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Online Companion: Fundamentals of Nursing Standards and Practice 2E
In this chapter, self-concept as the individual's frame of reference for perceiving and interacting with the world is presented. Self-concept is composed of four elements: identity, body image, role performance and self-esteem. Each of the components is developed throughout the lifespan primarily in response to social interactions and experiences. In childhood, positive experiences, role models and the family environment are crucial to the healthy self-concept of the growing child. Adolescence can be a crisis period during which physical changes in the body trigger the requirement to revise the body image and to expand the individual's identity and role performance aspects. Self-concept continues to develop and change in adulthood in response to social activities, work obligations and family responsibilities. There is a universal need for a positive self-concept. Altered health status as a result of illness, surgery, or pregnancy can impact an individual's self-concept. The developmental transitions associated with the new parental role or in menopause require the individual to revise self-concept. The nurse uses nursing process to assist the client to develop or maintain a positive self-concept. The nurse begins by assessing the client's ability to develop and maintain appropriate relationships, to care for self in order to meet basic needs, and to adapt to stressors in a positive manner. From this data, the nurse selects from a list of nursing diagnoses, the specific type of self-concept disturbance the client is at risk for or is currently demonstrating.. Specific goals are designed for the client and are directed toward teaching coping skills and developing personal resources. The implementation principles include: establish therapeutic interaction between nurse and client, support healthy defense mechanisms and ensure satisfaction of physical and psychosocial needs. There are interventions specific to different stages of development. Chapter 19 ends with a case study and care plan for a client with nursing diagnosis of Altered Role Performance.
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