Journal of Psychiatric and Mental Health Nursing, 2014, 21, 106–113
Emotional intelligence, life satisfaction and subjective happiness in female student health professionals: the mediating effect of perceived stress D. RUIZ-ARANDA1 1
Ph D,
N. EXTREMERA2
2
Ph D
& C. PINEDA-GALÁN3
Ph D
3
Lecturer, Senior Lecturer, Faculty of Psychology, and Senior Lecturer, Faculty of Health Sciences, University of Málaga, Málaga, Spain
Keywords: emotional intelligence,
Accessible summary
happiness, health professions, MSCEIT, perceived stress, satisfaction with life
•
Correspondence: D. Ruiz-Aranda Departamento de Psicología Básica Facultad de Psicología Universidad de Málaga Campus de Teatinos s/n 29071 Málaga
•
Spain E-mail:
[email protected] Accepted for publication: 17 February 2013 doi: 10.1111/jpm.12052
• •
The relevance of the scientific study of happiness and well-being in health professionals has been emphasized. In this sense, the intelligent use of emotions is considered essential for one’s psychological adaptation and well-being. Health professionals have to deal with high levels of occupational stress and students in nursing, and allied health sciences need to develop the ability to manage their own emotions because an affective deficit in self-regulation can lead to lower subjective well-being. This study aimed to examine the relationship between emotional intelligence (EI) and well-being indicators (life satisfaction and happiness) in a 12-week follow-up study in female student health professionals. Moreover, we examined the mediator role of perceived stress on the relationship between EI and well-being indicators. Our study found that emotionally intelligent people evaluate situations as less stressful which results in a higher satisfaction with life and happiness. Specific EI training programmes to help students to cope with the challenges they face should be included in the curriculum for students in nursing and allied health sciences.
Abstract The objective of the present study was to extend previous findings by examining the relationship between emotional intelligence (EI) and well-being indicators (life satisfaction and happiness) in a 12-week follow-up study. In addition, we examined the influence of perceived stress on the relationship between EI and well-being. Female students from the School of Health Sciences (n = 264) completed an ability measure of emotional intelligence. After 12 weeks, participants completed the Perceived Stress Scale, Satisfaction with Life Scale and Subjective Happiness Scale. Participants with higher EI reported less perceived stress and higher levels of life satisfaction and happiness. The results of this study suggest that perceived stress mediates the relationship between EI and well-being indicators, specifically life satisfaction and happiness. These findings suggest an underlying process by which high emotional intelligence may increase well-being in female students in nursing and allied health sciences by reducing the experience of stress. The implications of these findings for future research and for working with health professions to improve well-being outcomes are discussed.
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© 2013 John Wiley & Sons Ltd
Emotional intelligence, well-being and perceived stress
Introduction Positive psychology has captured the interest of scientists over the last decade (Seligman & Csikszentmihalyi 2000, Seligman 2003). This new line of research has emphasized the relevance of the scientific study of happiness and wellbeing in psychology. Whereas the literature on health professionals has concentrated on the role of individual differences as predictors of psychological maladjustment such as burnout or job stress (Edwards et al. 2000), the body of research on the influence of personal resources over positive aspects of human beings such as well-being and happiness has grown substantially in recent years (Lyubomirsky 2001, Tkach & Lyubomirsky 2006, Sin & Lyubomirsky 2009). Theoretical models of positive psychology could be enriched by the inclusion of differences in the processing of affective information because the intelligent use of emotions is considered essential for one’s psychological adaptation and well-being (Brackett & Mayer 2003). People differ in their abilities to process and use emotional information. These abilities have been conceptualized under the general term of emotional intelligence (EI), which is defined as the ability to perceive, appraise and express emotion accurately; the ability to access and generate feelings when they facilitate cognition; the ability to understand affectladen information and make use of emotional knowledge; and the ability to regulate emotions to promote growth and well-being (Mayer & Salovey 1997). Research has shown that EI is not just a protective factor against negative emotional states, but is also directly related to positive emotions and psychological well-being (Mayer et al. 1999, Brackett & Mayer 2003; Brackett et al. 2006; Brackett et al. 2011; Zeidner et al. 2012). In this sense, EI has been theoretically related to several important real-life outcomes such as positive mental health and subjective well-being (Mayer et al. 2008). There are different theoretical approaches to EI. On the one hand, ability EI (e.g. Mayer & Salovey 1997) conceives of EI as an ability that must be assessed by maximum performance tests. On the other hand, trait EI (e.g. Petrides & Furnham 2003) conceives of EI as a constellation of emotion-related dispositions that must be assessed by selfreport questionnaires. Tests of ability capture maximal performance, whereas tests of self-report capture typical performance. Some studies point out that higher EI measured by ability tests is associated with well-being indicators (Brackett & Mayer 2003, Extremera et al. 2011a). Two important aspects of individuals’ emotional well-being are life satisfaction and happiness (Lyubomirsky 2001, Fujita & Diener 2005). Although many studies have examined the relationship between EI evaluated by self-report © 2013 John Wiley & Sons Ltd
measure and life satisfaction and happiness (Shulman & Hemenover 2006, Extremera et al. 2011b), studies using ability measures are rather scarce. Comparing the two main approaches, we can see that EI measured as a trait is apparently a better well-being predictor. This may be because self-report scales have ‘common method variance’, i.e. the use of self-reports for both predictor and criterion variables could account for their relationship, owing to response dispositions (Martins et al. 2010). On the other hand, the measure of ability of EI assesses how people perform certain tasks and solve emotional problems. The main advantage of these measures is that the results are based on the actual ability of the person executing a task and not only on their belief in such ability. Therefore, these scores are barely affected by the self-concept or social desirability (Mayer et al. 2002, Rivers et al. 2008). On the other hand, some authors have pointed out that, beyond the direct influences of EI on psychological wellbeing, emotional abilities might influence significantly with stress in the prediction of well-being (Gohm et al. 2005). In this sense, processing of emotional information helps our better psychological adjustment and greater adaptation to the demands of our environment, contributing to greater well-being. In this vein, some variability in EI scores might explain how situations in one’s life are appraised as stressful (Davis & Humphrey 2012). Therefore, health professionals with higher EI may be more able to identify a specific emotion during stressful situations, use less time to pay attention on their emotional reactions and correctly invest the cognitive resources which allow them to experience more positive emotions and reduce negative ones (Montes-Berges & Augusto 2007). It may be that those individuals who deal with their emotions and repair their negative moods cope with and minimize the impact of stressful events. EI might to help assimilate the experience, making it more positive and less threatening. Why could EI be an important factor in nursing and allied health sciences? Some professions, by their characteristics and the context in which they are exercised, are more likely to be stressful. Nursing is one of them. Some studies have shown that EI allows health professions to develop therapeutical relationships to meet patients and their families and to better manage stress (Cadman & Brewer 2001). Nurses feel a professional obligation to emotionally engage with patients, families and colleagues, and this engagement is often stressful (McQueen 2004). Perceiving, understanding and managing emotion are core health professional skills (Freshwater 2004, Freshwater & Stickley 2004, McQueen 2004). Specifically, nursing and health sciences students face significant challenges to their mental health from the clinical events of suffering and grief that they experience and because sometimes they are not 107
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prepared to deal with the emotional needs of their patients (Timmins et al. 2011). Also, previous research has shown a clear effect of the EI on stress and health in the sense that EI emerges as a protective factor against stress in professional health sciences (Augusto et al. 2008). Health professionals have to deal with high levels of occupational stress, and students need to develop the ability to manage their emotions because an inability to self-regulate emotions can lead to an increase in stress and anxiety (Montes-Berges & Augusto 2007, Por et al., 2011). In the literature, we found gender differences in variables related to emotional adjustment. Specifically, women experience a higher incidence of depressive and anxiety disorders than men (Compas et al. 1993, Nolen-Hoeksema 2000). Also, some empirical evidences on gender differences in life satisfaction and happiness have been reported (Nolen-Hoeksema & Rusting 2003). For these reasons, it seems necessary to analyse the role of EI on well-being in female student health professionals. Previous studies have analysed the predictive role of EI on well-being using cross-sectional designs, which does not allow causal conclusions (Palmer et al. 2002, Lopes et al. 2003). In this study, however, we employed a 12-week prospective design to assess the predictive validity of EI on well-being. It has been found that EI is associated with well-being indicators (Schutte et al. 2002), but the psychological mechanism through which EI might predict wellbeing is unclear yet. In this context, whereas emotional abilities are directly related to well-being (Brackett et al. 2006), other variables may play an important role in the emotional abilities/well-being relationship. One such variable may be perceived stress. Therefore, in considering a mediation model in which perceived stress is conceptually viewed as a causal mechanism accounting for the EI/well-being link, one may also consider why emotionally intelligent people who have the ability to perceive, facilitate, understand and manage their own and others’ moods may be more likely to cope effectively with stressful experiences, responding in a less stressed way (Gohm et al. 2005). On the other hand, experiencing chronic interpersonal stressors may have considerable influence on the development of negative emotional responses that can lead to lower levels of happiness (Schiffrin & Nelson 2010), suggesting that less stressed people may experience increased levels of well-being. Hence, the assessment of perceived stress as a potential mediator of the link between EI and emotional well-being seems to be warranted. The objective of the present study was to investigate perceived stress as a possible mediator between EI and well-being indicators (life satisfaction and happiness) 12 weeks later. We hypothesized that perceived stress would 108
influence the predictive relationship between EI and satisfaction with life and happiness in a sample of female student health professionals.
Method Participants and procedure Participants were 264 female students from a University in Spain. The sample was selected by simple random sampling. Specifically, 38.3% of the participants were students of physiotherapy, 33.3% students of nursing, 17% students of occupational therapy and 11.4% students of chiropody. Their mean age was 21.41 years [standard deviation (SD) 4.66; range 18–50]. Participants signed an informed consent form and completed the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT), and they returned 12 weeks later to complete questionnaires [Perceived Stress Scale (PSS), Satisfaction with Life Scale (SWLS) and Subjective Happiness Scale (SHS)]. The research study protocol was approved by the Technical Council of the Ethical Committee of the University.
Measures EI The MSCEIT (MSCEIT v.2.0; MHS, Toronto, Canada; Mayer et al. 2002) was used to assess EI. This instrument is a measure of ability or performance that assesses people’s emotional skills in the performance of various tasks and processing of emotional situations. The MSCEIT assesses the four branches of the theoretical model of Mayer & Salovey (1997): emotional perception, emotional facilitation, emotional understanding and managing emotions, both intrapersonal and interpersonal, which combine to form two areas (experiential and strategic), with a total score that includes all branches. The psychometric properties of the MSCEIT v.2.0 are appropriate and convergent, and the instrument has discriminant validity (Mayer et al. 2002). The Spanish version of this instrument has also shown satisfactory psychometric properties (Extremera & Fernández-Berrocal 2009). In this study, we scored the MSCEIT using consensus criteria. In that method, each one of a respondent’s answers is scored against the proportion of the sample that endorsed the same MSCEIT answer. The scale had adequate reliability in this study (Cronbach’s alpha, 0.76). Perceived Stress The short form of the PSS (Cohen et al. 1983) measures the degree to which situations in one’s life are appraised as stressful. This shortened version consists of four items © 2013 John Wiley & Sons Ltd
Emotional intelligence, well-being and perceived stress
assessed on a scale of five response options from 0 = ‘never’ to 4 = ‘very often’. Participants completed the Spanish version of the short form of the PSS (Remor & Carrobles 2001). The Cronbach’s alpha in this study was 0.54. Satisfaction with life The SWLS (Diener et al. 1985) measures global cognitive judgements of satisfaction with one’s life. The scale comprises five self-referencing statements on perceived global life satisfaction and requires subjects to rate the extent to which they agree or disagree with each statement on a 7-point scale (1 = strongly disagree to 7 = strongly agree). Participants completed the Spanish version of the SWLS (Atienza et al. 2003). The scale had adequate reliability in this study (Cronbach’s alpha 0.77). Happiness The SHS (Lyubomirsky & Lepper 1999) is a four-item measurement of global subjective happiness. Two items refer to how happy people consider themselves to be using absolute ratings and ratings relative to peers. The other two items provide brief descriptions of happy and unhappy individuals and ask respondents the extent to which each characterization describes them. All items are measured on a scale of 1–7 and higher scores essentially reflect higher
levels of subjective happiness. The scale has acceptable psychometric properties. In this study, the Cronbach’s alpha was 0.48.
Results Descriptive and correlation analyses Means, SDs and Pearson correlations for the study variables are shown in Table 1. Table 1 shows that the total EI score showed a significant negative relationship with perceived stress and significant positive correlations with happiness and satisfaction with life. The bivariate relationship between perceived stress and satisfaction with life was negative and negative correlations were also found between perceived stress and happiness. Analysis of EI branches separately showed negative correlations between all branches and perceived stress and positive correlations with satisfaction with life and happiness. The only statistically significant correlation, however, was between emotional regulation and perceived stress and between emotional regulation and satisfaction with life and happiness. Descriptive statistics for the scales for different professional health sciences separately are shown in Table 2.
Table 1 Means, SDs and intercorrelations between measures
1. 2. 3. 4. 5. 6. 7. 8.
Total EI Emotional perception Emotional facilitation Emotional understanding Emotional regulation Satisfaction with life Subjective happiness Perceived stress
M
SD
1
0.44 0.48 0.42 0.45 0.39 5.34 5.20 2.19
0.04 0.07 0.05 0.06 0.06 0.94 0.70 0.45
–
2
0.71** 0.70** 0.59** 0.67** 0.16* 0.14* -0.13*
3
4
5
6
7
8
– -0.42**
–
– 0.40** 0.16** 0.20** 0.05 0.02 -0.05
– 0.17** 0.40** 0.10 0.11 -0.09
– 0.25** 0.08 0.10 -0.08
– 0.20** 0.17** -0.13**
– 0.58** -0.46**
n = 264 EI, emotional intelligence; SD, standard deviation. * P < 0.05; **P < 0.01.
Table 2 Descriptive statistics for the scales for different professional health sciences
Total EI Emotional perception Emotional facilitation Emotional understanding Emotional regulation Satisfaction with life Subjective happiness Perceived stress
Physiotherapy mean (SD)
Nursing mean (SD)
Occupational therapy mean (SD)
Chiropody mean (SD)
0.45 0.49 0.43 0.46 0.40 5.41 5.17 2.20
0.42 0.46 0.41 0.44 0.39 5.41 5.23 2.22
0.43 0.50 0.41 0.46 0.39 5.43 5.32 1.95
0.44 0.49 0.43 0.45 0.38 5.08 5.02 2.39
(0.04) (0.07) (0.05) (0.06) (0.06) (0.09) (0.07) (0.05)
(0.03) (0.08) (0.04) (0.06) (0.05) (0.09) (0.06) (0.04)
(0.04) (0.07) (0.06) (0.06) (0.06) (0.09) (0.07) (0.04)
(0.04) (0.08) (0.06) (0.05) (0.06) (1.03) (0.07) (0.04)
EI, emotional intelligence; SD, standard deviation.
© 2013 John Wiley & Sons Ltd
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Table 2 shows nursing student scoring less than the other students on EI and scoring higher on perceived stress than students of physiotherapy and occupational therapy.
Perceived stress
−0.46 **
−0.13* Emotional intelligence
Satisfaction with life
0.16* (0.10, ns)
Mediation analyses In this case, mediation can be said to occur when: (1) the EI (independent variable) is associated with perceived stress (the mediator); (2) the mediator is associated with satisfaction with life and happiness (dependent variable); (3) the EI and satisfaction with life and happiness are significantly associated in the absence of the mediator; and (4) that relationship is significantly reduced when controlling for the influence of the mediator (Baron & Kenny 1986). For complete mediation, beta (at the direct effect) must be (not significantly different from) 0. A mediator model of the relation between EI and satisfaction with life and happiness was devised according to Baron & Kenny (1986). We conducted different mediation analyses to examine whether the relationship between EI and satisfaction with life and happiness 12 weeks later was mediated by perceived stress. Because high correlations between the overall EI and branch scores were found, in the mediation analyses, we used overall EI scores as a global construct. Moreover, no significant relationships were found between EI branches and satisfaction with life, happiness and perceived stress except for the managing emotions branch, which is a necessary prerequisite for conducting mediation analyses. We conducted a series of three regressions to test for a mediation effect of perceived stress on the relationship between EI and satisfaction with life on the one hand, and happiness on the other. The mediational role of perceived stress on the relationship between EI and satisfaction with life and happiness is represented in Figures 1 and 2, respectively. As shown in Figures 1 and 2, the mediations were total. Analysis of the EI–well-being relationship (satisfaction with life and happiness) indicated that the previously significant relationship between these two variables (b = 0.16, P < 0.05 for satisfaction with life; b = 0.14, P < 0.05 for happiness) is reduced in magnitude and rendered not significant by controlling for perceived stress. The beta weight when EI was regressed alone on satisfaction with life was 0.16. When perceived stress was entered into the equation, the beta weight dropped from 0.16 to 0.10. With respect to happiness, the beta weight when EI was regressed alone on happiness was 0.14, and when perceived stress was entered into the equation, the beta weight dropped to 0.09. 110
Figure 1 Model of relationships between emotional intelligence, perceived stress and satisfaction with life. Values presented are standardized regression coefficients. The value in parentheses represents the coefficient for the indirect (i.e. mediated) path
Perceived stress −0.4**
−0.13*
Emotional intelligence
0.14* (0.09, ns)
Happiness
Figure 2 Model of relationships between emotional intelligence, perceived stress and happiness. Values presented are standardized regression coefficients. The value in parentheses represents the coefficient for the indirect (i.e. mediated) path
Discussion In the present study, we analysed the influence of EI, using a measure of ability (MSCEIT), on life satisfaction and happiness in a sample of female student health professionals. In general, our results suggest that EI is an important predictor of well-being. The hypothesis that emotional processing influences subjective well-being has been explored in different studies (Brackett & Mayer 2003, Brackett et al. 2006), but research has yet to clarify why people with high emotional abilities, specifically student health professionals, report more life satisfaction and happiness. In the present study, we tried to extend previous cross-sectional works by analysing the mediating role of perceived stress in the relationship between EI, as assessed through an ability measure, and life satisfaction and happiness 12 weeks later in a sample of students of health sciences (Palmer et al. 2002, Lopes et al. 2003). Consistently with previous studies, people with less perceived stress report higher levels of life satisfaction and happiness (Extremera et al. 2009, Schiffrin & Nelson 2010). In addition, our study found that students of health sciences with greater EI reported lower perceived stress. Emotionally intelligent people evaluate situations as less stressful, which results in a higher satisfaction with life and happiness. Those who are able to understand and regulate their emotions should be able generally to maintain a better © 2013 John Wiley & Sons Ltd
Emotional intelligence, well-being and perceived stress
outlook on life and experience better emotional health. In this sense, they are able to use the emotional information to cope with emotional problems. People with high EI feel more in control of their environment because they can manage the negative emotions which life events produce in them. Students of health sciences with higher EI evaluate their situations as less aversive because they are able to identify, use, understand and implement strategies to regulate their emotions, which results in greater life satisfaction and happiness. Specifically, in this study, female nursing students appear to have less EI than other students of health sciences. In this sense, it would be very positive for nursing professionals and students to use and develop these emotional abilities to increase well-being. We acknowledge several limitations in this study. First, the sample is made up exclusively of women, which means that the results obtained cannot be generalized to the male population. The works carried out in this area show that men and women differ in terms of their emotional abilities (Brackett et al. 2004). Future research should extend the study to include the male population and analyse the existence of possible differences. Furthermore, previous studies have shown gender to be associated with well-being (Fujita et al. 1991, Nolen-Hoeksema & Rusting 2003). Second, empirical research has been interested in examining personal and demographic factors that affect well-being (Keyes et al. 2002). Future studies will need to control personality to confirm our findings. Along with extraversion and neuroticism, a substantial body of research has demonstrated that personality variables are significantly related to subjective well-being and happiness (Lucas et al. 1996, DeNeve & Cooper 1998, Hills & Argyle 2001). Third, the conclusions of the present study may be limited by the low reliability of some of the scales. In order to generalize our findings, further studies with another sample or scales to assess the variables analysed in this study would be necessary. In future studies, it would be interesting to explore other psychological mechanisms through which EI may influence life satisfaction and happiness. Other variables might mediate the effect of EI on life satisfaction and happiness. One such variable is optimism–pessimism, which is considered an important predictor of psychological well-being (Scheier et al. 2001). In this field, studies have also shown that these constructs have implications for the manner in which people cope with stressful experiences and the success with which they cope in their lives, and this is related to greater life satisfaction (Chang et al. 1997) and less perceived stress (Chang 2002). Another variable that can moderate the effect of EI on life satisfaction and happiness is gender because men and women show different baseline rates of emotional and affective deficits (Brackett et al. © 2013 John Wiley & Sons Ltd
2004). Moreover, it would also be interesting to examine whether the explanatory mechanism proposed in this study also helps explain other types of well-being such as eudaemonic well-being.
Implications for health professionals Beyond the limitations, the present study provides insight into how emotional abilities influence perceived stress and well-being, which may help to design psychological interventions aimed at increasing these abilities in students of health sciences. Insufficient emotional preparation ranked as the highest overall stressor in Por’s (2005) examination of stressors associated with clinical practice among health science students. Perceiving, understanding and managing emotions are important to a profession that requires sensitivity within relationships (Freshwater & Stickley 2004, McQueen 2004, Reeves 2005). Sometimes, these relationships become stressful situations. Students need a focused and clear understanding of the central place of emotion in practice relationships to effectively execute the nursing and health profession role (Cadman & Brewer 2001, McKinnon 2005). Montes-Berges & Augusto (2007) indicating that undergraduate nursing students who recognize, pay attention to and regulate emotion moderately well are more able to cope and rebound from stress. Their findings might mean that students who posses EI are more likely to cope with stressful situations that arise in their clinical practice and consequently improve their well-being. Therefore, it seems reasonable to develop specific EI training programmes, based on the ability model of EI, to help students of health sciences to cope with the challenges they face. Educational EI programmes that explicitly work with the emotional abilities based on the capacity to perceive, use, understand and regulate emotions enhance diverse relevant dimensions of psychosocial adjustment and well-being. It would be interesting to create a programme focused on making students more aware of the emotional processes and helping to reason and understand the emotions. This training should focus in part on developing understanding own emotions, in order to enhance coping in individuals experiencing stress in daily life. This training could even be included in the curriculum for these students. In this sense, some authors propose this EI training could be developed through a tutorial action programme. The tutorial action programme is an optional cross-curriculum programme, for students and lecturers, which is presented as an opportunity to develop students’ skills and to have a mentor to lead and support decisions (Montes-Berges & Augusto 2007). 111
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In conclusion, our study found that emotionally intelligent female evaluates situations as less stressful which results in a higher satisfaction with life and happiness, and
this have important implications for students of health sciences.
Compas B.E., Ey S. & Grant K.E. (1993) Tax-
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