Document Type

Thesis - Open Access

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Marge Hegge


A low self-esteem is a critical, pervasive problem in the lives of clients with eating disorders. The purpose of this study was to validate the defining characteristics of the nursing diagnosis, Disturbance in Self-Esteem, in a specific population group. The purposive, nonprobability sample consisted of 26 females between the ages of 13 and 24 who had a medical diagnosis of Anorexia Nervosa. This study addressed the following question: Does the cluster of defining characteristics for Disturbance in Self-Esteem, as defined by NANDA, occur in clients diagnosed as having Anorexia Nervosa; clients in whom a disturbed self-esteem is manifest.
The Tennessee Self-Concept Scale (TSCS) (Fitts, 1965) was used to assess self-esteem. The mean positive score of the subjects who took part in this study was 280.9, which falls in the 4th percentile, indicating a low self-esteem. The Self-Esteem Assessment Tool (Norris & Kunes-Connell, 1985) was used to assess the defining characteristics. Descriptive statistics were used to describe the actual frequency of each identified defining characteristic manifest in this sample population. The eight defining characteristics of Disturbance in Self-Esteem do occur in this sample population of subjects with a low self-esteem.
Those defining characteristics which occurred in 77% to 96% of all subjects and appear to be critical indicators of the label Disturbance in Self-Esteem are lack-of follow-through, overly conforming/dependent on other's opinions, indecisive, seeks excessive reassurance, minimizes positive/exaggerates negatives regarding self, expresses shame/guilt, and evaluates self as unable to deal with difficult situations. These defining characteristics should be further researched in clinical validation studies.

Library of Congress Subject Headings

Anorexia nervosa -- Patients
Anorexia nervosa -- Psychological aspects



Number of Pages



South Dakota State University


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Nursing Commons