Introduction for Nursing Diagnosis
Low chronic self-esteem is a condition that affects individuals who have an unrealistic and negative view of themselves that is difficult to change, even with positive reinforcement or corrective measures. Nurses can help by recognising the signs of low self-esteem and implementing interventions that can improve an individual's self-perception and sense of wellbeing.
Nursing Diagnosis Definition
The nursing diagnosis definition of Risk of Low Self-Esteem is "Vulnerability to development of a pattern of thoughts and feelings about one's self that is less than ideal." This definition covers a broad range of negative thoughts and feelings a person could have about themselves and implies that nursing interventions may be necessary to reduce the risk of low self-esteem and improve overall psychological wellbeing.
Defining Characteristics
Subjectives
- Expresses persistent feeling of worthlessness
- Expresses unrealistic expectations of oneself
- Expresses dissatisfaction and unhappiness about self-image
- Reports difficulty making decisions and setting goals
- Exhibits lessened capacity to judge own capabilities
Objectives
- Low of self-esteem documented by formal assessment tools
- Verbal cues suggesting doubt of self-worth
- Evidence of non-engagement in activities
- Aversive attitude towards praise and recognition
- Negative thought patterns evident in response to stressors
- Negative self-talk: Negative thought patterns such as self-deprecation, blaming oneself, or irrational self-criticisms.
- Stressful life events: Trauma, illness, abuse, discrimination, job loss, or other events that can lead to self-doubt and lowered self-image.
- Societal messages: Persistent messages from the media or peers which appear to condemn those who don't fit a certain image.
- Unrealistic expectations: Unrealistic goals or expectations which are difficult to accomplish and can lead to feelings of inadequacy.
- Past negative experiences: Experiences where a sense of inferiority or "failure" has been instilled.
Risk Population
Individuals who may be at risk for developing low self-esteem include adolescents, women, people with disabilities, seniors, and those from minority ethnic/cultural backgrounds. People who live in poverty or are socially isolated from others may also be more vulnerable to developing low self-esteem.
Associated Problems
Low self-esteem can lead to depression, anxiety, and other mental health issues. It can also lead to relationship difficulties, social isolation, and unhealthy coping mechanisms such as substance abuse.
Suggested Interventions
Interventions that have been used to address low self-esteem include cognitive behavior therapy (CBT), client-centered therapy, dialectical behavior therapy (DBT), psychoeducation, and group therapy. Education on the topics of appropriate assertiveness, communication and interpersonal relationships, and the use of relaxation techniques can also contribute positively toward the individual’s subjective wellbeing.
Suggested Alternative Nursing Diagnosis
Other nursing diagnoses that may be applicable to an individual with low self-esteem include: Ineffective Coping, Anxiety, Hopelessness, Spiritual Distress, and Risk for Suicide.
Usage Tips
When writing plans of care for clients with low self-esteem, it is important to keep in mind the individual's unique experiences and circumstances and focus on strengths, rather than weaknesses. Set realistic goals and collaborate with the client in the creation of an individualized plan of care.
NOC Results
For clients managing low self-esteem, nurses can review the following NOC results: Self-Esteem, Stress Tolerance, Decision Making, Sense of Wellbeing, Social Support, and Personal/Subjective Wellbeing.
NIC Interventions
For clients with low self-esteem, nurses can consider the following NIC interventions: Therapeutic Communication, Stress Management, Self-Awareness, Coping Enhancement, and Reality Orientation. Additionally, providing support, both in the form of reinforcement of self-efficacy beliefs, and resources to facilitate access to services, and support groups, may be helpful.
Conclusion and FAQ
Low chronic self-esteem is a widespread issue with potentially serious consequences. Understanding the symptoms, causes and treatments that can help to mitigate the risks associated with low self-esteem is essential in order for nurses to provide for patient care and promote wellness.
If you have any questions about how to identify, assess and respond to patients with low self-esteem, please feel free to contact one of our registered nurses for assistance.
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