Effects of a Theory-Driven De-Escalation and Empathic Communication Training Program on Workplace Violence Management Perspectives, De-Escalation Performance, and Coping Confidence Among Emergency Nurses: A Pre–Post Educational Evaluation Study

Background/Objectives: Workplace violence against emergency nurses remains a persistent global challenge associated with adverse consequences for staff wellbeing and patient care. Although de-escalation training is widely recommended, evidence from theory-driven interventions evaluated using observer-rated simulated de-escalation performance in emergency settings remains limited. This study evaluated the effectiveness of the Emergency Nurse De-escalation and Empathic Communication (ED-DEC) training program on de-escalation competence, coping confidence, attitudes toward communication-skills learning, and violence-management perspectives among emergency nurses. Methods: A prospective, two-group pre–post educational study was conducted in the emergency department of a medical center in Taiwan. Seventy-two emergency nurses were randomly assigned to either a 20-session ED-DEC training program (n = 38) or routine in-service education (n = 34). Outcomes included de-escalation competence, confidence in coping with patient and visitor aggression, attitudes toward communication-skills learning, and perspectives on aggression and violence management at baseline and post-intervention. Generalized estimating equations and baseline-adjusted analyses of covariance were used to evaluate intervention effects. Results: Compared with the routine education group, participants receiving ED-DEC demonstrated greater improvements in de-escalation competence (Cohen’s d = 1.00; partial η2 = 0.303; p < 0.001) and coping confidence (Cohen’s d = 2.01; partial η2 = 0.561; p < 0.001). The ED-DEC training group was also associated with more positive communication attitudes (Cohen’s d = 2.36; p < 0.001), and significant changes in violence-management perspectives, including the interactional dimension of aggression attribution (p < 0.001; partial η2 = 0.667). Conclusions: The ED-DEC intervention significantly enhanced emergency nurses’ simulated de-escalation performance and coping confidence while fostering positive attitudes toward communication-skills learning and constructive violence management perspectives. The findings suggest that theory-informed de-escalation and empathic communication training may be a valuable component of continuing professional development for enhancing nurses’ preparedness to manage aggressive encounters in emergency care settings.