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| ORIGINAL ARTICLE |
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| Ahead of print publication |
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Impact of imparting emotional intelligence skills training program to enhance emotional intelligence and work stress among staff nurses of tertiary care hospital of North Gujarat
P Sharma1, Kajal Srivastava2, J Landge3, S Vyas4
1 Department of Community Medicine, Gmers Medical College, Dharpur, Patan, Gujarat, India
2 Department of Community Medicine, Dr. D.Y.Patil Medical College, Pimpri, Pune, Maharashtra, India
3 Department of Community Medicine, Nootan Medical College, Visnagar, Gujarat, India
4 Department of Community, Medicine, Himalayan Institute of Medical Sciences, Jolly grant, Dehradun, India
| Date of Submission | 09-May-2021 |
| Date of Decision | 18-Nov-2021 |
| Date of Acceptance | 19-Nov-2021 |
| Date of Web Publication | 07-Nov-2022 |
Correspondence Address:
Kajal Srivastava,
B-2/302, Swarganga Society Near Gg International School, Vallabhnager, Pune - 411 018, Maharashtra
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/mjdrdypu.mjdrdypu_337_21
Context: Nurses play a pivotal role in patient care and at the same time, face stressful situations due to workload, so the need of the hour is to create awareness about emotional intelligence (EI) among nurses to tide over such situations. Aims: This study aimed (1) to measure baseline levels of EI in the control and intervention group of staff nurses, (2) to find the association between the sociodemographic factors and EI, (3) to give EI training skills program to the experimental group, (4) to measure any enhancement in EI Skills after the intervention, and (4) to assess any improvement in work performance (WP) after EI intervention. Settings and Design: An experimental study was conducted among nurses working in GMERS Hospital, Patan, who were working in critical care units and general hospital wards. Materials and Methods: One-third of nurses from each of the two blocks were taken (convenience sampling) from the two blocks (critical care units and general units), i.e., 24 and 42 nurses, respectively, and allocated into experimental and control groups, respectively. Questionnaire containing questions related to sociodemographic variables, the Schutte Self-Report EI test, and WP survey questionnaire by the University of Michigan Health System were used. Statistical Analysis Used: Quantitative data were summarized using means and standard deviation. The data were assessed for normality and suitable tests such as t-test and paired t-test were used. Results: A significant enhancement in mean EI score i.e 145.16±5.938 after intervention from base mean EI score of 132.42±4.21 was noticed. Furthermore, the job performance showed a statistically significant improvement after EI Intervention. None of the sociodemographic variables showed a statistically significant association with the EI scores of intervention group. Conclusions: The Study highlights the importance of EI Training among Staff nurses as an essential part of their training program, to cope up with stress level in their day to day life and this training also has a positive impact on their Job performance thereby enhancing the quality of patient care.
Keywords: Emotional intelligence, nurses, tertiary care hospital
How to cite this URL:
Sharma P, Srivastava K, Landge J, Vyas S. Impact of imparting emotional intelligence skills training program to enhance emotional intelligence and work stress among staff nurses of tertiary care hospital of North Gujarat. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2023 Mar 20]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=360555 |
| Introduction | |  |
Emotional Intelligence (EI) is defined as a type of social intelligence that involves the ability to monitor one's own and others' emotions, to discriminate among them, and to use the information to guide one's thinking and actions. EI has four main pillars, namely the ability to perceive emotions; utilize these emotional perceptions to accomplish various activities or tasks; understand emotional variations; and manage emotions to achieve goals.[1] The concept of emotional quotient (EQ) was first coined by Salovey and Mayer (1990). It is composed of four main skills including self-awareness, self-management, social awareness, and relationship management, two first components are focused on the person and two second components are focused on the person's relationships.[2],[3] The concept of EI is relevant to health care practitioners to understand patients' perspectives and for nursing leaders to engage in relationships that will facilitate successful management.[1] Quality of working life is one of the most imperative issues in any organization;[4] in fact, it is a multidimensional structure keeping in mind the role of the individual in the organization including concepts such as welfare and health services, incentive programs, job fitness, and security which play a pivotal role in providing growth and development and participation in decision-making.[5] Nurses play a critical role in the care of a patient. Through that care, the nurse has the ability to improve the patient's experience or ruin it. Nursing is a rewarding and satisfying profession. However, at the same time, it can also be extremely stressful. Nurses in India are overburdened as the nurse-to-patient ratio is low. Similarly, in relation to stress in their daily life, 87.4% reported some stress while 28.7% (25/87) reported severe/extreme stress.[6] As nurses have an important role in the patient care, it is necessary to create awareness about EI among nurses. EI and communication skills go hand in hand, so it is important to include training on EI among nurses by institutional heads for better health of nurses in turn patients as well.[7] As life is becoming more stressful, it is the need of the hour to make nurses aware of the EI, as this important part is missing in the nursing curriculum; hence, this study was conducted on staff nurses working in a tertiary hospital to assess the effect of EI on their job performance and the importance of inclusion of EI training in the nursing teaching curriculum. This study was thus planned with the aim to see the effect of EI training among staff nurses to improve working skills and mental health of nursing staff. It was done with the objectives (1) to measure baseline levels of EI in the control and intervention group of staff nurses, (2) to find the association between the sociodemographic factors and EI scores of staff nurses, and (3) to measure the effect of EI training on EI scores and work performance (WP) of staff nurses.
| Materials and Methods | | |
It was an iInterventional study done on nursing staff working in general and critical care units. The study was planned for 3 months' duration at a tertiary care hospital. Exclusion criteria were nurses who have <3 years of experience and did not give proper informed consent. All nurses who had a work experience of 3–10 years, with rotational working shifts, and without a managerial role were included in the study. To eliminate the confounding effects related to the variables of working ward and difficulty of work, nurses working in critical care units (including medical intensive care unit [ICU], surgical ICU, neonatal-ICU, ICU, and casualty) and general hospital wards (including general surgical, female medical ward, female orthopedic ward male, burn ward, major operation theater [OT], labor room, pediatrics ward, gynecology OT, septic ward, gynecology and obstetrics ward, and psychiatrics, dental, ophthalmology, ear, mouth, and nose care wards) were allocated into two independent blocks. In the hospital, approximately 72 nurses were working in critical care unit and approximately 124 nurses were working in general wards. Depending on informed consent and inclusion criteria, one-third of nurses from each of the two blocks have been taken (convenience sampling) from the two blocks (critical care units and general units), i.e., 24 and 42 nurses, respectively. Nurses from each of the two blocks were then allocated into experimental and control groups. To avoid the dissemination of the intervention between the two groups, the nurses were selected as a cluster according to their shift timings and assigned to the different groups to minimize their meeting time.
The aim, methods, and purpose of the study were explained to the study participants after obtaining their written consent. They were ensured about confidentiality and that they could voluntarily withdraw from the study. Moreover, the questionnaires were anonymized and by numerical codes. The nurses were asked to remember these codes. Then, all nurses in both study groups were asked to complete the study questionnaire including information regarding sociodemographic variables, the Schutte Self-Report EI test (SSEIT) was used. Items of the test relate to the three aspects of EI: (1) appraisal and expression of emotion, (2) regulation of emotion, and (3) utilization of emotions. SSEIT is a 33-item scale; each item scored on a 5-point Likert scale, i.e., 1 = strongly disagree to 5 = strongly agree. Item 5, 28, and 33 are reversely scored. WP survey questionnaire by the University of Michigan Health System was modified (parameters A5 to A13) and used according to feasibility to obtain baseline scores.
Thereafter, the EI training intervention was implemented for the nurses in the experimental group, while the nurses in the control group received no EI intervention. The training program developed was based on the Bradberry and Greaves program consisting of four EI skills, including self-awareness, self-management, social awareness, and relationship management. The training was given in 60-min session; each twice a week session using various teaching and learning aids. In reference to first sentence where twice a week session was mentioned. So that the skills can be applied by the nurses in their daily lives. The training material was compiled and given to the nurses in the intervention group. In last, experimental group was asked to fill SSEIT questionnaire again and their changes in score of SSEIT questionnaire were studied. Furthermore, difference in EI and WP between the experimental group's score and control group's score was studied. After the study was over, positive changes were seen in the intervention group so the control group was also given EI training. Ethical clearance for the study was obtained from the institutional ethical committee (GMERS Medical College, Dharpur, Patan, Gujarat), letter number MCD/Patan/IEC/52/2019 and date of approval was March 6, 2019.
Statistical analysis
The data were entered into Microsoft Excel and analyzed using SPSS version 20 Statistical Package for social sciences (SPSS-26.0 SPSS South Asia Pvt. Ltd. Dolphin, Hennur main road, opoo. Harmony Apartments, Kacharkanahalli, Banglore). Quantitative data were summarized using means and standard deviation (SD). The data were assessed for normality and suitable tests such as t-test and paired t-test were used.
| Results | | |
The baseline scores in the control and intervention groups were found to be comparable [Table 1]. It was found in the current study that baseline EI scores for intervention group [Table 2] were slightly higher in the staff nurses from general ward (mean = 131.05 ± 3.60 SD) compared to those working in critical unit and this was statistically significant (t = 2.057 with 64 degrees of freedom; P = 0.044). A statistically significant association was not found between the sociodemographic characteristics (age, sex, religion, type of family, number of children, and night shifts) and EI scores [Table 3]. An enhancement in the EI scores was found after EI Therapy [Table 4] in the intervention group (enhancement of mean EI score = 145.16 ± 5.938 after intervention from mean EI score = 132.42 ± 4.21 after intervention). Furthermore, job performance showed a statistically significant improvement after EI intervention [Table 5]. | Table 1: Baseline emotional intelligence score of control and intervention group (objective 1)
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 | Table 3: Associations of sociodemographic factors with EI scores (n=66) (objective 2)
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 | Table 4: EI scores pre- and postintervention (intervention group) (objective 3)
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 | Table 5: Self-perceived job performance scores before and after intervention (objective 3)
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| Discussion | | |
Effectiveness of emotional intelligence training
The present study was carried out among 66 staff nurses (general = 42, critical = 24), out of these, 33 were given EI skills training. The control variables such as gender and age were included in the analysis because they could affect the results. However, none of these variables showed a statistically significant effect in any of the variables assessed. After the EI training sessions, significant enhancement in the EI score was noticed in the intervention group (mean EI = 132.42 ± 4.21) compared to the baseline scores (mean EI = 145.16 ± 5.938) which was statistically significant (t= −11.799, P = 0.000 which shows P < 0.001). Nelis D et al.[8] found that group-based EI training significantly improved emotion identification and management skills. They also found that EI training significantly improved emotion regulation and comprehension and general emotional skills.
In the current study, the overall EQ was found to be 132.42 ± 4.21, out of which nurses working in the critical care unit had slightly lower EQ scores (128.13 ± 7.91) compared to those working in general ward (131.05 ± 3.60). Similarly in a study on EI of staff nurses working in Villupuram district, Srinivasan and Jebaseelan[9] found that more than half (52%) of the respondents witness low level of overall EI which explains that nurses have emotional deviations due to job and as a person who requires suitable treatment affecting their performance in Job and need to enhance their EI.
The present study showed a significant improvement in the EI Scores after the intervention (132.42 ± 4.21) as compared to baseline levels (145.16 ± 5.938). It was found that there was a significant difference between the posttraining EI mean scores of training (233.53 ± 42.14) and control (199.40 ± 30.22) groups of students (t: 3.912; P = 0.000) in a study by Erkayiran and Demirkiran.[10] It was also found that posttraining interpersonal relationship style mean scores of training group students (139.19 ± 12.89) were higher when compared to pretraining (135.11 ± 10.58) and that this difference was statistically significant (t: −2.134, P = 0.040).
Effect of emotional quotient training on job performance
In the current study, the job performance was higher in the intervention group post-EI training as compared to the control group and the difference was found to be statistically significant (mean: −1.212, SD: 0.9924 and Standard error of mean (SEM): 0.1728; 95% confidence interval for difference: −1.564 to − 0.8602, t = −7.016; P = 0.000), highlighting the fact that imparting EQ skills can have a positive impact on the WP of nurses. Similarly in a study by Puri and Mehta[11] among hospital employees, A significant enhancement in mean EI score i.e 145.16±5.938 after intervention from base mean EI score of 132.42±4.21 was noticed.
In contrast to this, in another study carried out by Mahajan and Kaur[6] among staff nurses, the correlation between EI and job performance was found to be 0.1, which showed that there is a weak positive correlation. Similar to our study findings, in another study by Bakr and Safaan.[12] among staff nurses, a positive and statistical significant relation related to overall score of job performance and EI (r = 0.57, P < 0.0001) was found. Hence, overall EI training is really helpful in dealing with day-to-day stress and improved patient care.
| Conclusions | | |
The Study highlights the importance of EI Training among Staff nurses as an essential part of their training program, to cope up with stress level in their day to day life and this training also has a positive impact on their Job performance thereby enhancing the quality of patient care. So based on findings of this study, EI training should be included in their curriculum and also be implemented as part of their on job training. This training can help in enhancing their skills for dealing with stress and WP as well.
Acknowledgments
We would like to mention that student named Mr. Janmejay C. Bhavsar, roll no. 12 of mentioned medical college, has done the above work under the guidance of author, but it is really sad that we lost him in road traffic accident, 2 months ago. We want to thank all nurses who participated in this study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
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