06.04 Self Concept

In this lesson, we are going to look at self concept.

As nurses, we need to understand self-concept, and I’m sure you’re asking yourself two questions. What is self-concept, and why do we need it?

First off, self-concept is the general principle of one’s identity. It influences how they feel, what decisions they make, how society influences them, and basically it’s how you can empower your patients by bolstering their self concept. As nurses, we use it to help plan their care and their needs, like their needs for resources, and we can intervene quickly if we need to. Self-concept is really complex and has a lot of factors, and we are going to look at some big points today so that you can better prepare for your patients as you care for them.
Self-concept is really complex and has a lot of factors, and we are going to look at some big points today so that you can better prepare for your patients as you care for them. The main ideas behind self concept are identity, body image, role performance and self-esteem.

First up is identity. It’s how the patient views themselves in comparison to other people. It includes observations of themselves, and it’s heavily influenced from people like their parents, role models, friends. It’s also influenced by their culture or belief system as well as their sexuality. It helps separate them from others. For instance, Robin Williams was a HUGE influence on me during my childhood to teenage years, which is why I’m sometimes goofy and animated.

One thing you’ll see throughout this lesson are stressors, which are things that cause change, either positively or negatively. So for identity, stressors are cultural or societal. So if there is a group pressure to dress or act a certain way, it can change your patient’s feelings of identity. Also, personal feelings. If they feel like they have to do or act a certain way because it empowers them, then that influences identity as well. It’s especially impactful over adolescence. Grounded individuals who have great support systems and positive role models with few stressors may have a better self-concept than those who don’t.

Body image is almost a cornerstone of self-concept. It used to be taught by itself, but has been implemented into this idea of self-concept. Body image is how we see ourselves aesthetically, or how we feel that others see us physically. It’s heavily influenced by society and really can affect our self-esteem. Changes in appearance are the greatest stressor. Here, you can see a patient with an ileostomy. The fact is that ileostomies are really important for those who need it, but can often be viewed as “gross” by other people, because of its function. The problem here is that many people who perceive them as gross are uneducated, but often negatively affects people. Rape and assault can also change how people view their bodies. Pregnancy is another one. So be mindful of these changes and promote positivity for your patient when you’re assessing their self-concept.

Now, role performance may not seem like a part of self-concept, but it is. And here’s why. We are social creatures and we feel like we need to have our place in family, society or within other groups. So it’s important to recognize that it helps to reinforce the self of self, especially because it feels like it gives us purpose.

For the most part, role performance is stable throughout life, but difficulty in getting the roles we feel like we should be in decrease our sense of self-worth. For example, some people in society perceive that nurses are a female profession, when in fact that’s being challenged. Here’s Walt Whitman, the famous poet with his personal nurse. Whitman volunteered as a nurse in the Civil War. Another example is women in the corporate world and politics - many women are forging the way to becoming more respected and successful within these “perceived” male dominated roles.

Role changes are a big stressor. For instance, if the breadwinner in the household is hospitalized and they can’t work, the new forced pressure on the spouse to make money changes that dynamic. And if they struggle, they may feel like they’ve failed, and that impacts their self concept. Another is role ambiguity. This is something like teenagers who don’t know what they want to do when they grow up. They feel like they lack purpose, and it negatively affects their self-worth.

We all hear about self esteem, but what is it? Self esteem is how you feel about yourself, which is different from self-concept, which is what you know about yourself. If we feel like we’ve accomplished a lot, or we’ve gained a lot of knowledge and we can positively contribute to society, we feel a power of self-worth. But if not, that can negatively contribute to it. Things like chronic illness take people out of contributing to society, and also challenges. Some people run into financial barriers, and they can’t get ahead; this leaves them feeling failure, which negatively impacts their self esteem.

So what do you do about it? You’re the nurse right? Well, the biggest thing you can do is anticipate challenges and find resources for your patient. If your patient is getting an amputation, expect that they will see it as a challenge and that they may have an issue with body image, or that they may not be able to positively contribute to society. So plan your care so that your patient can experience successes, no matter how small they are. Transferring from the bed to the chair or to a wheelchair can seem like these mountains that patient has to overcome, but empowering them can show them that they can do it.

Also, look for opportunities to provide resources like mental health professionals and education for people who have severe negative perceptions of self. By being proactive, you can help your patient sooner, before they develop a long-term complication associated with their self-concept.

Today, we focused on health promotion and communication as well as how human development impacts self-concept.


So let’s recap for today:

First off, self-concept includes identity, or how the patient sees themselves as different from everyone else.

All patients will have some sort of perception of body image. This can be empowering for them, or can be detrimental to their own self-worth.

Role performance focuses on how the patient views themselves within their family and society and how they contribute to it.

And Self Esteem is a reflective of how the patient views themselves and their feeling of self worth.

And don’t forget your role - identify needs early and educate the patient to encourage positive self-concept.

That’s our lesson on self-concept. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!