Nurse-Patient RelationsNCT06827067
Communication Skills and Anger Management Training for Nurses
A study testing Simulation application with standard patient and Theoretical training in people with Nurse-Patient Relations, run by Yuksek Ihtisas University at 1 site in Turkey (Türkiye).
Trial summary
Objective: The aim of this study was to determine the effect of training given to nurses on communication and anger management skills in the presence of standardized patients. Method: The study was conducted using a convergent parallel design, which is a mixed-method design. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Nurse-Patient Relations
- What is being tested?
- Simulation application with standard patient and Theoretical training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 56 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Mar 2017to 13 Feb 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Volunteering to participate in the research
- Working as a nurse in any of the surgical or internal medicine clinics of the hospital
- According to the results of the pre-test application, anger control scores were lower than the other nurses participating in the study.
Who cannot join
- Not volunteering to participate in the study
- Not having participated in simulation training in the experimental group
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Yuksek Ihtisas University
Ankara, Çankaya, 06520
About this study
Official title: Assessment of Effectiveness of Communication Skills and Anger Management Training Accompanied with Standardized Patient Given to Nurses
Objective: The aim of this study was to determine the effect of training given to nurses on communication and anger management skills in the presence of standardized patients.
Method: The study was conducted using a convergent parallel design, which is a mixed-method design. The experimental and control groups of the study were conducted with a total of 56 nurses. Data were collected using a socio-demographic data collection form, Communication Skills Inventory and State-Trait Anger and Anger Expression Scale. The intervention group participated in the simulation, and qualitative data were collected during the debriefing session of the simulation. The scales were administered to the groups 3 times in total: before the training, after the training and 6 weeks after the end of the training.
Read the detailed description
The patient-nurse relationship is a dynamic process that can change as the patient's health needs change and nurses can show positive emotions and behaviors to their patients. However, due to the nature of human beings, it may be impossible to show positive behaviors at all times, and in communication processes, situations that make communication difficult may occur from time to time (Gorman 1996). When the studies examining the communication between patients and nurses are examined, it is found that some patient behaviors that may cause problems in the relationship and the inadequacies of nurses in controlling their emotions are the causes. When these studies are examined, the concept of "difficult patient" attracts the most attention (Akgün-Çıtak 2011, Wolf and Smith 2007, Macdonald 2007, Kennedy Sheldon et al. 2006).
"Difficult patients" are defined in the literature as patients with behaviors that hinder communication. (Göral 2011, Koekkoek et al. 2006). In a study conducted by Essary et al. (2005), it was observed that patients were labeled as "difficult patients" as a result of ineffective communication between nurse and patient and that nurses tended to blame patients as a result of labeling. In the literature, it is stated that improving communication skills with the difficult patient group will benefit nurses and the onset of conflicts can be prevented, which should not be forgotten that conflicts that cannot be prevented arouse feelings of anger in individuals. (MacLean at all 2017, Baran and Okanlı 2015) For this reason, it is as important for nurses to improve their communication skills as it is for them to improve their ability to cope with anger.
Although anger is a frequently felt emotion in the nursing profession, this emotion should not be expressed with aggression or suppressed in order to be healthy and useful. Nurses should gain the ability to express anger in a healthy way by recognizing and accepting it like all other emotions (Bozkurt 2010, Akdeniz 2007). Expressing anger openly in an acceptable way is a positive personality trait. However, such emotions that cannot be controlled and are ignored by denial or suppression have the potential to be harmful for both the person and his/her environment (Kaya et al. 2012). In the study conducted by Baran and Okanlı in 2015, it was emphasized that nurses should regularly receive in-service trainings on anger and anger expression in order to recognize their anger, accept its existence and express their anger correctly. Trainings on anger management can be given in many ways like other trainings. These ways can be in the form of individual and group trainings as well as using various simulations.
Simulation-based trainings are ideal for nursing education as they include an interactive method that can be used to teach cognitive, psychomotor or emotional skills to individuals or groups at any skill or proficiency level. ( Zengin \& Eren Fidancı 2024, Tanis, Quinn, \& Bischoff, 2019) In standardized patient simulation, the patient or case study is animated by playing the scenario prepared with structured steps. The use of standardized patients in teaching contributes to the development of participants' communication skills, history taking and physical examination skills. ( Zengin \& Eren Fidancı 2024). When the literature is examined, it is seen that skill-oriented studies are frequently used in simulation-based studies, but emotion-oriented studies are weaker, and the majority of the studies are conducted with student nurses, and the intervention study conducted with working nurses is very limited.
- Conditions
- Nurse-Patient Relations
- Being tested
- Simulation application with standard patient, Theoretical training
- Keywords
- Difficult patient, Anger management, Communication, Simulation
- Medical subject headings
- Communication
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Simulation application with standard patientBehavioural
Before the encounter with the standard patient (SH), a preliminary interview was held with the nurses in the briefing room, where the content and purpose of the application were explained to the nurses, and the story of the SH was told to the nurses in line with the prepared scenario. Three nurses were interviewed for each scenario. The nurses communicated with the SH for 10-15 minutes and each interview was conducted using video recordings. Those who finished the interview with the SH watched the scenario of the other group as observers, and at the end of each 3 scenarios, the debriefing phase was carried out for an average of 60-90 minutes.
Theoretical trainingBehavioural
The trainings, each of which lasted 40-45 minutes on average, were conducted in a total of 7 sessions.
| Study group | Role | What they receive |
|---|---|---|
| Control group | Other | Theoretical training consisting of a total of 7 sessions of 40-45 minutes each was given to 30 nurses in the control group. Receives: Behavioral: Theoretical training |
| Experimental group | Experimental | Immediately after the theoretical trainings of 30 nurses in the experimental group were completed, simulation trainings conducted with a standard patient were given. A half-day training was given to the standard patient (SH) about the scenario content before the application. Before the encounter with the SH, a preliminary interview was held with the nurses in the briefing room, where the content and purpose of the application were explained to the nurses, and the story of the SH was told to the nurses in line with the prepared scenario. Three nurses were interviewed for each scenario. The nurses communicated with the SH for 10-15 minutes and each interview was conducted using video recordings. Those who finished the interview with the SH watched the scenario of the other group as observers and at the end of each 3 scenarios, the debriefing phase lasting an average of 60-90 minutes was carried out. Receives: Behavioral: Simulation application with standard patient; Behavioral: Theoretical training |
What is being measured
The primary outcome is the main question the study is designed to answer.
State-Trait Anger and Anger Expression Scale
State-Trait Anger and Anger Expression Scale is a self-assessment scale that measures the feeling and expression of anger. The State-Trait Anger and Anger Expression Scale , developed by Spielberger (1983) and whose Turkish validity and reliability were determined by Özer (1994), consists of 4 sub-dimensions and 34 items, namely anger-in, anger-out, anger control, and trait anger. Participants were asked to respond using a 4-point Likert-type scale (1 "Does not describe at all," 2 "Somewhat describe," 3 "Fairly describe," and 4 "Completely describe"). High scores on the trait anger dimension indicate that the level of anger is high, high scores on the anger control dimension indicate that anger can be controlled, high scores on the anger-out dimension indicate that anger is easily expressed, and high scores on the anger-in dimension indicate that anger is suppressed.
Measured: Measurements taken just before the training begins.
Communication Skills Inventory
Inventory developed by Balcı and Ersanlı (1998) to measure the level of communication skills among university students. The scale consists of three sub-dimensions including behavioral, cognitive and emotional. The scale consists of a total of 10 items. There are 15 items that measure each dimension. The scale has been developed in the 5-point Likert type. The highest score that can be achieved from the scale is 225, and the lowest score is 45. Correlation between the total score from Communication Skills Inventory and total scores of each dimension was found to be 0.85 for intellectual sub-dimension, as 0.73 for emotional sub-dimension and 0.82 for behavior sub-dimension. Regarding the validity study of the inventory; its correlation with Communication Skills Assessment Scale developed by Korkut (1996) was examined. In the validity study carried out, correlation coefficient between two scales was found as 0.70. This value is thought to be enough for the validity of the scale.
Measured: Measurements taken just before the training begins.
Secondary outcomes (2)
State-Trait Anger and Anger Expression Scale
After the theoretical trainings were completed, State-Trait Anger and Anger Expression Scale forms were applied to the control group and their scores were evaluated after the training. The scales were applied to the experimental group immediately after the simulation training was completed and their scores were evaluated.
Measured: Immediately after the trainings
Communication Skills Inventory
After the theoretical trainings were completed, Communication Skills Inventory forms were applied to the control group and their scores were evaluated after the training. The scales were applied to the experimental group immediately after the simulation training was completed and their scores were evaluated.
Measured: Immediately after the trainings
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Feb 2025
- Study start1 Mar 2017
- Primary completion1 Dec 2017
- Study completion13 Feb 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Nurse-Patient RelationsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A convergent parallel mixed-methods study design was used to address the questions comprehensively. In this study, randomized controlled trials were used quantitatively and a guided content analysis approach based on notes from debriefing sessions was used qualitatively. Quantitative data were evaluated with pre-test and post-tests.
- Masking
- None (open label)
- Enrolment
- 56 participants (actual)
Sponsor and investigators
- Lead sponsor
- Yuksek Ihtisas University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Arzu AYDOĞAN, Yuksek Ihtisas University
- Investigators
- Arzu AYDOĞAN, Principal investigator, Yuksek Ihtisas University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06827067
- Sponsor's protocol ID
- Dated 11/9/2016 and no. 15/10
- Status last verified
- Feb 2025
- First submitted
- 29 Jan 2025
- Last updated
- 14 Feb 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Study data may be shared upon request within the scope of data privacy
Study at a glance
From the registry record, last updated by the sponsor on 14 Feb 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessment of Effectiveness of Communication Skills and Anger Management Training Accompanied with Standardized Patient Given to Nurses
- ClinicalTrials.gov ID
- NCT06827067
- Acronym / sponsor ID
- Dated 11/9/2016 and no. 15/10
- Conditions
- Nurse-Patient Relations
- Keywords
- Difficult patient, Anger management, Communication, Simulation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 56 participants (actual)
- Lead sponsor
- Yuksek Ihtisas UniversityUniversity, hospital or other
- Study start
- 1 Mar 2017 (actual)
- Primary completion
- 1 Dec 2017 (actual)
- Study completion
- 13 Feb 2018 (actual)
- First posted
- 14 Feb 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Objective: The aim of this study was to determine the effect of training given to nurses on communication and anger management skills in the presence of standardized patients.
Method: The study was conducted using a convergent parallel design, which is a mixed-method design. The experimental and control groups of the study were conducted with a total of 56 nurses. Data were collected using a socio-demographic data collection form, Communication Skills Inventory and State-Trait Anger and Anger Expression Scale. The intervention group participated in the simulation, and qualitative data were collected during the debriefing session of the simulation. The scales were administered to the groups 3 times in total: before the training, after the training and 6 weeks after the end of the training.
Detailed description
The patient-nurse relationship is a dynamic process that can change as the patient's health needs change and nurses can show positive emotions and behaviors to their patients. However, due to the nature of human beings, it may be impossible to show positive behaviors at all times, and in communication processes, situations that make communication difficult may occur from time to time (Gorman 1996). When the studies examining the communication between patients and nurses are examined, it is found that some patient behaviors that may cause problems in the relationship and the inadequacies of nurses in controlling their emotions are the causes. When these studies are examined, the concept of "difficult patient" attracts the most attention (Akgün-Çıtak 2011, Wolf and Smith 2007, Macdonald 2007, Kennedy Sheldon et al. 2006).
"Difficult patients" are defined in the literature as patients with behaviors that hinder communication. (Göral 2011, Koekkoek et al. 2006). In a study conducted by Essary et al. (2005), it was observed that patients were labeled as "difficult patients" as a result of ineffective communication between nurse and patient and that nurses tended to blame patients as a result of labeling. In the literature, it is stated that improving communication skills with the difficult patient group will benefit nurses and the onset of conflicts can be prevented, which should not be forgotten that conflicts that cannot be prevented arouse feelings of anger in individuals. (MacLean at all 2017, Baran and Okanlı 2015) For this reason, it is as important for nurses to improve their communication skills as it is for them to improve their ability to cope with anger.
Although anger is a frequently felt emotion in the nursing profession, this emotion should not be expressed with aggression or suppressed in order to be healthy and useful. Nurses should gain the ability to express anger in a healthy way by recognizing and accepting it like all other emotions (Bozkurt 2010, Akdeniz 2007). Expressing anger openly in an acceptable way is a positive personality trait. However, such emotions that cannot be controlled and are ignored by denial or suppression have the potential to be harmful for both the person and his/her environment (Kaya et al. 2012). In the study conducted by Baran and Okanlı in 2015, it was emphasized that nurses should regularly receive in-service trainings on anger and anger expression in order to recognize their anger, accept its existence and express their anger correctly. Trainings on anger management can be given in many ways like other trainings. These ways can be in the form of individual and group trainings as well as using various simulations.
Simulation-based trainings are ideal for nursing education as they include an interactive method that can be used to teach cognitive, psychomotor or emotional skills to individuals or groups at any skill or proficiency level. ( Zengin \& Eren Fidancı 2024, Tanis, Quinn, \& Bischoff, 2019) In standardized patient simulation, the patient or case study is animated by playing the scenario prepared with structured steps. The use of standardized patients in teaching contributes to the development of participants' communication skills, history taking and physical examination skills. ( Zengin \& Eren Fidancı 2024). When the literature is examined, it is seen that skill-oriented studies are frequently used in simulation-based studies, but emotion-oriented studies are weaker, and the majority of the studies are conducted with student nurses, and the intervention study conducted with working nurses is very limited.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- A convergent parallel mixed-methods study design was used to address the questions comprehensively. In this study, randomized controlled trials were used quantitatively and a guided content analysis approach based on notes from debriefing sessions was used qualitatively. Quantitative data were evaluated with pre-test and post-tests.
| Arm | Type | Receives |
|---|---|---|
| Control group | Other | Behavioral: Theoretical trainingTheoretical training consisting of a total of 7 sessions of 40-45 minutes each was given to 30 nurses in the control group. |
| Experimental group | Experimental | Behavioral: Simulation application with standard patient, Behavioral: Theoretical trainingImmediately after the theoretical trainings of 30 nurses in the experimental group were completed, simulation trainings conducted with a standard patient were given. A half-day training was given to the standard patient (SH) about the scenario content before the application. Before the encounter with the SH, a preliminary interview was held with the nurses in the briefing room, where the content and purpose of the application were explained to the nurses, and the story of the SH was told to the nurses in line with the prepared scenario. Three nurses were interviewed for each scenario. The nurses communicated with the SH for 10-15 minutes and each interview was conducted using video recordings. Those who finished the interview with the SH watched the scenario of the other group as observers and at the end of each 3 scenarios, the debriefing phase lasting an average of 60-90 minutes was carried out. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Volunteering to participate in the research
- Working as a nurse in any of the surgical or internal medicine clinics of the hospital
- According to the results of the pre-test application, anger control scores were lower than the other nurses participating in the study.
Key exclusion criteria (2 listed)
- Not volunteering to participate in the study
- Not having participated in simulation training in the experimental group
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Simulation application with standard patientBefore the encounter with the standard patient (SH), a preliminary interview was held with the nurses in the briefing room, where the content and purpose of the application were explained to the nurses, and the story of the SH was told to the nurses in line with the prepared scenario. Three nurses were interviewed for each scenario. The nurses communicated with the SH for 10-15 minutes and each interview was conducted using video recordings. Those who finished the interview with the SH watched the scenario of the other group as observers, and at the end of each 3 scenarios, the debriefing phase was carried out for an average of 60-90 minutes. | Behavioural | Experimental group |
| Theoretical trainingThe trainings, each of which lasted 40-45 minutes on average, were conducted in a total of 7 sessions. | Behavioural | Control group, Experimental group |
Primary outcome
State-Trait Anger and Anger Expression Scale
Time frame: Measurements taken just before the training begins.
State-Trait Anger and Anger Expression Scale is a self-assessment scale that measures the feeling and expression of anger. The State-Trait Anger and Anger Expression Scale , developed by Spielberger (1983) and whose Turkish validity and reliability were determined by Özer (1994), consists of 4 sub-dimensions and 34 items, namely anger-in, anger-out, anger control, and trait anger. Participants were asked to respond using a 4-point Likert-type scale (1 "Does not describe at all," 2 "Somewhat describe," 3 "Fairly describe," and 4 "Completely describe"). High scores on the trait anger dimension indicate that the level of anger is high, high scores on the anger control dimension indicate that anger can be controlled, high scores on the anger-out dimension indicate that anger is easily expressed, and high scores on the anger-in dimension indicate that anger is suppressed.
Communication Skills Inventory
Time frame: Measurements taken just before the training begins.
Inventory developed by Balcı and Ersanlı (1998) to measure the level of communication skills among university students. The scale consists of three sub-dimensions including behavioral, cognitive and emotional. The scale consists of a total of 10 items. There are 15 items that measure each dimension. The scale has been developed in the 5-point Likert type. The highest score that can be achieved from the scale is 225, and the lowest score is 45. Correlation between the total score from Communication Skills Inventory and total scores of each dimension was found to be 0.85 for intellectual sub-dimension, as 0.73 for emotional sub-dimension and 0.82 for behavior sub-dimension. Regarding the validity study of the inventory; its correlation with Communication Skills Assessment Scale developed by Korkut (1996) was examined. In the validity study carried out, correlation coefficient between two scales was found as 0.70. This value is thought to be enough for the validity of the scale.
2 secondary outcomes
State-Trait Anger and Anger Expression Scale
Time frame: Immediately after the trainings
Communication Skills Inventory
Time frame: Immediately after the trainings
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Feb 2025.
- Individual participant dataSharing planned: No. Study data may be shared upon request within the scope of data privacy
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Arzu AYDOĞAN principal investigator
Yuksek Ihtisas University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Simulation application with standard patient and Theoretical training in people with Nurse-Patient Relations, run by Yuksek Ihtisas University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
State-Trait Anger and Anger Expression Scale (time frame: Measurements taken just before the training begins.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Feb 2025.