Situational low self-esteem

Domain 6. Self-perception
Class 2. Self-esteem
Diagnostic Code: 00120
Nanda label: Situational low self-esteem
Diagnostic focus: Self-esteem

Situational Low Self-Esteem is a nursing diagnosis defined by NANDA (North American Nursing Diagnosis Association) that is used to describe the symptoms and signs of a person suffering from low self-confidence, self-doubt and lack of self-worth due to detrimental or stressful life circumstances. Individuals affected by situational low self-esteem usually have difficulty dealing with challenges, cause distress in social situations, are hypersensitive to criticism and depend heavily on external validation. With proper guidance and clinical intervention this diagnosis can be managed and the effects alleviated.

NANDA Nursing Diagnosis Definition

According to NANDA, a situational low self-esteem nursing diagnosis includes: “The state in which an individual has a diminished sense of self-worth, leading to distorted self-concept, caused by current events or life circumstances.”

Defining Characteristics

Subjectives:

• Low self-concept
• Self-doubt
• Feelings of inadequacy, incompetence, or low self worth
• Lack of confidence
• Dependence on external validation

Objectives:

• Reduced assertiveness
• Social retreatism and isolation
• High sensitivity to criticism
• Difficulty coping with challenges
• Difficulty meeting goals and tasks

Related Factors

There are several factors that can contribute to the experiences linked to situational low self-esteem. These include:

• Life transitions
• Distance from a support system
• A high stress environment
• Strained relationships
• Hardships such as unemployment, homelessness or illness

It is important to note that these experiences can differ greatly between individuals and that different people are affected differently by the same experiences.

At Risk Population

Certain populations are more likely to experience situational low self-esteem than others. Research suggests that people belonging to the following groups are more at risk:

• Highly sensitive individuals
• People from non-traditional families or backgrounds
• Cultures which place an emphasis on gender roles or traditional norms
• Youth undergoing transitionary periods such as high school to college or post-academic life
• Older individuals facing retirement and health difficulties

Associated Conditions

Situational low self-esteem is associated with certain disorders including depression, anxiety and eating disorders. Additionally, this diagnosis can lead to fatigue and insomnia as well as a host of physical problems such as muscle tension and headaches. In addition, those suffering from situational low self-esteem may be prone to substance abuse and misuse.

Suggestions of Use

When attempting to identify whether a patient is suffering from situational low self-esteem, it is important to consider their current circumstances and the criteria for diagnosis. Providing a safe space for individuals to discuss these elements can produce helpful information during the evaluation process. Furthermore, using self-assessment tools or questionnaires in order to evaluate an individual’s sense of self-worth and self-confidence can be beneficial.

Suggested Alternative NANDA Nursing Diagnoses

There are several alternative NANDA nursing diagnoses that may be pertinent to cases of situational low self-esteem. These include:

• Physical Self-Concept Disturbance
• Sexual Self-Concept Disturbance
• Psychosocial Self-Concept Disturbance
• Academic Learning Difficulty
• Risk for Ineffective Coping
• Social Isolation

Usage Tips

When assessing a patient for situational low self-esteem, it is important for nurses to be open and honest about their feelings. Providing support and understanding, as well as using questions to encourage self-reflection, can help to identify whether the patient could benefit from a diagnosis and subsequent treatment. It is also important to remember to remain empathetic and to be patient with those who may be struggling.

NOC Outcomes

Below are a list of outcomes that can be expected as a result of proper management and treatment of situational low self-esteem.

• Self Esteem: The patient will be able to identify, accept and appropriately express their strengths, weaknesses and emotions in a healthy way – expressing accurate self-perception.
• Personal Responsibility: The patient will take responsibility and ownership for their decisions and actions without feeling guilty or ashamed.
• Communication: The patient will engage in conversations in a clear and tactful manner.
• Coping: The patient is able to manage difficult feelings, stress and other life events in an adaptive and healthy way.
• Patient Confidence: The patient will display increased levels of confidence and improved decision-making.

Evaluation Objectives and Criteria

Evaluation objectives and criteria should be tailored to the individual and should aim to identify areas of improvement. Below are some standard evaluation criteria:

• Self-reflective: Does the individual have an accurate self-perception?
• Problem-solving: Is the individual able to think logically and effectively solve problems?
• Motivation: Can the individual find adequate motivation to complete tasks or make changes?
• Interpersonal Skills: Is the individual able to communicate effectively with others?
• Responsibility: Is the individual taking responsibility for their own actions?

NIC Interventions

Below is a list of interventions that should be implemented when managing situational low self-esteem.

• Psychoeducation: Use tools and materials to educate the individual on how to better manage emotions, regulate behavior and increase self-worth.
• Therapeutic Graded Activities: Introduce activities and tasks that act as gentle stimuli to help the individual grow and strengthen their skills and confidence.
• Behavior Modification Strategies: Give feedback on specific behaviors and offer positive reinforcement for desirable behaviors.
• Cognitive Behavioral Therapy: Teach the individual ways of recognizing and changing unhelpful thinking patterns to understand the influence of thoughts on feelings and behaviors.
• Multimodal Therapies: Utilize various approaches including art therapy and talk therapy to effectively manage problematic behaviors and thought patterns.

Nursing Activities

As part of the treatment plan, nurses should work to provide a safe environment where patients can explore and express their thoughts and feelings. Nursing activities should include:

• One-on-one counseling to assist with self-exploration and personal development.
• Granting autonomy while encouraging self-confidence and ownership of decisions.
• Assisting in setting realistic, achievable goals and providing positive reinforcement and feedback.
• Building trust by formulating a validating therapeutic relationship.
• Educating the individual about problem-solving techniques, communication strategies and behavioral interventions.

Conclusion

Situational low self-esteem is a condition that can have a detrimental effect on an individual’s life. Though the quality and severity of the symptoms can vary from person to person, having a comprehensive understanding of the diagnosis can help professionals assess the patient and formulate an effective treatment plan.

FAQs

• Q1: What is Situational Low Self-Esteem?
  Situational Low Self-Esteem is an NANDA nursing diagnosis which is used to describe individuals who possess low self-confidence, self-doubt and lack of self-worth due to detrimental or stressful life circumstances.
• Q2: What are some associated conditions that may arise from situational low self-esteem?
  Situational low self-esteem is associated with certain disorders including depression, anxiety and eating disorders. Additionally, this diagnosis can lead to fatigue and insomnia as well as a host of physical problems such as muscle tension and headaches. In addition, those suffering from situational low self-esteem may be prone to substance abuse and misuse.
• Q3: What are some suggested interventions that can be used to help manage situational low self-esteem?
  When attempting to manage situational low self-esteem, some suggested interventions include psychoeducation, therapeutic graded activities, behavior modification strategies, cognitive behavioral therapy and multimodal therapies.
• Q4: What are some typical outcomes that can be expected after engaging in management and treatment of situational low self-esteem?
  Typical outcomes that can be expected after engaging in management and treatment of situational low self-esteem include increased self-esteem, taking personal responsibility, communication skills, increased confidence, ability to cope with difficult feelings and/or challenges, and improved decision-making.
• Q5: Who is at risk for experiencing situational low self-esteem?
  Those who are more at risk for experiencing situational low self-esteem include highly sensitive individuals, people from non-traditional families or backgrounds, those of cultures which place an emphasis on gender roles or traditional norms, youth undergoing transitionary periods such as high school to college or post-academic life, and older individuals facing retirement and health difficulties.