Self-Perception-Self-Concept Pattern



Self-Perception-Self-Concept Pattern






Fear (Specify Focus)* (1980, 1996, 2000)



DEFINITION

Feeling of dread related to an identifiable source that is perceived as a threat or danger to the self (specify focus [e.g., prognosis, surgical outcome, death, disability])


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Report of feelings of dread, nervousness, or worry/concern about a threatening event, person, or object with expectation of danger to the self


  • Describes (with or without assistance) the focus of perceived threat or danger (potential, actual, or imagined)


  • Narrowing focus of attention progressing to fixed (increased severity)

and one or more of the following:



  • Restlessness; fidgeting


  • Increased questioning or information seeking


  • Increased heart rate, increased respiratory rate


  • Increased muscle tension


  • Increase in quantity or rate of verbalization


  • Vigilance/scanning surroundings


  • Voice tremors, pitch changes


  • Hand tremor


  • Diaphoresis


  • Diminished productivity


  • Irritability


Severe



  • Anguish


  • Uncertainty



  • Distress


  • Sleep disturbance


  • Confusion (elderly)



OUTCOME


Fear



  • Absence of apprehension, tension, or uneasiness from an identifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Knowledge deficit; unfamiliarity with environmental experience(s)


  • Perceived inability to control events (see Powerlessness)


  • Language barrier


  • Sensory impairment (specify)


  • Phobic stimulus


HIGH-RISK POPULATIONS



  • Surgical or diagnostic procedures


  • Surgical outcome


  • First hospitalization


  • Discharge to self-care


  • Support system deficit (in stressful situation)



Anxiety (1973, 1982, 1998)



DEFINITION

Vague, uneasy feeling of discomfort or dread, the source of which is often nonspecific or unknown to the individual


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Reports feeling “anxious,” apprehensive, tense, scared, worried, “fearful”


  • Reports vague, uneasy feeling of concern about unspecified consequences or changes in life events

and one or more of the following:



  • Reports inability to relax, feeling jittery


  • Increased muscle tension, foot shuffling, hand or arm movements, trembling, hand tremor, shakiness


  • Facial tension


  • Lack of concentration


  • Insomnia


  • Sympathetic response (increased heart rate, respiratory rate, dilated pupils)


Supporting Cues



  • Focus on self


  • Verbalizes painful and persistent feelings of increased helplessness, inadequacy, regret (see also Ineffective Coping)


  • Restlessness, fidgeting, increased perspiration


  • Overexcited, rattled, jittery, scared


  • Increased wariness, glancing about, poor eye contact, facial tension, voice quivering


  • Diminished productivity


  • Scanning the environment, vigilance, impaired attention


  • Irritability, anguish, distress




OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness from an unidentifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Perceived threat to self-concept, health status, socioeconomic status, role functioning, interaction patterns, or environment


  • Unconscious conflict (essential values or life goals)


  • Unmet needs (specify)


  • Interpersonal transmission or contagion


  • Uncertainty



Mild Anxiety



DEFINITION

Increased level of arousal associated with expectation of a threat (unfocused) to the self or significant relationships


DEFINING CHARACTERISTICS



  • Verbalizes feelings of increased arousal, concern, vigilance


  • Increased questioning


  • Increased awareness


  • Increased attending


  • Mild restlessness


  • Lip chewing, nail biting, foot movements, finger or pencil tapping



OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness from an unidentifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Perceived threat to self-concept, health status, socioeconomic status, role functioning, interaction patterns, or environment


  • Unconscious conflict (essential values or life goals)


  • Unmet needs (specify)


  • Interpersonal transmission or contagion



Moderate Anxiety



DEFINITION

Increased level of arousal with selective attention and associated with expectation of a threat (unfocused) to the self or significant relationships


DEFINING CHARACTERISTICS



  • Expressed feelings of unfocused apprehension, nervousness, or concern


  • Verbalizes expectation of danger


  • Voice tremors, pitch changes, hand tremor


  • Narrowing focus of attention


  • Increased rate of verbalization


  • Restlessness, pacing, increased muscle tension


  • Diaphoresis


  • Increased heart and respiratory rate


  • Sleep or eating disturbances



OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness from an unidentifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Separation (use separation anxiety)


  • Perceived threat to self-concept, health status, socioeconomic status, role functioning, interaction patterns, or environment


  • Unconscious conflict (essential values or life goals)


  • Unmet needs (specify)


  • Interpersonal transmission or contagion



Severe Anxiety (Panic)



DEFINITION

Extreme arousal and scattered focus associated with expectation of a threat to the self or to significant relationships


DEFINING CHARACTERISTICS



  • Feelings of unfocused and severe dread, apprehension, nervousness, or concern


  • Inappropriate verbalization or absence of verbalization


  • Diminished ability to problem solve


  • Purposeless activity or immobilization


  • Perceptual focus scattered or fixed, or inability to focus on reality


  • Increased heart rate


  • Hyperventilation


  • Diaphoresis


  • Increased muscle tension


  • Dilated pupils


  • Pallor



OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness from an unidentifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Perceived threat to self-concept, health status, socioeconomic status, role functioning, interaction patterns, or environment


  • Unconscious conflict (essential values or life goals)


  • Unmet needs (specify)


  • Interpersonal transmission or contagion



Anticipatory Anxiety (Mild, Moderate, Severe)



DEFINITION

Increased level of arousal associated with a perceived future threat (unfocused) to the self or significant relationships


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Reports feeling anxious, apprehensive, jittery, tense, or fearful


  • Reports vague, uneasy feeling about unspecified future or impending event perceived as a threat to the self or significant relationships (unfocused)

and one or more of the following:



  • Inability to relax


  • Increased muscle tension, restless, foot shuffling, hand or arm movements, trembling


  • Sympathetic response (increased heart rate, respiratory rate, pupils dilated)



OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness from an unidentifiable source


ETIOLOGICAL OR RELATED FACTORS



  • Perceived threat to self-concept, health status, socioeconomic status, role functioning, interaction patterns, or environment


  • Unconscious conflict (essential values or life goals); unmet needs


  • Interpersonal transmission or contagion



Death Anxiety (1998)



DEFINITION

Vague uneasy feeling of discomfort or dread generated by real or imagined threat to one’s existence


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Expresses deep sadness


  • Reports concerns/fears about dying

and one or more of the following:


Concerns: Others



  • Worrying about the impact of own death on significant others (grief and suffering)


  • Concerns about overworking the caregiver as terminal illness incapacitates self


  • Worrying about being the cause of others’ grief and suffering


  • Fear of leaving family alone after death


Concerns: Dying Process



  • Expresses “fear” of the process of dying


  • Powerlessness (issues related to dying)


  • Expresses “fear” of loss of physical and/or mental abilities when dying


  • Anticipation of pain related to dying


  • Expresses concern over total loss of control over any aspect of own death


  • Negative death images or unpleasant thoughts about any event related to death and dying


  • Fear of prolonged dying


  • Fear of premature death because it prevents the accomplishment of important life goals


  • Fear of developing a terminal illness



Concerns: After Death



  • Concern about meeting one’s creator or feeling doubtful about the existence of a god or higher being


  • Denial of own mortality or impending death


  • Uncertainty about life after death



OUTCOME


Anxiety Level



  • Absence of apprehension, tension, or uneasiness about death/dying process


ETIOLOGICAL OR RELATED FACTORS



  • Diagnosis incorporates probable focus of anxiety/fear (i.e., death)


  • Treatment focuses on anxiety/fears about death



Reactive Depression (Specify Focus)



DEFINITION

Acute decrease in self-esteem, worth, or competency linked to a situational threat (specify situational threat [e.g., health outcome, disability, physical deterioration])


DEFINING CHARACTERISTICS


Diagnostic Cues



  • Expressions of sadness, despair, or hopelessness about a situation (specify situation)


  • Continual questioning of self-worth (self-esteem) or feeling of failure (real or imagined)


  • Pessimistic outlook

and one or more of the following to determine severity:

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Jun 12, 2016 | Posted by in NURSING | Comments Off on Self-Perception-Self-Concept Pattern

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