Chapter 19 Self-Concept Fundamentals of Nursing: Standards & Practices, 2E

 Copyright 2002 by Delmar, a division of Thomson Learning 19-2 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 19-3 Components of Self-Concept  Identity  Body image  Self-esteem  Role performance

 Copyright 2002 by Delmar, a division of Thomson Learning 19-4 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 19-5 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 19-6 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).

 Copyright 2002 by Delmar, a division of Thomson Learning 19-7 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 19-8 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 19-9  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.

 Copyright 2002 by Delmar, a division of Thomson Learning Factors Affecting Self-Concept  Altered health status  Developmental transitions  Experience

 Copyright 2002 by Delmar, a division of Thomson Learning 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.

 Copyright 2002 by Delmar, a division of Thomson Learning 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.

 Copyright 2002 by Delmar, a division of Thomson Learning  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.

 Copyright 2002 by Delmar, a division of Thomson Learning Nursing diagnoses associated with self-concept disturbances  Disturbed body image  Parental role conflict  Disturbed personal identity  Ineffective role performance  Chronic low self-esteem

 Copyright 2002 by Delmar, a division of Thomson Learning  Situational low self-esteem  Anxiety  Social isolation  Hopelessness  Powerlessness

 Copyright 2002 by Delmar, a division of Thomson Learning  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.

 Copyright 2002 by Delmar, a division of Thomson Learning  Implementation The nurse will  Initiate therapeutic interaction  Support healthy defense mechanisms  Ensure satisfaction of needs

 Copyright 2002 by Delmar, a division of Thomson Learning  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 self- concept with the plan of care to assess if the two are still congruent.

 Copyright 2002 by Delmar, a division of Thomson Learning  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.