Situational low self-esteem care plan and Nursing Interventions

At risk for developing negative perception of self-worth in response to a current situation (specify). Situational low self-esteem related to : See Risk Factors.
Situational low self-esteem related 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)

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Situational low self-esteem care plan – NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels – situational low self-esteem goals

• 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 in the situational low self-esteem care plan
Suggested NIC Labels

• Self-Esteem Enhancement

Nursing Interventions and Rationales for situational low self-esteem care plan

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 the 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 the client to maintain the 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 the 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 networks 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

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

Situational low self-esteem care plan 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 – situational low self-esteem care plan
4. Assess current environmental stresses and identify community resources.
   Accessing resources to help decrease environmental stress will increase the client’s ability to cope.
5. Encourage family members to acknowledge and validate the client’s strengths.
   Validation allows the client to increase self-reliance and to trust personal decisions.
6. Assess the need for establishing an emergency plan.
   Openly assessing safety risks increases the client’s sense of limits, boundaries, and safety.

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.

1. Conduct physical exam for indicators such as Abuse and neglect
2. Develop caring and trusting relationship
3. Teach/assist family members, caregivers on the importance of repositioning, skin hygiene, and obtaining supportive devices
4. Maintain hygiene
5. Provide nutrition – hydration (2000-3000 if tolerated), vit C, protein, carbs, iron, zinc, copper, well-balanced meals.
6. Avoid skin trauma
7. Provide supportive devices
8. Reducing pressure on body parts

Nursing diagnosis: situational low Self-Esteem related to Traumatic injury, situational crisis, forced crisis

situational low Self-Esteem Possibly evidenced by

• Verbalization of forced change in lifestyle
• Fear of rejection or reaction by others
• Focus on past strength, function, or appearance
• Negative feelings about body
• Feelings of helplessness, hopelessness, or powerlessness
• Actual change in structure and function
• Lack of eye contact
• Change in physical capacity to resume role
• Confusion about self, purpose, or direction of life

Desired Outcomes/Evaluation Criteria for situational low Self-Esteem—Client Will

1. Psychosocial Adjustment: Life Change
2. Verbalize acceptance of self in a situation.
3. Recognize and incorporate changes into self-concept in an accurate manner without negating self-esteem.
4. Develop realistic plans for adapting to role changes and new roles.

Nursing intervention with rationale for situational low Self-Esteem care plan

1. Acknowledge difficulty in determining the degree of functional incapacity and chance of functional improvement.
   Rationale: During the acute phase of injury, long-term effects are unknown, which delays the client’s ability to integrate the situation into self-concept.
2. Listen to the client’s comments and responses to the situation.
   Rationale: Active listening provides clues to the client’s view of self, role changes, needs, and level of acceptance.
3. Assess dynamics of client and SOs, including client’s role in family and cultural factors.
   Rationale: The client’s previous role in the family unit is disrupted or altered by injury. Role changes add difficulty in integrating self-concept and level of independence.
4. Encourage SO to treat the client as normally as possible, such as discussing home situations and family news.
   Rationale: Involving the client in the family unit reduces feelings of social isolation, helplessness, and uselessness and provides an opportunity for SO to contribute to the client’s welfare.
5. Provide accurate information. Discuss concerns about prognosis and treatment honestly at the client’s level of acceptance. Rationale: Open discussion of treatment and prognosis may focus on current and immediate needs. Ongoing updates enable assimilation.
6. Discuss the meaning of loss or change with the client and SO. Assess interactions between client and SO.
   Rationale: Actual change in body image may be different from that perceived by the client. Distortions may be unconsciously reinforced by SO.
7. Accept client and show concern for individual as a person. Identify and build on client’s strengths; give positive reinforcement for progress noted.
   Rationale: Genuine concern and regard for the client as an individual establishes therapeutic atmosphere for self-acceptance and encouragement.
8. Include client and SO in care, allowing client to make decisions and participate in self-care activities, as possible.
   Rationale: Encouraging client participation in care decision making recognizes that client is still responsible for own life and provides some sense of control over situation. It sets the stage for future lifestyle, pattern, and interaction required in daily care. Note: Client may reject all help or may be completely dependent during this phase.
9. Be alert to sexually-oriented jokes, flirting, or aggressive behaviour. Elicit concerns, fears, and feelings about current situation and future expectations.
   Rationale: Anxiety develops because of perceived loss and change in masculine or feminine self-image and role. Forced dependency is often devastating, especially in light of changes in function and appearance.
10. Be aware of your own feelings and reaction to the client’s sexual anxiety.
    Rationale: Personal reactions to the client’s sexual anxiety may be as disruptive as the behavior itself, creating conflicts between client and staff, and can potentially eliminate the client’s willingness to work through the situation and participate in rehabilitation.

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What is situational low self-esteem?

Low self-esteem is a person rejects as something precious and is not responsible for their own lives. If the individual often fails it tends to lower self-esteem. Low self-esteem if it loses the love and appreciation of others. Self-esteem is derived from self and others, the main aspect is to be accepted and receive awards from other people.

Low self-esteem disturbance is described as negative feelings about themselves, including the loss of confidence and self-esteem, sense of failure to reach the desire, self-criticism, reduced productivity, which is directed destructive to others, feelings of inadequacy, irritable and withdrawal socially.

Nursing Care Plan for Low Self-Esteem Nursing Assessment for Low Self – Esteem

1. Subjective Data: Clients say: I can not afford, can not, do not know anything, stupid, self-criticism, expressing feelings of shame about themselves.
2. Objective Data: Clients looked more like himself, confused when asked to choose an alternative action, want to injure himself / want to end life.

Nursing Diagnosis for Low Self – Esteem

1. Risk for Social Isolation: withdrawing associated with low self-esteem.
2. Self-Concept Disturbance: low self-esteem associated with dysfunctional grieving.

Nursing Intervention for Low Self – Esteem

Goals for treatment for Low Self – Esteem

1. Clients can build a trusting relationship with nurses
   1. Action
      1. Construct a trusting relationship: Greetings therapeutic, self introduction, Explain the purpose, Create a peaceful environment, definition of contract (time, place and subject.)
      2. Give clients the opportunity to express his feelings.
      3. Take time to listen to the client.
      4. Tell the client that he is someone who is valuable and responsible and able to help themselves.
2. Clients can identify the skills and positive aspects that are owned.
   1. Action
      1. Discuss the capabilities and the positive aspects of client owned.
      2. Avoid giving negative assessments of each meet clients, give praise a realistic priority. \
      3. Clients can assess the ability and positive aspect owned.
3. Clients can assess the capabilities that can be used.
   1. Action
   2. Discuss with the client’s abilities can still be used.
   3. Discuss also the ability to continue after returning home.
4. Clients can define/plan activities with appropriate capabilities.
   1. Action:
      1. Plan your activities with a client that can be done every day according to ability.
      2. Increase activities in accordance with the client’s tolerance condition.
      3. Give examples of how the implementation of activities that clients should do.
5. Clients can perform activities according to the conditions and capabilities.
   1. Action:
      1. Give a chance to try activities that have been planned.
      2. Give praise for success Discuss the possibility of implementation at home.
6. Clients can utilize the existing support system.
   1. Action:
   2. Give health education to families about how to care for clients.
   3. Helps families provide support for client care.
   4. Help prepare the family environment at home.
   5. Give positive reinforcement for family involvement.