Family Perspectives on ICU–ICCU Nurses’ Assertive Communication at Universitas Airlangga Hospital for Service Excellence

Abstract

Assertive communication by staff in intensive care units (ICU–ICCU) is essential for delivering family-centered care and achieving service excellence. This study aimed to explore patient families’ perceptions of ICU–ICCU nurses’ assertive communication at Universitas Airlangga Hospital, Surabaya. A quantitative descriptive-analytic design was employed involving 30 purposively selected family members. Data were collected using a validated 10-item assertive communication questionnaire (α = 0.93; r = 0.514–0.929) and analyzed using descriptive statistics, one-sample t-test, one-way ANOVA, and Pearson correlation. The mean total assertive communication score was 36.9 ± 3.7, with 74.2% of respondents rating the nurses’ communication as very assertive. The highest-rated indicators were empathetic listening (mean = 3.87) and comfort in asking for help (mean = 3.80), while openness to criticism received the lowest rating (mean = 3.07). A one-sample t-test showed the mean score was significantly higher than the theoretical midpoint of 25 (t(29) = 17.80; p < 0.001). No significant differences were found based on gender, age, education, or duration of accompaniment. However, a significant difference was observed based on the respondent’s relationship to the patient (F(3, 26) = 3.40; p = 0.032). Although ICU–ICCU nurses were generally perceived as highly assertive communicators, the low rating for feedback openness reveals a relational gap. Assertive communication training should therefore emphasize not only clarity and confidence, but also empathy, receptiveness to criticism, and inclusive, relationship-centered approaches to strengthen family engagement in care.