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Psychosocial Needs

Psychosocial Needs. Self-Concept. Self-Concept. How one thinks and feels about oneself Development of self-concept is a complex, lifelong process. Components. Identity Body image Role performance Self-esteem. Role Performance Behaviors. Reinforcement-extinction Inhibition Substitution

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Psychosocial Needs

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  1. Psychosocial Needs

  2. Self-Concept

  3. Self-Concept • How one thinks and feels about oneself • Development of self-concept is a complex, lifelong process

  4. Components • Identity • Body image • Role performance • Self-esteem

  5. Role Performance Behaviors • Reinforcement-extinction • Inhibition • Substitution • Imitation • Identification

  6. Self-Concept Stressors • Identity stressors • Body image stressors • Role performance stressors • Conflict • Ambiguity • Strain • Overload • Self-esteem stressors

  7. Effects on Self-Concept • Family • Nurse

  8. Assessment • Coping behaviors • Significant others • Client expectations

  9. Nursing Diagnoses • Examples • Disturbed personal identity • Ineffective coping • Disturbed body image • Chronic low self esteem

  10. Planning • Goals and outcomes • Priorities • Continuity of care • Cultural considerations

  11. Implementation • Health promotion • Acute care • Restorative care

  12. Evaluation • Client care • Client expectations

  13. The Experience of Loss, Death, and Grief

  14. Loss • Actual loss • Perceived loss • Maturational loss • Situational loss

  15. Grief • Mourning • Bereavement

  16. Theories of Grief • Kubler-Ross’s stages of dying • Bowlby’s phases of mourning • Worden’s four tasks of mourning • Application of theories to other types of loss

  17. Kubler-Ross Stages of Dying • DENIAL • ANGER • BARGAINING • DEPRESSION • ACCEPTANCE

  18. Types of Grief • Anticipatory grief • Complicated grief • Disenfranchised grief

  19. Assessment • Type and stage of grief • Grief reactions • Factors that affect grief • End-of-life decisions • Nurse’s experiences • Client expectations

  20. Factors Influencing Loss and Grief • Human development • Psychosocial perspectives • Socioeconomic status • Personal relationships • Nature of the loss • Culture and ethnicity • Spiritual beliefs

  21. Culture and Death Rituals, Mourning Practices

  22. Death Rituals by Culture • African American • Chinese • Hindu • Jewish • Mexican • Arab • Japanese

  23. Nursing Diagnoses • Anticipatory grieving • Dysfunctional grieving • Hopelessness • Powerlessness • Spiritual distress

  24. Planning • Goals and outcomes • Setting priorities • Continuity of care

  25. Implementation • Therapeutic communication • Promoting hope • Facilitating mourning • Postmortem Care

  26. Palliative Care • Symptom control • Maintaining dignity and self-esteem • Preventing abandonment and isolation • Providing a comfortable and peaceful environment • Therapeutic Communication • Promote spiritual comfort

  27. Supportive Care • Support for the grieving family • Assist with end of life decision making • Hospice care • Care after death (postmortem care) • Grieving nurse

  28. Evaluation • Client care • Client expectations

  29. Sexuality

  30. Sexual Development • Infancy and early childhood • School-age years • Puberty/adolescence • Young adulthood • Middle adulthood • Older adulthood

  31. Sexual Response Cycle • Desire • Arousal • Orgasm

  32. Sexual Orientation • Heterosexual • Homosexual • Bisexual

  33. Contraception • Nonprescription methods • Abstinence • Barrier methods • Timing methods

  34. Contraception • Prescription/health care intervention methods • Hormonal • Intrauterine devices • Diaphragm/cervical cap • Sterilization

  35. Sexually Transmitted Diseases • Syphilis • Gonorrhea • Chlamydia • Trichomoniasis • Human papillomavirus (HPV) • Herpes simplex virus (HSV)

  36. Sexually Transmitted Diseases • Human immunodeficiency virus (HIV) • AIDS • Transmission • Exposure categories • Education • Cultural considerations

  37. Sociocultural Influences on Sexuality • Pregnancy and menstruation • Discussing sexual issues

  38. Decisional Issues Related to Sexuality • Contraception • Abortion • STD prevention

  39. Alterations in Sexual Health • Infertility • Sexual abuse • Personal and emotional conflicts • Sexual dysfunction

  40. Assessment • Factors affecting sexuality • Sexual health history • Sexual dysfunction • Physical assessment • Client expectations • Nursing diagnosis • Cultural considerations

  41. Planning • Goals and outcomes • Priorities • Continuity of care

  42. Implementation • Health promotion • Acute care • Restorative care

  43. Evaluation • Client care • Client expectations

  44. Spiritual Health

  45. Spiritual Health • Caring for the whole person • Accepting beliefs and experiences • Helping with issues surrounding meaning and hope

  46. Framework of Systemic Organization • Maintenance • Change • Coherence • Individuation

  47. Traditional Concepts • Spirituality • Faith • Religion • Hope

  48. Problems—Spiritual Distress • Acute illness • Chronic illness • Terminal illness • Near-death experience

  49. Assessment • JAREL spiritual well-being scale • Faith/belief • Life and self-responsibility • Life satisfaction • Culture • Fellowship and community • Ritual and practice • Vocation • Client Expectations

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