Transcript Chapter 3 - Delmar

Fundamentals of Nursing:
Standards & Practices, 2E
Chapter 19
Self-Concept
Self-Concept
Self-concept is an individual’s
perception of self and is what helps make
each individual unique.
Everyone has both positive and negative
self-assessments in the physical,
emotional, intellectual, and functional
dimensions. These change over time.
One’s view of self affects the ability to
function and influences health status.
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Components of Self-Concept
Identity
Body image
Self-esteem
Role performance
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Identity
A sense of personal identity is what sets
one person apart as a unique individual.
Identity may include a person’s name,
gender, ethnic identity, family status,
occupation, and roles.
A person begins to develop identity
during childhood and constantly
reinforces and modifies it throughout life.
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Body Image
Body image is attitudes about one’s
physical attributes and characteristics,
appearance, and performance.
Body image is dynamic because any
change in body structure or function,
including the normal changes of growth
and development, can affect it.
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Self-Esteem
Self-esteem is an individual’s
generalized sense of worth and value, or
how a person regards one’s self.
Individuals will calculate their self-esteem
on the basis of achievement of factors
they value most highly (for example,
physical attributes, social
accomplishments).
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Role Performance
Role refers to a set of expected
behaviors that are determined by familial,
cultural, and social norms.
Individuals fulfill several roles
simultaneously - parent, sibling, friend,
spouse, student nurse.
Each role has a set of expected
behaviors.
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Development of Self-Concept
Self-concept evolves throughout life
and depends to an extent on an
individual’s developmental level.
A child’s sense of self is shaped by
family experiences and interactions
with parents.
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The numerous changes in physical,
emotional, and psychosocial status
during the adolescent years bring about
rapid changes in self-concept.
The adult’s perception of self continues
to develop as adults learn to adapt to the
numerous physical changes that normally
occur with aging.
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Factors Affecting Self-Concept
Altered health status
Developmental transitions
Experience
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Nursing Process and
Self-Concept
Assessment
• Consider both the client’s
developmental level and chronological
age when assessing self-concept.
• Determine the client’s strengths. This
enables assessment of characteristics
that can be used for coping and
problem solving.
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• Encourage clients to make a list of all
the positive things they have done,
then review the list.
• Ask clients to describe their
appearance and abilities.
• Determine what clients know about
their strengths and limitations.
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Diagnosis
• Individuals experiencing self-concept
disturbances usually have feelings of
anxiety, hostility, guilt, and shame.
• Self-concept alterations affect every
aspect of a person’s life: emotions,
relationships, functional ability.
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• Nursing diagnoses associated with
self-concept disturbances
 Disturbed body image
 Parental role conflict
 Disturbed personal identity
 Ineffective role performance
 Chronic low self-esteem
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 Situational low self-esteem
 Anxiety
 Social isolation
 Hopelessness
 Powerlessness
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Outcome identification and planning
• A major nursing goal is to promote the
client’s sense of well-being and to
facilitate growth.
• Planning includes teaching coping
skills and the effective use of personal
resources.
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Implementation
• The nurse will
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Initiate therapeutic interaction
Support healthy defense mechanisms
Ensure satisfaction of needs
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Evaluation
• A client’s behavior and attitudes will
reflect the degree of progress toward
restoring an altered self-concept.
• The nurse must reconsider the
alignment of the client’s targeted selfconcept with the plan of care to assess
if the two are still congruent.
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Because self-concept is based on
personal attitudes and feelings, it
often requires months or years to
change.
Nurses, clients, and families all
need to learn to be patient and to
work together to improve or restore
a client’s self-concept.
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