CHAPTER I

INTRODUCTION

A. Background

Self-concept is an individual’s perception of self. Self-concept affects every

aspect of life, including relationships, functional abilities, and health status. No

two people have an identical self-concept; self-concept is what helps make each

individual unique. Everyone has both positive and negative self-assessments in the

physical, emotional, intellectual, and functional dimensions, which change over

time and according to the context of the situation. Because self-concept is an

individual’s frame of reference for perceiving and interacting with the world, it

exerts a powerful influence on one’s life. Though neither visible nor tangible, a

positive self-concept is one of the greatest strengths a person can possess.

One’s view of self affects the ability to function. A person who sees self as a

competent individual will behave competently and vice versa. Individuals with a

positive self-concept approach new experiences and tasks with confidence; they

expect to be accepted by others and to succeed. Conversely, the person with a

negative self-concept tends to shy away from others and to avoid challenges. Self-

concept greatly influences health status. For example, a person with a positive

self-concept is more likely to care for one’s self—physically, emotionally, and

spiritually.

A nurse must understand about the basic of self-concept. Everyone has

different meaning and different level about their self-concept. By understanding

the basic knowledge about self concept, nurse can apply it on client, identify client

who has altered self-concept, and give nursing intervention to return client’s self-

concept into the normal level.

B. Aims

a. Explain the development of self-concept throughout the life span

b. Explain the continuum of self-concept response

c. Describe the five components of self-concept

CHAPTER II

DISCUSSION

A. Development of Self-Concept

Self-concept evolves throughout life and depends to an extent on an

individual’s developmental level. Self-concept changes during each

developmental stage. According to Stuart and Laraia (1998), the ongoing process

of self-concept development is facilitated by the following:

• Interpersonal and cultural experiences

• Self-perceived competence

• Self-actualization (living up to one’s potential)

Self-concept is developed primarily in response to social interactions and

experiences. Sullivan (1953) stated that self-concept is developed according to

perceptions mirrored by others to the individual. A person’s concept of self

depends, to an extent, on what one thinks that others think about oneself. As

individuals mature, they can accept or reject the appraisals of others and change

their behavior, in a way that leads to a more positive self-concept.

a. Baby

Initially, the newborn solely express the difference between pleasant

sensations and objects that cause the sensation is obtained. Neonates do not

have a clear self-restriction. The outside world is an extension of them. Only if

the function is a function of sensory perception and mature, the infants

gradually learn about their bodies. Babies really depend on adults to care for

their basic needs. If needs such as food and care are met quickly and

consistently, the baby starts to form a sense of trust with the world. Because

babies see themselves as part of primary care givers, the positive experiences

to help them gain confidence in themselves.

Weaning, contacts with others, and strengthen environmental awareness

self-extracting. In line the kids know his first birthday approached, the

coordination of sensory experience internalized into their body image.

Without adequate stimulation of motor and sensory abilities, the

development of body image and self-concept were damaged, as shown by

studies on premature infants in incubators that are less lulled, rocked and

cuddled (Kramel et al, 1975). A child's first experience with their bodies, a

very determined mother's affection and attitude, is the basis for the

development of body image. Reception and oengaturan body later in life and

other people's reactions to it is how we move our body-image formation

(Murray & Huelskoetter, 1991).

b. Toddler

Children ages play (1-3 years) were more active and able to interact with

others. The children move from total dependence to a sense of independence

and separateness from other people themselves. They also tend to view others

and themselves in terms of "all good" or "all bad". They achieve the skills to

feed themselves and perform basic hygiene tasks. Children ages play learn to

coordinate movement and imitate other people. They learn to control their

bodies through locomotion skills, toilet training, talking, and socializing.

Children ages play do not always know when they are sick, tired, too cold,

or thirsty because his pants wet. Children ages play full of impulse.

c. Preschool age

Limitation of the body, a sense of self and gender of pre-school age

children become more definite for them because of the development of sexual

curiosity and awareness about the differences with others of the same gender

or different. Learn about the body, where the start and where eventually, as it

seems, and what is done, is the basis for the formation of self-concept and

body image. They begin to learn about how they affect others and how others

respond to them. They also learn basic to control feelings and behavior. The

concept of the body is reflected in the way children talk, move, and make

drawings and play. The children began to examine the role and emulate the

likes of which they identify with same-sex parents or family members.

The children feel small in relation to adults. They set a positive or negative

view about themselves. Record hears and experiences the emotions of

statements from other people, especially parents about themselves as

individuals. They also hear about things and events around them. When this

experience repeated several times, they begin to shape the expected pattern.

Children internalize the views of others as part of themselves. They then act to

fulfill this vision. The view of this self start as assessments made by others.

For example, parents Andre consider skew interested in matters relating to the

mechanics. With the development of Andre, this perception becomes a part of

him and he acted to fulfill it by collecting things or fix things. Children learn

to appreciate something that is appreciated by parents. Appreciation of family

members becomes self-esteem. Family is very important for the formation of

self-concept of children, and negative feedback during this time will create a

decline in self-esteem, where that person as an adult would have to work very

hard to overcome.

d. School-aged children

Until the kids go to school, self-concept and body image are based

primarily on parents' attitudes. At school, others support the formation of self-

concept and body image. This will give harmonizing effect for children whose

family are very critical, or will be negative if the child has a negative

educational environment.

With the child enters school age, the growth becomes faster, and more

found motor skills, social, and intellectual. Child's body changes, and strong

sexual identity, increased attention span, and reading activities allow the

expansion of the concept of self through imagination into the role, behavior,

and elsewhere. Through play, children interact with peers; develop motor

skills and intellectual enhancement. The children express their feelings

through play, literature, pictures and music. Nurses can use this to get

instructions in the self concept of children. With the increasing problem

solving skills, self-awareness of strengths and limitations of self-development

of the greater. The concept of self and body image can be changed at this time

because the child continues to change physically, emotionally, mentally and

socially.

e. Teenagers

Teenagers bring physical upheaval, emotional and social. During sexual

maturation, feeling, role and new value, must be generated into the self. Rapid

growth and be attended by others is an important factor in the acceptance and

body image improvement.

The teenager was forced to change their mental picture of themselves.

Physical changes in size and appearance cause changes in self perception and

use of the body. Teenagers spend a lot of time in front of the mirror to

hygiene, dress, and dress in which they seek repair of their appearance as

much as possible, felt great distress about a perceived body imperfections.

The development of self concept and body image are intimately associated

with the formation of identity. This experience has important effects. Positive

experiences in childhood to empower youth to feel good about themselves.

Negative experiences as a child can lead to poor self-concept. Children who

enter adolescence with negative feelings facing this difficult period even more

difficult again.

Teenagers may be too stressed appearance; sharp nose, big ears, short

body or large body frame rate resulted in teenage bad against him. If teenagers

do not feel accepted themselves or their bodies, they will try to competence

through sports, hobbies or the success of academic, religious commitment, the

use of drugs or alcohol, or a group of friends to enhance prestige.

Compensation may result in sufficient negative or positive, depending on

public acceptance of that particular activity. Teenagers are also beginning to

show on a friend with a different gender in new ways and interests are further

improved. They collect a variety of roles in line with their behavior set a sense

of identity, including who they are, what the meaning of life for them and

where they went.

f. Young adult

Although physical growth has been stopped, changing of the cognitive,

social and behavior continue to occur throughout life. Young adults (early 20

years until the mid-40 years) are the period to vote. That is the period to assign

responsibility, achieving stability in employment, and began a close

relationship. The concept of self and body image become relatively stable in

this period.

g. Middle adult

Physical changes such as fat accumulation, hair loss, graying hair and

varicose attacking middle adulthood. This stage of development occurs as a

result of changes in hormonal and often a decrease in activity affect body

image, which in turn can interfere with self-concept. People realize that they

look older, and they may feel also that they become older. The work may be

very stressful if people with middle adulthood feel that your stamina, strength,

and sturdiness they declined to deal with the task. Decreased energy levels are

often the result of basal metabolism and decreased muscle tone.

Illness or death of a loved one can appear concern about the deaths

themselves. Middle adulthood individuals to feel inferior to young people

because of self-image of the body healthy and strong with an unlimited energy

has been replaced with self-image that reflects the changes of aging. The

difficulty in accepting the convenience is also caused by fears about the effects

of menopause, a story about sexuality, and social as well as pressure from the

media ads that depict youth.

Year adulthood is often a time to re-evaluate and redefine life experience

of the self in the role and value of life. This is called middle age crisis. This re-

evaluation can include choices about career and marriage. The way out of

successful integration includes a new quality into the concept of self. Most

people gradually adjust to the changes their bodies slowly and accept change

as part of maturity. People with emotional maturity to realize that they can not

return to be young and appreciate that the past and their own experiences are

valid and meaningful. Those middle aged adults who receive their age and

have no desire to return in times of young show healthy self-concept yan.

h. Elderly

Physical changes elderly appears to be a gradual decline in the structure

and function. Decreased muscle strength and muscle tone happened.

Osteoporosis, which is decrease of density and bone mass to create the

fracture.

Decrease in acuity views is factor that influences the elderly in their

interaction with the environment. Loss of hearing can cause personality

changes due to aging realize that they are no longer aware of everything that

has happened or is spoken. Suspicion, irritable, anxious or withdrawn may

occur because of damage to hearing. Often, the elderly view hearing aids as

other threats to body image. For many elderly, eyeglasses more socially

acceptable because the glasses used by all age groups, but a hearing aid is

considered as direct evidence of age. Adjustment of hearing aids hard happen;

if the low motivation of hearing aids can be rejected.

Loss of skin tone and accompanied by the appearance of wrinkles and can

affect self-esteem and cause the elderly to feel bad in a society that values

youth and beauty. Western culture is not too discriminate against age and

appearance is shown in men than in women demonstrated.

Sexual activity may disappear in line with age, although the ability to do

so still exists. Often the elderly do not engage in sexual activities because they

do not have a partner. Changes in body image may interfere with sexual

activity because of the rejection of the anticipated or perceived by a partner or

because of fears about the inability to do so, though most research shows that

there is no physical barrier.

Self-concept during the elderly is influenced by the experience of a

lifetime. Elderly is a time period where people reflect on their lives, reviewing

the successes and disappointments and thus create a sense of unity from the

world of meaning about them and help the younger generation in a positive

way to help the elderly often develop feelings have left a legacy. The concept

itself is also influenced by the perceived health status of people at this time.

B. Continuum of Self-Concept Response

Self-concept responses along with health-and-sick distance ranging from

adaptive until maladaptive response. The most adaptive response is self-

actualization; whereas the most maladaptive response is identify diffusion and

depersonalization. Adaptive responses include self-actualization and positive self-

concept. Self-actualization is the need to function at one’s optimal level, and to be

personally fulfilled. A favorable self-concept is likely the most important key to a

person’s success and happiness. Characteristics of an individual with a positive

self-concept are: self-confidence, willingness to take risks, ability to receive

criticism without defensiveness, ability to adapt effectively to stressors, and

innovative problem-solving skills. A person with a positive self-concept is likely

to engage in health-promoting activities. For example, a person who values self is

more likely to change unhealthy habits, such as smoking and sedentary lifestyle,

to promote health.

Maladaptive responses include low self-esteem, identify diffusion, and

depersonalization. Low self-esteem involves negative self-evaluations and is

associated with feelings of weak, helpless, hopeless, frightened, vulnerable,

fragile, incomplete, worthless, and inadequate. Low self-esteem is a major

component of depression, which acts as a form of punishment and anesthesia for

the individual. Low self-esteem indicates self-rejection and self-hate, which may

be a conscious or unconscious process expressed in direct or indirect ways.

Identify diffusion is an individual failure to integrate childhood identification into

a harmonic adult psychosocial personality. Depersonalization is a feeling of

unreality in which one is unable to distinguish between inner and outer stimuli. It

is, in essence, a true alienation from oneself. The individual has great difficulty

distinguishing self from others, and one’s body has an unreal or strange quality.

This related with panic level of anxiety and failure in reality.

Picture: The continuum of self-concept responses

C. Components of Self-Concept

Self-concept is composed of five components: identity, ideal self, body image,

self-esteem, and role performance. By considering these five elements of self-

concept, nurses can more effectively respond to a client (Stuart and Sundeen,

1998)

a. Identity

Identity is a self realization that comes from of self-assessment and

observation. Identity is characterized by the ability of looking at you

differently with other people, have confidence that can control themselves and

have a perception about the role of self-image. A sense of personal identity is

what sets one person apart as a unique individual. A well-formulated identity

provides the answer to the question “Who am I?” Identity may include a

person’s name, gender, ethnic identity, family status, occupation, and various

roles.

A person begins to develop identity during childhood and constantly

reinforces and modifies it throughout life. First, parents or caretakers provide a

child with elements of an emerging identity. Children may be told they are

good or naughty, shy or outgoing, creative or dull, powerless or empowered.

Adaptive response

Self-actualization

Depersonalization Identity diffusion

Low self-esteem

Positive self-concept

Maladaptive response

Children believe what they are told by others, and these beliefs influence the

developing identity. During adolescence, conflict often arises as the teenager

struggles to become independent and to establish a unique identity.

Eventually, people learn to observe themselves critically, as their social

environment expands. Feedback from others may support and strengthen an

aspect of identity already implanted, or it may contradict an aspect and help

change it.

The identity includes an internal sense of individuality, integrity, and

consistency of a person at all times and in different situations. The

achievement of identity is required for an intimate relationship because of

one's identity is expressed in dealing with others. Sexuality is part of a

person's identity. One's sexual identity is a picture of yourself as male or

female and the meaning of this picture. This picture and its meaning depends

on culturally determined values are learned through socialization.

b. Ideal self

Ideal self is the individual's perception of how he behaves in accordance

with standards, aspirations, objectives or specific personal value. Ideal self is

often referred to as the ideals, desires and expectations of ourselves.

c. Body image

Body image is an attitude about one’s physical attributes and

characteristics, appearance, and performance. Body image is dynamic because

any change in body structure or function, including the normal changes of

growth and development, can affect body image. Body image shapes one's

perception of the body, both internally and externally. This perception

includes the feelings and attitudes directed at the body. Body image is

influenced by personal views about the characteristics and physical abilities

and the perception of others' perspectives. Body image is also influenced by

the development of cognitive and physical development. School child's body

image is different with the image of the body of a baby. The difference is the

ability to walk. Attitudes and cultural and social values also affect body image.

The adolescent years are a good example of the interplay between an

individual’s physical changes and a developing sense of body image. Many

teenagers will have harmless body image distortions. It is not at all uncommon

for adolescents to feel self-conscious because they think their noses are too

big, or their hips too wide, or their blemishes too prominent. Usually, these are

normal concerns. Adolescents generally find that their perceptions continue to

evolve as their physical development continues to mature.

d. Self-esteem

Self-esteem is an individual’s generalized sense of worth and value, or

how a person regards self. Self-esteem refers to an individual’s self-

evaluation, whereas self-concept is a broader term encompassing an

individual’s overall self description.

The level of self-esteem at any given moment can be influenced by many

factors. Individuals will make decisions on what life factors (for example,

physical attributes, skills, social accomplishments) they deem important and

will calculate their self-esteem on the basis of their achievement of the factors

they value most highly. These values will be based on the individual’s familial

and cultural background and influenced by societal standards. Self-esteem will

vary over time depending on the situation (e.g., new job), the environment

(e.g., cocktail party with strangers), and an individual’s level of development

and overall self-confidence.

Self-esteem is an individual assessment of personal values obtained by

analyzing how well a person's behavior, according to the ideal self. High self-

esteem is a feeling that is rooted in self acceptance without conditions, despite

making mistakes, defeat, still feel as someone who is important and valuable.

Self-esteem or sense us about yourself: think this is an evaluation of where a

person makes or defend themselves.

Self-evaluation is ongoing mental processes. Self-esteem is one of basic

human needs, according to Maslow's Hierarchy. Self-esteem is important in

maintaining self-concept. Self-esteem is also influenced by a number of

control they have on the goals and success in life. Someone with high self-

esteem tended to show that he achieved success as a quality and personal

effort. When successful, an individual with low self-esteem tend to say that the

success he achieved was the luck and / or the assistance of others rather than

personal ability.

e. Role performance

Role refers to a set of expected behaviors that are determined by familial,

cultural, and social norms. Individuals fulfill several roles simultaneously—

parent, sibling, friend, spouse, student nurse. Each role has a set of expected

behaviors, that is, a belief about how a person in that role should behave. The

role is a set pattern of behavior expected by the social environment associated

with individual functions in different social groups. The role defined is the

role which the person does not have a choice. Accepted the role is the role of

the elected or selected individuals.

The role includes the expectations or standards of behavior that has been

accepted by the family, community, and culture. In order to function

effectively in that role, one must know the behavior and the expected value,

must have a desire to ensure this behavior and values, and should be able to

meet the demands of the role.

The nurse theorist Peplau examined roles in the context of the nurse-client

relationship. The nurse may assume several different roles, such as counselor,

teacher, leader, or surrogate parent. As the relationship progresses, the client

feels free to express deep feelings to the nurse because the nurse has assumed

the roles of listener, counselor, and expert. As teacher, the nurse may provide

information to the client or correct misconceptions. As counselor, the nurse

responds to the client’s feelings or behavior, helping the client to gain insight

or self-care or a health-affirming outlook.

CHAPTER III

CLOSING

A. Conclusion

Self-concept (an individual’s perception of self) affects every aspect of a

person’s life. A person who sees oneself as a competent individual will behave

competently and vice versa. Self-concept consists of four interrelated

components: identity, body image, self-esteem, and role performance. A well-

formulated identity provides the answer to the question “Who am I?” and may

consist of a person’s name, family status, occupation, and various roles. Body

image refers to a person’s mental picture of and attitudes about his or her

body. It includes physical attributes and characteristics, appearance, and

performance. Self-esteem is the individual’s generalized sense of worth and

value. Role refers to a set of expected behaviors that are determined by social

norms.

The development of self-concept begins at birth and depends, to a degree,

on interactions with others as the child grows and matures. The person’s

developmental level affects self-concept; with maturity comes a stronger self-

concept.

Self-concept responses along with health-and-sick distance ranging from

adaptive until maladaptive response. The most adaptive response is self-

actualization; whereas the most maladaptive response is identify diffusion and

depersonalization. Adaptive responses include self-actualization and positive

self-concept. Maladaptive responses include low self-esteem, identify

diffusion and depersonalization.

B. Suggestion

It is an important thing for nurse to learn and understand clearly about the

basic of self concept. Every client is a unique person and has a different

approach. Nurse must help client to have high self-esteem, positive self

concept and reach their self-actualization.

REFERENCES

DeLaune, Sue C. & Ladner, Patricia K. 2002. Fundamentals of Nursing: Standards &

Practice. 2nd ed. New York: Delmar/Thomson Learning

Potter & Perry. 2005. Buku Ajar Fundamental Keperawatan, Vol. 1. 4th ed. Jakarta:

EGC

Stuart, G.W and Sudeen, S.J. 2005. Principles and Practice of Psychiatric Nursing.

5th ed. St.Louis: Mosby

SELF-CONCEPT SEMINAR

(1st-3rd Topics)

This paper is compiled to fulfill adult nursing task

of self-concept module

Created by:

Anisa Suci M G2B 009 004

Ratih Purbo H. G2B 009 015

Mitsalina Maulida H. G2B 009 050

Alfiena Nisa Belladiena G2B 009 100

Maudy Melissa G2B 009 104

NURSING SCIENCE PROGRAM

MEDICAL FACULTY

DIPONEGORO UNIVERSITY

MAY, 2011