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

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      Abstract

      Background

      Effective 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.

      Methods

      This 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).

      Results

      A 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).

      Conclusions

      This 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 material

      The online version of this article (doi:10.1186/s12912-017-0224-4) contains supplementary material, which is available to authorized users.

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      Most cited references 55

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      A Brief Version of the Fear of Negative Evaluation Scale

       Mark Leary (2016)
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        A 30-item schedule for assessing assertive behavior

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          Workplace empowerment, incivility, and burnout: impact on staff nurse recruitment and retention outcomes.

          The aim of this study was to examine the influence of empowering work conditions and workplace incivility on nurses' experiences of burnout and important nurse retention factors identified in the literature. A major cause of turnover among nurses is related to unsatisfying workplaces. Recently, there have been numerous anecdotal reports of uncivil behaviour in health care settings. We examined the impact of workplace empowerment, supervisor and coworker incivility, and burnout on three employee retention outcomes: job satisfaction, organizational commitment, and turnover intentions in a sample of 612 Canadian staff nurses. Hierarchical multiple linear regression analyses revealed that empowerment, workplace incivility, and burnout explained significant variance in all three retention factors: job satisfaction (R(2) = 0.46), organizational commitment (R(2) = 0.29) and turnover intentions (R(2) = 0.28). Empowerment, supervisor incivility, and cynicism most strongly predicted job dissatisfaction and low commitment (P < 0.001), whereas emotional exhaustion, cynicism, and supervisor incivility most strongly predicted turnover intentions. In our study, nurses' perceptions of empowerment, supervisor incivility, and cynicism were strongly related to job satisfaction, organizational commitment, and turnover intentions. Managerial strategies that empower nurses for professional practice may be helpful in preventing workplace incivility, and ultimately, burnout.
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            Author and article information

            Affiliations
            [1]ISNI 0000 0001 0657 3887, GRID grid.410849.0, Department of Psychiatric and Mental Health Nursing, Graduate School of Nursing Science, , University of Miyazaki, ; 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki 889-1692 Japan
            [2]ISNI 0000 0001 0657 3887, GRID grid.410849.0, Organization for Promotion of Tenure Track, , University of Miyazaki, ; 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki 889-1692 Japan
            [3]ISNI 0000 0001 0657 3887, GRID grid.410849.0, Department of Psychiatric and Mental Health Nursing, School of Nursing, Faculty of Medicine, , University of Miyazaki, ; 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki 889-1692 Japan
            [4]ISNI 0000 0001 0657 3887, GRID grid.410849.0, Center for Medical Education and Career Development, Faculty of Medicine, , University of Miyazaki, ; 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki 889-1692 Japan
            [5]ISNI 0000 0004 0596 7181, GRID grid.416001.2, Department of Nursing, , University of Miyazaki Hospital, ; 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki 889-1692 Japan
            [6]ISNI 0000 0004 0531 3030, GRID grid.411731.1, Faculty of Nursing, , International University of Health and Welfare, ; 1-7-4 Momochihama, Sawara, Fukuoka City, Fukuoka 814-0001 Japan
            Contributors
            youhei_nakamura@med.miyazaki-u.ac.jp
            naoki-y@med.miyazaki-u.ac.jp
            hiroki_tanoue@med.miyazaki-u.ac.jp
            skato@med.miyazaki-u.ac.jp
            sayoko_nakamura@med.miyazaki-u.ac.jp
            keiko_aoishi@med.miyazaki-u.ac.jp
            s-yuko@iuhw.ac.jp
            Journal
            BMC Nurs
            BMC Nurs
            BMC Nursing
            BioMed Central (London)
            1472-6955
            6 June 2017
            6 June 2017
            2017
            : 16
            5461750
            224
            10.1186/s12912-017-0224-4
            © The Author(s). 2017

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            Funding
            Funded by: Program to Disseminate Tenure Tracking System from the Japanese Ministry of Education, Culture, Sports, Science and Technology
            Award ID: N/A
            Funded by: Grant from the Mitsubishi Foundation
            Award ID: 28339
            Categories
            Research Article
            Custom metadata
            © The Author(s) 2017
            ScienceOpen disciplines:
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