Chapter 42 Notes: Self-Concept

Learning Outcomes

• Describe the components of a healthy self-concept.
• Discuss factors that affect self-concept.
• Discuss the role of the nurse and the nursing process in regard to self-concept.

Understanding Self-Concept

• Definition: Self-concept is not innate; it develops over the lifespan.
• Importance: It represents an individual's unique answer to "Who do I think I am?".

Dimensions of Self-Concept

• Self-Knowledge: Understanding who you are.
• Self-Expectation: What you aspire to be.
• Self-Evaluation: How you feel about yourself in comparison to your ideals.

Formation of Self-Concept

• Influence of Childhood:
  • Infants learn about themselves in relation to their environment. Positive experiences create a healthy self-image.
  • As children grow, they internalize societal attitudes and standards.
• Developmental Stages:
  • Self-awareness (Infancy)
  • Self-recognition (Around 18 months)
  • Self-definition (Around 3 years)
  • Self-concept (Ages 6-7)

Internal and External Influences on Self-Concept

• Influences include:
  • Physical Appearance
  • Intellectual Abilities
  • Societal Standards
  • Relationships
  • Life Experiences (success, failures, illness, trauma)

Factors Affecting Self-Concept

• Developmental Considerations: Age and maturation.
• Cultural Background: Different cultures have varying influences on self-concept.
• Personal History: Past successes and failures shape self-perceptions.
• Stressors: Life events can significantly impact self-esteem and self-worth.

Assessing Self-Concept in Patients

• Key Assessment Areas:
  • Biological details
  • Functional abilities
  • Family and social relationships
  • Coping mechanisms and current health understanding
• Interpersonal Communication: Crucial for assessing connections with others and for encouragement.

Assessing Body Image

• Consider aspects of ideal vs. perceived body image, and body changes.
• Suggested questions: "Describe your body to me," "What do you like most/least about your body?"

Assessing Role Performance

• Evaluate actions in fulfilling personal roles: "What roles are important to you?" and "Are these roles satisfying?"

Assessing Personal Identity and Self-Esteem

• Personal Identity: How individuals view themselves as unique beings.
  • Questions to explore: "How would you describe yourself?" and "How do you feel about yourself?"
• Self-Esteem: How well individuals like themselves.
  • Questions to assess: "Does it bother you if others don’t like you?" and "Do you feel different or inferior?"

Signs of Low Self-Concept

• Behavioral indicators may include:
  • Avoidance of eye contact.
  • Slumped posture or negative self-talk.
  • Hesitance to express opinions or emotions.

Nursing Problems Related to Self-Concept

• Issues include:
  • Altered Body Image
  • Low Self-Esteem
  • Risk of Self-Harm
  • Coping Impairment

Expected Patient Outcomes

• Patients should provide a realistic appraisal of self, acknowledging strengths and areas for improvement.

Promoting a Healthy Self-Concept

• Build a therapeutic relationship:
  • Focus on communication and self-awareness.
• Consider consulting mental health professionals if needed.
• Encourage self-examination and introspection.

Strategies for Different Age Groups

• Children: Emphasize security, trust, and belonging.
• Adolescents: Stress responsibility, appreciation, and setting realistic goals.
• Adults: Highlight positive contributions and avoid negative comparisons.
• Elders: Promote participation, respect, and connection with life experiences.

Helping Patients Maintain Their Sense of Self

• Show respect and communicate their worth.
• Encourage discussion about personal experiences and provide clear explanations during care.
• Normalize expressions of negative feelings while reinforcing their strengths.