Ch 27 Self Concept

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Self Concept

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- Is an individual’s conceptualization of himself or herself
- Directly affects one’s self-esteem, or how one feels about himself or herself

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Development of Self Concept

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- Each stage builds on the tasks of the previous stage
- Self concept is always changing and is based on the following:
- Sense of competency
- Perceived reactions of other’s to one’s body
- Ongoing perceptions and interpretations of the thoughts and feelings of others
- Personal and professional relationships
- Academic and employment-related identity
- Self esteem is usually highest in childhood, drops during adolescence, rises gradually throughout adulthood, and declines again in old age

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Components of Interrelated Terms of Self Concept

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Components of self concept frequently considered by nurses are identity, body image, and role performance

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Identity

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- Involves the internal sense of individuality wholeness, and consistency of a person over time and in different situations
- The achievement of identity is necessary for intimate relationships because individuals express identity in relationships with others
- More a person identifies with social groups, the greater the person’s self esteem

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Body Image

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- Involves attitudes related to the body, including physical appearance, structure or function

- Include those related to sexuality, femininity and masculinity, youthfulness, health and strength

- Cognitive growth and physical development also affect body image
- Cultural and societal attitudes and values also influence body image
- Culture and society dictate the accepted norms of body image and influence one’s attitudes
- American society emphasizes youth, beauty, and wholeness
- Western cultures have been socialized to dread the normal aging process
- Eastern cultures view aging very positively and respect older adults

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Role Performance

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- Is the way in which individuals perceive their ability to carry out significant roles
- Parent, supervisor, or close friend
- To function effectively in multiple roles, a person must know the expected behavior and values, desire to conform to them, and be able to meet the role requirements

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Self Esteem

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- Is an individual’s overall feeling of self worth or the emotional appraisal of self concept
- Represents the overall judgment of personal worth or value
- Ideal self consists of the aspirations, goals, values, and standards of behavior that a person considers ideal and strives to attain

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Stressors Affecting Self Concept

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- Self concept stressor is any real or perceived change that threatens identity, body image, or role performance
- Individual’s perception of the stressor is the most important factor in determining his or her response
- Any change in health is a stressor
- Loss of a partner
- Stressors created as a result of a crisis

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Identity Stressors

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- Stressors affect an individuals identity throughout life, but individuals are particularly vulnerable during adolescence
- Cultural and social stressors, rather than personal stressors, have more impact on an adult’s identity

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Identity Confusion

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Results when people do not maintain a clear, consistent, and continuous consciousness of personal identity

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Body Image Stressors

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- Changes in the appearance of the body, such as an amputation, facial disfigurement, or scars from burns, are obvious stressors affecting body image
- Even some elective changes such as breast augmentation or reduction affect body image
- Chronic illnesses
- Negative body image often leads to adverse health outcomes
- Media frequently present positive stories about persons adjusting in a healthy manner following serious disabilities
- Theses stories change public perception of what constitutes a disability
- Providing a social environment that focuses on health and fitness, rather than on weight control, will possibly increase adolescent girls’ satisfaction with their bodies

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Role Performance Stressors

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- Situational transitions occur when parents, spouses, children, or close friends die or people move, marry, divorce, or change jobs
- Any of these transitions may lead to role conflict, role ambiguity, role strain, or role overload

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Role Conflict

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- Results when a person has to simultaneously assume two or more roles that are inconsistent, contradictory, or mutually exclusive
- Negotiating a balance of time and energy between her children and parents create role conflicts
- The sick role involves the expectations of others and society regarding how an individual behaves when sick
- Society expectations - take care of yourself, and you will get better
- Co-Workers - need to get the job done

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Role Ambiguity

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- Involves unclear role expectations, which makes people unsure about what to do or how to do it, creating stress and confusion
- Common in the adolescent years

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Role strain

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- Combines role conflict and role ambiguity
- Feeling of frustration when a person feels inadequate

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Role overload

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- Involves having more roles or responsibilities within a role than are manageable
- Unsuccessfully attempts to meet the demands of work while carving out some personal time

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Self Esteem Stressors

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- Individuals with high self esteem are generally more resilient and are better able to cope with demands and stressors than those with low self esteem
- Perceived inability to meet parental expectations, harsh criticism, inconsistent discipline, and unresolved sibling rivalry reduce the level of self worth of children
- Low self esteem and stressful life events in college age adolescents are potential predictors for suicidal thoughts
- Stressors affecting the self esteem of an adult include failure in work and unsuccessful relationships

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Family Effect on Self Concept Development

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- Child also gains accepted norms for thinking, feeling, and behaving from family member
- Some literature suggests that parents are most important influences on a child’s development
- High parental support and parental monitoring are related to greater self esteem and lower risk behaviors
- To reverse a client’s negative self-concept first assess the family’s style of relating

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Nurses Effect on Client’s Self Concept

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- Nurse’s acceptance of a client with an altered self concept helps promote positive change
- Self awareness is critical in understanding and accepting others
- A positive and matter of fact approach to care providers a model for the client and family to follow
- Conveying genuine interest and acceptance
- Nurses who put themselves in the client’s position, will incorporate measures to ease embarrassment, frustration, anger, and denial
- Is essential to assess the client’s perception of a problem and to work collaboratively to resolve self concept issues

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Assessment

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- First focus on each component of self concept (identity, body, image and role performance)
- Actual and potential self concept stressors and coping patterns
- Nurses gather much of data regarding self concept through observation of client’s nonverbal behavior and by paying attention to the content of the client’s conversation
- The way in which significant other talk about the client and the significant other’s nonverbal behaviors provide information about what kind of support is available for the client

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Client Expectations

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- Person experiencing increased muscle tension, shakiness a sense of being “rattled” or restlessness
- Expresses a predominantly negative self appraisal, including inability to handle situations or events and difficulty making decisions
- Key indicators of a client’s self concept are nonverbal behaviors