Psychosocial model

Types of psychosocial modes  Self – Concept Mode ( it focuses specifically on the psychological and spiritual aspects of person)  Role Function Mode ( it focuses on the roles the person occupies in society)  Interdependence Mode ( it focuses on interactions related to the giving and receiving of love, respect and nurturance)

1.1. The physical self Body sensation ( ability to feel and to experience oneself as a physical being and its response to changes in health status – “I feel sick”, “I feel exhausted”) Body image ( how one sees one’s body and its parts in terms of size, appearance and functioning – “My nose is too long”, “I’m 15 pounds overweight”) It is influenced by feedback from others as well as cultural and societal values.

1.2. The personal self Self – consistency ( it allows people to act and express feelings in fairly stable or predictable patterns as they carry out activities of daily living – “I don’t anticipate any problems with surgery”) Self – ideal ( what one would like to be or is capable of being or achieving. It serves as a guide to achieving goals – “ I would like to be able to walk without crutches”, “I want to get 12 in every subject”) Moral – ethical – spiritual self ( it includes one’s belief system and an evaluation of who one is. It learns to tell right from wrong and to set standards for behavior – “I believe that abortion is wrong”, “I must have done something bad to deserve this”)

Self - Esteem  Development of the personal self leads to feelings of self – esteem or the overall perception of one’s worth.  High self – esteem (self – assured, effective in solving problems, trusting, friendly, unselfish, happy, sincere, productive, independent, realistic view of the world, optimistic, hopeful)  Low self – esteem (poor view of self, lack of control, distrusting, demanding, self – centered, angry, depressive, isolated from others, pessimistic, helpless, depending upon others)

Common problems in Self – Concept Mode Body Sensation and Body Image: Nursing diagnosis:  Body image disturbance  Anticipatory grieving  Dysfunctional grieving Feeling of loss of function or body part, or of loss of control, grieving Self – Consistency Nursing diagnosis:  Anxiety  Fear  Ineffective coping (usual coping mech. aren’t working) Feelings that express anxiety (anger, sadness, fears, depression, worry) Self – Ideal Nursing diagnosis:  Hopelessness  Powerlessness Feelings that express powerlessness, hopelessness, frustration or anger.

Common problems in Self – Concept Mode Moral –Ethical – Spiritual Self: Nursing diagnosis:  Spiritual distress Feelings that express guilt or shame

Role Function Mode  Role – is the pattern of behavior expected in order to occupy a given position in society  Why do we assess role function? 1. Patients frequently are required to take on temporary roles: sick role, student role 2. Patients or clients may acquire a new permanent role: mother, diabetic 3. Patients may need to change a role: widow, breadwinner

Identify the Roles  Primary Role: filled as a result of developmental stage, determines most of your behaviors during a particular period of your life (age and sex – adolescent male, elderly female, generative female)  Secondary Role: the major roles played in a certain developmental stage, and certain tasks must be accomplished to fulfill these roles (mother, father, brother). Chronic illness fits here (diabetic, cancer, paralysis)  Tertiary Roles : temporary, usually associated with secondary, but may also be associated with primary. Usually chosen to fulfill a minor task in a developmental stage, such as room mother.

Interdependence Mode  Interdependence is  A comfortable balance with others  Feeling adequate and secure in relationship with other people – “able to give and take”  Being loved and supported yet able to love and nurture others as well as oneself  Belonging – affiliated within a given group

Components of the Mode  A. Significant others ( individuals or groups to whom importance is ascribed or inherent in the interaction – parent, family, friend, lover)  B. Support system ( persons, groups, animals, who support the individual irrespective of whether behaviors are adaptive or ineffective)

Needs that are met in a functionally interdependent person  To be trusted and believed, and to rust and believe in others  To be loved, nurtured and supported, and to love, nurture and support others  To be understood and to win approval from others, and to understand and approve of the self  To be needed by others and to recognize one’s own needs from others

Purpose  The purpose of interdependence is to be responded to by another and/or to establish an in – depth interaction with another person. It has characteristics of protection, caring, proximity, physical contact, recognition, praise, approval.

Major tasks  To live successfully in a world of other people, animals and objects  To recognize one’s own dependent and independent needs as well as those of other people.  The mastery of learning to live with others leads to feelings of security and adequacy in the individual

The effect of illness and hospitalization  Physically isolated  surrounded by strangers  visiting hours  procedures that are intimate