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Reducing burnout in novice nurses by assertiveness training

Research Project

Project/Area Number 19592426
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Fundamental nursing
Research InstitutionNagano College of Nursing

Principal Investigator

SUZUKI Eiko  Nagano College of Nursing, 看護学部, 教授 (20299879)

Project Period (FY) 2007 – 2009
Project Status Completed (Fiscal Year 2009)
Budget Amount *help
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2009: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2008: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2007: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Keywordsアサーティブネス / トレーニング / バーンアウ / バーンアウト / 新卒看護師 / アサーティブネストレーニング
Research Abstract

1) We conducted a pilot study to clarify the effect of assertiveness training on reduction of burnout of novice nurses to develop an assertiveness training program for them. The result showed no clear effect and indicated the necessity of involving nurse managers and promoting assertiveness of the whole ward staff. Therefore, we conducted an assertiveness training program for nurse managers first. After confirming that the program successfully promoted assertiveness of nurse managers, we applied the same program to novice nurses and studied its effect on reduction of their burnout.
2) The assertiveness and non-assertive situations among nurse administrators in facilities for persons with severe physical disabilities : The purpose of this study was to clarify the actual state of assertiveness and the reality of non-assertive situations among nurse administrators in facilities for persons with severe physical disabilities. A questionnaire was distributed to 102 participants in a workshop … More for nurse administrators working in such facilities all over Japan. We investigated their gender, age, position, experience, assertiveness (Japanese version of Rathus assertiveness schedule), and the situations where they could not be assertive. The respondents were 72 nurse administrators with an average age of 51.4 and the average assertiveness score of -8.5. A content analysis based on Krippendorff's method was carried out on their descriptions of non-assertive situations between nurse administrators and their staff. The situations where they felt "I wanted to say/decline, but I could not do so" yielded six categories : 1) "I can't educate nurse managers," 2) "I can't adjust working schedule/staffing," 3) "I can't control the dress and appearance of the staff," 4) "I can't improve the relation among the staff," 5) "I can't coordinate the work appropriately," and 6) "I can't teach the staff how to receive the patient." The situations where they felt "I should not have said/forced it" also yielded six categories : 1) "I can't give enough consideration to human relations between the staff," 2) "I can't respect the staff in personal consultation," 3) "I can't respect the staff in adjusting working schedule/staffing," 4) "I can't respect the staff in continuing education," 5) "I can't act appropriately as an administrator," and 6)"I can't respect the staff in work coordination." The nurse administrators tended to claim "I could not say it" in the situation where cautioning someone seemed to be natural and even necessary for their duty. Furthermore, their strong sense of responsibility and reflection of their performance were characteristic to the situation where "I should not have said so."
3) Relationship between assertiveness and burnout among nurse managers : We aimed to clarify the relationship between assertiveness and burnout of nurse managers at university hospitals. The directors at three university hospitals accepted our request for cooperation. During a one-month period from May to June 2007, a self-administered questionnaire was distributed to 203 nurse managers (head and sub-head nurses) who agreed to participate in present study. The Japanese version of Rathus Assertiveness Schedule (J-RAS) and the Japanese version of Maslach Burnout Inventory (MBI) were employed as scales. Burnout was operationally defined as having a total MBI score in the highest tertile. Valid responses were obtained from 172 nurse managers. The mean J-RAS of the burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). Responses about work experience and age showed no significant group difference. Total MBI was inversely correlated with J-RAS (R=-0.30, p<0.01). Multiple logistic regression analyses indicated the decrease of the risk of burnout by 26% (0.74 times) for every 10 point increase in J-RAS, and by 60% (0.40 times) for greater satisfaction with own care provision. The results indicate the possibility that increasing assertiveness and satisfaction with own care provision contributes to prevention of burnout among nurse managers.
4) Comparison of burnout scores before and after assertiveness training among nurse managers : The purpose of this study was to examine the possibility of reducing the burnout of nurse managers by assertiveness training. The nurse managers in university hospitals were asked to fill a questionnaire just before and three months after the assertiveness training. The questionnaire included questions about demographic attributes, workplace satisfaction, transfer preference, stress coping, thought on their work, assertiveness (J-RAS), and burnout (MBI). A total of 77 respondents (15 head nurses, 62 sub-head nurses) provided valid data for analysis. The pre-intervention average age, J-RAS, and MBI were 40.9, -5.0, and 10.8, respectively. For total data, t-tests detected a tendency of increase for J-RAS and a significant decrease for MBI. The stratified examinations showed that J-RAS increased significantly, or tended to increase, and MBI reduced significantly among those who had low pre-intervention J-RAS and those who intended to keep assertiveness after the training. The same tendencies, partly with statistical significance, were observed among those who were unsatisfied with their workplace or own care and those who could not consult with fellow workers, the boss, or any other persons in their work place. The results showed that the assertiveness training could reduce burnout of nurse managers. The reduction was apparent among persons who intended to keep assertiveness after the training, and those with low pre-intervention J-RAS. The reduction of burnout was also observed among those who lacked social support.
5) Reducing burnout in novice nurses by assertiveness training : The purpose of this study was to clarify the change of the burnout of novice nurses assertiveness training. We assigned 50 participants to the training group and 28 participants to the control group. Participants of both groups were asked to fill a questionnaire just before and three months after the training (June and October, 2008). The questionnaire included questions about demographic attributes, workplace satisfaction, transfer preference, stress coping, assertiveness (J-RAS), and burnout (J-MBI). A total of 66 respondents (training group 43, control group 23) provided valid data for analysis. The pre-intervention average age, J-RAS, and MBI were 23.3, -4.0, and 11.6, respectively for the training group and 22.3, -0.8, 11.5, respectively for the control group. The result showed no significant effect of assertiveness training. A multiple regression analysis showed that work load affected burnout. In our previous study, assertiveness significantly affected burnout of novice nurses. In the present study, however, the assertiveness training neither promoted assertiveness nor reduced burnout of novice nurses while it promoted assertiveness of nurse managers. The major cause of this discrepancy seems to be existence of overlooked confounding factors specific to the first year of employment other than work load, although inappropriateness of the length, period, or contents of the training program could be also responsible for it. Less

Report

(4 results)
  • 2009 Annual Research Report   Final Research Report ( PDF )
  • 2008 Annual Research Report
  • 2007 Annual Research Report
  • Research Products

    (13 results)

All 2009 2008 2007

All Journal Article (8 results) (of which Peer Reviewed: 4 results) Presentation (5 results)

  • [Journal Article] 重症身体障害者施設の看護管理者のアサーティブネスとアサーティブに慣れない状況の実態2009

    • Author(s)
      鈴木英子, 吾妻知美, 齊藤深雪, 丸山昭子, 香月毅史, 佐藤千文
    • Journal Title

      日本看護管理学会 12(2)

      Pages: 74-85

    • Related Report
      2009 Annual Research Report 2009 Final Research Report
  • [Journal Article] Relationship between assertiveness and burnout among nurse managers Japan2009

    • Author(s)
      SUZUKI E., SAITO M., TAGAYA A., MIHARA R., MARUYAMA A., AZUMA T., SATO C.
    • Journal Title

      Journal of Nursing Science 6

      Pages: 71-81

    • Related Report
      2009 Final Research Report
  • [Journal Article] 看護管理職のアサーティブネストレーニング前後のバーンアウト得点の比較2009

    • Author(s)
      鈴木英子, 多賀谷昭, 松浦利恵子, 他
    • Journal Title

      日本看護管理学会13巻2号 13(2)

      Pages: 50-57

    • NAID

      130007553726

    • Related Report
      2009 Final Research Report
  • [Journal Article] Relationship between assertiveness and burnout among nurse managers2009

    • Author(s)
      SUZUKI E., SAITO M., TAGAYA A., MIHARA R., MARUYAMA A., AZUMA T., SATO C.
    • Journal Title

      Japan Journal of Nursing Science 6

      Pages: 71-81

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 看護管理職のアサーティブネストレーニング前後のバーンテウト得点の比較2009

    • Author(s)
      鈴木英子, 多賀谷昭, 松浦利恵子, 他
    • Journal Title

      日本看護管理学会 13(2)

      Pages: 50-57

    • Related Report
      2009 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Factors affecting the turnover of novice nurses at university hospitals : A two year longitudinal study.2008

    • Author(s)
      Suzuki E., Itomine, I., Saito, M., et al.
    • Journal Title

      Japan Journal of nursing Science 5

      Pages: 9-21

    • Related Report
      2008 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 重症身体障害者施設の看護管理者のアサーティブネスとアサーティブに慣れない状況の実態2008

    • Author(s)
      鈴木英子, 吾妻知美, 齊藤深雪, 丸山昭子, 香月毅史, 他
    • Journal Title

      日本看護管理学会 12(2)

      Pages: 74-85

    • Related Report
      2008 Annual Research Report
    • Peer Reviewed
  • [Journal Article] 看護管理者の日本版Rathus Assertiveness Schedule (J-RAS)の信頼性と妥当性の検証2007

    • Author(s)
      鈴木英子, 斎藤深雪, 丸山明子, 吾妻智美, 香月毅史, 佐藤千文
    • Journal Title

      日本保健福祉学会誌 14(1)

      Pages: 33-41

    • Related Report
      2009 Final Research Report
  • [Presentation] 新卒看護師のバーンアウトに対するアサーティブネストレーニングの効果2008

    • Author(s)
      鈴木英子, 土屋清子, 斎藤深雪, 三原利江子, 多賀谷昭, 丸山昭子
    • Organizer
      第28回日本看護科学学会
    • Place of Presentation
      福岡
    • Year and Date
      2008-12-13
    • Related Report
      2009 Final Research Report 2008 Annual Research Report
  • [Presentation] アサーティブネス・トレーニングのバーンアウト予防への効果2008

    • Author(s)
      鈴木英子, 丸山昭子, 多賀谷昭, 三原利江子, 斎藤深雪
    • Organizer
      第12回日本看護管理学会
    • Place of Presentation
      東京
    • Year and Date
      2008-08-22
    • Related Report
      2009 Final Research Report 2008 Annual Research Report
  • [Presentation] 看護管理職のバーンアウトとアサーティブネスの関連2008

    • Author(s)
      丸山昭子, 鈴木英子, 斎藤深雪
    • Organizer
      第18回日本精神保健看護学会
    • Place of Presentation
      東京
    • Year and Date
      2008-06-21
    • Related Report
      2009 Final Research Report 2008 Annual Research Report
  • [Presentation] 看護部長のアサーティブネスの実態とアサーティブになれない状況2007

    • Author(s)
      鈴木英子, 斉藤深雪, 丸山昭子, 香月毅史
    • Organizer
      日本精神保健看護学会
    • Year and Date
      2007-06-09
    • Related Report
      2009 Final Research Report
  • [Presentation] 新卒看護師の早期離職とバーンアウト及びアサーティブネス2007

    • Author(s)
      鈴木英子, 齋藤深雪, 真木智, 吾妻知美, 香月毅史, 佐藤千史
    • Organizer
      日本看護科学学会
    • Related Report
      2009 Final Research Report

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Published: 2007-04-01   Modified: 2016-04-21  

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