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How is self-concept developed?
- Development of self-concept is a lifelong process.
- Eriksons psychosocial theory:
- Each stage builds on tasks of the previous stage.
- Successful mastery leads to a sense of self.
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According to Eriksons psychosocial theory of development, what are the stages of development related to self-concept?
- Trust versus Mistrust (Birth to 1 Year)
- Develops trust following consistency in caregiving and nurturing interactions
- Distinguishes self from environment
- Autonomy versus Shame and Doubt (1 to 3 Years)
- Begins to communicate likes and dislikes
- Increasingly independent in thoughts and actions
- Appreciates body appearance and function (e.g., dressing, feeding, talking, and walking)
- Initiative versus Guilt (3 to 6 Years)
- Identifies with a gender
- Enhances self-awareness
- Increases language skills, including identification of feelings
- Industry versus Inferiority (6 to 12 Years)
- Incorporates feedback from peers and teachers
- Increases self-esteem with new skill mastery (e.g., reading, mathematics, sports, music)
- Aware of strengths and limitations
- Identity versus Role Confusion (12 to 20 Years)
- Accepts body changes/maturation
- Examines attitudes, values, and beliefs; establishes goals for the future
- Feels positive about expanded sense of self
- Intimacy versus Isolation (Mid-20s to Mid-40s)
- Has stable, positive feelings about self
- Experiences successful role transitions and increased responsibilities
- Generativity versus Self-Absorption (Mid-40s to Mid-60s)
- Able to accept changes in appearance and physical endurance
- Reassesses life goals
- Shows contentment with aging
- Ego Integrity versus Despair (Late 60s to Death)
- Feels positive about life and its meaning
- Interested in providing a legacy for the next generation
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What are the components of self-concept? Identity ?
Self concept: a mental self-image of strengths and weaknesses in all aspects of personality. Self-concept depends in part on body image and roles but also includes other aspects of psychology and spirituality
- Identity: Involves the internal sense of individuality, wholeness, and consistency of self
- Body image: Involves attitudes related to physical appearance, structure, or function
- Role performance: How individuals carry out their significant roles
- Self-Esteem: an individual's overall feeling of self-worth or the emotional appraisal of self-concept.
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What stressors can affect self-concept?
- Any real or perceived change that threatens identity, body image, or role performance can affect self-concept.
- Changes that occur in physical, spiritual, emotional, sexual, familial, and sociocultural health affect self-concept.
- Change in health
- Other crises
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In what way can the nurse effect the clients self-concept?
- Nurses need to remain aware of their own feelings, ideas, values, expectations, and judgments:
- Use a positive and matter of fact approach.
- Build a trusting relationship.
- Be aware of facial and body expressions.
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How can the nurse enhance a clients self-esteem?
- Encourage self-care
- Elicit patients perceptions of strengths and weaknesses
- Explore coping responses
- Reinforce strengths and successes
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What would the nurse be assessing related to self-concept?
- In assessing self-concept and self-esteem, first focus on each component of self-concept (identity, body image, and role performance
- Avoidance of eye contact
- Slumped posture
- Unkempt appearance
- Overly apologetic
- Hesitant speech
- Overly critical or angry
- Frequent or inappropriate crying
- Negative self-evaluation
- Excessively dependent
- Hesitant to express views or opinions
- Lack of interest in what is happening
- Passive attitude
- Difficulty in making decisions Self-Concept and the Nursing Process
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Identify nursing diagnosis related to self-concept.
- Disturbed body image
- Caregiver role strain
- Disturbed personal identity
- Ineffective role performance
- Readiness for enhanced self-concept
- Chronic low self-esteem
- Situational low self-esteem
- Risk for situational low self-esteem
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What goals would the nurse develop for a client experiencing altered self-concept?
- Goals and outcomes: Be realistic and inividualize
- Setting priorities: Focus on adaptations to stressors.
- Collaborative care: Consider additional resources.
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How would the nurse implement care to a client based on the levels of health promotion, acute care, and restorative/continuing care when dealing with self- concept issues?
- Health Promotion: Work with patients to help them develop healthy lifestyle behaviors that contribute to a positive self-concept. Measures that support adaptation to stress such as proper nutrition, regular exercise within the patient's capabilities, adequate sleep and rest, and stress-reducing practices contribute to a healthy self-concept.
- Acute Care: In the acute care setting some patients experience potential threats to their self-concept because of the nature of the treatment and diagnostic procedures. Remain sensitive to the patient's level of acceptance of any changes. Forcing confrontation with a change before the patient is ready likely delays the person's acceptance.
- Restorative and Continuing Care: Interventions designed to help a patient reach the goal of adapting to changes in self-concept or attaining a positive self-concept are based on the premise that the patient first develops insight and self-awareness concerning problems and stressors and then acts to solve the problems and cope with the stressors.
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Describe how the nurse would use critical thinking to evaluate a clients success in meeting established goals and outcomes related to self-concept?
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Frequent evaluation of patient progress is necessary.
- Apply knowledge of behaviors and characteristics of a healthy self-concept when reviewing the actual behaviors patients display.
- Expected outcomes for a patient with a self-concept disturbance:
- Nonverbal behaviors showing positive self-concept
- Statements of self-acceptance
- Acceptance of change
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