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Learning Objective 1: Explain the impact of shame on wellness.
Learning Objective 2: Identify means to heal shame in adolescent females thus permitting engagement in wellness behaviors.
Shame and its Impact on Wellness among Adolescent Females
Purpose
Shame, often unrecognized and seldom discussed, may result in serious consequences. Adolescent females are particularly subject to feelings of shame that negatively impact relationships and lead to dysfunctional health behaviors. The purposes of this analysis were to (1) explore the way in which chronic shame impacts wellness in vulnerable adolescent females and (2) to guide research related to interventions on an individual and societal level.
Methods
Walker and Avant’s (2006) approach to concept analysis was used to explore the meanings and impact of shame. Antecedents and defining attributes were identified. Model cases were developed.
Bandura’s (1986) social cognitive theory will be utilized to guide a health promotion program aimed at healing shame and improving health behaviors in adolescent females.
A randomized controlled trial using a pretest / posttest design will be used to test the effectiveness of a comprehensive health promotion program titled ‘Total Girl’. Outcomes of the 12-week program to be measured include self-efficacy for health behaviors, level of fitness, health risk behaviors, and general wellness. Data will be analyzed using descriptive statistics and analysis of variance.
Results
Individual and societal consequences of shame on health for adolescent females were explored and will be presented. Shame is experienced as a “culture-specific manifestation” (Shweder, 2003). For nursing this means attaching a global generality to shame can be misleading. Lack of awareness of shame perpetuates culturally incompetent care.
Conclusion
Shame affects nursing practice because clients cover symptoms and details that may delay care or inhibit wellness. Comprehensive nursing care requires being alert to the presence of nuanced behaviors indicating the presence of shame. Goals of nursing care include placing the shame experience in socio-cultural context, promoting acceptance of differences, and exploring alternative ways to manage shame enabling adolescent females to attend to and engage in healthy behaviors.