Chronic Low Self Esteem

5 Chronic Low Self Esteem Nursing Care Plans

Chronic Low Self Esteem NCLEX Review Care Plans

Nursing Care Plans on Chronic Low Self-Esteem

Self-esteem is a psychological condition affecting all aspects of our lives. This condition can have an overall effect on one’s worth and relationships with other people as well as their mental health. 

Self-esteem is described as a person’s confidence in dealing with life’s challenges and the assurance that he is worthy of love, achievements, and happiness in life.

Nursing Stat Facts 1

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Nursing Stat Facts 1

Positive self-esteem occurs when an individual feels good about himself and is capable of responding positively when triggered by stress and challenges.

Moreover, when there is an incredible shift from this positive mindset to feeling unworthy, anxious, and inability to thrive, low self-esteem occurs. Dr. Frazier added that one’s self-esteem becomes low when a person feels helpless in controlling certain situations, unable to adapt and recover when faced with life’s adversities.

Self-esteem is crucial in the foundation of harmony and balance in one’s life. When a person has chronic low self-esteem, the root cause should be identified and therefore be eliminated in order to prevent detrimental effects it will have in one’s mental health.

Signs and Symptoms of Chronic Low Self-Esteem

There are several signs to spot a person who has chronic low self-esteem. These include:

  • Social withdrawal like avoiding new things and not grabbing opportunities
  • Sensitivity in accepting criticism
  • Having unhealthy habits leading to Anorexia, Substance Abuse etc.
  • Hostility as a defense mechanism (blaming others or lashing out aggressively)
  • Depression and anxiety
  • Feeling of being unwanted and unloved
  • Fear of failing
  • Having low self-image

Related Factors to Chronic Low Self-Esteem

There are various factors that influence low self-esteem:

  • Genetics. Childhood plays an important part in an individual’s self-esteem. Unhappy childhood wherein parents are very critical or having relationship breakdowns, child is bullied by other kids, or child has poor performance in school can all cause chronic low self-esteem.
  • Society and age. These can cause social problems especially when a person feels pressured by the society. When a person deviates from his expected role and what is considered a norm in society, he may be viewed as having a bad behavior or different from society. When this happens, at an early age, he will consider dropping out of school and engage in delinquent activities such as pre-marital sex, alcohol consumption, and other violation of social norms; when entering adult stage, he might resort to violence and crime like illegal drugs.
  •  Gender. Gender roles influence greatly a person’s self-esteem. Over the years, males are viewed as the one with high self-esteem or confidence brought about by their stereotyping feature where they must be competitive, strong, and powerful whereas females encounter situations wherein they need to be protected and supported. When it comes to emotions, on one hand, men are more likely to feel unsatisfied with their body and unable to voice out their feelings leading to problems in mental health and resulting to suicide. Women, on the other hand, feels greater responsibility when it comes to academic performance and often feels pressured to keep up with it.

5 Nursing Care Plans for Chronic Low Self-Esteem

Nursing Care Plan 1

Conduct Disorder

Nursing Diagnosis: Chronic low self-esteem related to lack of value to self as evidenced by: short temper and is often argumentative and has a bully attitude, history of being violent towards animals and individuals; has damaged some properties in the community; was involved in robbery, all occurring in the last twelve months, and verbalization of difficulty in handling his behavior and managing his emotions

Desired Outcomes:

  • The patient and family will participate in the care and treatment plan.
  • The patient will be able to not inflict harm to people and destroy properties.
  • The patient will demonstrate a positive outlook in life using effective coping skills.
  • The patient will demonstrate awareness and responsibility in showing acceptable behavior with others and well-managed emotions.
InterventionRationale
  Provide health education and recreational activities for the patient and family.    Having a support system increases the patient’s chance of complying and participating in the treatment.  
The nurse must show a non-judgmental behavior, set limits to the patient, and make him feel that he is still worthwhile and valued despite the disruptive behavior.  This will help patient to reflect on his behavior and be mindful of his actions.      
 The patient will have to state two to three positive things about himself every day.  Positive affirmations such as being grateful in life can help an individual deal with the stresses in life and appears happier.    
The nurse will guide and assist the patient in expressing his emotions and teach ways on how to interact with other people in an acceptable behavior.Expressing emotions eases anxiety and depression. It also removes the power of that certain emotion helping the individual see the problem in a new light.  


Nursing Evaluation

  • The patient was able to participate in treatment.      
  • The patient showed no propensities nor actual harm to other people and properties
  • The patient appears to be happier and is now more positive in his outlook in life even in the presence of some stress.    
  • The patient has improved in managing his emotions, showed acceptable behavior, and is taking more accountability for his actions.

Nursing Care Plan 2

Major Depression

Nursing Diagnosis: Chronic low self-esteem related toimpaired cognitive self-appraisal as evidenced by: extreme destructive view of oneself, his abilities and his negative view point towards society, as well as lacks recognition in his achievements, shows signs of shyness and is socially withdrawn

Desired Outcomes:

  • The patient will be able to assess the severity of his low self-esteem and gain confidence.
  • Patient will verbalize being encouraged to participate in group activities and share his thoughts.
  • Patient will verbalize minimized feelings of self-hate, guilt, and shame.
  •  Patient will be able to demonstrate a love for life and the ability to enjoy his present status/condition.
  •  
InterventionRationale
  The patient is able to identify his strengths and weaknesses.   Identifying strengths and weaknesses gives the patient a better viewpoint of oneself, his roles and function in the society.    
The patient engages in activities, shares his thoughts, and do simple to complex tasks in group setting.This is to lessen feelings of isolation when in a group setting.    
The patient will report and express feelings of negativity or social withdrawal using the scale method (1 being the lowest and 10 being the highest).To evaluate the patient’s feelings.
The patient will perform daily personal care and verbalize positive self-image.   A positive mindset and good grooming are a great start in enhancing and building one’s self-esteem.  

Nursing Evaluation:

  • The patient abstained from drug use and alcohol intake for a month now.
  • The patient verbalized that he is more open to discuss and talk about his feelings to other people without lashing out.
  • The patient verbalized he meditates and attends anger management counseling when feeling stress.
  • The patient verbalized that he can already handle difficult situations with a positive mindset and is now confident with his image.

Nursing Care Plan 3

Dissociative Disorder

Nursing Diagnosis: Chronic low self-esteem related to disturbed thought processes secondary to dissociative disorder as evidenced by: verbalized feelings of being detached and disconnected emotionally with other people but mentioned having multiple identities inside him; result of psychiatric interview revealed: decreased attention span, inability to recall specific events, substance abuse, inability to make sound decisions or solve problems; having delusions and hallucinations.

Desired Outcomes:

  • The patient will verbalize awareness of having dissociative behaviors when faced with stress.
  • The patient will verbalize understanding that his memory loss is due to stressors.
  • The patient will demonstrate improved memory and develop a more adaptive ways of handling and dealing with stressful situations.
  •  The patient will verbalize having an overall improved self-esteem.
InterventionRationale
  Explore patient’s feeling and response stress.  Being aware or understanding the behavior results to an effective plan and treatment.



Identify the trigger or stressor with a therapist and create healthy and desirable behaviors.    Identifying the correct stressors leads to an effective management of stress.

 
Explore patient’s feeling and response to stress by asking him to monitor and keep a record of his emotions.    To better manage his emotions especially his unpredictability.


Enhance patient’s self-esteembyproviding positive feedback and support for his effort to changeIt encourages good repetitive behavior.  


Nursing Evaluation:

  • The patient was able to verbalize his awareness of having dissociative behaviors when feeling stressed.
  • Patient was able to identify the triggers and stressors.
  • Patient learned to contain the symptom and control his emotions.
  • Patient demonstrated desirable behaviors and an improved self-esteem.

Nursing Care Plan 4

Substance Abuse

Nursing Diagnosis: Chronic low self-esteem related to ineffective coping secondary to substance abuse as evidenced by: verbalization of an unhappy and traumatizing childhood as one of the members in the family deals with substance abuse problems; personal report of problems in controlling his substance use like alcohol despite his desire to totally remove it in his system; verbalization that he craves for alcohol most of the time with the need to consume higher doses; admits to blaming other people for his substance abuse; expressed problems with self-image such as not being confident; laboratory test indicated declining liver function.

 Desired Outcomes:

  • The patient will refrain from alcohol consumption and drug use.
  • The patient will be able to express his feelings openly and directly.
  •  The patient will verbalize accountability for his actions/behaviors.
  •  The patient will practice effective coping mechanism with the support of his family and find alternative solutions that does not involve chemicals in dealing with stress.
  •  The patient will report a change in dealing with chronic low self-esteem to a positive mindset and high self-esteem.
InterventionRationale
Provide health teaching for the patient and family about the cause and effect of substance abuse and the road to recovery.  

Health teaching is essential in helping an individual to stay away from harmful practices like substance and explore ways on how to recover from it.    
Address issues arising in the family, the need of family support and treatment.    Addressing issues and identifying problems help figure why such problems exist and decide the course of action on how to fix them.  
Encourage patient to identify problems they have in the family and why substance abuse has intensified those problems.    Addressing issues and identifying problems in the family help figure why such problems exist and decide the course of action on how to fix them.  
Promote effective coping mechanism and high self-esteem by verbalizing positive ways in handling stress and a positive self-image.    The presence of support from the family members and a supportive surrounding is needed to increase coping skills and a positive mindset.  

Nursing Evaluation:

  • The patient abstained from drug use and alcohol intake for a month now.
  • The patient verbalized that he is more open to discuss and talk about his feelings to other people without lashing out.
  • The patient verbalized he meditates and attends anger management counseling when feeling stress.
  •  The patient verbalized that he can already handle difficult situations with a positive mindset and is now confident with his image.

Nursing Care Plan 5

Sexual Dysfunction

Nursing Diagnosis: Chronic low self-esteem related to sexual issues and feelings of rejections from her partner as evidenced by: verbalization of having no excitement and attraction for sexual activity, report of being unable to produce enough lubrication and inability to achieve orgasm, and report of feelings of repulsion and anxiety responses to genital contact.

Desired Outcomes:

  • The patient will recommence her desire for sexual activity on a satisfactory level with her partner.
  • The patient will verbalize sexual relationship satisfaction.
  • The patient will express satisfaction with her own sexuality.
InterventionRationale
  Determine the stressors that hinders the patient from having no desire for sexual activity.Stressors can greatly affect the mood and desire of the person to engage in sexual activity.



Encourage patient to engage in a healthy discussion about sexual issues to her partner and how they can overcome them.

Healthy discussion promotes good sexual relationship.
Identify the factors that may cause conflict with the patient’s sexual routine and practices.Identifying factors (cultural, racial, and religious) appropriate and acceptable will enhance sexual well-being and remove conflict.

Nursing Evaluation:

  • The patient was able to begin again her desire for sexual activity.
  •  The patient was able to healthily discuss with her partner sexual issues and how to resolve them.
  • The patient was able to identify the factors and address the issues that cause conflict with her sexual practices and was able to meet her sexual needs.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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