Patient-Centered Care: Psychosocial Theory and Self-Concept

Psychosocial Theory

• Psychosocial Theory: A method of understanding individuals as a combination of psychological and social events.
  • Key frameworks:
  • Erikson’s Theory of Development (G&D)
  • Maslow’s Hierarchy of Human Needs
• Patient responses to illness influenced by:
  • Overall wellness
  • Physical pathology
  • Psychosocial health

Psychosocial Influences on Health

• Factors include:
  • Socioeconomic status
  • Coping mechanisms
  • Support networks
  • Crisis management
  • Emotional well-being
  • Family, friends, and pets
  • Education and career
  • Physical well-being and environment

Self-Concept

• Self-concept: One’s overall view of oneself, including multiple dimensions such as:
  • Friendships
  • Intellectual abilities
  • Problem-solving and coping abilities
  • Physical appearance
  • Sexual performance
  • Success in the workplace
  • Unique talents

Four Components of Self-Concept

1. Body Image: Mental image concerning one's physical self (appearance and function).
2. Personal Identity: Understanding oneself as a unique individual, encompassing culture and personal preferences.
3. Role Performance: Actions and behaviors in fulfilling various roles.
4. Self-Esteem: Overall appreciation or value one places on oneself.

Factors Affecting Self-Concept

• Aging
• Crisis or life stresses
• Cultural influences
• Developmental considerations
• History of successes/failures
• Illness
• Internal/external resources
• Trauma

Psychosocial Assessment: Self-Concept

Subjective Data

• Cultural background
• Feelings related to body image changes, sexuality issues, and self-concept
• Coping mechanisms
• Psychosocial assessment and quality of relationships

Objective Data

• Appearance, demeanor, and grooming
• Mood, posture, and usual behavior

Anxiety

• Anxiety: A vague, uneasy feeling of discomfort or dread without a physical threat; characterized by physical symptoms.
  • Levels can be mild to disabling
  • Results from psychological conflicts
• Fear: Known or unknown physical or psychological threat

Depression

• Depression: A mood disorder resulting in persistent sadness and loss of interest, prevalent across age groups.
  • Risk factors must be identified
  • Important to consider suicide prevention strategies

Delirium: Differential Diagnosis

Nursing Interventions for Self-Concept

• Encourage patients to recognize and utilize their personal strengths.
• Foster positive self-concept through compassionate care and acknowledgment of individuality
• Assist at-risk patients in coping with dependency associated with age or illness.

Evaluation of Self-Concept

• Nursing evaluation should assess behaviors linked to a healthy self-concept.
• Expected Outcomes:
  • Acceptance of change
  • Identification of personal strengths
  • Maintenance of self-concept
  • Positive nonverbal behaviors
  • Articulation of self-acceptance and strengths