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Volume 12, Issue 3 (Summer- In Press 2026)
JCCNC 2026, 12(3): 0-0 |
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Machado D, Brás M, Almeida A, Vilela C. Assertive Communication in Evidence-Based Nursing: A Scoping Review. JCCNC 2026; 12 (3)
URL: http://jccnc.iums.ac.ir/article-1-926-en.html
URL: http://jccnc.iums.ac.ir/article-1-926-en.html
1- School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal , up202202663@up.pt
2- LiveWell Research Center, Instituto Politécnico de Bragança, Portugal
3- School of Health, University of Aveiro, Aveiro, Portugal
4- RISE-Health, Nursing School of Porto, Porto, Portugal
2- LiveWell Research Center, Instituto Politécnico de Bragança, Portugal
3- School of Health, University of Aveiro, Aveiro, Portugal
4- RISE-Health, Nursing School of Porto, Porto, Portugal
Abstract: (3 Views)
Background: Nurses’ assertive communication and evidence-based nursing (EBN) are essential for improving healthcare outcomes. However, how they interrelate in clinical practice remains underexplored, limiting a full understanding of their synergistic effect. This scoping review aims to map the relationship between nurse assertiveness and EBN, analyzing its nature, facilitators, barriers, and impacts on clinical practice.
Methods: We conducted a scoping review following framework proposed by Arksey and O’Malley, JBI and PRISMA-ScR guidelines. The search included the databases Scopus, CINAHL, MEDLINE, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials (via EBSCO), MedicLatina, APA PsycInfo, Web of Science and gray literature. Primary and secondary research articles in Portuguese, English, Spanish, and French, published since 1976 were also included. Rayyan software was used for data management and screening. Data synthetized and organized thematically.
Results: Initial search yielded 4146 records (2722 databases, 1424 gray literature). Twelve studies were included for synthesis after screening. The findings were synthesized into four themes, described the relationship's nature, methodologies, facilitators, barriers, and manifestations/impacts. Analysis suggests a complex, bidirectional link: EBN knowledge drives assertiveness, which is crucial for EBN implementation. Facilitators include knowledge, organizational support, and psychological safety; barriers are rigid hierarchies, fear of retaliation, and workload. Assertiveness manifests in questioning practices and client advocacy, positively impacting safety, decision-making, and collaboration. Its absence is associated with practice deviations and increased error risk.
Conclusion: Assertive communication is vital for EBN implementation and promoting excellent healthcare. Developing this skill through educational and organizational interventions to ensure safe environments is critical. Literature gaps, like fragmented study and geographical asymmetry, necessitate robust, comprehensive future research.
Methods: We conducted a scoping review following framework proposed by Arksey and O’Malley, JBI and PRISMA-ScR guidelines. The search included the databases Scopus, CINAHL, MEDLINE, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials (via EBSCO), MedicLatina, APA PsycInfo, Web of Science and gray literature. Primary and secondary research articles in Portuguese, English, Spanish, and French, published since 1976 were also included. Rayyan software was used for data management and screening. Data synthetized and organized thematically.
Results: Initial search yielded 4146 records (2722 databases, 1424 gray literature). Twelve studies were included for synthesis after screening. The findings were synthesized into four themes, described the relationship's nature, methodologies, facilitators, barriers, and manifestations/impacts. Analysis suggests a complex, bidirectional link: EBN knowledge drives assertiveness, which is crucial for EBN implementation. Facilitators include knowledge, organizational support, and psychological safety; barriers are rigid hierarchies, fear of retaliation, and workload. Assertiveness manifests in questioning practices and client advocacy, positively impacting safety, decision-making, and collaboration. Its absence is associated with practice deviations and increased error risk.
Conclusion: Assertive communication is vital for EBN implementation and promoting excellent healthcare. Developing this skill through educational and organizational interventions to ensure safe environments is critical. Literature gaps, like fragmented study and geographical asymmetry, necessitate robust, comprehensive future research.
Keywords: Assertiveness, Interdisciplinary communication, Health communication, Evidence-based nursing, Clinical decision-making
Type of Study: Review Article |
Subject:
General
Received: 2025/07/10 | Accepted: 2026/02/1 | Published: 2026/08/23
Received: 2025/07/10 | Accepted: 2026/02/1 | Published: 2026/08/23
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