Nurses’ Emotional Intelligence and Patient Satisfaction

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Table of Contents

Introduction
Relationship between nurses’ emotional intelligence and patient satisfaction
Theoretical and Operational Definitions
Empirical Structure and Theoretical-Empirical Consistency
References

Introduction

Most of the available literature that is related to management shows that service providers who have high emotional intelligence usually garner high customer satisfaction scores (Kerfoot, 1996). As indicated by Rowell (2004), service excellence and quality health care are not only decisive, but also important in differentiating between service providers. The service providers who offer good services to their clients are more frequented by clients than those who offer undesirable services to clients. Clients usually frequent areas where the value of their money and resources is highly appreciated. Gessell and Wolosin (2004) state that patient satisfaction is a measure of the quality of medical care, as well as being a forecaster of a number of upbeat outcomes for patients and organizations. There is little available literature that offers evidence of the impact of the emotional intelligence of nurses on the relationship between patients and nurses, as well as patient satisfaction (Wagner et al., 2002; Stratton et al., 2005). Emotional intelligence has been defined as the capacity to examine one’s and other people’s feelings, and to tell them apart, with the intention of making use of this information in order to direct one’s thoughts and action (Salovey and Mayer, 1990).

As a result, emotional intelligence is thought to be a vital individual trait that is concerned with fostering nurse-patient relationship; hence, its presence in medical education curriculum has been increased tremendously. According to Goleman (1998), nurses that are more conscious of the emotions of their patients, enjoy more success in their treatment than their counterparts who are oblivious. Accordingly, three quarters of the success of a high achiever is related to emotional intelligence, while only a quarter is related to technical proficiency (Harvard & Rutgers, 2002). As a result, Epstein and Hundert (2002) note that emotional intelligence is among the evaluation items under moral and affective domains. Several medical practitioners have realized that although a number of nurses may be clinically competent, they may lack adequate practical social skills. Consequently, evaluation of emotional intelligence is presently employed in the selection of medical school hopefuls, with the intention of checking an applicant’s proficiency in interpersonal skills (Elan, 2000; Carrathers et al., 2000).

Studies on factors that affect the nurse-patient relationship mainly put emphasis on the demographic characteristics of a nurse (Duberstein, Meldrum, & Fiscella et al., 2006); whether a patient visits the same nurse routinely, or not (Kearley, Freeman & Heath, 2001); and the interview style of the nurse style (Graugaard, Holgersen, & Finset, 2006). As a result, it is very important to explore the existing association between emotional intelligence and personal satisfaction between patients and nurses. Expounding on this connection would enable nurses to not only provide clinically sound care, but to be emotionally responsive as well.

This research will investigate three concepts; the nurse-patient relationship, caring behaviors of a nurse, as well as the patient’s trust by application of a multi-source and multi-level data methodologies. These three concepts will be explored amongst nursing directors, senior staff, as well as nurses, including surgeons, who cover different specialties. This is contrary to earlier studies that used self-ratings of nurses who were board-certified in psychiatry or family medicine, individual patients, or medical students, as their units of analysis. This study will also take a look at how these concepts associate with each other.

Relationship between nurses’ emotional intelligence and patient satisfaction

Theoretical and Operational Definitions

Concept	Theoretical definition	Operational definition
Nurse-patient Relationship	This is defined as a formal relationship that is present between a patient and a nurse, and it is usually linked to medical duties, which the nurse has to carry out in a proficient and up to standard manner. The nurse-patient relationship starts when a nurse acknowledges, or agrees to accept, or embarks on giving care to a patient (LeBlang, Basanta & Kane, 1996)	The Nurse-patient Relationship Inventory (Wagner et al., 2002)
Caring Behaviors	Cronin and Harrison (1988) developed this definition of nurse caring behaviors. They defined nurse caring behaviors as those things that are said or done by a nurse which are employed in the communication of care to the patient.	Caring Behaviors inventory scale (CBI) (Cronin and Harrison, 1988)

Patient Trust	Patient trust has been defined as a group of expectations or beliefs that a nurse would conduct himself/herself in a certain manner, and thus offer a reassuring feeling of reliance or confidence in both the nurse and his/her intent (Pearson & Raeke, 2000)	The Patient Perception of Satisfaction Scale (PPCC) was developed by Hall et al. (2002)

Empirical Structure and Theoretical-Empirical Consistency

The Nurse-patient Relationship Inventory

Service providers, who have high levels of emotional intelligence, normally possess self-reported contentment with group relationships, as well as observation of increased social support. These individuals are would probably not report negative relations with other persons (Lopes, Salovey, & Straus, 2003). In the midst of the mixture of social relations appreciated by individuals, Magee and D’Antonio (1999) stated that the relationship between patients and nurses was more important than the recognition it was given. According to Magee’s and D’Antonio’s (1999) survey, the nurse-patient relationship is enormously or extremely important to 67% of those surveyed. This was greater than the relationship people had with spiritual advisors (52%), pharmacists (45%), as well as co-workers (44%). With the help of the Bar-On Emotional Quotient Inventory for evaluation of emotional intelligence, Wagner et al.’s (2002) study concentrated on the emotional intelligence of a nurse, and the nurse-patient relationship. In this study, only happiness, one of the sub-scales of emotional intelligence was interrelated to higher patient satisfaction. It is evident that the other sub-scales, mood, stress, adaptability, and interpersonal skills, were not related. The summation of scores from the five groupings provided the total score for the nurse-patient relationship. Higher scores values on the scale was a sign of an increase in the effectiveness of the nurse-patient relationship.

Caring Behaviors Inventory

Cronin and Harrison (1988) developed this definition of nurse caring behaviors Inventory scale (CBI). According to McQueen (2004), nurses have the ability to not only initiate a self-reflective procedure, but also happen to be conscious of their own emotions. In addition, Vitello-Cicciu (2003) notes that nurses that are emotionally intelligent are capable of selecting the manner in which they would react to different interactive state of affairs devoid of being emotionally weighed down by these situations. Nurses that are self-encouraged are inclined to be more unrelenting when they face difficult situations, crises and obstacles, more relentless when offering emotional support to patients, as well as more positive when they are at the center of a catastrophe. Consequently, they propagate their positive emotions, strengths and competencies to patients (Goleman, 1998).

Another expectation, which is placed on nurses, was discovered to be the demonstration of non-judgmental approach with patients, which in turn promotes a sense of security and trust. While looking at the seven-point scale, the description that nurses gave themselves was either highly or reasonably emotionally intelligent. However, this was not the case when describing emotional self-control, which had a low mean score of 3.9. On the other hand, self-encouragement had a relatively high mean score of 6.0. The instrument was developed to depict the nurses caring behaviors which comprised of 41 items rated on a five-point Likert scale.

The Trust Inventory

The Trust Inventory Scale was developed by Hall et al. (2002). Yamashita, Forchuk and Mound (2005) claim that a triumphant encounter is the gathering of social capital, which is regarded as the value that is builded up between two persons who are both parties of a relationship that is illustrated by commitment, willingness and trust; they agree that medicine can be referred to as a “covenant of trust”. According to Pearson and Raeke (2000), a patient’s trust can be defined as a collection of expectations or beliefs that a nurse would conduct himself/herself in a certain manner, and thus, offer a reassuring feeling of reliance or confidence to both the nurse and his/her intent. According to studies by Thom, Hall, and Pawlson (2004), Shenolikar et al. (2004), as well as Duberstein, Meldrum, and Fiscella (2006), there exists a positive association linking between trust, the nurse-patient relationship, and patient satisfaction. Seeing the importance that trust plays in a nurse-patient relationship, there was need to include the patient’s trust, along with the nurse’s emotional intelligence, as forecasters of the relationship between the patient and the nurse. In this case, trust was evaluated with the help of the scales given by Hall et al. (2002). The value for the Cronbach’s alpha (α) for the trust of the patient was found to be 0.92. Initially, patients had been invited and instructed to respond to 11 items by means of a five-point answer set (1 = strongly disagree to 5 = strongly agree), which was applicable to their diabetes. Higher score values on the scale was a sign of superior levels of patient’s trust towards the nurse.

Linkage

The emotional intelligence of clinical nurses in the real situation is connected to the nurse-patient relationship and the effective caring behaviors. Therefore, being aware of the emotional needs of a patient regarding the nurse-patient relationship and the effective caring behaviors will enable health organizations (and nurses) to implement changes with the intention of meeting the patients’ needs. Patients’ perception of their level of confidence in their satisfaction will be related to the nurse-patient relationship and the effective caring behaviors. Again, it is important to take care of the nurse-patient relationship and attain enhanced patient satisfaction by providing care that is both emotionally responsive and clinically sound. Training nurses in emotional intelligence could be as significant as choosing applicants to medical educational institutions with high emotional intelligence.

References

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Cronin, S.N., and Harrison, B. (1988). Importance of nurse caring behaviors as perceived by patients after myocardial infarction. Heart Lung, 17, 374-80.

Damasio, A. R. (1994). Descartes’error: Emotion, reason, and the human brain. New York: Grosset/Putnam.

Duberstein, P., Meldrum, S., Fiscella, K., Shields, C. G., & Epstein, R. M. (2006). Influences on patients’ ratings of nurses: Nurses demographics and personality. Patient Education and Counseling.

Elam, C. L. (2000). Use of “emotional intelligence” as one measure of medical school applicants’ noncognitive characteristics. Academic Medicine, 75 (5), 445-446.

Epstein, R. M., & Hundert, E. M. (2002). Defining and assessing professional competence. JAMA: The Journal of the American Medical Association, 287, 226-235.

Gesell, S. B. & Wolosin, R. J. (2004). Inpatients’ rating of care in 5 common clinical conditions. Quality Management Health Care, 13(4), 222-227.

Goleman, D. (1998). Working with Emotional Intelligence. New York: Bantam.

Graugaard, P. K., Holgersen, K., Eide, H., & Finset, A. (2005). Changes in nurse-patient communication from initial to return visits: a prospective study in a haematology outpatient clinic. Patient Education and Counseling, 57 (1), 22-29.

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LeBlang, T., Basanta, W. E., and Kane, R. J. (1996). The Law of Medical Practice in Illinois, 2^nd ed. Rochester, N.Y: Lawyers Cooperative Publishing.

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Magee, M., & D’Antonio, M. (1999). The Best Medicine. New York: St. Martin’s.

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Pearson, S. D., and Raeke, L. H. (2000). Patients’ trust in nurses: Many theories, few measures, and little data. J Gen Intern Med., 15 (7), 509–513.

Salovey, P., & Mayer, J. D. (1990). Emotional intelligence. Imagination, Cognition and Personality, 9 (3), 185-211.

Shenolikar, R. A., Balkrishnan, R. & Hall, M. A. (2004). How patient-physician encounters in critical medical situations affect trust: results of a national survey. BMC Health Service Research, 4 (24), 1-6.

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Vitello-Cicciu, J. M. (2003). Innovative leadership through emotional intelligence. Nursing Management, 24 (10), 28-34.

Wagner, P. J., Moseley, G. C., Grant, M. M., Gore, J. R., & Owens, C. (2002). physicians’ Emotional Intelligence and Patient Satisfaction. Family Medicine, 34 (10), 750-754.

Yamashita, M., Forchuk, C. and Mound, B. (2005). Nurse Case Management: Negotiating Care Together Within a Developing Relationship. Perspectives in Psychiatric Care, 41(2), 62–70.

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