Week 2 - Self Concept, Stress, Adaptation & Crisis Flashcards
Self Concept
A mental image or picture of yourself - it is what you understand and believe about yourself including your unique traits, skills, and personality
How one views self in relation to others and their environment
It is shaped and guided psychologically by our development
Self Concept can be __ or __
positive or negative
What are the 3 dimensions of self concept
self knowledge
self evaluation
self expectations
What do the 3 dimensions of self concept stem from?
Self Esteem
Self Knowledge
What is one’s emotional intelligence, knowledge of basic facts about themselves like sex, race, age, position in social groups, qualities or traits, and their own global self
Self Evaluation
How well one likes themselves at the current time
It boils down to a positive or negative self image from how we have experienced life thus far
Self Expectations
Who or what do I want to be?
This develops from role models
These are based on 3 factors
What are Self Expectations based on?
Self Respect
Self Approval
Self Worth
What are the 4 components that make up the 3 dimensions and self concept?
Self Esteem
Body Image
Role Performance
Personal Identity
What are the components of a Personal identity
Intellectual Self
Physical Self
Emotional Self
Moral/Ethical Self
What are some examples of things that shape personal identity
friends
family
interested
objects and possessions
creations
choices
values
beliefs
appearance
ethnicity
practices and habits
work and hobbies
Intellectual Self
Cognitive Ability - or - How one learns, their literacy level, and ability to think and push attention span
Includes: memory, learning, attention span, educational literacy, creative/artistic ability, understanding of illness they may have, how has our past shaped how we think and what we believe is true
Physical Self
View of physical body and an effect illness has on it including: appearance, function, control, mental and social aspects, and sexual function
Review of Systems gleans information on this aspect of the patient
The whole body is a part of personal identity
Moral/Ethical Self
Moral and ethical values/ what the person believes in including belief systems (personal beliefs, values, conscience, religious preferences) and cultural influences (traditions, food, role in the family)
An outsider like a nurse needs to be non-judgmental particularly for this aspect
Emotional Self
Mental health and psychological functioning
includes expressiveness (is it done in a healthy way?), needs and drives, mood and affect, support systems, psychological status, and beliefs
Must be intact to know how hard to work, get out of bed in the morning or deal with illness and loss
Personal Identity Assessment (Assessment of Self Concept)
list of labels that identify a person according to importance in order to see what is most important to a patient or person’s self concept
Why is assessment of self concept so important?
Understanding our patients will help us facilitate a change in their behavior and maximize coping
It also helps us understand why their priorities do not always match our own
By understanding, we can find sources of support and strengths that are meaningful to that individual to guide their care
How does Self Concept develop early on?
It begins as self awareness as an infant, which then grows to self recognition as a person and self definition, and eventually leads to a child’s self concept of themselves as a person
What are some characteristics of Self Concept
Dynamic and Complex
Holistic- all aspects of a person are important, not just one
Unique - to each person
Reflective of culture (influences values and beliefs)
Paplau’s Theory of Interpersonal relations
Appraisals made by significant others about the self are made –> these appraisals are repeated into a pattern and are incorporated into the self –> the person’s behavior morphs to match the appraisal
The self is then open to reappraisal from biophysical, maturational, and/or environmental changes
Developmental Cycle of Self Concept
Erikson’s Stages of Psychosocial Development
Mastery of each stage will support positive self concept and problems in one stage can delay mastery, stagnation, and lead to a negative self concept
We have to move up the ladder of trust –> autonomy –> etc to have a positive outcome
How does Maslow fit into the idea of self concept?
We need to meet the lower needs (physiological –> safety –> love and belonging –> self esteem –> self actualization) in order for a patient or person to move forward
Self esteem is near the top and a part of self concept, so inability to meet the first 3 stages can lead to negative self concept outcomes
Characteristics of a Health Self Concept
satisfaction with role performance
real self = ideal self to them
high self esteem
distinct sense of identity
emotionally stable
realistic life goals and aspirations
body image satisfaction
beliefs
understands faults and positive attributes
What are some events that can lead to altered self concept in a patient?
Altered appearance
Altered function
Altered control
Altered relationships
Altered beliefs
A combination of events
(But beliefs can influence the impact of these events)
Risk Factors for Self concept Disturbance
Major developmental change
not meeting developmental milestones
new trauma or multiple traumas
loss of a body part
loss of a valued role (ex: like if a stay at home mom loses her husband and now needs a job but cannot juggle both roles and “take care of everything” like she though she could before.)
inability to meet role expectations
gender and cultural issues
relationship and social concerns
Characteristics of Low Self Concept
refusal to look at or touch a body part (ex: ostomy)
unwillingness to talk about a problem
denial of the existence of a problem
increasing/abnormal dependence on others
self destructive behavior
withdrawal from social contracts
change in patterns of normal responsibilities
change in usual behavior patterns
self sabotage
Examples of Nursing Process and Self Concept Diagnoses
Disturbed body image
low self esteem
ineffective role performance
disturbed personal identity
ineffective coping
(note most are psychological)
Examples of Nursing Diagnoses that are NOT related to Self concept
Impaired physical mobility
ineffective breathing
risk for infection
risk for falls
pain
(all more physiological)
What is key to getting a patient to open up and be truthful about self concept
establishing a therapeutic relationship with them
The first step to being able to help a patient with self concept issues is…
understanding your own self concept first and being able to be nonjudgmental, caring, and available
Stress
Condition in which the human system RESPONDS TO CHANGES from its normal balanced state
What are the 3 main factors about stress?
- changes come from MANY SOURCES
- it can be positive or negative
- PERCEPTION greatly influences stress
How does perception influence stress
how you experience stress depends on beliefs, identity, environment, and pas events that shape your perception
Examples of Types of Stressors
- Physiological (chemicals, physical agents, infectious agents, nutritional imbalances, hypoxia, immune issues, pandemics)
- Psychological (accidents, traumatic experiences, horrors of history, fear of aggression or mutilation, rapid changes in the world, pandemics)
What is a key interaction between two systems when stress occurs?
The Mind-Body Interaction
When the mind experiences stress, the body will respond
What are some physiologic (body) stress indicators?
Anxiety Backache Constipation or diarrhea Dry mouth HA Increased urination Increased pulse, BP, respirations Nausea Sleep Disturbances Stiff neck Increased perspiration Chest pain Weight gain or less Decreased sex drive
Coping Mechanisms
behaviors that are SHAPED and LEARNED in order to deal with stress
What 3 things shape and teach a person coping mechanisms?
- Family
- Past Experiences
- Sociocultural Influences and Expectations
What are some important aspects about coping mechanisms?
They can be positive or negative
If they are effective they will be used again regardless of what they are
Additional methods can create a sense of emotional strength and endurance - so the more the better
Defense Mechanisms
Unconscious and AUTOMATIC reactions to stressors
Something in the past experiences we have had has taught us to do this automatically in response
Examples of Defense Mechanisms
compensation
denial
displacement
introjection
projection
rationalization
regression
sublimation
undoing
What aspects of a person can be impacted by stress?
Physiologic Functions
Safety and Security Feelings
Love and Belonging Feelings
Self Esteem
Self Actualization
Stress effects…
all parts of a person not just compartments.
Crisis
What occurs when coping mechanisms no longer resolve a situation of stress
What can cause a crisis
Threat
-or-
Perceived Threat to Self
Threat
something that is, or expected to, lead to an unexpected or dangerous situation affecting an individual, group, community, or whole society
Perceived Threat to Self
Disturbance caused by a PRECIPITATING EVENT: Perceived loss, a threat of loss, or a challenge
What are the characteristics of a person in crisis
time limited to 4-6 weeks
self concept assaulted
personalized experience
inability to cope due to a lack of frame of reference for the situation
change in normal behavior patterns - become uncharacteristic of self
Crisis is a ___ to self concept
assault
Types of Crisis
Situational Crisis
Maturational and Developmental Crises
Adventitious and Social Crises
Situational Crises
unanticipated, sudden in onset
life events disrupts persons psychological equilibrium
Maturational/Developmental Crises
growth and development
events that require a role change
predictable
Adventitious/Social Crises
major event affecting many people
accidental and unexpected (ex: Pandemic)
What is more important than what type of crisis someone is having?
How the crisis impacts that person, self, or family
as a nurse we need to focus on that personalized impact aspect
EX: do not focus on the loss of a job but the financial instability that is causing the stress
Crisis Impact
may be a mixture of crises depending on the situation
most important to measure the crisis impact on the client/family rather than the specific type of crisis
8 Phases of Emotional Reactions`
8 emotions that can occur in order, out of order, only some, none, or all depending on the person reacting to crisis and stress
they are: High anxiety, denial, anger, shame, guilt, remorse, grief, and reconciliation
What are some risk factors for a Crisis
crisis prone lifestyle - frequent exposure to losses, threats, role changes, poor life choices
failure to achieve developmental tasks
lack of supportive relationships, social problems
lack of coping skills
lack of resources
negative perception of the event
What are some examples of Nursing Diagnoses used for Crises
fatigue
sleep pattern disturbance
anxiety
coping, defensive
coping, individual, ineffective
decisional conflict
denial, ineffective
fear
grieving, dysfunctional
hopelessness
powerlessness
Crisis Intervention
as a nurse you should bring the person in emotional crisis back to homeostasis (breathe)
problem solving techniques to promote adaptive outcomes, including improved ability to cope with future crises should eb explored
5 Steps for Crisis Intervention
- ID the problem
- List alternatives, all possible solutions
- Choose best alternative for that specific individual
- Implement the plan
- Evaluate the outcome
How should a nurse identify the problem during crisis intervention?
- Define the problem from the CLIENT’S perspective (focus on the immediate problem) - validate how they feel and let them no there is no right or wrong way to feel
- Assess the situation of the client and the family
- Provide the opportunity for the client to express feelings.
When implementing a plan for crisis intervention the nurse may have to…
provide support/encouragement and promote coping behaviors
A crisis situation that has been intervened on can…
promote growth potentially if intervention works
A nurse should always do what when doing crisis intervention for a patient?
Approach from the clients perspective to get alternatives and possibilities they may not have thought of that best suit the patient
What are Coombs 2 major reasons for helping professions to concern themselves with self concept? (Reading)
- Facilitating client change is seriously impaired if the self concept is ignored
- Clients judge the value of their experience with helpers from the frame of reference of self concept
The fundamental purpose of self theory is? (Reading)
to optimize the pleasure-pain balance of the individual over the course of a lifetime
What is the difference between self concept and self report? (Reading)
Self concept is what the person perceives himself to be
Self report is what the person believes about himself
The function of self concept is to… (Reading)
direct behavior
4 Components of Self Concept (Reading)
Body Image
Self Esteem
Role
Personal Identity
Body Image (Reading)
that picture of schema of our own body which we form in our minds as a tridimensional unity involving interpersonal, environmental, and temporal factors
Also includes perceptions, attitudes, emotions, and personality reactions of the individual in relation to their own body
Self Esteem (Reading)
The ability of individuals to use themselves functionally to achieve a precise goal
The individuals perception of their worth
Personal Identity (Reading)
Part of the self concept through which we recognize ourselves as unique beings separate from the rest of the world
Bonham-Cheney Model of Self Concept (Reading)
Initial attempt to define a nursing focus for self concept
Utilizes a system approach to present self concept as a 2 dimensional process that includes the real self and the perceived self
Systems Theory of Self Concept (Reading)
Demands we treat systems as wholes, composites of related parts between which interaction occurs to a major degree
In the case of self concept we look as the two interrelated subsystems of personal identity! and self perspective! which then divide further
What are the 2 main systems of the System Theory of Self Concept (Reading)
Self Perspective
Personal Identity
*These two make up the Concept of Self
Concept of Self (Reading)
a 2 dimensional process that evolves from the interaction between personal identity and the self perspective
Personal Identity (Reading)
the fundamental construct of the concept of self comprised of 4 elements: Intellectual self, Physical self, Moral and Ethical Self, Emotional Self
Intellectual Self (Reading)
that element of personal identity which includes all the COGNITIVE AND CREATIVE FUNCTIONS`
Physical Self (Reading)
that element of personal identity which encompasses the STRUCTURE, FUNCTION, and APPEARANCE of the body
Moral and Ethical Self (Reading)
That element of personal identity which determines the PERSONAL BELIEF AND VALUE SYSTEMS
Emotional Self (Reading)
that element of the personal identity which encompasses the entire spectrum of FEELINGS AND ATTITUDES
Self Perspective (Reading)
That aspect of the concept of self which views personal identity from 3 different foci
Located as an outer ring containing personal identity with 3 sections: Self Esteem, Self Image, Self in Action
Self Perspective: Self Esteem Foci (Reading)
That perspective of personal identity which is concerned with HOW I VALUE myself
Self Perspective: Self Image Foci (Reading)
That perspective of personal identity which is concerned with HOW I SEE myself
Self Perspective: Self In Action Foci (Reading)
That perspective of personal identity which is concerned with HOW I USE MYSELF TO INTERACT WITH THE ENVIRONMENT
Data of self concept should include what 2 things? (Reading)
Nurse observations AND Client perspective on things
Body Image
How a person experiences ones 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 needs and ambitions that significant people, such as parents, have for them
Global Self
term used to describe the composite of all the basic facts, qualities, traits, images, and feelings one holds about oneself
Ideal Self
self a person would like to be or thinks one 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 full development of ones unique capabilities
Self Compassion
being kind and understanding when confronted with personal failings
Self Concept
mental image or picture of self; includes body image, subjective self, ideal self, and societal self
Self Esteem
persons perception of ones total being, including self worth and body image
Adaptation
adjustment of living with other living things and environmental conditions
Allostasis
the process of achieving stability or homeostasis through physiologic or behavioral change
Anxiety
vague sense of impending doom or apprehension precipitated by new and unknown experiences
Burnout
- Cumulative state of frustration with the work environment that develops over a long time
- Behaviors exhibited as the result of prolonged occupational stress
Caregiver Burden
stress responses experienced during prolonged periods of home care by family caregivers
Coping Mechanisms
patterns of behaviors used to neutralize, deny, or counteract anxiety
Crisis
- Point at which body temperature drops rapidly to normal
- Occurs when coping and defense mechanisms are no longer effective, resulting in high levels of anxiety, disorganized behavior, and the inability to function normally
Crisis Intervention
five step problem solving technique to promote adaptation and improve future coping
Defense Mechanisms
forms of self deception; unconscious process the self uses to protect itself from anxiety or threats to self esteem
Fear
a feeling of dread; a cognitive response to a known threat
Fight or Flight Response
the body preparing itself against threat, to either resist (fight) or evade (flight) the danger
General Adaptation Syndrome (GAS)
biochemical model of stress describing the bodys general response to stress
Homeostasis
various physiologic and psychological mechanisms respond to changes in the internal and external environment to maintain a balanced state
Inflammatory Response
localized response of the body to injury or infection; protective mechanism that eliminates invading pathogens and allows for tissue repair to occur
Local Adaptation Syndrome (LAS)
localized response of the body to stress, precipitated by trauma or pathology
Psychosomatic Disorder
physiologic alterations and illness believed to be due to psychological influences
Reflex Pain Response
automatic response of the CNS to the stimulus of pain
Stress
condition in which the human system responds to change in its normal balanced state
Stressor
anything causing a person to experience stress; change in the balanced state
