DISTURBED PERSONAL IDENTITY
Inability to maintain an integrated and complete perception of self
• 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
• 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.)
• Sexual practices
• Mental status
• Cultural beliefs
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;
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.
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-
Inform: Instruct patient to journal feelings and list coping strategies.
Journaling can help a patient maintain self-control and may increase
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
Boyd, M. A. (2008). Psychiatric nursing. Philadelphia: Lippincott Williams &