- Title
- Design and evaluation of assertiveness communication training program for Japanese nursing students
- Creator
- Omura, Mieko
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2018
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- The aim of this thesis by publication was to design and evaluate a culturally appropriate, evidence-based assertiveness communication training program for Japanese nursing students. Five papers have been published in peer-reviewed journals and two manuscripts are undergoing review at the time of submission. A body of international research attests to the link between assertive communication and patient safety. The hierarchies and power differentials evident in traditional healthcare cultures can make it difficult for healthcare professionals to raise concerns about patient safety. In collectivist societies such as Japan, multiple cultural barriers make it particularly challenging for nurses and students to be assertive. An exploratory, sequential, mixed methods design with a three-stage approach was used in this study. The first stage comprised a systematic review of the literature to identify, appraise and synthesise the best available evidence concerning the effectiveness of assertiveness communication training programs for healthcare professionals and students. It identified key elements essential for effective assertiveness communication training programs. In the second stage of the study, Japanese registered nurses’ perceptions and beliefs about the relevance and use of assertive communication in healthcare were elicited using a series of interviews informed by the Theory of Planned Behaviour. Twenty-three nurses participated, and the findings indicated that cultural barriers related to collectivism, hierarchy and power strongly influenced their beliefs about, and attitudes towards, assertive communication. In the third stage of the study, a culturally appropriate, evidence-based assertiveness communication training program, informed by Gagne’s instructional design principles, was designed, implemented and evaluated. The multi-methods training program emphasised the importance of patient safety as a motivation for speaking up when one has concerns. It included role-plays with realistic clinical scenarios and provided opportunities for students to practise using graded assertiveness tools. One-hundred and twenty-three third-year Japanese nursing students participated in the program. A quasi-experimental design, with two parallel groups, using the Japanese version of Rathus Assertiveness Schedule (J-RAS) and the Theory of Planned Behaviour: Assertive Communication Questionnaire (TPB-ACQ), was used to evaluate the impact of the assertiveness communication training program on students’ level of assertiveness and their intention to speak up. Participants in the intervention group had a higher mean assertiveness score than the control group, although this difference was not statistically significant. Similarly, a higher percentage of participants who attended the program demonstrated the intention to speak up, more positive attitudes towards assertive communication and higher perceived behaviour control scores than students who did not attend, but this result was not significant. The results of the Satisfaction with Assertiveness Communication Training Program Survey (SACTPS) indicated that all participants were highly satisfied with the program. The assertiveness communication training program developed during this study has the potential to improve nursing students’ intentions to speak up, particularly when working in traditional and hierarchical healthcare contexts. Given the compelling research about the importance of assertive communication in healthcare, the results of this study support continuing investment in, and ongoing evaluation of, assertiveness communication training programs for nursing students.
- Subject
- assertiveness; communication; nursing; patient safety; speak up; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1394350
- Identifier
- uon:33683
- Rights
- Copyright 2018 Mieko Omura
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 19 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 614 KB | Adobe Acrobat PDF | View Details Download |