Situational Low Self-Esteem | NCP Hepatitis

Nursing diagnosis: situational low Self-Esteem related to Annoying, debilitating symptoms; confinement or isolation; length of illness and recovery period

Possibly evidenced by
Verbalization of change in lifestyle, fear of rejection or reaction of others, negative feelings about body, feelings of helplessness
Depression, lack of follow-through, self-destructive behavior

Desired Outcomes/Evaluation Criteria—Client Will
Self-Esteem
Verbalize feelings.
Identify methods for coping with negative perception of self.
Verbalize acceptance of self in situation, including length of recovery and need for isolation.
Acknowledge self as worthwhile; be responsible for self.

Nursing intervention with rationale:
1. Contract with client regarding time for listening. Encourage discussion of feelings and concerns.
Rationale: Establishing time enhances trusting relationship. Providing opportunity to express feelings allows client to feel more in control of the situation. Verbalization can decrease anxiety and depression and facilitate positive coping behaviors. Client may need to express feelings about being ill, length and cost of illness, possibility of infecting others, and (in severe illness) fear of death. May have concerns regarding the stigma of the disease.

2. Avoid making moral judgments regarding lifestyle, such as alcohol use, drug abuse, and sexual practices.
Rationale: Client may already feel upset or angry and condemn self; judgments from others will further damage self-esteem.

3. Discuss recovery expectations.
Rationale: Recovery period may be prolonged (months), potentiating family and situational stress and necessitating need for planning, support, and follow-up.

4. Assess effect of illness on economic factors of client and significant other (SO).
Rationale: Financial problems may exist because of loss of client’s role functioning in the family and prolonged recovery.

5. Offer diversional activities based on energy level.
Rationale: Enables client to use time and energy in constructive ways that enhance self-esteem and minimize anxiety and depression.

6. Suggest client wear bright reds or blues and blacks instead of yellows or greens.
Rationale: Enhances appearance because yellow skin tones are intensified by yellow and green colors. Note: Jaundice usually peaks within 1 to 2 weeks, then gradually resolves over 2 to 4 weeks.

7. Make appropriate referrals for help as needed, such as community case manager, social services, and other community agencies.
Rationale: Can facilitate problem-solving and help involved individuals cope more effectively with situation.