Chapter 42 objectives: Self-concept
Differentiate positive and negative self-concept and high and low self-esteem
-Factors affecting self-concept: developmental considerations, culture(influences sense of self), internal and external resources, history of success and failure, crisis or life stressors, aging, illness, disability or trauma, pride, guilt, shame -people with high self esteem are accustomed to being well received and successful -children exposed to higher levels of paternal anxiety are at risk for developing lower self-esteem and a greater self-representation of "bad-me"
describe three dimensions of self-concept, self-knowledge, self-expectations, and self-evaluation(self-esteem)
-Self-concept is the mental image or picture of self, has the power to either encourage or thwart personal growth -Self-knowledge includes basic facts(sex, age, ethnicity, occupation, cultural background, sexual orientation), person's position in social groups, qualities/traits that describe typical behaviors, feelings, moods -Self-expectations are expectations for self flow from various sources, develops unconsciously early in childhood and are based on images of role models like parents and other figures -Self evaluation is the evaluative and affective component of self-concept sometimes like self-respect, self-approval, self-worth 1)significance(way people feel they are loved and approved by the people important to them 2)competence or the way tasks are considered important are performed 3)virtue, attainment of moral-ethical standards 4)power, extent to which people influence their own and other's lives
develop nursing diagnosis/health problems to identify disturbances in self-concept(body image, self-esteem, role performance, personal identity)
-personal identity(developmental changes, trauma, gender dysphoria, cultural dissonance) -body image(loss of body part or function, disfigurement, developmental changes) -self-esteem(unhealthy interpersonal relationships, failure to achieve developmental milestones, failure to achieve life goals, failure to live up to personal moral code, sense of powerlessness) -role performance(loss of valued role, ambiguous role expectations, conflicting role expectations, inability to meet role expectations)
identify major steps in the development of self-concept
1)infant learns the physical self is different from the environment 2)child internalizes other peoples attitudes toward self, attitudes directed towards child's tendencies 3)child or adult internalizes the standards of society
Identify six variables that influence self-concept.
1-developmental considerations 2-culture 3-internal and external resources 4-history of success and failure 5-crisis or life stressors 6-aging, illness, trauma
use appropriate interview questions and observations to asses a patient's self-concept
1-personal identity: "how would you describe yourself to others?" risk factors include- developmental changes, trauma, gender dissonance, cultural dissonance 2-body image: "Describe your body to me" "what do you like the most/least about your body" "is there anything about your body that you would like to change?" risk factors-loss of body part of function, disfigurement, 3-self-esteem: "Who would you like to be?" risk factors-unhealthy interpersonal relationships, failure to achieve developmental milestones 4-role performance: "How do you feel about your ability to do all the things your roles demand of you?" risk factors include-conflicting role expectations, inability to meet role expectations
plan, implement, and evaluate nursing care related to select diagnoses/health problems for disturbances in self-concept
Initiate Therapeutic Interaction, Support Healthy Defense Mechanisms, Ensure Satisfaction of Needs, Physical needs, Psychosocial needs
describe how the experience of aging, illness, trauma, disability, loss, diagnostic testing, and treatment can threaten a patients self-concept
a sudden illness, trauma, or bodily disfigurement, or even the suggestion of disease, as well as signs of the aging process may pose serious threats to the self. - People vary greatly in their response to aging, illness, and trauma. This is due to the threats to self-concept and internal beliefs about the self that these conditions may pose.
describe nursing strategies that are effective to resolving self-concept problems
helping at risk patients maintain a sense of self, teaching self-compassion, modifying a negative self-concept(help patient find positive things about themselves the patient can recognize), developing a positive body image, developing self-esteem in children and adolescents, enhancing self-esteem in older adults, evaluate(how nursing care plan has effect on patient's self concept)
