Definition :
Related Factors
NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
Suggested NIC Labels
Client Outcomes
NIC Interventions (Nursing Interventions Classification)
Home health Care Interventions
Confusion in mental picture of one's physical self Defining Characteristics: Nonverbal response to actual or perceived change in structure and/or function; verbalization of feelings that reflect an altered view of one's body in appearance, structure, or function; verbalization of perceptions that reflect an altered view of one's body in appearance, structure, or function; behaviours of avoidance, monitoring, or acknowledgment of one's body.
Related Factors
- Situational changes (e.g., pregnancy, temporary presence of a visible drain or tube, dressing, attached equipment)
- Permanent alterations in structure and/or function (e.g., mutilating surgery, removal of body part [internal or external])
- Malodorous lesions
- Change in voice quality
NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
- Body Image
- Self-Esteem
Suggested NIC Labels
- Body Image Enhancement
- Grief Work Facilitation
- Coping Enhancement
Client Outcomes
- States or demonstrates acceptance of change or loss and an ability to adjust to lifestyle change
- Calls body part or loss by appropriate name
- Looks at and touches changed or missing body part
- Cares for changed or nonfunctioning part without inflicting trauma
- Returns to previous social involvement
- Correctly estimates relationship of body to environment
NIC Interventions (Nursing Interventions Classification)
- Use a tool such as the Body Image Instrument (BII) to identify clients who have concerns about changes in body image.
- Observe client's usual coping mechanisms during times of extreme stress and reinforce their use in the current crisis
- Acknowledge denial, anger, or depression as normal feelings when adjusting to changes in body and lifestyle.
- Identify clients at risk for body image disturbance (e.g. body builders, cancer survivors).
- Clients should not be rushed into sharing their feelings.
- Do not ask clients to explore feelings unless they have indicated a need to do so.
- Explore strengths and resources with client. Discuss possible changes in weight and hair loss; select a wig before hair loss occurs.
- Encourage client to purchase clothes that are attractive and that de-emphasize their disability.
- Allow client and others gradual exposure to the body change.
- Encourage client to discuss interpersonal and social conflicts that may arise.
- Encourage client to make own decisions, participate in plan of care, and accept both inadequacies and strengths.
- Help client accept help from others; provide a list of appropriate community resources.
- Help client describe self-ideal, identify self-criticisms, and be accepting of self.
- Encourage client to write a narrative description of their changes.
- Avoid looks of distaste when caring for clients who have had disfiguring surgery or injuries. Provide privacy; care should be completed without unnecessary exposure.
- Encourage client to continue same personal care routine that was followed before the change in body image.
- Focus on remaining abilities. Have client make a list of strengths.
Home health Care Interventions
- Assess client's stage of grieving or acceptance of body change upon return to home setting. Include the future role of sexuality in the psychological assessment of acceptance as appropriate.
- Assess family/caregiver level of acceptance of client's body changes.
- Be accepting of changes in all interactions with client and family/caregivers.
- Help client to see new or changing roles in family.
- Refer to medical social services for level of acceptance and possible financial impact of changes.
- Teach all aspects of care. Involve client and caregivers in self-care as soon as possible. Do this in stages if client still has difficulty.
- Teach family and client complications of medical condition and when to contact physician.
- Refer to occupational therapy if necessary to evaluate home setting for safety and adaptive equipment and to assist client with return to normal activities.
- If appropriate, provide home health aide support to help the client and family through ADL transition.
- Refer to physical therapy if necessary to build range-of-joint-motion (ROJM) flexibility and strength, prevent contractures.
- Assess for and promote good nutrition and sleep patterns. Adapt nutrition to specific physiological situations.