Concept of self - health

LOGO

outlines
Definition Meaning Constitute of healthy self concept Dimensions Components Development of self concept Stressors that affect the self concept Characteristics of positive self concept Memory trick- I LIKE ME Client teaching Nursing process Summary

Self concept is an individuals perception of self and is what helps make each individual unique.

Your VIEW of yourself - The ENTIRE picture...

It changes SLOWLY

 Self concept : Self image

Each individual is unique with own self concept

 The ability to know yourself; to be able to assess your strengths, weaknesses, talents and potential. The ability to love and accept yourself as you are, knowing that you can improve and develop any aspects of yourself that you choose.

 The ability to be honest with yourself and be true to who you are and what you value.
The ability to take responsibility for your choices and actions.

 It includes: 1. Basic facts: sex, age, race, occupation, cultural background, sexual orientation 2. Persons position with social groups 3. Qualities or traits that describe typical behaviours, feelings, moods and other characteristics (generous, ambitious, intelligent....

 The ideal self constitutes the self one want to be. Self expectations develop unconsciously early in childhood and are based on image of role models such as parents

Self esteem is the evaluative and affective component of self concept Maslows Subsets of Esteem Needs: 1. Self-esteem (strength, achievement, mastery, competence, ..) 2. Respect needs or the need for esteem from others

Identity Body image Self-esteem Role performance

 A sense of personal identity is what sets one person apart as a unique individual. Identity includes a persons name, gender, family status, occupation, and roles.

 Ones personal identity begins to develop during childhood and is constantly reinforced and modified throughout life.

 Body image is an attitude about ones 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.

 Self-esteem is the judgment of personal performance . Self-esteem is derived from a sense of giving and receiving love, and being respected by others.

The way YOU THINK and FEEL about yourself

Can change from

MOMENT to MOMENT

 Role refers to a set of expected behaviors determined by familial, cultural, and social norms. The level of self-esteem is dependent upon the self-perception of adequate role performance in these various social roles.

Development of Self-Concept

Eriksons (1963) psychosocial theory states that an individuals development proceeds throughout life. Each of his eight developmental stages includes psychosocial tasks that need to be mastered.
- Erik Erikson (1902-1994)

 The first stage of Erikson's theory of psychosocial development occurs between birth and one year of age and is the most fundamental stage in life. Because an infant is utterly dependent, the development of trust is based on the dependability and quality of the child's caregivers.

 If a child successfully develops trust, he or she will feel safe and secure in the world. Caregivers who are inconsistent, emotionally unavailable, or rejecting contribute to feelings of mistrust in the children they care for. Failure to develop trust will result in fear and a belief that the world is inconsistent and unpredictable.

 Psychosocial Conflict: Trust vs Mistrust Major Question: "Can I trust the people around me?" Basic Virtue: Hope

Autonomy vs Shame & doubt

 This stage occurs between the ages of 18 months to approximately age two to three years. According to Erikson, children at this stage are focused on developing a greater sense of self-control. Gaining a sense of personal control over the world is important at this stage of development. Toilet training plays a major role; learning to control ones body functions leads to a feeling of control and a sense of independence.

 Other important events include gaining more control over food choices, toy preferences and clothing selection.
Children who successfully complete this stage feel secure and confident, while those who do not are left with a sense of inadequacy and self-doubt.

 Psychosocial Conflict: Autonomy versus Shame and Doubt

Major Question: "Can I do things myself or am I reliant on the help of others?" Basic Virtue: Will

Initiative vs. Guilt

 This stage occurs during the preschool years, between the ages of three and five. During the initiative versus guilt stage, children begin to assert their power and control over the world through directing play and other social interactions. Children who are successful at this stage feel capable and able to lead others. Those who fail to acquire these skills are left with a sense of guilt, self-doubt, and lack of initiative.

 Play and imagination takes on an important role at this stage. Children have their sense of initiative reinforced by being given the freedom and encouragement to play. When efforts to engage in physical and imaginative play are stifled by caregivers, children begin to feel that their self-initiated efforts are a source of embarrassment. Success in this stage leads to a sense of purpose, while failure results in a sense of guilt.

 Psychosocial Conflict: Initiative versus Guilt

Major Question: Am I good or bad?

Basic Virtue: Purpose

Industry vs. Inferiority

 This stage covers the early school years from approximately age 5 to 11.

Through social interactions, children begin to develop a sense of pride in their accomplishments and abilities.
During the industry versus inferiority stage, children become capable of performing increasingly complex tasks. As a result, they strive to master new skills.

 Children who are encouraged and commended by parents and teachers develop a feeling of competence and belief in their skills. Those who receive little or no encouragement from parents, teachers, or peers will doubt their ability to be successful. According to Erikson, this stage is vital in the development of self-confidence. During school and other social activities, children receive praise and attention for performing various tasks such as reading, writing, drawing and solving problems. Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.

 Psychosocial Conflict: Industry versus Inferiority Major Question: "How can I be good?" Basic Virtue: Competence

Identity vs. Role Confusion

 This stage occurs during adolescence between the ages of approximately 12 to 18. In the adolescent years, youths develop a desire for independence from parents, achieve physical maturity and are concerned with the question of Who am I? Achievement of the task result in a sense of confidence, emotional stability, and a view of the self as a unique individual.

 Commitment are made to the choice of career and to relationship with members of other genders. Parents are available to offer support when needed and to encourage the development of an independent sense of self.

Non achievement results in sense of self consciousness, doubt, and confusion about once role in life.

 Psychosocial Conflict: Identity Versus Confusion Major Question: "Who

am I?

Basic Virtue: Fidelity or faithful

Intimacy vs. Isolation

 This stage takes place during young adulthood between the ages of approximately 19 and 40. During this period of time, the major conflict centers on forming intimate, loving relationships with other people. Erikson believed it was vital that people develop close, committed relationships with other people. Success leads to strong relationships, while failure results in loneliness and isolation.

 Psychosocial Conflict: Intimacy Versus Isolation Major Question: "Will I be loved or

will I be alone?

Basic Virtue: Love

Generativity vs. Stagnation

 This stage takes place during middle adulthood between the ages of approximately 40 and 65. During adulthood, we continue to build our lives, focusing on our career and family. Those who are successful during this phase will feel that they are contributing to the world by being active in their home and community. Those who fail to attain this skill will feel unproductive and uninvolved in the world.

 Psychosocial Conflict: Generativity Versus Stagnation Major Question: "How can I contribute to the world?"

Basic Virtue: Care

Integrity vs. Despair

 This stage occurs during late adulthood from age 65 through the end of life. During this period of time, people reflect back on the life they have lived and come away with either a sense of fulfillment from a life well lived or a sense of regret and despair over a life misspent.

 Those who feel proud of their accomplishments will feel a sense of integrity. Successfully completing this phase means looking back with few regrets and a general feeling of satisfaction. These individuals will attain wisdom, even when confronting death.

Those who are unsuccessful during this phase will feel that their life has been wasted and will experience many regrets. The individual will be left with feelings of bitterness and despair.

 Psychosocial Conflict: Integrity versus despair

Major Question: "Did I live a meaningful life?

Basic Virtue: Wisdom

1. Identity stressors
Job loss Divorce Neglect Rape Assault Dependency on others

Repeated failure Societal attitude Conflict with others Retirement Sexuality concerns

2. Body image stressors

Amputation
Facial disfigurement

Burns

 Surgical procedures :- Mastectomy & Colostomy Chronic illness such as heart and renal disease

 Effects of pregnancy Weight gain or loss Radiation therapy

 Societys response to an individuals physical changes may be affected by the conditions surrounding the alteration.
eg. Paralysis patient

3. Role performance stressors

Role conflict Role ambiguity Role strain Role overload

4. Self esteem stressors

Stressors affecting he self-esteem of an adult include-: Failure in work Failure in relationships Prenatal and postpartum depression

Child care stress Life stress Marital relationship Socioeconomic status Unplanned/unwanted pregnancy

Self concept stressors in older adults includes: Health problems

Declining socioeconomic status

 Spousal loss

Loss of social support

 Self-confidence

Setting obtainable goals

Ability to accept criticism and not become defensive

Willingness to take risks and try new Experiences

MEMORY TRICK :- I LIKE ME

I = Identify clients strengths. L = Listen to the clients self-description. I = Involve the client in decision making. K = Keep goals realistic. E = Encourage client to think positively. M = Maintain an environment conducive to client self expression. E = Explain to the client how to use positive self talk instead of negative self-talk.

Positive Self-Talk
Positive self-talk can be used to change negative inner messages to positive ones. 1. Send yourself positive thoughts. 2. Say the positive thoughts out loud. 3. Remind yourself of your positive attributes and accomplishments. 4. Recall memories of success. 5. Tell yourself out loud something new that you learned or something good that you did today.

Activities That Increase Self-Esteem

Taking good care of self Taking time to do enjoyable activities Getting something done that has been put off Spending time with people that make you feel good about yourself Learning something new Forgiving yourself Doing something nice for someone else Positive self-talk Giving yourself rewards

NURSING PROCESS

The nursing process facilitates providing nursing care to clients at risk for alterations in self-concept, body image, self esteem, role performance.

Assessment
Assessment data are the basis for prioritizing the clients problems and the nursing diagnoses. Clients at risk for alterations in self-concept, identity, body image, self-esteem, and role performance require a health history and physical examination.

Health History
The nurse begins gathering data for the health history by assessing the clients perception of their identity, body image, selfesteem, and role performance.

Physical Examination
The nurse should focus the physical examination on: Nonverbal actions and behaviors Withdrawal Lack of appetite Wanting to sleep all the time Not participating in care Intentional hiding, not touching, or not looking at the body part involved Isolation Interaction with others

Nursing Diagnosis
Disturbed Body Image Parental Role Conflict Disturbed Personal Identity Ineffective Role Performance Chronic Low Self-Esteem Situational Low Self-Esteem

Disturbed Personal Identity Anxiety Social Isolation Hopelessness Powerlessness

Planning/Outcome
Planning and outcome identification for the client focuses on promoting a healthy self-concept or facilitating change in an altered self concept. Nursing interventions are selected and prioritized to support the clients achievement of expected outcomes based on the goals. For example, if the client states that she considers herself overweight, unattractive, and undesirable to others, this leads to a nursing diagnosis of Disturbed Body Image, and the goals might include expressing positive feelings about herself and integrating a realistic body image.

Implementation
Several interventions can promote a positive healthy self concept in clients; they are as follows:

Encourage client to list past and current accomplishments Ask client to describe how they and others would describe them Assess the clients report of changes in their selfconcept, body image, self-esteem, or role performance Encourage verbalization of the positive and negative feelings and perceptions of the changes that have occurred to their self-concept, body image, self-esteem, or role

 Acknowledge normalcy of changes in the emotional response and grieving stages to changes Assist client in incorporating the necessary changes into their daily life Assist the client in identifying methods of coping that have been useful in the past Assist client in contacting appropriate support groups and/or counseling as needed

Evaluation
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

SUMMARY

No one can make you feel inferior without your consent

- Eleanor Roosevelt

LOGO