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Yang and Kim: Integrative Review of Nonviolent Communication Intervention Studies
Original Article

Perspectives in Nursing Science 2016;13(1):36-47.

Published online: 19 April 2016

DOI: https://doi.org/10.16952/pns.2016.13.1.36

Integrative Review of Nonviolent Communication Intervention Studies

Jeong Woon Yang1, Sungjae Kim2,

1Clinical Instructor, Department of Nursing, Korean Bible University, Seoul

2Professor, College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Kim, Sungjae College of Nursing· The Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongro-gu, Seoul 03080, Korea. Tel: +82-2-740-8803, Fax: +82-2-765-4103, E-mail: sungjae@snu.ac.kr

Received 28 February 2016       Revised 4 March 2016       Accepted 6 March 2016

Copyright © 2016 The Research Institute of Nursing Science, Seoul National University

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

This study aimed to uncover the evidence for developing effective communication intervention programs by analyzing and evaluating Communication Intervention Studies using Nonviolent Communication (NVC-CI). The specific purposes were to analyze general characteristics of NVC-CI studies, intervention contents, and the effectiveness of the studies. Methods: This was an integrative review that analyzed NVC-CI studies published from 2005 to 2015 identified through searches of five Korean electronic databases. The method proposed by Whittemore and Knafl was applied. This contains four stages: problem identification, literature search, data evaluation, and data analysis. Results: Twelve studies met the inclusion criteria. Most of the experimental designs were Quasi-experimental studies. These included 9 papers (75%), one qualitative study, one mixed methodology, and one case study (8.3% respectively). Most NVC-CI studies used group intervention. In order to effectively change communication patterns, interventions needed about 10~11 sessions 1~2 times a week. Conclusion: Future research with well-designed clinical trials using NVC-CI needs to be done in the area of mental health nursing to promote communication skills.

Keywords: Nonviolent communication, Communication intervention, Communication skills, Interpersonal relationship

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Figure 1.
Flowchart for article relevance assessment.
pns-13-36f1.tif
Table 1.
A Summary of the Reviewed Papers
Author (year) Research design Subject (n) Variable Key finding
Cheung & Choi (2011) Quasi-Experimental study (nonequivalent control group pretest-posttest design) Employee (24) E:12, C:12 ․ Interpersonal relationship skill ․ Improvement of interpersonal relationship through NVC program
․ Stress among interpersonal relationship ․ Stress reduced among Personal relationship
․ Job satisfaction ․ Improve job satisfaction
Shin & Cho (2014) Quasi-Experimental study (nonequivalent control group pretest-posttest design) Mother (14) E:7, C:7 ․ Mother-child relationship
․ (Emotional stability, intimacy, respect, filial duty)
․ Self-concept		 ․ Communication could be changed by practice
․ Emotional stability, intimacy, respect showed effective among the experimental group
․ Self-concept (achievement-self and body-self) were found effective
Lee & Kim (2010) Quasi-Experimental study (nonequivalent control group pretest-posttest design) 10 couple (20) E:10, C:10 ․ Self-esteem ․ Changes in couple interaction pattern
․ Anger thought ․ Improve emotional communication
․ Emotional communication ․ Mutual opening, improve sympathy ability
․ Problem solving communication ․ Improve expressing affection and sexual intimacy
․ Sexual intimacy ․ Improvement in self-efficacy, self choice and responsibility
․ Recognize anger and relieve
Lee & Kwon (2014) Quasi-Experimental study (nonequivalent control group pretest-posttest design) Parent & adolescent (20) E:10, C:10 ․ Communication skill ․ Understand communication style of self
․ Conflict solving method ․ Recognize the emotion of self and other in the conflict situation and could express
․ Practicing various situation improves the communication skill
Chang et al. (2015) Quasi-Experimental study (nonequivalent control group pretest-posttest design) 12 couple (24) E:12, C:12 ․ Marriage satisfaction ․ Understand the difference of characteristics and find the communication method
․ Self esteem ․ Through accepting emotion and practicing sympathy, communication skill would be knowledged
․ Communication skill ․ Express self need exactly and find out the others’ emotion
․ Through mutual respect, experience positive emotion and improve self esteem
Lee & Park (2007) Quasi-Experimental study (nonequivalent control group pretest-posttest design) Elementary school student (18) E:9, C:9 ․ Self esteem ․ Positive effect to the interpersonal relationship and self esteem would improve
․ Peer relationship ․ Could feel sympathy to others
․ Conflict would reduce through respecting each other
Lee et al. (2009) Quasi-Experimental study (nonequivalent control group pretest-posttest design) Middle school student (60) E:30, C:30 ․ Interpersonal communication ․ Find out one's own bad habit in the communication
․ Peer relationship ․ Express what was observed, not evaluating
․ Recognize others’ feelings & need and express self's opinion
․ Enhanced open communication
․ Express one's own anger in a correct way
․ Acknowledge the member and develop amicable peer relationship
Koo (2006) Quasi-Experimental study (nonequivalent control group pretest-posttest design) College student (149) E:79, C:70 ․ Interpersonal communication ․ Feel sense of belonging and embracement to the group
․ Communication skill ․ Experience positive interpersonal relationship
․ Satisfaction among interpersonal relationship ․ Achieve confidence among interpersonal relationship
․ Members helping each others
Kim et al. (2015) Mixed Method research (one group pretest-posttes design, contents analysis) Elementary school student (27) E:27 ․ Quantity analysis
- Social emotional competencies (Self-awareness, relationship management, social awareness)
- Community consciousness
․ Qualitative analysis
- Social emotional competencies		 ․ Knowing various emotions through self recognition
․ Learning how to feel sympathy in the social awareness
․ Reducing maladaptive phenomenon (bullying, violence) through improved social awareness
․ Experiencing qualitative interpersonal relationship
․ Finding joyful communication method
․ Compositing community consciousness and bond
․ Enhance community spirit through improved relation management ability
․ Express emotions in the emotion diary
Koo (2005) Qualitative study College student (90) ․ Analysis of impression
- Basic behavior for the interpersonal relationship
- Sense of intimacy
- Sense of confidence		 ․ Learning basic attitude and behavior to have matured interpersonal relationship
․ Not criticizing oneself and others but respect the need of one's own and others
․ Experience intimate interpersonal relationship
․ Experience expressing real emotion, intimacy and confidency
Lee & Son (2011) Quasi-Experimental study (nonequivalent control group pretest-posttest design) College student (24) E:12, C:12 ․ Level of childhood trauma childhood trauma
․ Level of adult attachment adult attachment
․ Express characteristic anger
․ Level of maladaptation in the early stage		 ․ Reduced characteristic anger level and anger expression
․ Express the need behind the anger to adaptive way
․ Could control anger in the real life
․ Knowing others have same need and pain like oneself
Kim (2011) Case study A couple (2) ․ Stress, empathy, conversation pattern, life account ․ Knowing the bad habit in the communication
․ Learning to listen carefully, to compliment, and to say thank
․ Improved communication ability through learning conversational method
․ Honestly expressing emotions without criticizing and blaming
․ Enhance safety and confidence through honest expressing of the emotions
․ Reduced subjective stress (space, work, financial, etc)
․ Telling what have changed helps relationship improvement

E=Experimental group, C=Control group.

Table 2.
General Analysis of the Reviewed Papers (N=12)
Variables Content n(%)
Published years 2005~2007 3 (25.0)
2008~2010 2 (16.7)
2011~2013 3 (25.0)
2014~2015 4 (33.3)
Research design Quasi-experimental study 9 (75.0)
Qualitative study 1 (8.3)
Mixed method 1 (8.3)
Case study 1 (8.3)
Types of intervention Group (7~15people/group) 11 (91.7)
Individual 1 (8.3)
Group members 2 people 1 (8.3)
7~9 people 2 (16.7)
10~12 people 7 (58.3)
13~15 people 2 (16.7)
Intervention period & session (time/1 session) 4 weeks, 8 session (70~90 min) 1 (8.3)
5 weeks, 10 session (60~180 min) 2 (16.7)
12 weeks, 24 session (60 min) 1 (8.3)
8 weeks, 14 session (120~180 min) 1 (8.3)
6 weeks, 6 session (90 min) 1 (8.3)
10 weeks, 10 session (45~150 min) 2 (16.7)
11 weeks, 11 session (40~100 min) 3 (25.0)
8 weeks, 14 session (120~180 min) 1 (8.3)
2 days, 8 session (120 min) 1 (8.3)
Total participant (E/C) 2 (2/0) 1 (8.3)
14 (7/7) 1 (8.3)
18 (9/9) 1 (8.3)
20 (10/10) 2 (16.7)
24 (12/12) 3 (25.0)
27 (12/15) 1 (8.3)
60 (30/30) 1 (8.3)
120 (120/0) 1 (8.3)
149 (70/79) 1 (8.3)
Table 3.
Analysis of Intervention
Author (year) Contents
Cheung & Choi (2011) ․ Applying 4 factors of NVC (Case of the workplace)  
   
Shin & Cho (2014) ․ Understanding 4 factors of NVC ․ Applying 4 factors of NVC and make cooperative
․ Applying 4 factors of NVC and express as message relationship
․ Self acceptance and practice ․ Express gratitude
Lee & Kim (2010) ․ Understand couple relationship types ․ Learn 4 steps of NVC
․ Accept me and partner ․ Control conflict in a safe way
․ Self sympathy ․ Express intimacy
․ Express anger through recognition ․ Say gratitude
Lee & Kwon (2014) ․ Teenager – Knowing the importance of communication ․ Parents –Recognize the emotion of the children
 - Learning NVC communication method  - Effective respond to the children's emotion
 - Control and express negative emotions  - Enforce the positive behavior of the children
․ Family – Focus on the real problem  - Purify the negative behavior of the children
 - Set the goal  
Chang et al. (2015) ․ Understand the partner ․ Control recent conflict
․ Look at the partner as positive way ․ Find out the way to control conflict
․ Find out the points to improve among the couple communication ․ Find out role of partner and discuss ․ Write thanks letter
․ Exercise NVC communication ․ Share the impression and opinion
Lee & Park (2007) ․ Self-awareness ․ Learning core element of NVC
․ Finding bad habits in the ommunication ․ Applying – Expressing self empathy
․ Learning core element of NVC (4 factors)  - express anger
  ․ Share the impression and opinion
Lee et al. (2009) ․ Self-awareness ․ Applying –expressing self empathy
․ Finding bad habits in the communication  - expressing gratitude
․ Learning core element of NVC (4 factors)  - express anger
  ․ Share the impression and opinion
Koo (2006) ․ Looking back the past communication style ․ Empathy oneself and others
․ Learn empathy principle ․ Express anger and gratitude
  ․ Ending
Kim et al. (2015) ․ Learning feeling words through video ․ Role play with NVC
․ Discuss the emotion after watching 3 videos ․ Share the impression and opinion of the role play
․ Learn 4 steps of NVC ․ Share the impression and opinion
Koo (2005) ․ Looking back the past communication style ․ Empathy oneself and others
․ Learn empathy principle ․ Express anger and gratitude
  ․ Share the impression and opinion
Lee & Son (2011) ․ Recognize the primary emotion and relax training ․ Explain 4 steps of NVC and practice
․ Reflective communication education and practice ․ Recognize the need behind the anger
․ Relevance communication practice ․ Empathy
․ Imagery work related with past trauma ․ Practice expressing anger through role play
  ․ Share the impression and opinion
Kim (2011) ․ Listening to the appeal with empathy and support ․ Experience the obstacles toward empathy of one’s
․ Do role play as opponent communication style
․ Say 4 factors of NVC ․ Communicate through sexual life
․ Sympathy ․ Explore life territory ․ Plan the performance plan
Table 4.
Research Tool (N=23)
Types n (%)
Communication skill related scale 5(21.7)
Interpersonal relationship related scale 4(17.3)
Self esteem related scale 4(17.3)
Peer relationship examination scale 2(8.6)
Anger though scale 2(8.6)
Sexual intimacy scale 1(4.3)
Conflict solving method scale 1(4.3)
Job satisfaction 1(4.3)
Group consultation's therapeutic scale 1(4.3)
Childhood trauma questionnaire 1(4.3)
Adult attachment questionnaire 1(4.3)
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