function ability

Functional Ability in Nursing Practice

Lesson Overview

  • Definition: Functional ability encompasses the physical, psychological, cognitive, and social abilities required to engage in normal daily activities.
  • Goals:
    • Define and describe functional ability.
    • Identify situations and factors that increase the risk for functional impairment.
    • Recognize the presence of functional impairment.
    • Implement appropriate interventions aimed at optimizing functional ability and minimizing complications.

Definition of Functional Ability

  • Definition: The physical, psychological, cognitive, and social abilities to carry out the normal activities of life.
  • Related Terms:
    • Functional performance
    • Functional impairment
    • Disability

Scope of Functional Ability

  • Continuum: Functional ability exists on a spectrum ranging from full function to complete disability.
  • Lifespan Considerations:
    • Functional ability varies throughout the lifespan due to:
    • Developmental stage
    • Achievement of developmental milestones
    • Physical health
    • Psychosocial health
    • Cognitive ability
    • Social and cultural factors

Attributes and Criteria

  • Capacity: The inherent ability to perform a task.
  • Actual Performance Circumstances:
    • Amount of assistance required
    • Time needed to perform tasks
    • Level of performance achieved
  • Roper-Logan-Tierney Model of Nursing:
    • Focused on 12 activities of daily living (ADLs).
    • Emphasizes health promotion and wellness over illness.
    • Core Elements:
    • Ongoing assessment
    • Facilitation of patient independence

Context to Nursing and Health Care

Risk Recognition (1 of 5)
  • Factors Increasing Functional Impairment Risk:
    • Developmental abnormalities
    • Advanced age
    • Cognitive declines
    • Mental health issues (especially depression)
    • Physical or psychological trauma
    • Acute or chronic illness
Functional Assessment (2 of 5)
  • Comprehensive functional assessment: Time-intensive process requiring interprofessional collaboration.
  • Examples of Functional Ability:
    • Basic Activities of Daily Living (BADLs): Basic self-care tasks.
    • Instrumental Activities of Daily Living (IADLs): More complex tasks necessary for independent living.
  • Indications for Assessment:
    • Delayed developmental milestones in children.
    • Loss of functional ability, changes in mental status, or presence of multiple health conditions in adults.
    • Assessment is particularly crucial in frail elderly individuals residing within community settings.
Additional Functional Aspects (3 of 5)
  • Key aspects assessed during functional evaluation include:
    • Vision
    • Hearing
    • Mobility
    • History of falls
    • Continence issues
    • Nutritional status
    • Cognition
    • Emotional well-being (affect)
    • Home environment
    • Social participation
Care Delivery Considerations (4 of 5)
  • Levels of Assistance:
    • No assistance
    • Partial assistance
    • Total assistance
  • Levels of Difficulty:
    • No difficulty
    • Some difficulty
    • Unable to perform
Optimizing Function (5 of 5)
  • Objective: Maintain optimal independent function and prevent functional decline to enhance health-related quality of life.
  • Key Strategies:
    • Reduce risk factors.
    • Early detection and screening of functional impairments.
    • Multidisciplinary management of activity impairments.

Interrelated Concepts

Reducing Risk (1 of 3)
  • Patient Education: Teach patients and families about maintaining high-level functional ability through:
    • Well-balanced nutrition
    • Regular physical activity
    • Routine health checkups
    • Stress management practices
    • Participation in meaningful activities
    • Fall prevention measures
    • Avoidance of tobacco and other harmful substances.
Nursing Interventions (2 of 3)
  • Support for BADLs and IADLs:
    • Tasks include dressing, toileting, bathing, ambulation, shopping, cooking, and eating.
  • Additional Interventions:
    • Fall prevention strategies.
    • Exercise therapy programs.
    • Education on the safe use of assistive devices.
Concepts Impacting Function (3 of 3)
  • Concepts interrelated to functional ability include:
    • Development
    • Cognition
    • Culture
    • Family dynamics
    • Stress and coping mechanisms
    • Mobility
    • Nutrition
    • Sensory perception
    • Gas exchange and perfusion
    • Elimination
    • Sexuality.

Featured Exemplars

  • Conditions: Understanding functional ability through examples of specific conditions:
    • Cerebral palsy
    • Autism spectrum disorder
    • Alzheimer’s disease
    • Rheumatoid arthritis
    • Parkinson’s disease

Assessment Questions

Question 1
  • What are the three dimensions of nursing care related to functional ability?
    • Choices:
    • A) Risk recognition, functional assessment, and communication
    • B) Risk recognition, functional assessment, and individualized care planning
    • C) Functional assessment, personal hygiene, and communication
    • D) Functional assessment, communication, and individualized care planning
  • Correct Answer: B) Risk recognition, functional assessment, and individualized care planning.
Question 2
  • Which functional assessment tool is considered objective?
    • Choices:
    • A) Self-report
    • B) Patient survey
    • C) Performance based
    • D) Patient questionnaire
  • Correct Answer: C) Performance based.