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Body Image

How a person experiences his or her body.

Depersonalization

Subjective experience of the partial or total disruption of ones ego and the disintegration and disorganization of ones self-concept.

False Self

A sense of self that might develop in individuals who have the emotional need to respond to the need and ambitious significant people, such as parents, have for them.

Ideal Self

Self a person would like to be or thinks he or she should be; includes aspirations, moral ideas, and values.

Identity Diffusion

Failure to integrate various childhood identifications into a harmonious adult psychosocial identity.

Personal Identity

An individuals conscious sense of who he or she is.

Role Performance

Ability to successfully execute societal expectations regarding role-specific behaviors.

Self Actualization

Reaching of ones potential through the development of ones unique capabilities.

Self Concept

Mental image or picture of self; includes body image, subjective self, ideal self, and social self.

Self Esteem

Persons perception of his or her total being, including self worth and body image.

Global Self

Term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself.

Characteristics of someone with positive self-concept:

Greater and more diversified self-knowledge, more realistic perceptions and expectations, and a higher evaluation of themselves or self esteem.

Characteristics of someone with negative self-concept:

Exhibit poorer self knowledge, less realistic perceptions and expectations, lower self esteem.

What does a persons self-knowledge include?

Basic facts (sex, age, race, occupation, cultural background, sexual orientation), persons position within social groups, qualities or traits that describe typical behaviors, feelings, moods, and other characteristics (generous, hot-headed, ambitious, intelligent, sexy.)

What did Maslow identify as subsets of esteem needs?

Self esteems needs (strength, achievement, mastery and competence, confidence in the face of the world, independence and freedom), and respect needs or the need for esteem from others (status, dominance, recognition, attention, importance, and appreciation).

What are the four bases of self-esteem identified by Coopersmith?

Significance - the way a person feels he or she is loved and approved by the people important to that person. Competence - the way tasks that are considered important are performed. Virtue - The attainment of moral ethical standards. Power - the extent to which a persons influences his or her own and others lives.

What are the three major self-evaluation feelings or affects found in individuals?

Pride based on a positive self evaluation, Guilt based on behaviors in-congruent with ideal self and Shame associated with low global self worth.

What are the factors affecting self-concept?

Developmental considerations, culture, internal and external resources, history of success and failure, crises or life stressors, aging, illness or trauma.

What are the changes affecting self concept in infancy?

No self-concept at birth. Beginning differentiation of self and nonself.

What are the Implications for Nursing in changes affecting self concept in infancy?

Teach parents the critical importance of providing consistent and affectionate parenting. Assess if the parents have reasonable expectations of the infant: sleeping, eating, and other awake behaviors.

What are the changes affecting self concept in childhood?

An intact body is important to the young child who fears bodily mutilation. During middle childhood a sense of being trusted and loved, or being competent and trustworthy develops. Differences between self and others are strong.

What are the changes affecting self concept in Adolescence?

Development of secondary characteristics, rapid body changes. Sense of self is consolidated. Emphasis is on sexual identity. Parental influences on self-concept are often rejected; peers become more important, movement is toward development of own identity.

What are Implications for Nursing in changes affecting self concept in Adolescence?

Assess adolescent self knowledge and understanding of body changes. Counsel adolescent regarding mature and health use of independence he or she craves. Provide anticipatory guidelines regarding hazards to life, health and human functioning.

What are the changes affecting self concept in adulthood?

Society places emphasis on intactness of body, fitness, energy, sexuality, style, productivity, sophistication and beauty. Important to meet role expectations well.

What are Implications for Nursing in changes affecting self concept in adulthood?

Assess how realistic the adults expectations are and the incentive they provide for growth and development. Assist patient to deal constructively with negative influences in self image. Preretirement counseling.

What are the changes affecting self concept in the later years?

Declining physical and possibly mental abilities. Multiple losses. Increasing dependency. Impending death. Diminished choices/options.

What are Implications for Nursing in changes affecting self concept in the later years?

Assess how the older person is adjusting to effects of aging. Counsel regarding meaningful use of time. Explore resources. Assess depression, substance abuse. Recognize and value elders life experiences.

What do you asses for with self-concept?

Personal identity, personal strengths, body image, self-esteem, and role performance.

In outcome identification and planning, what are objectives that the patient should achieve?

Describe self realistically, id both strengths and deficiencies. Verbalize realistic expectations for self based on who he or she would like to be. Verbalize that self is liked, or at least OK. Communicate his or her feelings and needs in a way that is comfortable and effective in meeting needs. Nurture relationships in which needs for love and worth are mutually met. Assume role-related responsibilities with confidence. Express satisfaction with ability to live according to ones moral-ethical standards. Demonstrate confidence in ability to accomplished what is desired.

What are specific strategies that can be used to help patients identify and use personal strengths?

Encourage patients to identify their own strengths, replace self-negation with positive thinking, notice and reinforce patient strengths, encourage patients to will for themselves the strengths they desire and to try them on, help patients cope with necessary dependency resulting from aging or illness.

How can you help a patient maintain a sense of self and worth?

Use looks, speech, and judicious touch to communicate worth. Acknowledge the patient status, roles, and individuality. Speak to the patient respectfully and in a non-patronizing manner. Converse with the patient about his or her life experiences. Address the patient by preferred name whenever entering the patients room. Offer the patient a simple explanation before initiating any procedures. Move the patients body respectfully if the patient is unable to do this. Respect the patients privacy and sensibilities. Acknowledge and allow expression of negative feelings. Help the patient to recognize strengths and explore alternatives.

What are helpful nursing interventions to modify a persons negative self-concept?

Help the patient identify and describe in detail how he or she thinks and feels about situations related to self concept. Explore with the patient alternative ways of viewing the same situation. Teach the patient to "red flag" faulty thinking behaviors as soon as he or she is aware. The goal is to replace negative thinking and self-talk. Help the patient explore the positive dimensions of himself or herself that he or she wishes to develop, and incorporate this new knowledge into the self-concept.

What outcomes should a patient be able to meet in evaluation of self-concept?

Is comfortable with body image and able to use it effectively to meet human needs, is able to describe self positively, is able to meet realistic role expectations without undue anxiety and fatigue, is capable of interacting appropriately with environment while recognizing self to be a separate and distinct entity.

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