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

AIM: To evaluate the long-term effectiveness of modified brief assertiveness training (with cognitive techniques) for nurses. BACKGROUND: Most assertiveness training takes a long time to conduct; thus, briefer training is required for universal on-the-job training in the workplace. METHODS: In this single-group study, nurses received two 90-min training sessions with a 1-month interval between sessions. The degree of assertiveness was assessed by using the Rathus Assertiveness Schedule as the primary outcome, at four time points: pre- and post-training, 3-month follow-up and 6-month follow-up. RESULTS: A total of 33 nurses received the training, and the mean Rathus Assertiveness Schedule score improved from -14.2 (SD = 16.5) pre-training to -10.5 (SD = 18.0) post-training (p < .05). These improvements were maintained until the 6-month follow-up. The pre-post effect size of 0.22 (indicating small effect) was larger than the effect sizes ranging from -0.56 to 0.17 (no effect) reported in previous studies that used brief training. CONCLUSIONS: Modified brief assertiveness training seems feasible and may achieve long-term favourable outcomes in improving assertiveness among nurses. IMPLICATIONS FOR NURSING MANAGEMENT: The ease of implementation of assertiveness training is important because creating an open environment for communication leads to improved job satisfaction, improved nursing care and increased patient safety.

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

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.

Possible criteria for obesity based on insulin resistance in Japanese college athletes.

OBJECTIVE: The purpose of this study was to search for possible criteria for obesity in Japanese college student athletes by examining insulin resistance. METHODS: The subjects were 219 male college students (mean age 20.4 ± 1.3 years), including 119 athletes who belonged to a university sports team and 100 non-athletic individuals who did not. Fasting blood glucose, hemoglobin A1c (HbA1c), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) levels were examined in relationship to body mass index (BMI) and waist circumference (WC). RESULTS: Although none of the subjects had diabetes mellitus, 15 (5 athletes (4.2%) and 10 non-athletes (10.0%)) had insulin resistance with HOMA-IR ≥2.5. HOMA-IR was significantly higher in athletes with BMI ≥27.0 kg/m(2) and non-athletes with BMI ≥25.0 kg/m(2) than in subjects with BMI <25.0 kg/m(2). A similar pattern was seen for WC ≥90 cm in athletes and ≥85 cm in non-athletes. Nearly all athletes with increased insulin resistance had BMI ≥27.0 kg/m(2) and WC ≥90 cm. Among non-athletes, nine of the 10 subjects with insulin resistance had BMI ≥25.0 kg/m(2) and WC ≥85 cm. According to these criteria, the sensitivity and specificity were nearly 100% and 93% for athletes, and 90% and 70% for non-athletes, respectively. CONCLUSION: Japanese college athletes may be at risk for increased insulin resistance when BMI exceeds 27.0 kg/m(2) and WC exceeds 90 cm.