Demand‐Matched Self‐Efficacy and Perceived User Incivility in Healthcare: A Two‐Wave Study and an Exploratory Training Intervention

Aim(s) To examine which of three functionally distinct, demand‐relevant self‐efficacy beliefs showed the most consistent prospective association with baseline‐adjusted changes in perceived user (i.e., patients, relatives and visitors) incivility, psychosomatic symptoms and job satisfaction among healthcare workers, and whether a targeted training programme can strengthen this resource in acute nursing settings. Design Two linked studies: Study 1 used a two‐wave change‐over‐time design, and Study 2 used an exploratory pre–post intervention design. Methods In Study 1, 74 healthcare workers completed measures at two time points over three months. Standardised residualised change analyses examined whether three baseline self‐efficacy beliefs differing in their level of specificity and primary capability domain—self‐efficacy in managing challenging user behaviour, regulatory emotional self‐efficacy in managing negative emotions at work (RESE‐W) and trauma‐related coping self‐efficacy (CSE)—predicted changes in perceived user incivility, psychosomatic symptoms and job satisfaction. In Study 2, 22 nurses from acute units participated in a unit‐tailored training programme grounded in social cognitive theory. Pre–post analyses assessed changes in self‐efficacy for managing challenging user behaviour and related communication competencies. Results In Study 1, higher baseline self‐efficacy in managing challenging user behaviour predicted more favourable changes in perceived user incivility, psychosomatic symptoms and job satisfaction. In contrast, CSE was associated only with psychosomatic symptoms, while RESE‐W showed no significant associations. In Study 2, self‐efficacy in managing challenging user behaviour showed a significant immediate pre–post increase following the intervention. Conclusion Among the self‐efficacy beliefs examined, self‐efficacy in managing challenging user interactions showed the most consistent predictive pattern across the three outcomes. Preliminary findings indicate a short‐term increase in this psychological resource following brief, context‐sensitive training. Implications for Nursing Management Assessing and supporting interaction‐focused self‐efficacy may complement broader organisational strategies for managing user incivility. Controlled studies are needed to determine whether targeted training produces durable improvements in occupational well‐being or care quality and whether it can be scaled across settings. Reporting Method Study 1 adhered to the STROBE guidelines; Study 2 adhered to the TREND and TIDieR guidelines. Patient or Public Contribution No patient or public involvement.