• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.1
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• pp.54-67
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• 2001

This study was tried to investigate the effectiveness of assertive training on the state anxiety and assertive behavior which nursing students had experienced during clinical practice training from April 29, to June 5, 2000. Subjects for this study were thirty-six nursing students of practicing in a general hospital. Eighteen nursing students were assigned for the experimental group and trained by assertive training program during 4 weeks and eighteen nursing students were assigned for the control group. The assertive training program was composed of cognitive, behavioral and emotional assertive training. Post- test assessment was administrated to all subjects on a week later after the last session. The data were analyzed with SPSS PC programs. The results of this study were summarized as follows: 1) There were no significant differences between the experimental group and the control group on post- intervention comparisons of the state anxiety score (p=0.230), but in the experimental group, the anxiety score more decreased after the assertive training than that in the control group with significant differences(p=0.019). 2) There were no significant differences between the experimental group and the control group on post- intervention comparisons of assertive behavior (p=0.530). However, after the assertive training, the experimental group became more assertive than the control group with no significant differences(p=0.721). 3) The hypothesis that the more the assertive behavior, the less the state anxiety experienced by nursing students of clinical practice training was supported(r=-0.397, p=0.017). On the basis of this study results, the assertive training is effective for the reduction of the state anxiety experienced by nursing students of clinical practice training.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.255-264
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• 2013

Purpose: This study was done to examine the effects of assertiveness training on Intensive Care Unit (ICU) nurses' assertive behavior, job stress, communication conflict, and self-esteem toward improving their communication skills and coping. Methods: The assertiveness training program was developed to a 10-hour program consisting of 3 sessions. The goals were to understand assertive behavior and learn how to practice assertive communication in general conflict situations and/or a difficult conflict situation in the ICU. Participants were 65 nurses recruited from a tertiary teaching hospital and of these, 27 nurses completed the program. Data were collected from Jan. 30th to Mar. 28th, 2009 using a questionnaire which included demographic characteristics, assertive behaviour scale, job stress scale, communication conflict inventory-specific, and self-esteem scale. Data were analyzed using SPSS v. 14.0 for $x^2$ test and t-test. Results: ICU nurses in the experimental group had a significant increase in aspects of assertive behavior and a decrease in job stress. Conclusion: The results of the study indicate that assertiveness training is effective in increasing ICU nurses' assertive behavior and decreasing job stress through reinforcement of assertiveness behavior.

• The Korean Journal of Elementary Counseling
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• v.5 no.1
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• pp.185-204
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• 2006

The object of this study is to inspect how much influence the play-based assertive training program has on the self-expression and learning attitude of elementary students. To perform this study, I set up two subjects of research. First, does the play-based assertive training program have influence on the self-expression improvement of elementary students? Second, does the play-based assertive training program have influence on the attitude of elementary students? I established 28 students in the third grade of K elementary school in Gongju City as experiment group for this research. In experiment group, 1 peformed play-based assertive training program in the class of discretion and extra-curricula activity twice a week and maintained the program for 6 weeks. By the standard of 12 times of performances, I put pre-test and post-test into operation. The major consequences revealed through above processes are followed: First, as the consequence of analyses of differences between pre-test and post-test about self-expression of experiment group adapted by play-using assertion training program, the level of self-expression was advanced meaningfully. Second, as the consequences of analyses of differences between pre-test and post-test about learning-attitude of experiment group adapted by play-based assertive training program, the level of learning-attitude was advanced meaningfully. Among 8 sub-fields of learning attitude, the field of superiority, accomplishment motives, concentration, self-study show statistically meaningful difference s respectively. The conclusion drawn from above consequences is that the play-based assertive training program is very effective in developing students' self-expression and attitude for learning.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.215-228
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• 1998

The purpose of this study is analysis of 52 dissertations on assertiveness training which presented from 1982 to 1997 in Korea. It was diversified the research purpose to by 1) time of publication or presentation 2) research design, characteristics of subjects used in each study 3) related concepts, the effects of nursing interventions according to related concepts 4) the effects of nursing interventions according to the subjects 5) the effects of nursing interventions according to the frequency and the period of assertiveness training 6) the effects of nursing interventions according to the group size. 7) the effects of nursing interventions according to the necessary time per round. Findings obtained in the study were as follows : 1. At the point of the numbers of studies presented by year, the number of the studies tend to increase, especially the most plentiful papers were presented during five years from 1991 to 1995. 2. Research design of the studies belong to experimental research. The subjects of research consists of 5 Nursing related subjects and 47 Non-nursing related subjects so that Non-nursing related subjects contain much large proportion. 3. When studies were classified by the related concepts, they were classified that 17 studies were by assertiveness & assertive behaviour, 15 ones anxiety, 9 ones self & ego, 7 ones depression. It can be inferred that studies related to assertive behaviour, self & ego, sociality and power of learning were increasing. Otherwise, studies related to anxiety, depression, aggression, shyness and anguish were decreasing. 4. At the point of the nursing intervention effect by the subjects, the concepts of assertive behavior, feeling of self-respect and sociality were increasing, but the concepts of conflict and interpersonal stress were decreasing and the concepts of anxiety and sociality were ineffective in the subjects related Nursing. On the contrary, the concepts of assertive behavior, sociality and personalty were increasing, but the concepts of anxiety, depression, aggression, shyness, self-estranged feeling were decreasing and the concepts of assertive behavior, aggression, personalty, power of learning, anxiety, self-concepts and self-expression were ineffective in the subjects related Non-Nursing. 5. 18 studies can be found, which investigated 10 times for 5 weeks from the point of the nursing intervention effect by the times and the period of assertiveness training. In case of over 5 times of assertiveness training, assertiveness, assertive behavior and personality(tranquility, depression) increased. In 6 times, feeling of self-respect & egorespect increased but depression, interpersonal stress and anxiety decreased. In over 10 times, shyness, shame and feeling of self-estrangement decreased. In over 12 times, interpersonal anxiety decreased. 6. In the event of nursing intervention effect by the size of the group, it was greatest within 10 persons in 21 studies. In case of within 10 to 20, only feeling of self-expression were ineffective. Particularly, in case of over 31 persons, there were no ineffective concepts. 7. At the viewpoint of nursing intervention effect by the necessary time of one time, it was greatest within 1 to 2 hours in 32 studies. In case of within 1hour, aggression, power of learning and assertiveness were ineffective. In case of within 1 to 2 hours, assertive behavior, self-expression, personality and anxiety were ineffective. Particularly, in case of within 2 to 3 hours, there were no ineffective concepts.

• Korean Journal of Adult Nursing
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• v.21 no.2
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• pp.199-211
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• 2009

Purpose: The purpose of this study was to develop a program for anger management based on self-efficacy. Methods: In this study, four types of approaches to enhance anger control were developed; 1) a role play for vicarious experiences; 2) an assertive training for anger expression; 3) a 30-minute long education program & a 20-minute long telephone call coaching for verbal persuasion; and 4) a booklet for anger management and self care behaviors. One group pretest-posttest design was used for evaluating the program. Study subjects were 6 cancer patients undergoing chemotherapy. The group were received a 4-week intervention, 60 ~ 90 minutes a day weekly, and measured the variables at baseline, 4 weeks later. Anger-in, anger-out, and anger-control were measured by STAXI-K. Data was analysed by Wilcoxon using SPSS/WIN 12.0 program. Anger situation was analysed according to primary anger-thoughts and secondary anger-thoughts based on cognitive theories of anger. Results: The program for anger management consisted of a role play, assertive training, education, telephone call coaching and a booklet. The program revealed significantly less Anger-in (Z = -1.997, p = .046), anger-out (Z = -2.207, p = .027). No difference, however, was found in anger control (Z= -1.826, p=.068). Conclusion: This evaluation suggested that more assertive training and longer intervention may be needed to maximize anger control.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.896-903
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• 2005

Purpose: This study was designed to exam me the effects of an assertive training program on interpersonal relations, and psychiatric symptoms in patients with a mental disorder. Method: The study employed a quasi experimental design. The subjects included 44 patients with a mental disorder, 20 in the experimental group, and 24 in the control group. Data was collected using structured questionnaires over a 3 month period. Results: There were greater significant increases in scores of interpersonal relations and content of communication in the experimental group than the control group. Also, there was a greater significant decrease in the score of psychiatric symptoms in the experimental group than the control group. Conclusion: Assertive training has an effect on increasing content of communication and decreasing psychiatric symptoms.

• Journal of Korean Academy of Nursing
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• v.36 no.5
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• pp.681-690
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• 2006

Purpose: The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. Method: A non-equivalent control group pretest-posttest design was used in this study, Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. Results: The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. Conclusion: There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.149-167
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• 1999

This study was designed and carried out to investigate the effect of Assertiveness Training on the stress response and assertive behavior of emergency room nurses from September 22, to December 21. 1997. The subjects were 45 emergency room nurses of three general hospitals of Korea University Medical Center; 25 assigned for the experimental and 20 for the control group. The Assertive Training Program was composed of cognitive training, behavioral training and progressive muscle relaxation. The subjects of the experimental group carried out the 15-minute progressive muscle relaxation according to recorded-tape once a day for 6 weeks. The cognitive and the behavioural training were conducted by the investigator for 5-8 subjects at a time for 9 series, at an interval of 4-5 days. Post-measurement were administered to all sujects in two groups three weeks after the last session. The level of general stress (Cline, 1992), job stress (Kim & Koo, 1984), physiological response to stress (cortisol, epinephrine, norepinephrine), symptoms of stress (Lee, 1984) and assertive behavior (Kim, 1982) were measured before the first and after the last experiments. Data were analysed by x2, t, paired t, Wilcoxon signed rank tests Wilcoxon rank sums tests. The results are as follows : 1. The level of general stress of the experimental group was lower than that of the control group, however, no significant difference between the two groups (P=0.234) was revealed. 2. A significant reduction of job stress was revealed in the experimental group (P=0.017). 1) A significant reduction of interpersonal conflicts in the experimental group was revealed (P=0.018). 3. The physiological stress-response were analyzed as follows : 1) A decrease of Cortisol in both the experimental and the control groups was noticed, however, the difference between the two groups was not statistically significant (P=0.991). Pre-and post-measurement of the level of Corti sol revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.765), a significant decrease was noted on the level of Cortisol of the experimental group in the night-night nurses (P=0.036). 2) An increase of Epinephrine in both groups was noticed, however, a difference was not statistically significant between the two groups (P=0.082). Pre-and post-measurement of the level of Epinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.136). increases were noted on the level of Epinephrinel of both groups in the night-night nurses (P=0.136), 3) The level of Norepinephrine of the experimental group was significantly decreased (P=0.020). Pre-and post-measurement of the level of Norepinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.073). a significant decrease was noted on the level of Norepinephrine of the experimental group in the night-night nurses (P=0.036), 4. Symptoms of stress were reduced in both groups, with no significant differences between the groups (P=0.127). 1) The physical stress symptoms were reduced in both groups, with no significant difference (P=0.386), 2) The cognitive-behavioral stress symptoms were significantly reduced in the experimental group (P=0.037). 3) The emotional stress symptoms were reduced in both groups with no significant difference between the groups (P=0.110). 5. The assertive behavior was significantly increased in the experimental group (P=0.000). This study signified the Assertiveness Training as an effective mean of self intervention for the reduction of stress of nurses assigned to emergency rooms.

• Korean Journal of Occupational Health Nursing
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• v.14 no.1
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• pp.71-82
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• 2005

Purpose: This study analyzed domestic articles that studied job-stress of nurses using Meta Analysis to evaluate the responses resulted from job-stress and the factors affecting them. Method: To conduct this study, data were collected primarily from database of "richis" and additionally from 8 nursing journals and 5 theses for a degree on job-stress of clinical nurses. Result: As a result of Meta Analysis casual factor of job-stress, the result represented that two reasons; personal factor was the age, occupational factor were ward, duration of employment and position. By the result of analysis of effect of job-stress, satisfaction of the job, exhaustion, health status and immersion of the job were strongly related to job-stress. According to the general solution against job-stress that referred from job-stress related theses, there are several; Imagination Therapy, Assertive Training and Value Clarification Training could bring significant result. Conclusion: This study showed that because job-stress of clinical nurses had nothing to do with personal factors, job-stress management plans for nurses are needed to focus on occupational factors. Also the study suggested that various coping skills that proved to be effective are needed to be used to relieve job-stress and that's responses on nurses.

• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.556-565
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• 2002

Due to the fact that nurses may deal with diverse populations in the work place, it is very important for then to maintain appropriate interpersonal relationships with clients. Nurses should maintain diverse types of relationships appropriately with patients with special needs and their families during crisis, other nursing colleagues and staff on the same team, clients in the school or work place as well as the community. In particular, a hospital is a society with a system and hierarchy, and the importance of interpersonal relationships is much more emphasized. In interpersonal relationships, it is very important for a person to communicate with others in an accurate manner, and when the communication is not achieved appropriately, the person may have troubles and experience distress and conflicts because of the inaccurate communication of thoughts. According to the findings of previous studies, nurses actually experience much distress in the work place because of the miscommunication that they have with others. The purpose of this study was to observe a correlation between Myers-Briggs Type Indicator and assertiveness behavior, and to exam the effects of assertiveness training on the assertiveness behavior and conflict management mode. The subjects of this study included 20 persons in the experimental group and 20 persons the in control group. Myers-Briggs Type Indicator was applied before the study. The assertiveness training group received six, 120 minutes sessions over a 3 week period. Pre-test on assertiveness behavior, Communication Conflict Inventory-General, Role Conflict Inventory- General, Conflict Management Mode was achieved for all the subjects prior to the training. Post-test was administered to all the subjects one week following the last session. The data were analyzed using SPSS PC program to obtain findings on mean. standard distribution, t-test, and Pearson correlation. The results are as follows: (1) Myers-Briggs Type Indicator Introvert/Extrovert was correlated to assertive behavior and avoid- response type conflict management mode. (2) The assertiveness training was correlated to assertiveness behavior, communication conflict degree, and avoid- response type conflict management mode. (3) The post-test scores between the training group and the control group were significantly different in assertiveness behavior and avoid-response type conflict management mode. It is suggested that more studies need to be done to differentiate the effects of Myers-Briggs Type Indicator and assertiveness training on assertiveness behavior and avoid-response type conflict management mode.