorsed by INKA as an evidence-based foundation for nursing assessment.
Holistic assessment is the first step in the nursing process and sets the direction for all care that follows. By exploring FHPs, nurses begin to notice meaningful connections in the information patients share.
For example:
These insights help nurses identify nursing diagnoses across interrelated patterns, which describe how people respond to health conditions or life situations. Nursing diagnoses then guide nursing actions, such as education, emotional support, coordination of care, or prevention strategies, and help nurses evaluate outcomes that matter to patients, such as improved confidence, comfort, safety, or quality of life.
When nurses understand what matters most to patients, care becomes more meaningful and effective. In this way, holistic assessment creates a clear and meaningful pathway from understanding the person to providing effective nursing care.
Functional Health Patterns are especially well suited to person-centered care because they:
By focusing on how people live and what they value, nurses can work in partnership with patients to develop care plans that feel relevant, respectful, and achievable.
While Functional Health Patterns provide a strong foundation, nursing practice is enriched by other holistic frameworks that may be especially helpful in certain situations. For example, some approaches are particularly useful in rehabilitation, chronic illness, and community settings, where adapting to change is a central concern.
Assessments guided by the importance of relationships, compassion, and meaning in healing can be useful for attending to emotional, spiritual, and relational needs alongside physical concerns. Culturally responsive assessments encourage nurses to explore cultural beliefs, values, and practices that influence health behaviors and decisions, supporting care that is respectful and culturally meaningful.
No single assessment framework fits every person or situation. Skilled nursing practice involves choosing and combining approaches based on:
Functional Health Patterns often serve as a core structure, with other frameworks incorporated as appropriate. What matters most is that assessment remains thoughtful, flexible, and grounded in nursing knowledge.
Holistic nursing assessment helps make nursing’s unique contribution to health care visible. By focusing on human responses rather than diseases alone, nurses are able to:
Ultimately, holistic assessment ensures that nursing care addresses the full experience of health and illness.
Holistic nursing assessment is essential to person-centered care. Frameworks such as Marjory Gordon’s Functional Health Patterns, along with other holistic nursing perspectives, provide structure while honoring individuality.
When nurses truly understand the whole person, they are better equipped to support health, dignity, and quality of life. Holistic assessment is not about completing a checklist; it is about listening, understanding, and turning that understanding into meaningful nursing care.
To learn how INKA advances the development and implementation of diagnosis-centered nursing knowledge, explore:
Gordon, M. (1982). Conceptual approaches to nursing assessment. McGraw-Hill.
Gordon, M. (1994). Nursing diagnosis: Process and application (3rd ed.). Mosby.
Herdman, T. H., Kamitsuru, S., & Takáo Lopes, C. (2024). NANDA International nursing diagnoses: Definitions and classification, 2024–2026 (13th ed.). Thieme.
Leininger, M. M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13(3), 189–192. https://doi.org/10.1177/10459602013003005
NANDA International. (2010). Position statement on the use of nursing diagnoses and assessment frameworks. NANDA-I.
Roy, C. (2009). The Roy adaptation model (3rd ed.). Pearson.
Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). University Press of Colorado.
Join INKA and connect with a global network of nurses and leaders, committed to advancing nursing knowledge and practice.