Chapter 43

Self-Concept

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Self-Concept

Self-concept is an individual’s perception of self and is what helps make each individual unique.

Positive and negative self-assessments in the physical, emotional, intellectual, and functional dimensions change over time.

Self-concept affects the ability to function and greatly influences health status.

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Components of Self-Concept

Identity Body image Self-esteem Role performance

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Interrelationship of Components of Self-Concept

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Components of Self-Concept

A sense of personal identity is what sets one person apart as a unique individual.

Identity includes a person’s name, gender, ethnic identity, family status, occupation, and roles.

One’s personal identity begins to develop during childhood and is constantly reinforced and modified throughout life.

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Components of Self-Concept

Body image is an attitude about one’s physical attributes and characteristics, appearance, and performance.

Body image is dynamic because any change in body structure or function, including the normal changes of growth and development, can affect it.

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Components of Self-Concept

Self-Ideal is the perception of behavior based on personal standards and self-expectations.

Self-ideal serves as an internal regulator to support self-respect and self-esteem.

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Components of Self-Concept

Self-esteem is the judgment of personal performance compared with the self-ideal.

Self-esteem is derived from a sense of giving and receiving love, and being respected by others.

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Components of Self-Concept

Role refers to a set of expected behaviors determined by familial, cultural, and social norms.

The level of self-esteem is dependent upon the self-perception of adequate role performance in these various social roles.

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Components of Self-Concept

Stressors Affecting Role Performance- Role overload- Role conflict

• Whenever a person is unable to fulfill role responsibilities, self-concept is impaired.

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Development of Self-Concept

Self-concept evolves throughout life and depends to an extent on an individual’s developmental level.

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Development of Self-Concept

Childhood• A child’s sense of self is shaped by

interactions with parents and siblings, through shared experiences with extended family members, and relationships with others.

• Their sense of self changes as they move through each developmental stage.

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Development of Self-Concept

Adolescence• The numerous changes in physical,

emotional, and psychosocial status during the adolescent years bring about rapid and often continuous changes in self-concept.

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Development of Self-Concept

Adulthood• The adult’s perception of self continues to

develop and change as an individual progresses through the adult years.

• Periods of relative stability may be interspersed with realizations of physical changes, as well as changes in roles and responsibilities.

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Factors Affecting Self-Concept

Altered Health Status Developmental Transitions Experience

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Assessment

Consider both the client’s developmental level and chronological age when assessing self-concept.

Determine the client’s perception of self-concept and the factors affecting it.

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Assessment

Assess the client’s strengths to be used as a foundation on which to build therapeutic interventions.• Maintain appropriate relationships• Care for self in order to meet basic needs• Adapt to stressors in a positive manner

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Nursing Diagnoses

Disturbed Body Image Parental Role Conflict Disturbed Personal Identity Ineffective Role Performance Chronic Low Self-Esteem Situational Low Self-Esteem

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Disturbed Personal Identity Anxiety Social Isolation Hopelessness Powerlessness

Nursing Diagnoses

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Outcome statements reflect specific behavior that is measurable and that has an appropriate time frame for evaluation.

The nurse and client develop mutually established objectives. This encourages the client to assume an active role in recovery.

Outcome Identification and Planning

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Initiate Therapeutic Interaction Support Healthy Defense Mechanisms Ensure Satisfaction of Needs

• Physical needs• Psychosocial needs

Implementation

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Implementation

Promote positive self-esteem across the life span• Childhood• Adolescence• Adulthood

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A client’s behavior and attitudes will reflect the degree of progress toward restoring an altered self-concept.

The nurse must reconsider the alignment of the client’s targeted self-concept with the plan of care to assess if the two are still congruent.

Evaluation

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Because self-concept is based on personal attitudes and feelings, it often requires months or even years to change.

Evaluation