SELF CONCEPT, STRESS COPING, DEATH AND DYING

self concept

The way how you see yourself ● One’s mental image of one self (acc. to kozier and erbs)

positive self concept

Able to develop and maintain better interpersonal relationships ● Resistpsychological and physical illness

strong self concept

Can better accept or adapt to changes that may occur over the lifespan

Negative Self-Concept

Tends to avoid creating relationship to others because one can view themselves as a negative person

a. self knowledge

b. self expectations

c. social self

d. social evaluation

a. Insight into one’;s own abilities , nature , and limitations

b. What one expects of oneself; may be realistic or unrealistic expectations

c. How one is perceived by others and society (how others view you)

d. The appraisal of oneself in relationship to others, events, or situations

4 dimensions

me centered

Individual who value “how I perceive me “ above “how others perceive me “ ● Try hard to live up their own expectations and compete only with themselves

other centered

Individuals who have a high need for approval from others and try hard to live up to the expectations of others , comparing , competing , and evaluations themselves in relation to others ● Tend to have difficulty asserting themselves, and fear of disapproval

self-awareness

The relationship between one individual's own and other;s perception of self

introspection

Involves the nurse reflecting on personal beliefs, attitude, motivation , strengths , and limitations

t

t/f: We are not born with a self concept , rather it develops as a result of social interactions with others

a. infant learns that the physical self is separate and different front he environment

b. child internalizes other’s attitudes toward self

c. child and adult internalize the standards of society

The development of one’s self-concept consists of three broad steps:

global self

Collective beliefs and images one holds about oneself ○ An individual’s frame of reference for experiencing and view of the world

ideal self

Individual’s perception of hone one should behave based on certain personal standards , aspirations , goals and values (how we should be or would prefer to be )

personal identity, body image, role performance, self esteem

4 components of self concept

personal identity

It is the conscious sense of individuality and uniqueness that is continually evolving throughout life. name, gender, age, race, ethnic origin or culture, occupation or roles, talents, and other situational characteristics

body image

Image of physical self or connected to the individual prostheses (dentures, artificial limbs, and hairpieces, and also, the devices required for functioning (wheelchairs, canes, and eyeglasses). clothing, makeup, hairstyle, jewelries, and other things intimately

cognitive aspect

(knowledge of the material body)

affective aspect

(sensations of the body: pain, pleasure, fatigue and physical improvements)

role

a set of expectations about how the individual position behaves

role performance

how an individual in a particular role behaves in comparison to the behaviors expected of that role

role mastery

individual’s behaviors meet role expectations.

role development

socialization into a particular role

role ambiguity

occurs when expectations are unclear, and individuals do not know what to do or how to do it and are unable to predict the reactions of others to their behavior.

role strain

feel or are made to feel inadequate or unsuited to a role and sex role stereotypes

role conflicts

arise from opposing or incompatible expectations

self esteem

is one’s judgment of one’s own worth, that is, how that individual’s standards and performances compare to others’ standards and to one’s ideal self.

a. global

b. specific

2 types self esteem

a. how much one likes oneself as a whole

b. how much one approves of a certain part of oneself. Self-esteem is derived from self and others.

Stage of development ● Stressors ● Resources ● History of success and failure ● Illness

5 factors of self concept

identity, body image, role, self esteem

4 Stressors Affecting Self-concept

stress

It isa condition in which an individual experiences changes in the normal balanced state.

stressor

-is any event or stimulus that causes an individual to experience stress.

coping strategies ,coping responses, or coping mechanisms

When an individual faces stressors,responses are referred to as

internal, external, developmental, situational

4 sources of stress

internal stressor

originateswithinanindividual, forexample, infection or feelings of depression.

external stressor

originates outside the individual, for example, amovetoanothercity,a deathinthefamily,orpressureforpeers.

developmental stress

occur at predictable timesthroughoutanindividual'slife.

situational stress

maybepositiveor negative (illness, new job, death of a family member, marriageordivorce,birthofachild.)

alters an individual’s relationships with others

give 1 effect of stress

child

Beginningschool ● Establishingpeer relationships ● Peercompetition

adolescent

Changing physique ● Relationships involvingsexual attraction ● Exploring independence ● Choosinga career

young adult

Marriage ● Leavinghome ● Managinga home ● Gettingstartedin anoccupation ● Continuingone’s education ● Children

middle adult

Physical changesofaging ● Maintaining socialstatusand standardof living ● Helpingteenage childrento become independent ● Agingparents

older adult

Decreasing physicalabilities andhealth ● Changesin residence ● Retirementand reducedincome ● Deathofspouse andfriends

stimulus based model

Stress is defined as a stimulus,a life event or a set of circumstances that arouses physiological and psychological reactions that may increase the individual’svulnerabilitytoillness.

response-based model

“Stress may also be considered as a response” ● “Stress is the nonspecific response of the body to any kind of demand made upon it”

General Adaptation Syndrome

Stress response is characterized by a chain or pattern of physiologic events. ● It occurs with release of certain adaptive hormones and subsequent changes in the structure and chemical composition of the body.

1- alarm rxn(mobalize resources), 2-resistance(cope/ stressor), 3- exhaustion(reserves depleted)

phase 1, 2 , 3 for GAS

local adaptation syndrome

Thebody can also react locally, that is, one organ or a part of the body reacts alone ➢ Itonlysubsides in a specific area.

alarm rxn

Initial reaction which alerts the body’s defenses

shock, countershock phase

2 phases of alarm rxn

shock phase

the stressor may be perceived consciously by the individual.

countershock phase

the changes produced in the body during the shock phase are reversed. ● Individual is best mobilized to react during the shock phase of the alarm reaction

stages of resistance

It is the second stage of GAS and LAS syndromesadaptation takes place. In other words, the body attempts to cope with the stressor and to limit the stressor to the smallest area of the body that can deal with it.

stages of exhaustion

It is the third stage where adaptation that the body made during the second stage cannot be maintained.

Lazarus’ transactional stress theory

encompasses a set of cognitive, affective, and adaptive (coping) responses that arise out of individual-environment transactions

transaction based model

Individual and environment are inseparable; each affects and is affected by the other. ● The individual responds to perceived environmental changes with adaptive or coping responses

anxiety

a state of mental uneasiness, apprehension, dread, or foreboding or a feeling of helplessness related to an impending or anticipated unidentified threat to self or significant relationships.

mild, moderate, severe, panic

4 levels of anxiety

mild anxiety

slight arousal that enhances perception, learning, and productive abilities.

moderate anxiety

increases the arousal to a point where the individual expresses feelings 3. of tension, nervousness or concern. (perception is narrowed; attention is focused on a particular aspect of situation)

severe anxiety

consumes most of the individual's energies and requires intervention (perception is further decreased; unable to focus on what is happening.)

panic

an overpowering, frightening, level of anxiety causing the individual to lose control (distorted perception) and worse some may be unconscious or collapse.

fear

an emotion or feeling of apprehension aroused by impending or seeming danger, pain, or another perceived threat

anger

it is an emotional state consiting of a subjective feeling of animosity or strong displeasure

hostility

Marked by overt antagonism and harmful or destructive behavior

aggression

unprovoked attack or a hostile, injurious, or destructive action or outlook

violence

Exertion of physical force to injure or abuse

constructive

Clearly expressed verbal communication of anger, when the angry individual tells the other individual about the anger and carefully identifies the source, is —

depression

It is a common reaction to events that seem overwhelmingornegative. It isanextremefeeling of sadness, despair, dejection, lack or worth, emptiness, affects millions of individuals each year.

Ego Defense Mechanisms

these are unconscious psychological adaptive mechanisms that develop as the personality attempts to defend itself, establish compromises among conflicting impulses,and calm innertensions.

defense mechanism

unconscious mind workingtoprotect theindividual fromanxiety.

altruism

Emotional conflicts and stressorsdealt with by performing helpful service to others that results in satisfaction andpleasure

compensation

Making up for aperceivedor real inabilityby focusing on another area and becoming proficient (may be conscious or unconsous)

conversion

Transfer of a mental conflict intoaphysical symptom

denial

Avoiding, ignoring, or rejectingareal situation and the feelings associated withit

displacement

Transfer of emotions from one personor object onto another less threatening and more neutral person or object (sometimes called “scapegoat” defense mechanism)

humor

Emphasizing ironic or amusing aspects of a conflict or stressor

identification

Process whereby an individual takes on thoughts, mannerisms, or tastes of another individual whom the individual admires

intellectualization

Excessive reasoning or logic to transfer disturbing feelings into the intellectual sphere

introjection

Attributing to oneself the qualities of another intense identificationin which the qualities are incorporated into the individual’s own ego structure

isolation

Separating ideas, thoughts, and actions from feelings associated withthem

projection

Unconsciously attributing one's thoughts or impulses to another person

rationalization

Justifying illogical Ideas, actions, or feelings by using acceptable explanations

rxn formation

Developing the opposite behavior or emotion to unacceptable feelings or behaviors

repression

The unconscious exclusion of unwanted experiences, ideas, emotions; repressionisa first line of psychologic defense against anxiety

sublimation

The unconscious substituting of acceptable behaviors for unacceptable behaviors

supression

Theconscious denial of a disturbing situation or feeling

undoing

Making up for an intolerable act or experience to lessen or alleviate feelings of guilt

Problem-solving

thinkingthroughthe threatening situation, using specific stepstoarriveatasolution

structuring

arrangement or manipulation of a situation so threateningeventsdonot occur

self control

assuminga manner and facial expression that conveya sense of being in control or in charge

supression

consciouslyandWilfully puttingathoughtorfeelingoutofmind"I won't deal with that today, I'll do it tomorrow"

fantasy day dreaming

likened to make-believe. Unfulfilled wishes and desires are imagined as fulfilled, or threatening experience is reworked or replayed so it ends differently from reality.

coping

is the cognitive and behavioral effort to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person

coping strategy

natural or learned wayofrespondingtoachanging environmentorspecificproblemorsituation.

caregiver burden

a reaction to long termstress seen in family memberswhoundertakethecareofanindividual inthehomeforalongperiod.

crisis

is an acute, time-limited state of disequilibrium resulting from situational, developmental, or societal sources of stress.

burnout

a complex syndrome of behaviors that can be likened to the exhaustion stage of the general adaptation syndrome

loss

It is a removal, change or reduction in which something of value (an object, a person, or a situation) is no longer availabl

actual, perceived, anticipatory, maturational, situational

a. can be identified by others

b. can be experienced by one person, but cannot be verified by others

c. experienced before the loss really occurs

d. occurs as one moves from on development stage to another

e. occurs in response to external events, usually beyond one’s control