Self -Concept

1. Self -Concept NUR101 Fall 2009 Lecture # 13 K. Burger MSEd, MSN, RN, CNE PPP by: Sharon Niggemeier RN MSN Revised 10/05 kb

2. 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-actualization

3. 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

4. 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.

5. 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

6. 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???

7. RolesSelf-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 expectationsANDRealistic possibilities

8. 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

9. 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).

10. Erikson- Psychosocial 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

11. Trust vs Mistrust Infancy Infant relies on caregivers for basic needs Autonomy vs Shame and doubt Toddler Gains independence: If expectations too high or low feelings of inadequacy develop Erikson

12. Initiative vs guilt Preschooler 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 Erikson

13. Identity vs role confusion Adolescence 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 Erikson

14. 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 Reminiscence about life -sense of purpose. If believes life was misdirected despair results Erikson

15. Assessing Self-concept • Developmental and chronological age • Assessing includes questions on identity… body image…self esteem…roles… • Patient’s strengths/weaknesses

16. Assertive Self-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 High self-esteem vs Low self-esteem

17. 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…

18. 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 needsReduce pain Decrease anxiety • Promote positive self-esteemEncourage participation in careEncourage socialization

19. Nursing Interventions NIC • Encourage client to recognize and discuss thoughts and feelings • Assist client to:Realize everyone is uniqueRealize impact of illness on self-conceptBe aware of negative self-statements and modify themGain more controlIdentify positive attributes of selfIdentify and use personal strengths

20. Nursing Evaluation • Outcome criteria addressed???? • Behavior and attitude changes will indicate altered self-esteem • Long term outcome –can take many months or years

21. Evaluation (NOC) • Client should be able to meet the following outcomes: Be comfortable with body imageBe able to describe self positivelyBe able to meet realistic goals Be capable of interacting appropriately with environment and others

22. “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?

23. 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

24. “No one can make you feel inferior without your consent” - Eleanor Roosevelt