Self-concept and body image after illness or surgery
- Fundamental
Losing a body part or function, or living with a stoma or scar, changes how a person sees themself; the nurse helps them adapt step by step.
What it is
Self-concept is the set of ideas and feelings a person has about who they are; body image is the part that concerns how they see and feel about their own body, closely linked to self-esteem. Surgery (an ostomy, a mastectomy, an amputation), visible scars, hair loss, weight change or the loss of a function can be experienced as a loss and grieved like one. People may at first feel estranged from their body, hide it, fear the looks of others and withdraw socially; many adapt gradually and come to accept the change as part of themselves. Nursing care treats the person as a whole, not as a body part to be managed: it gives time, listens, teaches self-care, involves the family and watches for signs of poor coping.
Key points
- Losses can be of a body part, a function, appearance, independence or a social role.
- Adaptation is gradual and differs from person to person.
- Adaptive coping: seeking information, support, expressing emotions; maladaptive: avoidance, withdrawal, substance misuse.
- The reaction of family and staff (looks, comments) strongly influences the patient.
Components
- Body image: how the person perceives and feels about their body.
- Self-esteem: how much the person values themself.
- Role and identity: work, family and social roles that may change with the illness.
What it is for
- Guides emotional support before and after surgery.
- Supports learning of self-care and return to social life.
- Detects people who need psychological support or referral.
In nursing practice
- Before surgery, explain what the body will look like and how it will be cared for; where available, offer contact with peer support groups.
- Let the patient choose the pace to look at and touch the change; stay neutral in face and words during care.
- Teach self-care in small steps so the patient regains control.
- Ask about sexuality, clothing, work and social life: these are common worries.
- Refer to psychology or support services when distress persists or there are signs of depression.
Common mistakes
- Showing disgust or haste during care of a stoma or wound.
- Forcing the patient to look at the change before they are ready.
- Talking only about the technical care and not about feelings.
- Ignoring that men, older adults and people without a partner can also be deeply affected.
Test yourself
Think of the answer, then tap the question to see it.
What is body image and how does it relate to self-concept?
Body image is how a person perceives and feels about their own body. It is part of self-concept and is closely linked to self-esteem.
What signs suggest that a patient is adapting to a stoma?
Looking at and touching the stoma, taking part in its care, talking about it and gradually returning to social activities.
Which signs suggest poor coping with a change in body image?
Persistent refusal to look at the change, hiding, social withdrawal, self-rejection or signs of depression. They are reported and may need referral.
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Body consciousness of people with intestinal stoma: a phenomenological study (Revista Brasileira de Enfermagem (SciELO), 2018); Nursing Fundamentals, 17.2: Grief and loss, basic concepts (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2021); Nursing: Mental Health and Community Concepts, 3.3: Coping (Open RN, Wisconsin Technical College System (CC BY 4.0), LibreTexts, 2022).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.