Situational Low Self Esteem Nursing Diagnosis and Nursing Care Plan

Last updated on May 18th, 2022 at 10:28 am

Situational Low Self Esteem Nursing Care Plans Diagnosis and Interventions

Situational Low Self Esteem NCLEX Review and Nursing Care Plans

Self-esteem is described as an individual’s perception of oneself and how well he or she believes about himself or herself. When people feel refined and capable of reacting to difficulties and pressures, they develop positive self-esteem.

On the other hand, situational low self-esteem pertains to having a wrong impression of oneself due to changes in one’s circumstances, such as losing physical parts or functional capacity.

Low self-esteem is frequently caused by actual or predicted changes in lifestyle, stress, unpleasant sentiments, relationship problems, low resilience, or condemnation by others.

Negative sentiments regarding one’s body, focusing on prior abilities, function, or looks, feeling of powerlessness, preoccupation with losing circumstance or bodily part, and alleged changes in the typical patterns of physical or series of responsibilities can also result in situational low self-esteem.

Furthermore, parental rejection, unrealistic parental involvement, recurrent failures, having less individual responsibility, and relying on others all affect self-esteem. While the initial pressures can come from both internal and external sources, including:

  • Trauma, such as sexual abuse and psychological or seeing threatening occurrences.
  • Tensions related to the influence or roles of the expected position in which the person is frustrated.

Signs and Symptoms of Situational Low Self-Esteem

  • Making negative comments and being judgmental of oneself
  • Self-loathing humor
  • Concentrating on the negatives while neglecting one’s accomplishments
  • Blaming oneself or others when things do not go their way
  • comparing oneself with others
  • Depriving oneself the opportunity to enjoy life
  • Refusing to acknowledge compliments
  • Rejecting challenges due to worry of failure
  • Being greatly irritated by criticism or disapproval
  • Extreme sadness, depression, nervous breakdown, feeling humiliated, furious, or worthless feelings
  • Having problems making friends
  • Lack of interest and motivation
  • Rejecting new experiences and failing to seize possibilities
  • Feeling rejected and unwelcome

Causes of Situational Low Self-Esteem

Some of the many possible causes of situational low self-esteem include:

  • Terrible childhood in which parents (or other significant figures such as teachers) were overly critical
  • Inadequate academic achievement at school leads to a lack of confidence.
  • A continuing potentially stressful situation, such as a romantic breakup or financial difficulty
  • Poor treatment by a partner, parent, or caregiver, such as being in an unhealthy relationship
  • Chronic pain, primary disease, or physical handicap or ongoing medical issues.
  • Anxiety disorders and depression are examples of mental illnesses that could also lead to low self-esteem.

Self-esteem can be influenced by a variety of factors, including:

  • Age. Based on research, self-esteem rises from adolescence through middle age. According to an American study, self-esteem peaks at the age of 60. As people get older, their self-esteem plummets, especially among seniors over 60. Changes in socioeconomic position and physical health could explain a large portion of this reduction.
  • Body Type. Children who are overweight or obese are more likely to be bullied. These children are more prone to depression as children and later in life. Low self-esteem can also be exacerbated by isolation and loneliness.
  • Gender. Women are more likely to have lower self-esteem than men throughout cultures. This phenomenon appears to be especially noticeable in Western societies.
  • Mental health status. Self-esteem among adults with mental health disorders was explored in a 2012 study. Higher self-esteem levels have been associated with humor, community engagement, and favorable ingroup stereotypes. People who kept their conditions hidden or worked hard to disprove negative preconceptions had situational low self-esteem.
  • Race and ethnicity. A 2011 research of high school students looked at disparities in self-esteem between ethnic and racial groupings. Asian-American kids had the most negligible levels of self-esteem in the survey. Hispanic pupils scored slightly better than white students. African American kids exhibited the highest levels of self-esteem. These data points correspond to the findings of previous studies.
  • Socioeconomic status. In 2017, a study looked at self-esteem in seventh-graders from low-income homes. Years later, students who thought American society was “fair” were more likely to have low self-esteem. During middle school, most kids faced discrimination and systematic obstacles.

Diagnosis of Situational Low Self-esteem

There is no commonly approved test or technique for detecting low self-esteem. However, the Rosenberg Self-Esteem Scale (RSE) has been frequently employed to measure low self-esteem  since it was established in 1965.

Treatment for Situational Low Self-esteem

Various psychosocial interventions that target poor self-esteem or self-criticism have been created. Cognitive-behavioral therapy (CBT), Competitive Memory Training (COMET), and Compassion-oriented Treatment (CFT) are a few examples. They are practical kinds of treatment. There is also a considerable similarity with psychosocial interventions for depression.

Effective CBT for low self-esteem includes the following components:

  • Identifying fundamental beliefs
  • Identifying rules for living
  • Creating healthier and more adaptable rules and beliefs
  • Utilizing behavioral experiments
  • Confronting personal worries and anxiety-inducing situations
  • Self-compassion replaces self-criticism
  • Living according to the new basic principles

Thus, since many individuals who struggle with low self-esteem have a distorted internal narrative, learning to trust a therapist can help improve patients’ negative thoughts.

A therapist’s rational thinking, acknowledgment, and lack of bias create a safe environment where the patient can understand that others accept him or her. In this sense, the therapeutic practice functions as a form of exposure treatment comparable to the strategy employed with patients suffering from diseases such as agoraphobia.

Nursing Considerations for Situational Low Self-Esteem

  • Make use of active listening. When patients have a situational low self-esteem, they frequently believe that no one is paying attention to them or is interested in what they have to express. When healthcare practitioners hurry through discussions and neglect to notice their patients’ complaints, it can undermine their respect and make them less likely to rely upon their nurse or other healthcare team members at some point. Active listening can also make patients feel more assured. This approach demands the nurses to pay close attention to patients, listen attentively, reaffirm their statements, and respond. Here are a few examples of active listening:
    • Continue to make eye contact.
    • Face the patient when sitting or standing.
    • Smile when appropriate.
    • Stay away from distractions.
    • Pose pertinent questions.
    • Use nods or verbal affirmations
    • Restate a summary of their remarks.
  • Create a natural nurse-patient relationship. The nurse must make patients feel at ease to increase their self-esteem. One way to accomplish this is to establish a friendly conversation beyond discussions about their health and treatment. Moreover, ask them questions about their families, pets, profession, and interests, or offer sincere praise to engage the patient. Find common ground, such as a similar passion, to create a connection and earn their trust. Authentic interest boosts patients’ confidence and dramatically improves the entire patient experience. When treating apprehensive patients or having needle phobia, building a relationship might be an effective diversion tool. Patients will feel safer and more at peace if the conversation is diverted away from any upcoming treatments.
  • Involve patients in the establishment of their treatment regimen. Involving patients in developing their treatment regimen is one of the most effective ways to boost patient self-esteem, generate better results, and raise positive patient outcomes. One of the pillars of patient-centered care is integrated care plans. Begin by educating the patient and authorized loved ones about their disease and providing them with all the information needed to make an appropriate judgment. Thus, inquire about their choices and make sure the treatment plan fits their beliefs, views, and culture. The more collaborative the approach is, the more the patient engages in it, and the more motivated they will feel to follow it.

Situational Low Self Esteem Nursing Diagnosis

Situational Low Self Esteem Nursing Care Plan 1


Nursing Diagnosis: Situational Low Self-Esteem related to the loss of a part of the body or a shift in functional capacity secondary to amputation as evidenced by anticipated lifestyle adjustments, fear of criticism, unpleasant sentiments about the body, an emphasis on past strength, efficiency, or appearance, and feelings of failure or helplessness

Desired Outcomes:

  • The client will begin to adapt and verbalize acceptance of himself in the situation (amputee).
  • Patients will accurately recognize and incorporate changes into self-concept without undermining self-esteem.
  • Patients will create realistic plans for adjusting to new responsibilities or role changes.
Situational Low Self Esteem Nursing InterventionsRationale
Evaluate and consider the patient’s readiness and attitude toward amputation.  According to studies, amputation poses a significant risk to the patient’s behavioral and mental health adjustment. Patients who see amputation as a life-saving or reconstructive procedure may be able to accept their new identity more instantly. However, patients who have had a sudden traumatizing amputation or believe their amputation results from the failure of other therapies are more likely to experience self-concept distortions.  
Assist the amputee in adjusting to his new body image.    This intervention aims to assist the patient in accepting the new self as quickly as possible.
Encourage patients to express their worries, negative emotions, and anguish over losing a part of the body.      Emotional release assists the patient in coming to terms with what happened and the reality of life without a body part.
Help enforce preoperative information, such as the size and location of amputation, the kind of prosthetic fitting (instantaneous or prolonged), and the anticipated postoperative course, including pain control and rehabilitative services.  This method allows the patient to ponder and comprehend and begin to deal with altered body image and function, which can aid in postoperative healing.  
Determine the level of assistance available to the patient.  Adequate support from significant others and friends can help with the rehabilitation process.  
Determine personal strengths and subsequent effective coping behavior patterns.  It is beneficial to build on the patient’s current abilities to help the patient cope with the present predicament.    
Inspire the patient to partake in activities of daily living (ADLs). Allow visitors to observe and care for the wound, taking advantage of the opportunity to highlight promising developments of recovery.  This intervention encourages independence and boosts feelings of self-worth. Although integrating a stump into one’s body image can take several months or even years, looking at the stump and having to hear supportive remarks (made in a standard, matter-of-fact manner) can aid in the patient’s affirmation.  
Motivate and make arrangements for a visit from another amputee, preferably one who is effectively rehabilitating.  A peer who has gone through a comparable venture can serve as a role model and provide validation to comments and hope for healing and a normal perspective.  
Take note of withdrawn behavior and attitude, negative self-talk, refusal, or excessive concern about actual and perceived changes.  This intervention helps determine the phase of anguish and the need for treatments.  
Make it possible for patients to express their concerns openly.  This approach encourages sharing beliefs and values about their worries and identifying misconceptions and myths that may impede adjustment to the situation.  
Explain the selection of various resources, such as psychiatric counseling and an occupational therapist.    These issues may necessitate assistance to enhance the best possible adjustment and rehabilitative services.

Situational Low Self Esteem Nursing Care Plan 2

Seizure Disorder

Nursing Diagnosis: Situational Low Self-Esteem related to the sense of being uncontrollable, changes in social roles, abandonment feelings, and unpredictable behavior secondary to seizure disorder as evidenced by changes in one’s self-perception of one’s role, a shift in the typical patterns of responsibilities, noncompliance or lack of participation in therapy, and expressions of powerlessness.

Desired Outcomes:

  • The patient will discover feelings and coping strategies for dealing with a negative self-perception.
  • The patient will have an elevated sense of self-esteem concerning the diagnosis.
  • The patient will express a realistic perspective and appreciation of himself in a new role or way of life.
  • The patient will have a favorable opinion of himself.
Situational Low Self Esteem Nursing InterventionsRationale
Ascertain the patient’s current situation concerning low self-esteem.Verbalization of worries about possible consequences can help the patient accept or deal with the matter.  
Examine the patient’s feelings about the diagnosis and the perception of a threat to oneself. Encourage the expression of emotions.   Individual reactions vary, and preceding experience or knowledge of this circumstance influences acknowledgment of the treatment protocol.  
Examine the public’s potential or predicted response to the situation. Encourage the patient not to hide the difficulties.    This approach allows for a problem-solving response and measuring control over the situation. Concealment is harmful to one’s self-esteem (it promotes denial), impedes advancement in dealing with the issue, and may cause serious injuries or an adverse reaction when a seizure occurs.
Explain current and previous accomplishments and strong points of the patient.    Focusing on the positive elements of the situation can help relieve the sense of guilt and self-consciousness and help the patient acknowledge the disease’s manageability.
Avoid overprotecting the patient; instead, encourage activities while providing monitoring and supervision as needed.    Participating in as many personal experiences as possible can help alleviate depression caused by limitations. Gymnastics, climbing and water sports may necessitate the provision of observation and monitoring.
Understand the significant other’s attitudes and abilities. Help the person apprehend that his or her feelings are valid; nevertheless, remorse and blame are not beneficial.    Contrary or unpleasant aspirations from a significant other may impact a patient’s sense of expertise and self-esteem and intrude on support received from a significant other, limiting the potential for effective management and self-growth.
Explain to the family or significant others the benefits of keeping calm throughout seizure activity.  Stress and anxiousness among caregivers are contagious and can be passed on to the patient, amplifying or exacerbating the individual’s negative views of the predicament or oneself.  
Refer the patient and significant other to a support organization such as the Epilepsy Foundation of America, the National Association of Epilepsy Centers, or the Delta Society’s National Service Dog Center.    This intervention allows the patient to get relevant data, assistance, and concepts for dealing with issues from others who have experienced similar experiences. Important note: Some service dogs can detect or anticipate seizure activity, allowing patients to implement safety precautions while raising independence and personal sense of control.
Begin by explaining the patient’s and significant other’s recommendation for cognitive therapy.  Seizures significantly impact personal self-esteem, and the patient or significant other may experience guilt due to perceived constraints and negative stereotypes. Counseling can assist in overcoming feelings of inadequacy and self-consciousness.  

Situational Low Self Esteem Nursing Care Plan 3


Nursing Diagnosis: Situational Low Self-Esteem related to biophysical variables, a reduction in reproductive capacity, and hormonal imbalances secondary to menopause as evidenced by self-deprecating utterances, expressions of self-worth loss, hot flushes, expressions of regret, despair, anxiousness, and sleeplessness.

Desired Outcomes:

  • During menopausal adjustment, the patient will have less frustration, worry, nervousness, and an increased sense of self-worth.
  • The patient will have more self-esteem and self-worth.
  • The patient’s uneasiness and tension will be lessened.
  • The patient will be able to express concerns and build a trusting relationship with the caregiver.
Situational Low Self Esteem Nursing InterventionsRationale
Examine the patient’s representations of negative thoughts, self-worth, anxiousness, and overall concerns about his or her current life situation.  Menopause makes things harder for women who believe that childbearing is the primary reason for their existence and self-worth. The loss of reproductive ability has far-reaching psychological consequences.  
Encourage the expression of feelings in a non-judgmental setting.    This method allows for the release of worries and reduces stress.
Inform the patient that emotions and manifestations caused by the decrease in hormone production are common.  This intervention promotes problem comprehension in preparation for resolution and acceptance.  
If the patient’s condition does not continue improving, suggest that she consider therapy for persistent anxiety or depression.  This method prevents long-term depression and emotional impairment.  
Encourage the patient to open up with her trusted peer who experiences the same thing when she feels sad about her current situation.  This approach may help the patient to release anxiousness. Having someone who understands the situation can be beneficial to prevent situational low self-esteem.  

Situational Low Self Esteem Nursing Care Plan 4

Prenatal Substance Dependence

Nursing Diagnosis: Situational Low Self-Esteem related to biochemical transformation, and maternal crisis accompanied by a lack of control over life circumstances secondary to prenatal substance dependence as evidenced by confusion regarding one’s identity, purpose, or life path, and denial that there is a problem with substance abuse.

Desired Outcomes:

  • The client will discover feelings and coping mechanisms for a negative self-perception.
  • The client will express verbal acceptance of self “as is” and a greater sense of value.
  • The client will develop goals and engage in practical planning for lifestyle adjustments required to live without medicines and produce the intended pregnancy outcome.
Situational Low Self Esteem Nursing InterventionsRationale
Examine the cognitive function for any changes. Examine for the presence of any other psychiatric disorders.    Pregnancy decisions may be altered. Some patients use drugs or alcohol to treat mental health disorders such as depression or anxiety.
Allow for the expression of one’s feelings.    Clients typically have trouble expressing themselves and, even more so, admitting the level of importance that the substance has assumed in their lives and its relevance to their current situation or pregnancy.  
Facilitate the expression of emotions such as rage, remorse, and shame.  The patient frequently lacks self-esteem and believes that the situation is hopeless. The admission of these feelings allows the patient to accept responsibilities for himself and take the first steps toward transformation.  
Examine the dynamics of the family and the efficiency of support.    Substance misuse is a family disease, and how the patient’s family members react to her pregnancy and conduct affects the development of the condition and how the patient sees herself. Many unintentionally become “enablers,” assisting the individual in concealing the effects of the abuse.
Explain the patient’s conduct and drug use in a nonjudgmental manner.    The nurse’s presence indicates recognition of the individual as a valuable individual. The discussion provides a chance to gain relevant data about patients’ problems caused by substance abuse.
Create a plan to address additional mental disease issues.  Patients who use medications to treat other mental health issues will remain to do so. Both prenatal substance dependence and mental health issues must be addressed to optimize cessation potential.  

Situational Low Self Esteem Nursing Care Plan 5

Perinatal Loss

Nursing Diagnosis: Situational loss of self-esteem related to failure to succeed in a life event secondary to perinatal loss as evidenced by negative thoughts regarding oneself are expressed verbally, a negative self-evaluation in response to a life event, and difficulty making appropriate decisions.

Desired Outcomes:

  • The patient shows adaptation to newborn death and acceptance of bereavement into daily life by making plans for the future.
  • The patient discovers his or her strengths and accessible resources.
  • The patient feels pleased with himself.
Situational Low Self Esteem Nursing InterventionsRationale
Discuss what happened to the patient with the parent and determine how they feel about the death.  Anger between family members may be transmitted to the patient or couple, causing a misrepresentation of actual occurrences.    
Investigate damaging actions, distinguishing between responses from others and self-elicited responses such as expressions of blame and remorse.  Destructive activities may be visible during the stages of rage, isolation, and sadness. Denial can be employed to protect oneself from self-esteem loss. Guilt may be expressed verbally, mainly if the loss results from a genetic issue, uterine trauma, or teratogens from environmental factors or drug use.  
A positive reward should be given for communicating needs and recognizing concerns.  This method aids in dealing with the grief of the circumstance. This intervention also aids parents recognize their importance as human beings.  
As necessary, consider the parental demands of other children.  Maintaining the patient’s or couple’s identity as a worthwhile parent is aided by continuing to care and feel needed.  
Allow time for verbalization, emotional venting, and crying.    Sharing loss allows for much-needed acceptance, assists parents in sorting through thoughts, and affirms parents’ natural feelings of impotence and inadequacy.

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. (2022). 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


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