开场白(8分钟).doc

Chapter 3 Self-concept in the nurse-client relationship【开场白（8分钟）】 Hello everyone, Im very glad to see you again in the class of international relationships. In this term, I will give you the lessons of the court three times. Since this is called international relationships, it needs communication among us. I dont want to speak only by myself. I have told you that I will change the traditional teaching pattern. I want to “explore knowledge” with you together rather than deliver knowledge to you as an authority. I hope all of you can express your own opinion freely without any pressure. Even you make mistakes or just talk a little, I wont blame you, because everyone must has his or her shortcomings through seeking knowledges. So its very common. I may mistake something or not know something at all. Perhaps I need your help. So just be easy and active in the class. We do our best commonly.omit if possibleI want you to be divided into 10 groups. I will call them “ study group” numbered with 1,2,3 . Meanwhile every group selects a leader to organize any study activity that I request. The performance of a group member will represent the whole lever of the group . I will give the group appraisal and record its result which will be counted into general results in the end of this term. （必要时用中文解说/ 在内护课上已提前表述）Ok ,lets look at our first class. We can try to learn in this way as possible as we can. Please remember “explore knowledge”.【正文】【引言（5分钟）】I think you have learned “self-concept” before . Where do you remember we have seen it? （用中文解释、提问）Answer: 在所学过的NAHDA 的128个护理诊断中有，但中国人并不常用。这个诊断就是“自我概念紊乱”（Self-concept Disturbance）。 NAHDA对该诊断的定义是：指个体在怎样感觉、怎样思考或怎样看待自己方面处于有危险或处于消极变化的状态。这种状态可以包括自我形象、自我理想、自尊、角色行为和自我认同等方面的变化。（放幻灯1）（从这个概念中可看出concrete elements of self-concept）因此自我概念紊乱代表的是一个宽泛的概念。在它下面有更确定的种类，大家可以回忆一下，它们分别是：（放幻灯2）自我形象紊乱（Body image Disturbance）自我认同紊乱（personal identity Disturbance）自尊紊乱（Self-esteem Disturbance）长期自尊低下（Chronic low self-esteem）情景性自尊底下（Situational low self-esteem）Because we dont understand the real meanings of them, so we dont often emphasis these diagnoses. But these diagnoses on psychology are often used in America where the quality of holistic nursing is very high. What is self-concept? How to apply the related concepts in the nursing job? Chapter 3 will help you learn . （放幻灯3）【Outline（3分钟）】Now lets look at the outline to learn of the frame of this chapter.（放幻灯4-7）（对标“”单词做解释）l Basic ConceptsDefinitionsHow Self DevelopsCharacteristicsDynamic ProcessHolistic ConstructUnique ConstructSocial and Cultural NormsPsychological CentralityFunctions of Self-ConceptErikson's Model of Psychosocial DevelopmentTrust Versus MistrustAutonomy Versus Shame and DoubtInitiative Versus GuiltIndustry Versus InferiorityIdentity Versus Identity DiffusionIntimacy Versus IsolationGenerativity Versus Stagnation and Self-AbsorptionIntegrity Versus Despairl Applications Body ImageFunctions of Body ImageTypes of AlterationsHow Body Image DevelopsAssessment StrategiesPlanning and InterventionEvaluation Personal IdentityPerceptionCognitionSelf-TalkEmotionsSpiritual Aspects of Personal IdentitySelf-EsteemSelf-AwarenessSelf-Recognitionl Summary【objectives（2分钟）】You know we only have 2 classes, so the important objectives of the class I think is: （放幻灯8）1. Define self-concept2. Identify the psychosocial stages of self-development3. Apply the psychosocial stages of self-development to assess different clients psychosocial problem.【说明】The other objectives should be achieved by teaching yourself, of course if you have difficulties during the learning process, Ill welcome you to discuss them with me.【目标1】Define self-conceptFirst, look at this sentence :（请同学翻译）引用（3分钟）The greatest gift I can conceive of having from anyone is to be seen by them, heard by them, to be understood and touched by them. The greatest gift I can give is to see, hear , understand and to touch another person. When this is done, I feel contact has been made.（放幻灯9）This sentence can help you to understand the concept and functions of self-concept.简单的说，现实生活中，每个人都想知道我是谁，我想做什么，我能做什么，我在他人眼里是怎样的一个人，这些心理活动在心理学中称为自我概念定义（5分钟）The self, self-concept, or self-system is an organized network of ideas, feelings, an actions, which every person has as a consequence of experiences and interactions with other people, with parents being the most important in the development process. （放幻灯10）（字面翻译）辅助理解：人们通过对自己的内外在特征以及他人对其反应的感知与体验而形成的对自我的认识与评价，是个体在与其心理社会环境相互作用过程中形成的动态的，评价性的“自我肖像”。（引用自健康评估）。（放幻灯11）So we can know: at birth, infants do not have a "self.” They are simply a biological bundle of drives, predispositions and tendencies to develop in ways determined by their heritage. These essentially biological beings, interacting with their human socializing agents known as parents, evolve into psychosocial beings, complete with selves and self-esteem. : Nurses need to address not only the biological components of patients but the psychosocial components as well.过渡But how to assess client attainment of normal psychosocial tasks as a nurse. Here is Eriksons model of psychosocial development for you to refer to.【目标2】Identify the psychosocial stages of self-development我们曾经在护理学导论中学习过这个学说。Erikson 认为： 人格的各部分分别是在发展的各阶段形成的，个体应通过所有这些阶段以发展成一个完整的整体。但当时这个理论在描述时是对所有的人而言的，没有特定的对像，因此所描述的正负性指标很抽象，不利于护士作为评估的指标。今天我们教材就考虑到这个问题，作者从专业的角度将护士在护患关系中可能要应对的心理问题与人的心理社会发展阶段结合起来，供护理人员在工作中参考。解释table 3-1（5分钟） Look at table 3-1.To help you to understand the content more easily, I add 3 rows to the table. Please look at the screen. They are forming period（形成时期）, learn（学习）, primary person orientation（对人的心理定向）. （放幻灯12）The other rows are 人格发展阶段,实际上就是每个时期主要要面对的心理社会危机（psychosocial crisis），危机就是个体逐渐成熟的自我与社会之间的一种普遍冲突。这个危机处理的好与不好将导致正性或负性的心理社会发展结果。解决的愈好就愈接近正性，愈能发展成健康的人格。Factually, clinical behavior guidelines（临床指导）is just the positive norm. But stressors （心理紧张因素）is just the negative norm. 我们可以根据正性或负性指标评估病人的表现，分析在相应的发展阶段上心理社会危机（psychosocial crisis）解决的情况，然后给予正确的指导。这就是我们学习 Erikson心理社会发展阶段学说的意义所在。学生主讲（预计30分钟）了解学生小组自学质量，每小组派一名代表谈谈本组对各发展阶段中的一个阶段内容的理解。（每组3分钟）根据学生讲课情况，在难点部分加以提示帮助学生理解，或一起讨论。（讲义准备完备）【目标3】Apply the psychosocial stages of self-development to assess different clients psychosocial problem.课堂讨论 （5分钟）Exercise 3-4 （放幻灯13）Procedure: To set your knowledge of Eriksons stages of psychosocial development. Identify the psychosocial crisis（es） each of the following clients might be experiencing.1.A 16-year-old unwed mother having her first child 2.A 50-year-old executive “let go” from his job after 18 years of employment3.A stroke victim paralyzed on the left side4.A middle-aged woman caring for her mother who has Alzheimers disease5.A 49-year-old woman dying of pancreatic cancer6.A 63-year-old woman whose husband announces he has fallen in love with a younger woman and wants to divorce7.A 17-year-old high school athlete suddenly paralyzed from the neck down. Discussion:1. What criteria did you use to determine the most relevant psychosocial stage for each client situation?（与以上问题同时进行课堂讨论）（放幻灯14）2. In what ways were your answers similar or different from those of your peers? （自由）3. What conclusions can you draw from doing this exercise that would influence how you would respond to each of these clients? （自由）【回答过程（预计20分钟）】：1.各小组派一名代表回答一个问题，本小组可以补充完整.必须回答问题依据所在。教师补充。2.最后由一小组谈谈“criteria used” 的讨论结果，教师评价。Answer: The relevant psychosocial stages are described as bellow:1. 自我认同-角色紊乱（角色模糊不清，难以进入角色要求）；主动-内疚；勤奋-自卑。2. 创造-停滞；自我完善-失望；勤奋进取-自嘲自卑；自我认同-角色紊乱。3. 自我认同-角色紊乱；自我完善-失望；信任-不信任；勤奋进取-自嘲自卑。4. 自我认同-角色紊乱；主动-内疚；信任-不信任；自我完善-失望。5. 创造-停滞；主动-内疚；6. 亲密-孤独；自我完善-失望。7. 自我认同-角色紊乱；自我完善-失望；信任-不信任；勤奋进取-自嘲自卑。【Thinking】 After you finish exercise 2 ,Please think about that: How can we interfere with his psychological crises by usinghe knowledge of chapter 3 ? （放幻灯15）【说明】第一次教学活动是给大家一个适应的过程，因此这次各组表现情况不记成绩。但今后，重要的教学活动均记录成绩，一个组每个人成绩一致。【Medical Vocabulary】见幻灯1619。【布置chapter 8教学活动（4分钟）】Chapter 8 introduces communication styles. The knowledge is not difficult for you to master. So group 9 and group 10 ,please listen carefully, please prepare for giving lessons on verbal communication and nonverbal communication. I want to see your abilities of teaching-yourself. The two group leaders please come on. I will tell you the details.【课后记】