Week 6 D2 Self Concept Past Paper PDF

Self Concept PNUR104 Teacher Slides How or Why is this a need?  essential to mental & physical well being (health)  important for establishing relationships  assists in resisting psychological & physical illness  helps individuals to adapt or accept events that occur in one's l...

Self Concept PNUR104 Teacher Slides How or Why is this a need?  essential to mental & physical well being (health)  important for establishing relationships  assists in resisting psychological & physical illness  helps individuals to adapt or accept events that occur in one's life Self Concept  mental image of oneself  subjective and a complex mixture of conscious and unconscious thoughts, attitudes, and perceptions that a person has about his or her own identity  includesvalues, beliefs, appearance and behaviour Dimensions of Self Concept Self-knowledge – insights into one`s abilities, nature, limitations Self-expectation – what person expects of self (realistic or not realistic) Social Self – how society perceives person Social Evaluation – appraisal of relationships, events, situations Scientific Knowledge Base  Parents and caregivers influence a child’s self- concept.  Individuals learn and internalize cultural influences on self-concept and self-esteem during childhood and adolescence.  Job satisfaction and job performance in adulthood are linked to self-esteem.  The sense of self is often negatively affected in older persons.  Formation of Self-Concept  Develops throughout life (a lifelong process)  Influenced by the different stages in life  Results from social interactions with others  Influenced by age and gender  Can be better understood using Erikson’s Development Tasks Self-Concept: Erikson's Developmental Tasks  Trust Versus Mistrust (Birth to Age 1 Year) Develops trust from consistency in caregiving and nurturing interactions of parents and others Distinguishes self from environment  Autonomy Versus Shame and Doubt (Ages 1 to 3 Years) Begins to communicate likes and dislikes Is increasingly autonomous in thoughts and actions Appreciates body appearance and function Develops self through modelling, imitation, and socialization Self-Concept: Erikson's Developmental Tasks  Initiative Versus Guilt (Ages 3 to 6 Years) Takes initiative Identifies with a gender Gains enhanced self-awareness Increases language skills, including identification of feelings Is sensitive to family feedback  Industry Versus Inferiority (Ages 6 to 12 Years) Incorporates feedback from peers and teachers Increases self-esteem with new skill mastery (e.g., reading, math, sports, music) Experiences strengthening of sexual identity Is aware of strengths and limitations Self-Concept: Erikson's Developmental Tasks(Ages 12 to 20 Years)  Identity Versus Role Confusion Accepts body changes and maturation Examines attitudes, values, and beliefs; establishes goals for the future Feels positive about expanded sense of self Interacts with people whom he or she finds sexually attractive or intellectually stimulating  Intimacy Versus Isolation (Ages Mid-20s to Mid-40s) Has intimate relationships with family and significant others Has stable, positive feelings about self Experiences successful role transitions and increased responsibilities Self-Concept: Erikson's Developmental Tasks  Generativity Versus Self-Absorption (Ages Mid-40s to Mid-60s) Accepts changes in appearance and physical endurance Reassesses life goals Shows contentment with aging  Ego Integrity Versus Despair (Ages Late 60s and Older) Feels positive about own life and its meaning Is interested in providing a legacy for the next generation  Development of Self-Concept 1. Infancy- learning that physical self is separate and different from environment 2. Childhood - internalization of others’ attitudes toward self 3. Child-> Adulthood - internalization of standards of society towards self Quick Quiz! When caring for children or adolescents who have not achieved an age-appropriate developmental stage, the nurse understands that they may do which of the following? A. Remain unchanged during illness or crisis B. Regress to an earlier stage during illness or crisis C. Recognize that they have an illness or crisis D. Proceed as though nothing has changed in their lives Self Concept Self- Concept is based on…..  vocational performance  intellectual functioning  personal appearance & physical attractiveness  sexual attractiveness & performance  being liked by others  ability to cope with & resolve problems  independence  particular talents What makes up one’s self concept? Nursing Considerations for the Client Identity Role Performance Body Image Self-esteem Global Specific  Personal Identity  uniqueness  beliefs & values; personality & character  tangible & factual  it is what differentiates you from others Body Image  Image, attitude of your physical self  how you perceive your appearance, structure & functioning  both cognitive & affective aspects; conscious & subconscious  includes clothing, makeup, grooming, jewellery, tattoos, prostheses, assistive devices (e.g. hearing aids, walkers)  results partly from others reactions to self; partly from own exploration of body Body Image Healthy or Positive (+) Unhealthy or Negative(-)  occurs when image  usually person ignores, resembles ideal (culturally won’t look at or touch influenced) body  normally person pays  having feelings of attention to health & helplessness, healthy behaviours powerlessness and  different people have vulnerability different values (e.g. hair length, size of waist, etc) Role Performance Role : a. set of expectations b. some roles are permanent (e.g. sister) & some are temporary (e.g. student) Role Performance - behaviours that are expected based on the role or function Role Mastery - indicates successful mastery of expectations Role Development - includes socialization into the particular role i.e. student- >PN Role Ambiguity - means unclear role, responsibilities -> confusion results Role Strain - results when person feels inadequate or unsuited to role (can be related to stereotypes i.e. helpless female Self-Esteem The affective or emotional aspect of self  own judgement of your worth  how standards & performance compare to others & your own ideal  if self-esteem does not match ideal self -> low self-concept results  derived from self & others acceptance, own competence, significance & coping  2 types : 1. global self-esteem - how see self as a whole 2. specific self-esteem - how see specific part ie. cooking skills Factors that affect Self- Concept  Growth & Development - provisions for maturation  Family & Culture - during younger years; may be peer influence later = conflict  Stressors – coping successfully or unsuccessfully  Resources – internal & external  History of Success & Failures – overcoming failures  Illness – may affect body image or coping Stressors Affecting Self-Concept (that interfere with a positive self-concept)  Identity Stressors i.e. change in physical appearance, decline in abilities  Body Image Stressors i.e. loss of body parts or function, disfigurement  SelfEsteem Stressors i.e. lack of positive feedback, repeated failures  RolePerformance Stressors i.e. loss of parent, spouse, child from illness/divorce The Nurse’s Effect on the Client’s Self-Concept  Nurses need to remain aware of their own feelings, ideas, values, expectations, and judgements.  Usea positive and matter-of-fact approach.  Build a trusting relationship.  Be aware of facial and body expressions. Assessment Guide for the Need of Self-Concept Assessment – Interview Questions Self-Concept and the Nursing Process  Assessment  Behaviours suggesting altered self- concept  Actual and potential self-concept stressors  Coping patterns  Significant others  Client’s expectations NURSING DIAGNOSIS  Examples of nursing diagnosis  Disturbed body image  Caregiver role strain  Ineffective role performance  Chronic low self-esteem  Situational low self-esteem  Risk for situational low self-esteem  Readiness for enhanced self-concept OTHER NURSING DIAGNOSES May also lead to other nursing diagnoses such as:  Personal identity disturbance  Parental role conflict  Anxiety  Disturbed sleep pattern  Ineffective coping  Social isolation  Grieving  Spiritual distress  Hopelessness  Disturbed thought processes  Powerlessness PLANNING: Goals:  to enhance the self-esteem, body image, personal identity or role performance Nursing Orders or Interventions Identifying Areas of Strengths  examine interests, abilities, accomplishments, experiences-> for strengths  stress positive thinking rather than negative  identify & reinforce client’s strengths  acknowledging goals that have been met  provide honest & positive feedback Resiliency  adapting well in the face of adversity, trauma, stress  able to "bounce back" from difficult experiences Factors that contribute to Resiliency:  supportive relationships  encouragement & reassurance from others ie nurses  helping pt. to focus on strengths & skills to increase personal coping Enhancing Self-Esteem Adults (& Older Adults):  encourage clients to appraise situation & express feelings  encourage clients to ask questions  provide accurate information  be aware of distortions, inappropriate or unrealistic standards  explore positive qualities & strengths  encourage clients to examine more positive self-evaluation more than negative  avoid criticism  teach to substitute negative self-talk with positive self-talk Quick Quiz! Having a positive self-concept is most likely to result when an individual has which of the following? (Select all that apply) A. High self-esteem B. Positive ethnic identity C. A supportive family D. Community resources E. Access to higher education F. Fulltime employment Evaluation Questions to ask & what to observe to see :  If goals met, not met or partially met  If nursing orders effective  If nursing diagnosis still needed Case Studies on Self-Concept Mr. C Cleo Michael Case Study #1 Mr. C., age 70 had a stroke 1 month ago. He is in rehab now and gets very frustrated during his physio exercises. His speech is slurred & he yells when the nurse doesn’t understand what he says. He dresses in a clean shirt and pants daily. Every morning, he tries to shave himself but often forgets to do the right side of his face. Case Study # 2 Cleo, age 60 has just had a colostomy because of a bowel obstruction. She is refusing to change the bag or even look at the stoma. Her husband is concerned about her and says “she was always a ‘take charge person’, now she just lies in bed with her eyes closed.” Cleo asks the nurse during her morning bath “Will I ever be normal again?” Case Study # 3 Michael, age 26, was involved in a motor vehicle accident. He has some sensory and motor function impairment at the level of the umbilicus. His girlfriend visits him frequently, but he doesn’t want to talk with her. He prefers it when his “buddies” come in and they tell jokes. Michael often whistles at the young female nurses and asks them for dates. He refuses to get dressed and just wears the hospital gown.