RAJIV GANDHI UNIVERSITY HEALTH SCIENCES, KARNATAKA, BANGALORE
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
MISS .TISY VARGHESE
NAME OF THE CANDIDATE
SAHYADRI COLLEGE OF NURSING,
AND ADDRESS
SAHYADRI CAMPUS, NH-48, ADYAR
1
MANGALORE-575007
SAHYADRI COLLEGE OF NURSING
2
NAME OF THE INSTITUTION
SAHYADRI CAMPUS,NH-48,ADYAR
MANGALORE-575007
M.SC NURSING,
3
COURSE OF STUDY AND SUBJECT
MENTAL HEALTH NURSING
4
DATE OF ADMISSION TO COURSE
1
04-06-2010
TITLE OF THE TOPIC:
5
A
STUDY
ASSERTIVE
TO
ASSESS
TRAINING
THE
PROGRAME
EFFECTIVENESS
OF
ON ASSERTIVENESS
AMONG NURSING STUDENTS AT SELECTED COLLEGE IN
MANGALORE, KARNATAKA.
1
6.
BRIEF RESUME OF THE INTENDED WORK
Introduction
Students often suffer stress and need to be assertive to r esist and to cope successfully.
Assertiveness is the ability to express yourself and your rights without violating the rights
of others. Assertiveness is frequently misunderstood. Assertiveness is very different from
aggressiveness and non-assertiveness. Aggressiveness involves expressing thoughts,
feelings and beliefs in a way that is inappropriate and violates the rights of others while
assertiveness tries to find a solution. Non assertive b ehavior is passive and indirect. It
permits others to violate the rights and shows lack of respect to our own needs. It
communicates a message of inferiority 1 .
Assertiveness is a tool for expressing confidently and a way of saying ‘yes’
or ‘no’ in an appropriate way. We are consciously working towards a “win -win” solution
to problem. A win -win solution means that we are trying to make sure that both parties
end up their needs met to the degree possible. An assertive person effectively influences,
listens and negotiates, so that others check to corporate willingly 2 .
An assertive person should be emotionally honest, direct, se lf enhancing,
expressive, confident and self respecting. It teaches students not to be aggressive, loud,
bullying and trying to dominate others. Assertive nurse remains calm under supervision,
free to ask for help when necessary, ability to give and accept complaints, honesty in
admitting mistakes and taking responsibility 3 .
6.1 Need for study
Assertiveness
is the direct, honest and appropriate expression of your
feelings,thoughts,needs,wants, opinion or rights in a way that respect the rights of other.
Assertive behavior promotes equality in human relationship, personal power and self confident.
Becoming more assertive empowers individuals by promoting self-esteem and help to act in own best
way. Assertiveness is an antidote to fear, shyness, passivity and even anger. As nurses work in
different situations they have to be assertive in order to meet the challenges and to win the
cooperation from others1.
2
Assertiveness enables to withstand the stress. Those suffering from bullying and
stress need to have high level of assertiveness to resist and to cope successfully. Hence it
was considered vital to assess the assertiveness level of nursing students . It is considered
healthy behavior
for
all
people
that
when
present,
m itigates
against
personal
powerlessness and result in personal empowerment 4 .
Assertiveness training program are designed to improve an individual’s assertive belief and
behavior, which can help the individual change how they view themselves and establish self
confident and avoid social anxiety. It is useful for patient with depression and depressive phase of
bipolar disorder, anxiety disorder or adjustment disorder. Nurses can give assertiveness training to the
patient5.
A study on factors affecting assertiveness among student nurses was
conducted at Faculty of Nursing, Port-Said University, on 207 student nurses from four different
grades. The study results showed that 60.4% of the students were assertive, while about half of the
students were empowered. A positive relation between student assertiveness and psychological
empowerment was detected. Moreover, positive relations regarding family income and students'
assertiveness and psychological empowerment were determined. The study recommended
introduction of specific courses aiming at enhancing the acquisition of assertiveness skills, in
addition, nurse educators must motivate their students to express their opinion and personal rights and
also they must pay attention for students’ empowerment and enhance students’ autonomy6.
The investigator felt that nursing students require being more assertive to
express confidently their views and to resist and cope successfully with stress. It will help in
professional development of nursing students and honest expression of rights, thoughts and feelings.
As the student nurse come in contact with the various patients in the wards they can help the patient
to be more assertive .It is useful in depression and anxiety reduction and enables to face responsibility
with respect to the situation, needs and rights. Thus the investigator is interested in giving assertive
training program to nursing students in selected college in Mangalore.
6.2 Review Literature
A study was conducted to assess the level of assertiveness among undergraduate
nursing students in Greece. The study population was composed of nursing students in different
semesters at one school in Central Greece (n=298) who agreed to complete a questionnaire on
3
“assertiveness level assessment”. Mean assertiveness scores between semesters were compared by
ANOVA and comparisons between the responses of the first semester students and responses of
advanced semester students were done by Pearson's chi square. The main finding of this study was
that the assertiveness levels displayed by students increase slightly in advanced semesters by
comparison to those displayed by first-semester.7
A study was conducted on evaluation of an assertiveness training program on nursing and
medical student’s assertiveness, self-esteem and interpersonal Communication satisfaction.
Sixty
nine participants whose scores on the Assertive Scale were < or = 50% (i.e., low assertiveness) and
33 subjects who were willing to participate were included and assigned to an experimental group.
Participants in the experimental group received eight 2 hour sessions of assertiveness training once a
week. The generalized estimated equation (GEE) method was used for Statistical analysis. The
assertiveness and self-esteem of the experimental group were significantly improved in nursing and
medical students after assertiveness training, although interpersonal communication satisfaction of
the experimental group was not significantly improved after the training program8.
An evaluative study was conducted on Irish students changing level of
assertiveness during their pre-registration program. The students commencing general nurse
education program in two schools in Southern Ireland agreed to take part (n=72). A questionnaire
adapted from a number of assertiveness scales was used to collect data.
reported an increase in levels of
The students in this study
assertiveness as they approached completion of their three-year
education program. To function as effective, safe practitioners’ registered nurses need to be assertive,
therefore education in assertiveness should be an integral part of their preparation4.
A study was conducted to evaluate the effectiveness of assertiveness
training on levels of stress and assertiveness experienced by nurses in Taiwan, republic of china.
Two-group experimental design was conducted in a 2,000-bed veteran general hospital. A sample of
60 volunteer Chinese-speaking nurses participated in the study were randomly assigned to one of two
treatments: assertiveness training (AT) or alternate treatment control (ATC). Subjects in each group
participated in six 2-hour workshops in the same two-week period. All subjects were pre-, post-, and
follow-up post tested for stress and assertiveness with the Perceived Stress Scale (PSS) and Rathus
assertiveness Schedule (RAS), respectively. Results indicate clear support for the effectiveness of
assertiveness training for treating sub assertive behaviors and stress in a population of professional
nurses in Taiwan9.
4
A study was conducted to assess the self esteem and assertiveness of final year Turkish
university students. This study developed a quantitative methodology to ascertain the level of self
esteem and assertiveness. The research population was a total of 372 students who were in their final
year of university in different
programs. Total response rate was 77.9%. The data were collected
using a "Personal Information Form," Stanley Coppersmith Self Esteem Inventory (SEI) and
Rathus assertiveness Schedule (RAS). Frequency distribution, t test, correlation and Variance
analyses were used in the analysis of the data. The results of the study were that the nursing students
had the highest scores from SEI (80.64+/-15.83). Similarly the
nursing students had the highest
scores on the RAS (36.29+/-25.33) 10.
A study was conducted to evaluate the relationship between assertiveness and Burnout among
nurse managers. The Japanese version of the Rathus assertiveness Schedule (J-RAS) and the Japanese
versions of the Maslach Burnout Inventory (MBI) were used as scales. The mean J-RAS score of the
burnout group (-14.3) was significantly lower than that of the non-burnout group (-3.3). The results
suggest that increasing assertiveness and satisfaction with own care provision contributes to
preventing burnout 11.
6.3 Problem Statement
A STUDY TO ASSESS THE EFFECTIVENESS OF ASSERTIVE TRAINING
PROGRAME
ON
ASSERTIVENESS
AMONG
NURSING
STUDENTS
AT
SELECTED COLLEGE IN MANGALORE, KARNATAKA .
6.4 Objectives of the study
The objectives of the study are :

To assess the assertiveness among the nursing students before and after assertive
training program.

To determine the effectiveness of assertive training program on assertiveness
among nursing students.

To find the association between pre level of assertiveness among nursing students
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and selected demographic variables.
6.5 Operational definitions
1.
Effectiveness: According to oxford dictionary effectiveness refers to achieving the
intend result. In this study effectiveness refers to determining the extent to which
the assertiveness training program helps students to improve assertiveness as
measured by post test scores.
2.
Assertive training program:
In this study it refers to an organized training
program of one hour in lecture cum discussion, brainstorming and role play
method to improve assertiveness skill by techniques like thought stopping
technique, broken record, fogging, negative assertion, and negative inquiry.
3.
Assertiveness: It refers to the assertive behavior that promotes equality in human
relationship, enabling to act in our own best interests, expresses honest fee lings
comfortably, to exercise personal rights without denying the rights of others 12 .
4.
Nursing students: In this study nursing students refers to BSc nursing II year
students at selected nursing college in Mangalore .
6.6
Assumptions
The study assumes that:
Nursing students may be assertive.

Assertiveness is invaluable component for successful professional practice.

6.7
Delimitations

6.8
Assertiveness is a tool for expressing one confidently.
Study is delimited to nursing students at selected college in Mangalore.
Hypotheses (All hypotheses will be tested at 0.05 level of significance)
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H1:
The mean post-test score of assertiveness among nursing student will be
significantly higher than pre-test scores.
H2:
There will be a significant association between the pre-test assertiveness level and
selected demographic variables
7.
MATERIAL AND METHODS
7.1 Source of data
Data will be collected from nursing students at selected college in Mangalore.
7.1.1 Research design
The research design selected for the study is one group pre- test post- test design:
O1:
Pre-test
Treatment
Post-test
O1
X
O2
Pretest assessment of assertiveness before the administration of assertive training
program.
X:
O2:
Administration of assertive training program to the selected nursing students.
Assessment of post-test assertiveness score after the administration of assertive
training program.
7.1.2 Settings
Study will be conducted in selected nursing college at Mangalore, Karnataka.
7.1.3 Population
Populations of the study consist of BSc nursing students.
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7.2 METHOD OF DATA COLLECTION
7.2.1 Sampling procedure
Non-Probability purposive sampling technique will be used to select the samples.
7.2.2 Sample size
Sample consists of 50 nursing students from selected nursing college at Mangalore.
7.2.3 Inclusion criteria for sampling
Inclusion criteria for sampling refers to :

IIYr BSC (N) students of selected college.

Students available at the time of data collection.

Students willing to participate in the study.
7.2.4 Exclusion criteria for sampling
Students who are:

Not available at the time of data collection.

Previously exposed to assertive training program.
7.2.5 Instruments Used

Demographic Proforma.

Structured Questionnaire on assessment of assertiveness level .
7.2.6 Data collection method.

Formal administrative permission will be obtained from respective college of
Mangalore and the subjects will be selected according to the selection criteria of the
study.

Informed written consent will be obtained from the participants.

Pre test will be conducted by administering structured questionnaire to the samples.

Assertive training program will be administered.
8

Post test will be conducted after one week of intervention with structured
questionnaire.
7.2.7 Data analysis Plan

Demographic data will be analyzed by using descriptive statistics -mean, median,
mode, and standard deviation.

Effectiveness of assertive training will be analyzed by paired t test.

Chi-square test will be used to find out the association between pre -test scores and
selected demographic variables.
7.3 Does the study require any investigation or interventions to be conducted on
patient or other human or animals? If so please describe briefly?
Yes, in this study the researcher has to administer a non -invasive intervention –
assertive training program for improving assertiveness to the nursing student s.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, permission will be obtained from authorities of selected college.
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LIST OF REFERENCES
1.
Sudha R. How to be an assertive nurse. Nursing journal of India 2005 aug; 297(7):432436.
2.
http://www. Medical dictionary. The free dictionary.com/assertive.
3.
Ellis RJ, Love C. Managing and coordinating nursing care.3rd ed.Philadelphia: Lippincott;
2000.
4.
Begley CM, Glacken M. Changing level assertiveness during pre-registration. Journal on
Nurse Education today 2004 Oct; 24(7):345-352.
5.
Yang C, Lin Y, Wu M, Tang L, Chen T, Hsu C et.al. Evaluation of assertiveness training
for psychiatric patient. Journal of clinical nursing 2008 Nov;17(21) :2875-83.
6.
Delsidous A. Effectiveness of assertiveness among undergraduate nursing student in
Greece. Journal of Nurse Education in Practice 2009 sep9 ;(5):322-330 .
7.
Lin Y, Shai I, Chang Y, Lai L, Wang K, Chou K, et al. Evaluation of assertiveness
training program on nursing and medical students. Journal on Nurse Education today 2004
Nov; 24(8):656-665.
8.
Lee S, Crockett M S. Effect of assertiveness training on levels of stress and assertiveness
experienced by nurses. Issues in mental health nursing 1994 Jul; 15(4) :419-32.
9.
Karagozoglu S ,Khare E ,Koc O, Adamisoglu D. Self esteem and assertiveness of final
year Turkish University students. Journal of nurse education today 2008 jul; 28(5):641649.
10.
Suzuki E ,Saito M ,Tagaya A, Mihara R, Marrayama A, Azuma T et al. Relationship
between assertiveness and burn out among nurse managers. Japan journal of nursing
sciences 2009 dec; 6(12): 71-81.
11.
Sadock Benjamin J, Sadock Virginia A. Synopsis of psychiatry. 9
Lippincott; 2003. 501.
12.
Sanaa A, Azim I EL. Factors affecting assertiveness. Nurse Education Today 2010 jul;
1532 (2793).
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th
ed. Philadelphia:
9.
Signature of the candidate
10.
Remarks of the guide
11.
Name and designation of (in block
letters)
11.1
Guide
PROF. IRENE VEIGAS
H.O.D MENTAL HEALTH NURSING
SAHYADRI COLLEGE OF NURSING
SAHYADRI CAMPUS, NH-48, ADYAR
MANGALORE- 575007.
11.2
Signature
11.3
Co-guide (if any)
11.4
Signature
1.5 Head of the department
PROF. IRENE VEIGAS
H.O.D MENTAL HEALTH NURSING
SAHYADRI COLLEGE OF NURSING
SAHYADRI CAMPUS, NH-48,
ADYAR, MANGALORE- 575007.
11.6 Signature
12.
12.1
Remarks of the Principal
12.2
Signature
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