Normalcy Flashcards
Normalcy: DEFINITION
The promotion of human functioning and development
within social groups in accord with human potential,
known human limitations, and the human desire to be
normal.
person’s normalcy will affect how they react to illness
The Nurse’s Effect on the Client’s Self-Concept/ Sense of normalcy?
Nurses need to remain aware of their own feelings, ideas, values, expectations, and judgements.
Use a positive and matter-of-fact approach.
Build a trusting relationship.
Be aware of facial and body expressions.
TWO (2) ESSENTIAL PRINCIPLES IN ESTABLISHING A
TRUSTING RELATIONSHIP?
1. Apply therapeutic communication techniques: Maintain appropriate eye contact* Maintain neutral facial expression Listen actively & attentively Use therapeutic communication responses
- Consider concepts you learned in the Values Lab:
Maintain confidentiality
Awareness of your own values, biases and discomforts
Consider whether the patients behavior is related to culture
Assessment Guidelines?
Minimize interruptions
Create a quiet private environment
Use attending behaviors (What are these??)
Listen and attend the patients concerns
Remain non-judgemental (verbal and non-verbal)
Ask open ended relevant questions
Be culturally sensitive
Maintain confidentiality
Obtain permission to document data as well as in seeking further information from others
Observations during Assessment?
General appearance:
Facial expression
Hygiene
Grooming/dress
Nonverbal/Verbal behavior:
Body posture
Eye contact
Language, Tone, Volume
Self-Concept?
cognitive component of the self system
collection of notions, beliefs and feelings about ourselves
“How I see myself”
Is the mental image that one has of oneself
Is a composite of ideas, feelings, and attitudes that a person has about his or her own identity, worth, strengths, and limitations
Comprises social, emotional, physical, academic domains
Affects how a person adapts to challenges, difficult situations, and relationships
BCFs that impact Self Concept?
Age and Developmental Stage
Sociocultural orientation: Education, Religious/Cultural factors
Patterns of Living: Internal and external resources Life experiences Methods of coping (with Stressors?) Successful or maladaptive responses
Health Care System Factors: Current medical Diagnosis
Nursing Knowledge Base: Development of Self-Concept?
Development of self-concept is a lifelong process.
Erikson’s theory of psychosocial development (1963)
This theory is helpful in understanding key tasks.
Each stage builds on tasks of the previous stage.
Successful mastery leads to a sense of self.
The Family’s Effect on Development of Self-Concept?
Family plays a key role.
Attachment theory (Bowlby,1982) emphasizes the quality of the attachment children have with their caregivers.
Children develop a basic sense from family.
Strong parental support and parental monitoring create positive effects.
Family and cultural influences can be positive or negative.
Behaviours suggestive of altered self concept?
Avoidance of eye contact Slumped posture Unkempt appearance Being overly apologetic Hesitant speech Being overly critical or angry Frequent or inappropriate crying Negative self evaluation Being excessively dependent Potter: box 25-7 p406
Personal Identity: Definition?
Conscious sense of individuality and uniqueness that is evolving throughout life
What distinguishes yourself from others
Identity Stressors?
- Decline in physical, mental, sensory abilities,
- Unrealistic ideal self,
- Inability to achieve goals
- Relationship concerns
- Sexuality concerns
- Change in physical appearance i.e wrinkles, graying hair
- Confusion regarding sense of self, purpose in life
Personal Identity: Assessment?
Subjective data:
Are the words or the general feeling of the responses negative or positive?
Listen to HOW the patient describes themselves.
Might have difficulty making decisions
Maintain positive self-identity by?
setting small achievable goals
developing strategies to cope with self concept
Body Image: Definition?
Involves attitudes related to the body, including physical appearance, structure or function
Potter p399
Not always consistent with actual appearance
Includes the knowledge of the body and its attachments
Body Image Stressors?
- change in appearance
- Loss of body parts,
- Disfigurement,
- Loss of body functions,
- Unrealistic body ideal
Assessing Body Image?
Inspect/observe the following:
Will the patient experience a change in body structure or function?
Does the patient look at, touch or hide the affected body part?
Does the patient avoid social situations?
Does the patient willingly engage in self-care?
Include in your assessment: Functional significance of the part involved. Importance of physical appearance. Visibility of the body part. Meaning the person attaches to the part.
Assessing Body Image questions?
What do you like most/least about your body?
What parts of your body are most important to you?
Is there anything about your appearance that you would like to change?
What do you understand about your health problem?
What limitations do you think will result?
What changes in your body do you expect following your surgery
How have significant others in your life reacted to changes in your body?
Do you feel different or inferior to others?
Promote a positive body image by:?
setting realistic short term goals
involving in self care
seeking appropriate support system
Role Performance?
Definition: How an individual fulfills the expected duties of a particular role.
Way they perceive their ability to carry out the role
Sets of socially expected behavior patterns associated with an individual’s function in various social groups
Transitional
Roles are easily compromised during illness
Role Ambiguity?
occurs when people are unclear of role responsibilities and do not know what to do or how to do it and are unable to predict the reactions of others to their behaviour
Role Strain
occurs when people feel or are made to feel inadequate or unsuited to a role.
Role Conflicts?
arise from opposing or incompatible expectations of a role or position
- Interpersonal Conflicts - Interrole Conflicts - Person-role Conflicts
Role Overload?
Stress of multiple obligations and an inability to perform well in all roles.
Results in a loss of role?
Hospitalization/Illness
Role Stressors?
- Divorce,
- Illness,
- Loss of significant other,
- Inability to meet role expectations,
- Loss or change in job,
- Ambiguous or conflicting role expectations
Altered roles performance?
When one experiences a change, conflict or denial of role responsibilities or inability to perform role responsibilities
- inability to perform new or usual roles
- lack of knowledge or difficulty in learning about role
- different perception of role
Confusion or frustration about role performance
Changes in usual patterns of responsibilities
Change in physical ability to perform role
Roles: Assessment?
Will the patient experience a change in ability to perform role responsibilities related to hospitalization/illness?
Does the patient exhibit a lack of knowledge about or inability to learn a new role?
Maintain or promote role performance by?
discussing new roles
expressing feelings about role loss
Self-Esteem?
a person’s judgement of their own self worth, how their standards compare with those of others and with their ideal self
How Self-Esteem Develops?
Significant others (ie family)
Social role expectations
Completion of expected tasks at different stages of development
Questions to Assess self-Esteem?
Are you satisfied with your life?
How do you feel about yourself?
Are you accomplishing what you want?
What goals in life are important to you?
Self-Esteem: Assessment?
Does the client exhibit any of the following:
Self-negating verbalizations
Expressions of shame or guilt
Evaluates self as unable to deal with events
Rationalizes away or rejects positive feedback and exaggerates negative feedback about self
Unable to set goals
Lack of or poor problem-solving ability
Inability to engage in self-care
Overly critical of self or others
Avoids eye contact
Stooped or poor posture
Movements are slow
Poor hygiene, un-kempt appearance
Apologizes frequently
Verbalizes feeling hopeless, helplessness, powerlessness
Social withdrawal
Avoidance of new situations
Verbalizations of or behaviours indicating lack of self-confidence
