Self -Concept
NUR101 Fall 2008
Lecture # 13
K. Burger MSEd, MSN, RN, CNE
PPP by: Sharon Niggemeier RN MSN
Revised 10/05 kb
Self -Concept
Self-concept : self image
Each individual is unique with own
self-concept
View of self affects one’s ability to
function as well as health
components: self-knowledge
self-esteem
self-actualization
Identity
An internal sense of individuality
and wholeness. Who are you?
Name, gender, race, religion,
occupation, role, +++so much more
Begins during childhood as parents
provide role models
Continues during adolescence as
teens establish own identity
Self-Esteem
The emotional appraisal of selfconcept.
How do you regard yourself??????
Feel about self?
Sense of worth or value??
This appraisal is an on-going process
so…levels of self-esteem can
change.
Body Image
What do you think you look like physically?
?????
What do you think about your
appearance??????
Body image is dynamic: the body changes
thru normal growth and development.
Cultural and societal attitudes affect body
image
Roles
What is your role?????????
What are the expected behaviors you
perform????
Simultaneously hold many roles and
they change
Who do you want to be????
What do you want your role to be???
Roles
Self-Actualization
A part of self-concept is the way a person
perceives their ability to carry out
significant roles
Health self-concept can distinguish
between:
Ideal role expectations
AND
Realistic possibilities
Factors Affecting Self-concept
Health status: illness, injury, body chg, loss of
control, dependency on others
Role stressors; overload, strained,
feelings of inadequacy
Developmental transitions – aging in our culture
Personal “success” or failure history
Crisis and/or life events: personal and/or global
Internal and external resources
Individual perception of crisis
Self-concept: psychosocial
dimension
How one develops and grows can
have an affect on self-concept & health
Therefore nurses need to understand
normal stages of growth (physical
changes) & development
(psychosocial changes).
Erikson- Psychosocial
Developmental Theory
ID 8 stages from birth to old age
Each stage characterized by a
developmental task to be mastered
Unmet tasks may delay progress
through the next stage
Erikson
Trust vs Mistrust
Infancy
Infant relies on
caregivers for
basic needs
Autonomy vs
Shame and doubt
Toddler
Gains independence:
If expectations too
high or low feelings
of inadequacy
develop
Erikson
Initiative vs guilt
Preschooler
Seeks new
experiences if
restricted becomes
hesitant to seek new
challenges
Industry vs
inferiority
School-age
Focuses on
achievements and
if not accepted
develops a lack of
self-worth
Erikson
Identity vs role
confusion
Adolescence
Transition from
childhood to
adulthood. Acquires
sense of who they
are. Confusion if
unable to establish
sense of direction
Intimacy vs
Isolation
Young adulthood
Unite self with
others –
commitments. Fear
of commitment
results in isolation
and loneliness
Erikson
Generativity vs
stagnation
Middle adulthood
Desire to make a
contribution to the
world. Becoming
self absorbed
results in
stagnation
Ego integrity vs
despair
Later adulthood
Reminiscence about
life -sense of
purpose. If
believes life was
misdirected
despair results
Assessing Self-concept
Developmental and chronological age
Assessing includes questions on
identity… body image…self
esteem…roles…
Patient’s strengths/weaknesses
Self-Concept Questionnaire
Describe yourself.
What are your personal characteristics?
What are your strengths?
What are your fears or weaknesses?
Describe your body.
What do you like most about your body?
What do you like least about your body?
Tell me about some things you do or have done in the
past that give you a sense of achievement or
accomplishment.
Describe the primary roles you fill.
How do you feel about your ability to perform
these roles?
Are these roles satisfying to you?
High self-esteem vs Low self-esteem
Assertive
Self-directed
Makes
decisions
Praises self
Speaks clearly
Attends to
needs
Passive “who cares attitude”
Excessively Dependent
Hesitant to express views
Overly Critical of self
Monotone voice – lack of
emotion & energy
Neglects own needs
Difficulty making decisions
Overly apologetic
Avoidance of eye contact
Nursing Diagnoses
Disturbed body image
Low self-esteem; chronic or situational
Other Dx in which low self-concept is the
etiology:
 Ineffective health maintenance r/t …
 Self care deficit r/t …
 Risk for self-directed violence r/t…
Nursing Interventions
Nurse is a role model
Can a nurse NEGATIVELY affect a client’s selfconcept?
Form helping relationship:
Focus on client strengths; praise achievements
Meet physiological and psychological needs
Reduce pain
Decrease anxiety
Promote positive self-esteem
Encourage participation in care
Encourage socialization
Nursing Interventions NIC
Encourage client to recognize and discuss
thoughts and feelings
Assist client to:
Realize everyone is unique
Realize impact of illness on self-concept
Be aware of negative self-statements and modify
them
Gain more control
Identify positive attributes of self
Identify and use personal strengths
Nursing Evaluation
Outcome criteria addressed????
Behavior and attitude changes will
indicate altered self-esteem
Long term outcome –can take many
months or years
Evaluation (NOC)
Client should be able to meet the following
outcomes:
Be comfortable with body image
Be able to describe self positively
Be able to meet realistic goals
Be capable of interacting appropriately
with environment and others
“Know Thyself”
Socrates
Nurses need to reflect on their OWN selfconcept in order to effectively assist OTHERs.
Ask yourself these questions:
How do I perceive myself?
How do I think others see me?
What are my strengths and weaknesses?
What are my goals for self-improvement?
What does ALL THIS have to do with my
professional practice?
Summary
Self-concept based on 3 components
Need to understand how various
factors affect self-concept
Understand difference between high
& low self-esteem
Interventions to promote self-concept
Evaluate outcome criteria
“No one can make you feel
inferior without your consent”
- Eleanor Roosevelt