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-esteem self-actualization 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- P sychosocial 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 Infancy Infant relies on caregivers for basic needs Autonomy vs Shame and doubt Toddler Toddler Gains independence: If expectations too high or low feelings of inadequacy develop
Erikson Initiative vs guilt Preschooler Preschooler Seeks new experiences if restricted becomes hesitant to seek new challenges Seeks new experiences if restricted becomes hesitant to seek new challenges Industry vs inferiority School-age Focuses on achievements and if not accepted develops a lack of self-worth Focuses on achievements and if not accepted develops a lack of self-worth
Erikson Identity vs role confusion Adolescence Adolescence Transition from childhood to adulthood. Acquires sense of who they are. Confusion if unable to establish sense of direction Transition from childhood to adulthood. Acquires sense of who they are. Confusion if unable to establish sense of direction Intimacy vs Isolation Young adulthood Unite self with others – commitments. Fear of commitment results in isolation and loneliness Unite self with others – commitments. Fear of commitment results in isolation and loneliness
Erikson Generativity vs stagnation Middle adulthood Desire to make a contribution to the world. Becoming self absorbed results in stagnation Ego integrity vs despair Later adulthood Later adulthood Reminiscence about life -sense of purpose. If believes life was misdirected despair results Reminiscence about life -sense of purpose. If believes life was misdirected 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 AssertiveSelf-directed Makes decisions Praises self Speaks clearly Attends to needs Passive “who cares attitude” Excessively Dependent Hesitant to express views Overly Critical of self Monotone voice – lack of emotion & energy Neglects own 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