P7 · Unhappy with body appearance
Actual Emotions and mind
Definition
Distress about body changes from surgery, injury, illness, or aging.- Surgery
- scars
- hair loss
- amputation
- weight change
- aging
- Hides the body
- refuses to look
- avoids mirrors
- withdraws
- negative comments
📋 Scenario
After a mastectomy, a woman will not look at her scar.
Subjective (S): "I can't look at myself."
Objective (O): After mastectomy; refuses to view the scar; covers her chest; avoids her partner.
Assessment tools for this scenario: CP-MIND Mood & Mind Screen
Validated scales to consider: PHQ-9, GAD-7, C-SSRS
**CarePath diagnosis:** Unhappy with body appearance related to surgery, as evidenced by hides the body and refuses to look.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Allow her to express feelings. | Being allowed to talk about grief over body change helps her process feelings, and feeling heard reduces shame and isolation. |
| Support her at her own pace. | Letting her decide when to look or touch respects her control and avoids shock, which makes later acceptance more likely. |
| Involve her partner. | Her partner is an important source of support, and including them can reduce her fear of rejection and ease intimacy concerns. |
| Show options. | Information on prostheses, clothing, reconstruction or other options shows practical ways forward and can restore a sense of choice and confidence. |
| Refer to a counselor or support group. | Counselors and peer groups offer experience and understanding from women with similar changes, which helps with long-term adjustment. |
**Expected outcomes**
- Within 1-2 weeks: looks at the scar with support, discusses feelings, partner included.
- States acceptance steps.
**Linking the data to the diagnosis**
After a mastectomy, the woman says, "I can't look at myself." The nurse sees that she refuses to view the scar, covers her chest and avoids her partner. These behaviors show she is already distressed about her body, so this is an actual problem related to surgery. The plan aims, within 1 to 2 weeks, for her to look at the scar with support, discuss her feelings, include her partner and state steps toward acceptance.
CarePath diagnosis
Unhappy with body appearance related to surgery, as evidenced by hides the body and refuses to look.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Allow her to express feelings. | Being allowed to talk about grief over body change helps her process feelings, and feeling heard reduces shame and isolation. |
| 2. Support her at her own pace. | Letting her decide when to look or touch respects her control and avoids shock, which makes later acceptance more likely. |
| 3. Involve her partner. | Her partner is an important source of support, and including them can reduce her fear of rejection and ease intimacy concerns. |
| 4. Show options. | Information on prostheses, clothing, reconstruction or other options shows practical ways forward and can restore a sense of choice and confidence. |
| 5. Refer to a counselor or support group. | Counselors and peer groups offer experience and understanding from women with similar changes, which helps with long-term adjustment. |
Expected outcomes
- Within 1-2 weeks: looks at the scar with support, discusses feelings, partner included.
- States acceptance steps.
Linking the data to the diagnosis
After a mastectomy, the woman says, "I can't look at myself." The nurse sees that she refuses to view the scar, covers her chest and avoids her partner. These behaviors show she is already distressed about her body, so this is an actual problem related to surgery. The plan aims, within 1 to 2 weeks, for her to look at the scar with support, discuss her feelings, include her partner and state steps toward acceptance.