Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

Interview Questionnaire for Family-Focused Functional Assessment

Values/Health Perception

1. How does your family define health?
2. What do you think contributes to good health?
3. Do you have any cultural or spiritual beliefs that affect your family’s health practices?

Nutrition

1. What types of foods does your family usually eat?
2. Do you have any dietary restrictions or preferences?
3. How does your family ensure that they are getting the proper nutrition?

Sleep/Rest

1. How many hours of sleep do each family member typically get per night?
2. Does anyone in the family have trouble sleeping or getting enough rest?
3. Does the family have a bedtime routine?

Elimination

1. Is there anyone in the family with elimination problems or concerns?
2. How often do each family member use the bathroom?
3. What types of elimination practices does your family follow?

Activity/Exercise

1. What types of physical activities does your family engage in?
2. How often does your family exercise?
3. Does anyone in the family have any limitations that affect their physical activity?

Cognitive

1. How does your family usually cope with stress?
2. Does anyone in the family have any cognitive or memory problems?
3. Does anyone in the family participate in activities to stimulate their cognitive abilities?

Sensory-Perception

1. Does anyone in the family have any sensory impairments?
2. How does your family ensure safety in the home for those with sensory impairments?
3. Does your family have any routines to enhance sensory perception, such as mindfulness or meditation?

Self-Perception

1. How does your family view themselves?
2. Does anyone in the family have self-esteem or self-image issues?
3. Does your family participate in activities that promote positive self-perception?

Role Relationship

1. What roles do each family member play in the household?
2. Are there any conflicts or tensions in the household related to role expectations?
3. Does your family have any routines to promote positive relationships and communication?

Sexuality

1. Does your family have any cultural or spiritual beliefs related to sexuality?
2. Does anyone in the family have sexual health concerns?
3. Does your family have any routines to promote healthy sexual relationships and communication?

Coping

1. How does your family typically cope with challenges or stressors?
2. Does anyone in the family have coping difficulties?
3. Does your family have any routines to promote effective coping strategies?

Family Structure

The family interviewed consists of a married couple, John and Maria, and their three children, Jason (14), Emily (10), and Alex (7). John works as an accountant, and Maria is a stay-at-home mom. The family is middle-class and identifies as Caucasian. They live in a suburban area, and they are members of a local church. The family’s religious beliefs guide many of their values and health practices.

Overall Health Behaviors

The family reported that they place a high value on health and wellness. They eat healthy meals, get enough rest, and exercise regularly. The family also attends church and regularly participates in community service activities. John and Maria also noted that they try to model healthy behaviors for their children.

Functional Health Pattern Strengths

The family has a strong sense of spirituality and community involvement. Their religious beliefs guide many of their health practices and provide them with a strong support system. The family also places a high value on healthy eating and physical activity.

Health Problems and Barriers to Health

The family identified several health problems and barriers to health, including:

1. Maria struggles with chronic back pain, which limits her ability to engage in physical activity.
2. Jason has