Barriers to assertive skills in nurses.

The role of nursing involves interaction with clients, peers and other health professionals. This role is enhanced when nurses have a good command of communication skills. An essential component of effective communication is the ability to behave assertively. Several studies have indicated that nurses lack assertiveness skills. This lack of assertiveness results in diminished effectiveness of communication and compromised patient care. The purpose of this study was to examine the barriers, identified in the literature, that prevent nurses from being assertive and to determine nurses' perceptions of how these barriers prevent them behaving assertively. The design of the study was a cross-sectional, correlational survey whereby the relationships between identified variables could be systematically investigated. Assertiveness was assessed using the Assertiveness Behaviour Inventory Tool (ABIT), and the Barriers to Assertive Skills in Nurses (BASIN) were assessed using an instrument developed for the study by the investigators. The validity and reliability testing of the BASIN instrument is discussed. The results indicated that the 152 nurses sampled considered themselves to have moderate to low assertiveness skills, and a significant negative correlation was found between the level of assertiveness and the perception of barriers inhibiting assertive behaviour. The study concluded that assertiveness training is needed for qualified nurses and that further testing of the ABIT and BASIN instruments will result in reliable measures for research and educational evaluation of nurses following assertiveness training.