Risk for Situational low Self-esteem

Selasa, 16 Juli 2013

At risk for developing negative perception of self-worth in response to a current situation (specify)

Related Factors: See Risk Factors.

Risk Factors:

  • Developmental changes (specify); 
  • disturbed body image; 
  • functional impairment (specify); 
  • loss (specify); 
  • social role changes (specify); 
  • history of learned helplessness; 
  • history of abuse, neglect, or abandonment; 
  • unrealistic self-expectations; 
  • behavior inconsistent with values; 
  • lack of recognition/rewards; 
  • failures/rejections;
  • decreased power/control over environment; 
  • physical illness (specify)

NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Decision-Making
  • Self-Esteem
Client Outcomes
  • Accurate self-appraisal
  • Ability to self-validate
  • Ability to make decisions independent of primary peer group
  • Recognizes effects of media on self-appraisal
  • Recognizes influence of substances on self-esteem
  • Identifies strengths and healthy coping skills
  • Recognizes life events and change as influencing self-esteem

Client Outcomes

Suggested NIC Labels
  • Self-Esteem Enhancement

Nursing Interventions and Rationales

1. Help client to identify environmental factors which increase risk for low self-esteem.
Identification is early stage of problem solving process.

2. Help client to identify current behaviors resulting from low self-esteem.
Low self-esteem increases risk for unhealthy behaviors (Mcgee, Williams, 2000).

3. Encourage creative problem solving through writing exercises.
Using creative writing, allowing clients to "tell their story." Giving positive feedback can increase self-esteem (Chandler, 1999).

4. Encourage client to maintain highest level of functioning, including work schedule.
Positive self-esteem is maintained at higher levels in working individuals than in nonworking individuals (VanDongen, 1998).

5. Encourage client to verbalize thoughts and feelings about the current situation.
Allowing the client to clarify thoughts and feelings promotes self-acceptance (LeMone, 1991).

6. Help the client to identify what has helped maintain positive self-esteem thus far.
Identifying what works empowers the client and encourages positive outcomes.

7. Help the client to identify the resources and social support network available to them at this time.
Resourcefulness and social support are significant predictors of self-esteem (Dirksen, 2000).

8. Encourage the client to find a self-help or therapy group that focuses on self-esteem enhancement.
Improved self-esteem of such group members is reported (Hakim-Larson, Mruk, 1997).

9. Encourage the client to create a sense of competence through short-term goal setting and goal achievement.
Sense of competence is related to global self-esteem (Willoughby et al, 2000).

10. Educate female clients about self-esteem differences between genders, and encourage exploration.
Females tend to have lower self-esteem than males no matter what domain is measured (Bolognini et al, 1996).

11. Assess the client for symptoms of depression and anxiety. Refer to specialist as needed.


12. Teach client a systematic problem-solving process.
Crisis provides an opportunity for effective change in coping skills.

13. See care plans for Disturbed personal Identity and Situational low Self-esteem.

Geriatric

1. Help the client to identify age-related and/or developmental factors which may be affecting self-esteem.
Self-esteem levels vary with the normal aging process and tend to decrease with older age (Dietz, 1996).

2. Assist the client in life review and identifying positive accomplishments.
Life review is a developmental task that increases a person's sense of peace and serenity.

3. Help client to establish a peer group and structured daily activities.
Social isolation and lack of structure increase a client's sense of feeling lost and worthless.

Home Care Interventions

1. Assess current environmental stresses and identify community resources.
Accessing resources to help decrease environmental stress will increase the client's ability to cope.

2. Encourage family members to acknowledge and validate the client's strengths.
Validation allows the client to increase self-reliance and to trust personal decisions.

3. Assess the need for establishing an emergency plan.
Openly assessing safety risks increases the client's sense of limits, boundaries, and safety.

4. See care plans for Situational low Self-esteem and Chronic low Self-esteem.

Client/Family Teaching

1. Refer the client/family to community-based self-help and support groups.

2. Refer to educational classes on stress management, relaxation training, etc.

3. Refer to community agencies that offer support and environmental resources.

2 komentar:

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