Nurse's Pocket Guide

chronic low SELF-ESTEEM
Overly conforming; dependent on others’ opinions
Lack of eye contact
Nonassertive; passive; indecisive
Excessively seeks reassurance
Desired Outcomes/Evaluation
Criteria—Client Will:
• Verbalize understanding of negative evaluation of self and
reasons for this problem.
• Participate in treatment program to promote change in selfevaluation.
• Demonstrate behaviors/lifestyle changes to promote positive
self-image.
• Verbalize increased sense of self-worth in relation to current
situation.
• Participate in family/group/community activities to enhance
change.
Actions/Interventions
NURSING PRIORITY NO.1.To assess causative/contributing factors:
• Determine factors of low self-esteem related to current situation
(e.g., family crises, physical disfigurement, social isolation), noting
age and developmental level of individual. Current crises
may exacerbate long-standing feelings and self-evaluation as
not being worthwhile.
• Assess content of negative self-talk. Note client’s perceptions
of how others view him or her.
• Determine availability/quality of family/SO(s) support.
• Identify family dynamics—present and past—and cultural
influences. Family may engage in “put-downs” or “teasing”
in ways that give client the message that he or she is
worthless.
• Be alert to client’s concept of self in relation to cultural/religious
ideal(s).
• Note nonverbal behavior (e.g., nervous movements, lack of
eye contact). Incongruencies between verbal/nonverbal
communication require clarification.
• Determine degree of participation and cooperation with therapeutic
regimen (e.g., maintaining scheduled medications
such as antidepressants/antipsychotics).
• Note willingness to seek assistance, motivation for change.
NURSING PRIORITY NO. 2.To promote client sense of self-esteem
in dealing with current situation:
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
588 Cultural Collaborative Community/Home Care