chapter 33.txt

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chapter 33.txt
2015-06-14 12:48:38
self concept
self concept Chapter 33
Self concept Chapter 33
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  1. How is self-concept developed?
    • Development of self-concept is a lifelong process.
    • • Erikson’s psychosocial theory:
    • Each stage builds on tasks of the previous stage.
    • Successful mastery leads to a sense of self.
  2. According to Erikson’s 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
  3. 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.
  4. 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
  5. In what way can the nurse effect the client’s 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.
  6. How can the nurse enhance a client’s self-esteem?
    • Encourage self-care
    • • Elicit patient’s perceptions of strengths and weaknesses
    • • Explore coping responses
    • • Reinforce strengths and successes
  7. 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
  8. 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
  9. 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.
  10. 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.
  11. Describe how the nurse would use critical thinking to evaluate a client’s success in meeting established goals and outcomes related to self-concept?
  12. 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