Abstract
AIM: To examine nurses and other healthcare professionals' perspectives on the sociocultural communication strategies that shape both expressing and responding to nursing assertive communication behaviors in Saudi Arabia. BACKGROUND: Assertive communication skills are an integral part of safe nursing practice and are closely aligned with nursing empowerment. Saudi Arabia has unique sociocultural dimensions that shape how nurses express, respond, and adopt certain tactical choices when practicing assertive communication behavior with peers and other healthcare professionals. METHODS: A descriptive, qualitative case study design focusing on one university teaching hospital in the Eastern Province of Saudi Arabia was conducted. Data were collected using four focus groups, four semistructured interviews with nurses, doctors, pharmacists, and senior executive hospital personnel, along with document analysis. Data collection is guided by the modified version of Garon (2012)'s three communication dimensions on speaking up and examines the sociocultural communication strategies within the contexts of assertiveness or saying "no" indirectly. RESULTS: Analysis led to three major themes and seven subthemes: "Understanding the cultural context," "Tactical choices for practicing assertiveness," and "Change on the horizon." CONCLUSION: This study provides a valuable perspective on how nurses and other healthcare professionals from Saudi Arabia view and contextualize assertive communication in their practice. IMPLICATIONS FOR NURSING MANAGEMENT: The findings highlight the importance of understanding communication strategies that are utilized by the nursing workforce from diverse working environments, with a sociocultural focus on assertiveness strategies that promote staff empowerment.