SELF CONCEPT presentation for BSN programs

Concept about one self that is important in society for ones mental development

1. SELF CONCEPT AND SELF PERCEPTION Presented BY: Nusrat Hussain Nursing Lecturer GCON DG Khan

2. Learning Objectives Discuss factors that can effect self concept Identify possible manifestation of altered self concept Apply nursing process for a person with an altered self concept.

3. Factors That Can Influence Self-Concept: Many factors affect a person’s self-concept. Major factors are: Stage of development, Family and culture, Stressors, Resources, History of success and failure, Illness.

4. Cont… Stage of Development: As an individual develops, the conditions that affect the self-concept change. For example, an infant requires a supportive, caring environment, whereas a child requires freedom to explore and learn. Older adults’ self-concept is based on their experiences in progressing through life’s stages.

5. Cont…. Family and Culture: A young child’s values are largely influenced by the family and culture. Later on, peers influence the child and thereby affect the sense of self. When the child is confronted by differing expectations from family, culture, and peers, the child’s sense of self is often confused. For example, a child may realize that his parents expect he will not drink alcohol and that he will attend religious services each Saturday. At the same time, his peers drink beer and encourage him to spend Saturday with them.

6. Figure 39–2 • A child is often pulled in opposite directions by family and peer expectations. Jonathan Nourak/PhotoEdit Inc.

7. Cont… Stressors: Stressors can strengthen the self-concept as an individual copes successfully with problems. On the other hand, overwhelming stressors can cause maladaptive responses including substance abuse, withdrawal, and anxiety. The ability of a person to handle stressors will largely depend on personal resources. It is important for the nurse to identify any stressors that may affect aspects of the self-concept. for examples of stressors that may place a client at risk for problems with self-concept.

8. Cont… Resources: An individual’s resources are internal and external. Examples of internal resources include confidence and values, whereas external resources include support network, sufficient finances, and organizations. Generally the greater the number of resources a person has and uses, the more positive the effect on the self-concept.

9. Cont… History of Success and Failure: People who have a history of failures come to see themselves as failures, whereas people with a history of successes will have a more positive self-concept. Likewise, individuals with a positive self-concept tend to find contentment in their level of success, whereas a negative self-concept can lead to viewing one’s life situation as negative.

10. Cont… Illness: Illness and trauma can also affect an individual’s self-concept. A woman who has had a mastectomy may see herself as less attractive, and the loss may affect how she acts and values herself. People respond to stressors such as illness and alterations in function related to aging in a variety of ways. Acceptance, denial, withdrawal, and depression are common reactions.

11. PERCEPTION/SELF-CONCEPT Possible manifestation of altered self-concept: Disturbed Body Image Parental Role Conflict Disturbed Personal Identity Ineffective Role Performance

12. PERCEPTION/SELF-CONCEPT Chronic Low Self-Esteem Situational Low Self-Esteem Disturbed Personal Identity Anxiety Social Isolation Hopelessness Powerlessness

13. Cont… Disturbed Personal Identity (and Risk for) Anxiety related to changed physical appearance (e.g., amputation, mastectomy) Ineffective Coping with role change related to death of spouse Grieving or Complicated Grieving related to change in physical appearance Hopelessness

14. Cont… Powerlessness (and Risk for) Parental Role Conflict Readiness for Enhanced Self-Concept Disturbed Sleep Pattern Social Isolation Spiritual Distress

15. PERCEPTION/SELF-CONCEPT Nursing process for a person with an altered self-concept: Assessing: A thorough assessment includes a psychosocial assessment of the client and the family or support person because this provides clues to actual or potential problems.

16. Cont…. The nurse assessing self-concept focuses on its four components: Personal identity, Body image, Role performance, and Self-esteem.

17. PERCEPTION/SELF-CONCEPT Diagnosing: A positive self-concept can serve as a resource to a client when facing health challenges. Sometimes, as supported by data, the client has a problem in the area of self-perception and the classes of self-concept, self-esteem, and body image.

18. Diagnosis Three of the NANDA International (Herdman & Kamitsuro, 2014) nursing diagnostic labels relating specifically to this domain: Disturbed Body Image Ineffective Role Performance Chronic Low Self-Esteem (and Risk for).

19. Cont…. Additional nursing diagnoses that may apply to clients with problems of self-concept include the following: Disturbed Personal Identity (and Risk for) Anxiety related to changed physical appearance (e.g., amputation, mastectomy) Ineffective Coping with role change related to death of spouse Grieving or Complicated Grieving related to change in physical appearance Hopelessness

20. Cont…. Powerlessness (and Risk for) Parental Role Conflict Readiness for Enhanced Self-Concept Disturbed Sleep Pattern Social Isolation Spiritual Distress.

21. Cont…. Planning: The nurse develops plans in collaboration with the client and support people when possible, according to the client’s state of health, level of anxiety, resources, coping mechanisms, and socio cultural and religious affiliation. The nurse who has little experience in caring for clients with altered self-concept may wish to consult with a more experienced nurse to develop effective plans. The nurse and client set goals to enhance the client’s self-concept.

22. Cont… The goals or desired outcomes established will vary according to the diagnoses and defining characteristics related to each individual. Specific nursing interventions can be selected to meet the individual needs of the client.

23. Cont….. Implementing: Nursing interventions to promote or enhance a positive self-concept include helping a client to identify areas of strength. In addition, for clients who have an altered self-concept, nurses should establish a therapeutic relationship and assist clients to evaluate themselves and make behavioral changes.

24. Cont… Identifying Areas of Strength: People often perceive their problems and weaknesses more easily than their assets and strengths. People with low self-esteem tend to focus even more on their limitations and to be aware of fewer strengths and many more problems. When a client has difficulty identifying personality strengths and assets, the nurse provides the client with a set of guidelines or a framework for identifying personality strengths.

25. Cont… Enhancing Self-Esteem: Nurses assisting clients who have an altered self-concept or self-esteem must establish a therapeutic relationship. To do this the nurse must have self-awareness and effective communication skills. The following nursing techniques may help clients analyze the problem and enhance their self-esteem: Encourage clients to appraise the situation and express their feelings. Encourage clients to ask questions. Provide accurate information.

26. Cont… Become aware of distortions, inappropriate or unrealistic standards, and faulty labels in clients’ speech. Explore clients’ positive qualities and strengths. Encourage clients to express positive self-evaluation more than negative self-evaluation. Avoid criticism. Teach clients to substitute negative self-talk (“I can’t walk to the store anymore”) with positive self-talk (“I can walk half a block each morning”). Negative self-talk reinforces a negative self-concept.

27. Cont…. Evaluating: To determine whether client goals or desired outcomes have been achieved, the nurse uses data collected during interactions with the client and significant others. If outcomes are not achieved, the nurse should explore the reasons, considering questions such as the following: Have old situations recurred, triggering feelings or behaviors associated with low self-esteem? • Have new stressful situations occurred with which the client feels unable to cope, resulting in continuing or recurrent low self-esteem.

28. Cont…. Are new or additional roles causing increased stress in adapting? Are significant others supporting the client adequately in attempts to improve self-esteem? Did the client follow through on referrals to appropriate agencies? Did the agencies provide the expected services? Were the client’s expectations too high in relation to the time needed for successful resolution of self-esteem problems?

29. Reference: Berman, A, T. Snyder, S. Frandsen. (2008). Fundamentals of Nursing: Concepts, Process, and Practice (10 th ed). Pearson, USA. Jacob, A. R. R, Tarachand. S. J. (2011). Clinical Nursing Procedures: The Art of Nursing Practice (2 nd ed.) JAYPEE: New Delhi. Thapa, B. (2002). Fundamentals of Nursing (1 st ed.) Jaypee. New Delhi. India. Jacob, A. R. R, Tarachand. S. J. (2011). Clinical Nursing Procedures: The Art of Nursing Practice (2 nd ed.) JAYPEE: New Delhi.

30. Reference: Kozier & Erb’s Fundamental of Nursing ,8 th edition (Audrey Berman ,Shirlee J. Snyder). Berman, A, T. Snyder, S. Frandsen. (2008). Fundamentals of Nursing: Concepts, Process, and Practice (10 th ed). Pearson, USA. Jacob, A. R. R, Tarachand. S. J. (2011). Clinical Nursing Procedures: The Art of Nursing Practice (2 nd ed.) JAYPEE: New Delhi. Thapa, B. (2002). Fundamentals of Nursing (1 st ed.) Jaypee. New Delhi. India.