الفهرس 
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Abstract
Assertiveness is the ability to be honest, direct and appropriate expression of opinions, feelings, attitudes and rights, without undue anxiety, in a way that does not infringe on the rights of others. It is considered essential for successful communication. Hence, assertiveness is important in nursing activities, enabling them make decisions more appropriately. Moreover, it enhances self-awareness, improves performance, and fosters collaboration and cohesiveness. Nurses also need good self-esteem to know how close the real self is to the ideal self. Poor self-esteem leads to negative professional attitudes and behaviors. Therefore, nurses need to be assertive in order to be an effective patients’ advocate and to be able to empower them.
This study was aimed at investigating the relationship between self-esteem and assertiveness among staff nurses at Ain Shams University Hospitals. It hypothesized the presence of a relationship between self-esteem and assertiveness among staff nurses. The study was conducted at the five Ain-Shams University Hospitals using an analytic cross-sectional design. It involved a convenience sample of 98 staff nurses working in these settings with a work experience of at least one year. A self-administered questionnaire with a scale for self-esteem and a scale for assertiveness was used in data collection, in addition to a section for demographic characteristics. It was face and content-validated by five experts in nursing administration, and pilot-tested for feasibility and reliability. The fieldwork lasted from January to April 2017.
The main study findings were as follows.
The staff nurses’ age was mostly less than 30-year (51.0%), (66.3%) had a diploma degree, and their experience was mostly 10 years or more (38.8%).
The highest domains of assertiveness were those of negotiating system (74.5%), and action orientation (60.2%). Conversely, the lowest domains were those of control of anxiety/fears (37.8%) and relating to co-workers (40.8%).
In total, 53.1% of the staff nurses had high assertiveness.
The majority of staff nurses had high self-esteem related to positive (84.7%) and social (79.6%) personality, and 9.2% had high negative personality.
Overall, 63.3%of the staff nurses had high self-esteem.
A higher percentage of staff nurses having high total assertiveness was among those with less than 5-year experience (p=0.02).
A higher percentage of staff nurses with high positive personality self-esteem were having diploma degree in nursing (p=0.02).
Significantly more staff nurses with high social personality self-esteem were among those younger in age, with less than 5-year experience, and having previous attendance of training courses in assertiveness.
In total, a higher percentage of staff nurses having high total self-esteem was among those having a diploma degree in nursing (p=0.03).
Statistically significant relations were revealed between staff nurses’ total self-esteem and the various dimensions of assertiveness, except for the verbal and non-verbal, and the relating to co-workers dimensions.
A higher percentage of staff nurses with high social personality self-esteem was among those having high total assertiveness (p=0.005).
A statistically significant relation was found between staff nurses’ total self-esteem and total assertiveness (p=0.003).
A significant positive correlation was detected between staff nurses’ scores of assertiveness and positive personality self-esteem (r=0.201).
Staff nurses’ self-esteem scores had significant negative correlations with the level of nursing qualification (r=-0.211) and experience years (r=-0.222).
In multivariate analysis, the level of qualification and experience years were significant negative predictors of staff nurses’ self-esteem score.
In conclusion, the staff nurses in the study settings lack assertiveness, and this is significantly related to their experience years. They have slightly better self-esteem, which is significantly influenced by their nursing qualification and experience years. The staff nurses with high higher self-esteem are also having high assertiveness.
The study recommends more support and empowerment of staff nurses be through on-the-job training courses and workshops, more participation in unit, department, and hospital decision-making, a work environment helping them to demonstrate their skills, and periodical meetings with leaders and hospital administration for seeking their opinions. The training programs should be more targeted to bachelor degree nurses, and the orientation of newly appointed nurses should be aimed at reducing the shock of reality among them. The curricula of nursing schools should give more emphasis on the issues of assertiveness and self-esteem. The nursing syndicates and agencies should deploy more efforts for improvement of the image of the nurse in order to enhance self-esteem among staff nurses. Further research is proposed to examine the effectiveness of various interventions aimed at improving nurses’ self-esteem and assertiveness.