Lect13 Self Concept Stress and Coping by mkVhHYy

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									 Self -Concept
NUR101 Fall 2008
Lecture # 13
K. Burger MSEd, MSN, RN, CNE
PPP by: Sharon Niggemeier RN MSN
Revised 10/05 kb
      Self -Concept
Self-concept : self image
Each individual is unique with own
self-concept
View of self affects one’s ability to
function as well as health
components: self-knowledge
              self-esteem
              self-actualization
         Identity
An internal sense of individuality
and wholeness. Who are you?
Name, gender, race, religion,
occupation, role, +++so much more
Begins during childhood as parents
provide role models
Continues during adolescence as
teens establish own identity
        Self-Esteem
The emotional appraisal of self-
concept.
How do you regard yourself??????
Feel about self?
Sense of worth or value??
This appraisal is an on-going process
so…levels of self-esteem can
change.
         Body Image
What do you think you look like physically?
?????
What do you think about your
appearance??????
Body image is dynamic: the body changes
thru normal growth and development.
Cultural and societal attitudes affect body
image
            Roles
What is your role?????????
What are the expected behaviors you
perform????
Simultaneously hold many roles and
they change
Who do you want to be????
What do you want your role to be???
               Roles
         Self-Actualization
A part of self-concept is the way a person
perceives their ability to carry out
significant roles
Health self-concept can distinguish
between:
Ideal role expectations
AND
Realistic possibilities
Factors Affecting Self-concept

Health status: illness, injury, body chg, loss of
control, dependency on others
Role stressors; overload, strained,
                  feelings of inadequacy
Developmental transitions – aging in our culture
Personal “success” or failure history
Crisis and/or life events: personal and/or global
Internal and external resources
Individual perception of crisis
Self-concept: psychosocial
        dimension
How one develops and grows can
have an affect on self-concept & health
Therefore nurses need to understand
normal stages of growth (physical
changes) & development
(psychosocial changes).
    Erikson- Psychosocial
    Developmental Theory
ID 8 stages from birth to old age

Each stage characterized by a
developmental task to be mastered

Unmet tasks may delay progress
through the next stage
                   Erikson
  Trust vs Mistrust     Autonomy vs
                        Shame and doubt
Infancy                 Toddler
                       Gains independence:
Infant relies on        If expectations too
caregivers for          high or low feelings
basic needs             of inadequacy
                        develop
                      Erikson
Initiative vs guilt        Industry vs
                           inferiority
Preschooler               School-age

Seeks new                  Focuses on
experiences if
restricted becomes
                           achievements and
hesitant to seek new       if not accepted
challenges                 develops a lack of
                           self-worth
               Erikson
Identity vs role       Intimacy vs
confusion              Isolation


Adolescence           Young adulthood
Transition from
childhood to           Unite self with
adulthood. Acquires    others –
sense of who they      commitments. Fear
are. Confusion if      of commitment
unable to establish    results in isolation
sense of direction     and loneliness
                Erikson
 Generativity vs        Ego integrity vs
 stagnation             despair
Middle adulthood        Later adulthood

Desire to make a       Reminiscence about
 contribution to the    life -sense of
 world. Becoming        purpose. If
 self absorbed          believes life was
 results in             misdirected
 stagnation             despair results
  Assessing Self-concept
Developmental and chronological age

Assessing includes questions on
identity… body image…self
esteem…roles…

Patient’s strengths/weaknesses
   Self-Concept Questionnaire
Describe yourself.
    What are your personal characteristics?
    What are your strengths?
    What are your fears or weaknesses?
Describe your body.
    What do you like most about your body?
    What do you like least about your body?
Tell me about some things you do or have done in
the past that give you a sense of achievement or
accomplishment.
Describe the primary roles you fill.
    How do you feel about your ability to perform
    these roles?
    Are these roles satisfying to you?
High self-esteem vs Low self-esteem

 Assertive        Passive “who cares attitude”
 Self-directed    Excessively Dependent
 Makes            Hesitant to express views
 decisions        Overly Critical of self
 Praises self     Monotone voice – lack of
 Speaks clearly   emotion & energy
 Attends to       Neglects own needs
 needs            Difficulty making decisions
                  Overly apologetic
                  Avoidance of eye contact
         Nursing Diagnoses
 Disturbed body image
 Low self-esteem; chronic or situational

Other Dx in which low self-concept is the
  etiology:
 Ineffective health maintenance r/t …
 Self care deficit r/t …
 Risk for self-directed violence r/t…
    Nursing Interventions
Nurse is a role model
Can a nurse NEGATIVELY affect a client’s self-
concept?
Form helping relationship:
Focus on client strengths; praise achievements
Meet physiological and psychological needs
Reduce pain
Decrease anxiety
Promote positive self-esteem
Encourage participation in care
Encourage socialization
  Nursing Interventions NIC
Encourage client to recognize and discuss
thoughts and feelings
Assist client to:
Realize everyone is unique
Realize impact of illness on self-concept
Be aware of negative self-statements and modify
them
Gain more control
Identify positive attributes of self
Identify and use personal strengths
     Nursing Evaluation
Outcome criteria addressed????

Behavior and attitude changes will
indicate altered self-esteem

Long term outcome –can take many
months or years
        Evaluation (NOC)
Client should be able to meet the following
outcomes:
Be comfortable with body image
Be able to describe self positively
Be able to meet realistic goals
Be capable of interacting appropriately
with environment and others
        “Know Thyself”           Socrates




Nurses need to reflect on their OWN self-
concept in order to effectively assist OTHERs.
Ask yourself these questions:
How do I perceive myself?
How do I think others see me?
What are my strengths and weaknesses?
What are my goals for self-improvement?
What does ALL THIS have to do with my
professional practice?
           Summary
Self-concept based on 3 components
Need to understand how various
factors affect self-concept
Understand difference between high
& low self-esteem
Interventions to promote self-concept
Evaluate outcome criteria
  “No one can make you feel
inferior without your consent”

        - Eleanor Roosevelt

								
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