Nursing diagnosis – DISTURBED PERSONAL IDENTITY

DISTURBED  PERSONAL  IDENTITY

DEFINITION

Inability to maintain an integrated and complete perception of self

DEFINING CHARACTERISTICS

• Disturbed body image

• Contradictory personal traits

• Fluctuating feelings about self

• Ineffective role performance

• Gender confusion

• Ineffective coping

• Unable to distinguish between

• Uncertainty about ideological

inner and outer stimuli

and cultural values

• Delusional description of self

• Uncertainty about goals

• Feelings of emptiness

• Disturbed relationships

• Feelings of strangeness

RELATED FACTORS

• Organic brain syndrome

• Situational crisis

• Dissociative identity disorder

• Dysfunctional family processes

• Psychiatric disorders

• Cultural discontinuity

• Low self-esteem

• Cult indoctrination

• Manic states

• Discrimination or prejudice

• Social role change

• Use of psychoactive drugs

• Stage of growth

• Ingestion of toxic chemicals

• States of development

• Inhalation of toxic chemicals

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Safety

• Sexual practices

• Mental status

• Cultural beliefs

• Self-care

• Relationships

EXPECTED OUTCOMES

The patient will

• Contract for safety.

• Identify internal versus external stimuli.

• Maintain adequate nutritional intake.

• Identify personal goals and realistic steps toward those goals.

• Compile a list of resources to call when needed.

• Remain free from substance abuse.

• Secure a safe place to live in.

SUGGESTED NOC OUTCOMES

Coping; Distorted Thought; Impulse self-Control; Self-Control;

Self-Esteem

INTERVENTIONS AND RATIONALES

Determine:  Assess for suicidal/homocidal ideation, self-induced cuts

or burns. Assess for self-induced vomiting or restricting of food.

Thorough mental status examination. Individuals struggling with

identified issues are at an increased safety risk.

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Monitor mental status daily to be able to intervene if necessary.
Monitor weight weekly to be able to detect changes that may

require further intervention.

Perform:  Contract with patient for safety. Schedule meetings with

patient to process feelings and experiences. Demonstrating care and

compassion for the patient allows him or her to feel safe and pro-

motes healing.

Inform:  Instruct patient to journal feelings and list coping strategies.

Journaling can help a patient maintain self-control and may increase

insight.

Attend:  Accept patient in his or her struggle. Reinforce taking

healthy risks and appropriate expression of feelings. Appropriate

expression of feelings enhances self-esteem and promotes resiliency.

Manage:  Refer patients to mental health services for medication and

symptom management. Disturbed personal identity may require

ongoing mental health care.

SUGGESTED NIC INTERVENTIONS

Coping Enhancement; Environmental Management: Safety; Role

Enhancement; Self-Esteem Enhancement

Reference

Boyd, M. A. (2008). Psychiatric nursing. Philadelphia: Lippincott Williams &

Wilkins.

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