Self-Concept

How one thinks and feels about oneself Development of self-concept is a complex, lifelong process

Components Identity Body image Role performance Self-esteem

Role Performance Behaviors Reinforcement-extinction Inhibition Substitution Imitation Identification

Self-Concept Stressors Identity stressors Body image stressors Role performance stressors Conflict Ambiguity Strain Overload Self-esteem stressors

Effects on Self-Concept Family Nurse

Assessment Coping behaviors Significant others Client expectations

Nursing Diagnoses Examples Disturbed personal identity Ineffective coping Disturbed body image Chronic low self esteem

Planning Goals and outcomes Priorities Continuity of care Cultural considerations

Implementation Health promotion Acute care Restorative care

Evaluation Client care Client expectations

The Experience of Loss, Death, and Grief

Loss Actual loss Perceived loss Maturational loss Situational loss

Grief Mourning Bereavement

Theories of Grief Kubler-Ross’s stages of dying Bowlby’s phases of mourning Worden’s four tasks of mourning Application of theories to other types of loss

DENIAL ANGER BARGAINING DEPRESSION ACCEPTANCE Kubler-Ross Stages of Dying

Types of Grief Anticipatory grief Complicated grief Disenfranchised grief

Assessment Type and stage of grief Grief reactions Factors that affect grief End-of-life decisions Nurse’s experiences Client expectations

Factors Influencing Loss and Grief Human development Psychosocial perspectives Socioeconomic status Personal relationships Nature of the loss Culture and ethnicity Spiritual beliefs

Culture and Death Rituals, Mourning Practices

Death Rituals by Culture African American Chinese Hindu Jewish Mexican Arab Japanese

Nursing Diagnoses Anticipatory grieving Dysfunctional grieving Hopelessness Powerlessness Spiritual distress

Planning Goals and outcomes Setting priorities Continuity of care

Implementation Therapeutic communication Promoting hope Facilitating mourning Postmortem Care

Palliative Care Symptom control Maintaining dignity and self-esteem Preventing abandonment and isolation Providing a comfortable and peaceful environment Therapeutic Communication Promote spiritual comfort

Supportive Care Support for the grieving family Assist with end of life decision making Hospice care Care after death (postmortem care) Grieving nurse

Evaluation Client care Client expectations

Sexuality

Sexual Development Infancy and early childhood School-age years Puberty/adolescence Young adulthood Middle adulthood Older adulthood

Sexual Response Cycle Desire Arousal Orgasm

Sexual Orientation Heterosexual Homosexual Bisexual

Contraception Nonprescription methods Abstinence Barrier methods Timing methods

Contraception Prescription/health care intervention methods Hormonal Intrauterine devices Diaphragm/cervical cap Sterilization

Sexually Transmitted Diseases Syphilis Gonorrhea Chlamydia Trichomoniasis Human papillomavirus (HPV) Herpes simplex virus (HSV)

Sexually Transmitted Diseases Human immunodeficiency virus (HIV) AIDS Transmission Exposure categories Education Cultural considerations

Sociocultural Influences on Sexuality Pregnancy and menstruation Discussing sexual issues

Decisional Issues Related to Sexuality Contraception Abortion STD prevention

Alterations in Sexual Health Infertility Sexual abuse Personal and emotional conflicts Sexual dysfunction

Assessment Factors affecting sexuality Sexual health history Sexual dysfunction Physical assessment Client expectations Nursing diagnosis Cultural considerations

Planning Goals and outcomes Priorities Continuity of care

Implementation Health promotion Acute care Restorative care

Evaluation Client care Client expectations

Spiritual Health

Caring for the whole person Accepting beliefs and experiences Helping with issues surrounding meaning and hope

Framework of Systemic Organization Maintenance Change Coherence Individuation

Traditional Concepts Spirituality Faith Religion Hope

Problems—Spiritual Distress Acute illness Chronic illness Terminal illness Near-death experience

Assessment JAREL spiritual well-being scale Faith/belief Life and self-responsibility Life satisfaction Culture Fellowship and community Ritual and practice Vocation Client Expectations

Nursing Diagnoses Spiritual distress Readiness for enhanced spiritual well-being Fear Hopelessness

Planning Goals and outcomes Setting priorities Continuity of care

Implementation Establishing presence Supporting a healing relationship Support systems Diet therapies Supporting rituals Prayer Meditation Supporting grief work Pastoral Care

Evaluation Client care Client expectations