Development and evaluation of a modified brief assertiveness training for nurses in the workplace: a single-group feasibility study

Abstract

BackgroundEffective communication has a great impact on nurses’ job satisfaction, team relationships, as well as patient care/safety. Previous studies have highlighted the various beneficial effects of enhancing communication through assertiveness training programs for nurses. However, most programs take a long time to implement; thus, briefer programs are urgently required for universal on-the-job-training in the workplace. The purpose of this feasibility study was to develop and evaluate a modified brief assertiveness training program (with cognitive techniques) for nurses in the workplace.MethodsThis study was carried out as a single-group, open trial (pre-post comparison without a control group). Registered nurses and assistant nurses, working at two private psychiatric hospitals in Miyazaki Prefecture in Japan, were recruited. After enrolling in the study, participants received a program of two 90-min sessions with a 1-month interval between sessions. The primary outcome was the Rathus Assertiveness Schedule (RAS), with secondary measurements using the Brief Version of the Fear of Negative Evaluation Scale (BFNE) and the Brief Job Stress Questionnaire (BJSQ). Assessments were conducted at baseline and after a 1-month interval (pre- and post-intervention).ResultsA total of 22 participants enrolled in the study and completed the program. The mean total score on the primary outcome (RAS) significantly improved from −12.9 (SD = 17.2) to −8.6 (SD = 18.6) (p = 0.01). The within-group effect size at the post-intervention was Cohen’s d = 0.24; this corresponds to the small effect of the program. Regarding secondary outcomes, there were no statistically significant effects on the BFNE or any of the BJSQ subscales (job-stressors, psychological distress, physical distress, worksite support, and satisfaction).ConclusionsThis single-group feasibility study demonstrated that our modified brief assertiveness training for nurses seems feasible and may achieve a favorable outcome in improving their assertiveness. Further controlled trials with longer follow-up periods are required in order to address the limitations of this study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-017-0224-4) contains supplementary material, which is available to authorized users.

Is modified brief assertiveness training for nurses effective? A single-group study with long-term follow-up

“…This study demonstrated that this modified brief assertiveness training (total 180 min) could lead to consistent improvement in assertiveness among nurses on a long‐term basis. This matches and further replicates our preliminary results (Nakamura et al., ). In particular, the pre–post effect size of the modified brief training achieved a “small effect,” whereas previous brief trainings had “no effect” on improving nurses’ assertiveness (Honjo & Komada, ; Suzuki et al., ; Yamamoto et al., ; Zielinski & Williams, ).…”

“…An overview of the training programme is shown in Table ; the full original programme text written in Japanese is presented as an online supplemental file (see Nakamura et al, , for more details about the programme development). The training was developed based on existing assertiveness training literature (Alberti & Emmons, ; Hiraki, ) and shortened by four of the authors (NY, YN, HT and YS).…”

“…The authors developed a modified brief version of assertiveness training, totalling 180 min, that applied cognitive techniques, and preliminary positive results in improving nurses’ assertiveness were confirmed (Nakamura et al., ); however, this preliminary study had several limitations. First, the training was delivered by only one experienced nurse; thus, the high quality of the training leader might have contributed to larger effects.…”

Development and Testing of Psychological Conflict Resolution Strategies for Assertive Robots to Resolve Human–Robot Goal Conflict

“…For this, it seems reasonable to rely on psychological research not only for strategy development but also for implementation, e.g. training programs to promote appropriate assertiveness at work ( Thacker and Yost, 2002 ; Wilson et al, 2003 ; Nakamura et al, 2017 ). Additionally, future work is needed to determine appropriate conflict resolution strategies for more robot types (e.g.…”

Evaluating the impact of an assertiveness communication training programme for Japanese nursing students: A quasi‐experimental study

“…During the past decade, researchers have focused on improving healthcare professionals’ assertive communication and teamwork skills with some encouraging results (Lyndon et al, ). However, novice nurses are often hesitant to speak up or advocate for patients, particularly in countries such as Japan where there are deep‐seated cultural barriers to assertive communication (Nakamura et al, ; Suzuki, Azuma, Maruyama, Saito, & Takayama, ). Although training programmes have been introduced to address these issues, there are limited empirical data about the impact of such programmes on novice nurses’ communication behaviours.…”