• Cognitive component of the self system

• “ How I see my self “

• Self- perception becomes a self-
fulfilling prophecy
• Individuals actually behave as they
perceive themselves
Positions of Self Concept

 Ideal self  Other self

 most health position  Value= “other people”
 Value = “me” centered
centered  Has a high need of
approval from others
 Competes with own to feel good about
self self
 EX: “I made a poor  EX: Some actors,
grade on the test, so comedians who need
I’ll study harder next constant positive
time feedback from fans
 Global self-concept  Core self-concept
 Total or aggregate  Beliefs and images
beliefs and images that are most vital to
one holds about the person’s identity
aneself- some positive, and self esteem
some negative  the core self-concept is
 One’s frame of laid down from very
reference for early years (very
experiencing and difficult to change and
viewing the world (can usually related to
be changed, moral values and
depending on ethics
circumstances)
 Continuum of Self-Concept
Responses

Adaptive responses Maladaptive responses

self- positive low identity depersonalization

actualization self-concept self- esteem diffusion
 SELF-CONCEPT
PHYSICAL PERSONAL

Body Sensation Self-Consistency

Body Image Self-Ideal

Moral-Ethical-
Spiritual Self
A. BODY IMAGE
 Image of physical
self
 Stress occurs with
actual or potential
threat to self-
image (patient
experience this)
BODY IMAGE DISTURBANCE

 Perubahan persepsi tentang tubuh

- ukuran
- struktur
- fungsi
- keterbatasan
- makna dan objek
TANDA DAN GEJALA

 Menolak melihat
 Tidak menerima perubahan
 Menolak penjelasan
 Persepsi negarif
 Mengungkapkan keputusasaan
 Mengungkapkan ketakutan
B. SELF IDEAL
 Persepsi individu
tentang bagaimana
dia harus
berperilaku
berdasarkan
standar, tujuan,
atau nilai pribadi
tertentu
SELF IDEAL DISTURBANCE

 Ideal diri terlalu tinggi

 Sukar dicapai
 Tidak realistis
TANDA DAN GEJALA

 Mengungkapkan keputusasaan
 Mengungkapkan keinginan terlalu tinggi
C. SELF ESTEEM
DEFINITION OF SELF-ESTEEM
 Affective component of the self system.
 “How I feel about myself.”
 The way one perceives and structures one's self-
concept can result in positive or negative self-
esteem.
 Large discrepancies between ideal self and
perceived self can result in low self-esteem.
TYPES OF SELF-ESTEEM

 Global self-esteem--how much the

person likes his or her perceived self
as a whole.
 Specific self-concept--how much a
person approves of a certain part of
himself or herself.
COMPONENTS OF SELF-ESTEEM

 Basic self-esteem--foundation that

is established during early life
experiences (difficult to change).
 Functional self-esteem--results from
ongoing evaluation of interactions
between people and objects
(easier to change).
 ELEMENTS PERTINENT TO THE
DEVELOPMENT OF SELF-ESTEEM
 Significant others—include family, peers, teachers.
 Social role expectations—success in performing
social roles, such as mother, spouse.
 Crises of psychosocial development—success in
resolving trust, autonomy, etc.
 Communication/coping styles—success in problem
solving, dealing with stressors, role
relationships, etc.
SELF-EVALUATIVE CRITERIA
FOR SELF-ESTEEM

 Power--ability to influence others and

control events.
 Significance--sense of being valued and
cared about is communicated by others.
 Competence--success in meeting goals.
 Virtue—ability to adhere to own
moral/ethical standards
SELF ESTEEM DISTURBANCE

 Perasaan negatif
 Hilang percaya diri
 Merasa gagal
TANDA DAN GEJALA
 Perasaan malu
 Rasa bersalah
 Merendahkan martabat
 Gangguan hubungan sosial
 Percaya diri kurang
 Mencederai diri
D. ROLE PERFORMANCE
 Set of expectations about a position.
 Stress occurs with:
 Role ambiguity—no role is clear—should I be a nurse, a
student, a mother, a spouse?
 Role strain—how do I juggle all those roles?
 Lack of role mastery—I can’t perform any of those roles
adequately.
 Role conflicts—How can I study for this test when I have a PTA
meeting?
ROLE PERFORMANCE DISTURBANCE

 Berubah atau berhentinya fungsi peran

- penyakit
- proses menua
- putus sekolah
- putus hubungan kerja
TANDA DAN GEJALA

 Mengingkari ketidakmampuan menjalankan

peran
 Ketidakpuasan peran
 Kegagalan menjalankan peran baru
 Ketegangan menjalankan peran yang baru
 Kurang tanggung jawab
 Apatis dan putus asa
 Conscious sense of individuality and uniqueness
 Things or abilities I do well or not so well.
 What I like or don’t like about the way I look.
 Encompasses the tangible (name/occupation) and
the intangible (character/beliefs)
 Includes identity with a group (can be a positive or
a negative).
 Ketidakpastian memandang diri sendiri
- ragu
- sukar menetapkan keinginan
- sukar mengambil keputusan
 Tidak percaya diri
 Sukar mengambil keputusan
 Ketergantungan
 Masalah dalam hubungan interpersonal
 Ragu/ tidak yakin terhadap keinginan
 Menyalahkan orang lain
THE NURSING PROCESS
RELATED TO
SELF-CONCEPT/SELF-
ESTEEM
 Self-perception—physical self and
personal self.
 Role relationships—family, work and
social roles
 Behaviors associated with low self-esteem

 Avoids eye contact.

 Is overly critical of self—“I’m no good,” “People
don’t like me,” or is overly critical of others.
 Is unable to accept positive remarks about self.
 Apologizes frequently.
 Verbalizes helplessness, powerlessness, “I really
don’t care what happens,” Whatever will be will be.”
 Verbalizes guilt, “It’s all my fault.”
NEXT…..
 Behaviors associated with low self-esteem
 Is indecisive, “I can’t make up my mind.”
 Displays over-dependence, asks for assistance
unnecessarily, seeks attention by speaking
loudly, seeks approval or praise.
 Fails to follow through with activities or solve
problems effectively.
 Exhibits self-destructive behavior, such as excessive
alcohol or drugs.
 Avoids looking at or touching a body part, hides body
part.
 Displays a lack of energy.
SAMPLE NURSING DIAGNOSES
 Body image disturbance
 Personal identity disturbance
 Altered role performance
 Self-esteem disturbance (chronic, or situational)
 Powerlessness
 Ineffective individual coping
 Social isolation
 Sexual dysfunction
 Anticipatory grieving
 Dysfunctional grieving
 PLANNING
Overall goals
 Increased awareness of strengths and weaknesses.

 Improved feelings of self-worth.

 Perception and response to stressors in a constructive manner.

 Improved interpersonal relationships.

Example: The client (Example: will demonstrate improved

self esteem) as evidenced by:
 Demonstrating improvement in personal appearance.

 Verbalizing a realistic perception of self.

 Identifying at least five positive personal attributes.

 Ability to share feelings about self with significant others, etc.

Identify areas of strength
 Assists in more rounded self-concept.

 Mobilizes regenerative processes.

 Increases awareness of others' strengths.

Develop behavior specificity

 Assists to define goals clearly.

 Assists to think clearly

Change language patterns
 From passive to active phrasing.

 From “I can't” to “I choose not to.”

Encourage positive self-evaluation

 Modeling by the nurse.

 Appropriate praise.

 Encouraging positive self-feedback.

 Visualization—imagining a success.
Change thinking patterns
 Decrease or eliminate illogical or distorted thinking.
 Catastrophsizing—everything, even little things, are
presented as BIG things.
 Minimizing or maximizing–talks about a huge event, such
as a death, as if were nothing.
 Black and white thinking—there are no “grays.”
 Overgeneralizations—“everyone” does something.
 Self-referencing--anything and everything that happens
affects him or her—somehow.
 Filtering—only hears what he or she wants to hear
Enhancing Self-esteem in Children and Adolescents
The nurse can assist parents and teachers in the development of:
 Sense of security and trust...Provide child with well-defined,
consistent limits.
 Sense of identity...Provide positive feedback, acceptance of
strengths and shortcomings.
 Sense of belonging...Provide opportunities for social acceptance.

 Sense of purpose...Assist in setting reasonable, attainable goals

and expectations.
 Sense of personal competence...Assist child is attaining a
sequence of successes.
Enhancing Self-Esteem in Older Adults
The nurse can assist older adults through:
 Encouraging clients to participate in planning their own care.

 Encouraging clients to establish their own physical space.

 Asking permission before performing a nursing or ADL

function.
 Listening to what the client is saying.

 Allowing the client sufficient time to complete an interaction

or activity.
 Receiving contributions of thanks or appreciation graciously
and sincerely
Evaluation
 Overall success
achieved in nursing
care can be
determined by
eliciting the patient’s
perception of his/her
own personal
growth