Emotional intelligence and it's relation to stress coping strategies and academic achievement among Faculty of Nursing students

Introduction

Nursing is a challenging profession because it requires expertise in a broad range of skills and abilities. The nursing profession demands the nurse in the process of care to interact with the patients, the medical fraternity, and with the health care workers constantly. This interaction is not just conversation, but also a complex process that involves nurse perception, understanding of the patient emotions, and utilization of the perceptions; in order to manage patient problems that achieve the goal of effective patient care which facilitated when nurses having emotional intelligence (EI)(1).

Moreover, to be able to practice nursing, the nursing student should have the ability to understand the views and needs of a wide variety of people; as well as to remain sensitive and empathic to patient concerns; be able to keep personal emotional reactions in perspective; handle stress and promote social responsibility which is encompassing within the framework of EI (2). Goleman defined EI as the capacity for recognizing one's own feelings and those of others, motivating oneself and others, and managing emotions well in own self and in the relationships (3).

Nursing and medicine are professions that have a lot of social demands and stress (4). Thus nursing students, practice in the clinical setting which has a major source of stress. The mild levels of stress can have a positive effect on students by offering alternative solutions to problems and increasing motivation, while high stress levels can lead to depression (5). Therefore, determining main stress sources is fundamental in order to know which skills must be mastered and, in this way, contributing to the future of health and, indirectly, to have a better care of ill patients (6).

Moreover, nursing students must be prepared to communicate and make emotional connections with the diverse patient populations from various cultures with a highly stressful environment. Emotional responses to patient care, especially in the highly stressful environments, requires the ability to handle stress which based on the skills such as; accurately recognize the emotional state of patients; use emotions to facilitate thinking and reasoning; manage the emotions in others as well as one’s self; and understand emotions. These are the attributes of the emotionally intelligent nurse (7).

Recently, authors of nursing knowledge have emphasized the importance of EI in enhancing nursing students' performance (8). Academic performance in faculty can be adversely affected by stress and ability of students to manage their stress. Stress among college students was identified as the number one impediment to academic performance (9).  EI played a significant role in process of student coping. Stress and the way it is handled by students have a direct relationship to academic performance and affects academic performance and grade point average (GPA) (10).As well it was found that those who had high EI; had low perceived stress; controlling their emotions; and had high adaptability to the environment. Also, it is founded that those who have high EI show high academic performance (11).

Significance of the study

Today, the nurses’ job requires them to gain the knowledge of self, interpersonal and intrapersonal skills. Subsequently, nurses should use the features of EI in their interactions with colleagues and patient (12). Also, the selection processes of most nursing programs today are solely based on academic ability; however, it is clear that non-academic skills, such as empathy, self-efficacy, and emotional stability which considered under the umbrella of EI are important for the success in nursing school and in the nursing profession (2). In Egypt Abouelfettoh and Al-Ateeq (2013) found that students’ high EI level was significantly correlated with low perceived stress score (13).Therefore, there is need to study EI and its relation to stress coping strategies and academic achievement among nursing students.

Aim of the study

The aim of the current study is to assess emotional intelligence and it's relation to stress coping strategies and academic achievement among Faculty of Nursing students.

Research questions:

• What is the relationship between emotional intelligence and stress coping strategies among nursing students?
• What is the relationship between emotional intelligence and academic achievement among nursing students?
• What is the relationship between stress coping and academic achievement among nursing students?

Subjects and Methods

Research design:

A descriptive correlational research design was used to achieve the aim of the current study.

Setting:

The study was conducted at the Faculty of Nursing, Minia University.

Subjects:

A representative sample of 35% of total number of nursing students was used.  It was consisted of the nursing students at 1st, 2nd, 3rd, and 4th academic year during the academic year 2016-2017. Total number of subjects was (384) students.

Tools of Data collection:

Two tools was used for the data collection

Tool (I) – it consisted of two parts:

Part I: Socio- Demographic data sheet was attached with tools to get information about nursing students. It was including student code, gender, age, residences, academic year and last academic achievement (which was classified into: Fail, satisfactory, good, very good, and excellent).      

Part II: Emotional intelligence scale:

This tool was developed by Abo Elela (2004) (14) and was adopted by the researcher to measure nursing student's EI. It consisted of 35 items with five components of EI as follows: self-awareness, self-management, self-motivation, empathy and relationship management. Each statement was measured by four point Likert scale ranged as (1 = scarcely, 2= sometimes, 3 = often, and 4 = always). The scoring system of total EI was 35 to 140.

Tool (II) – ways of coping questionnaire:

This tool was developed by Folkman and Lazarus (1985) (15) and modified by the investigator to measure stress coping strategies.  It was consisting of 66 items.The subscales that represent the different ways of coping are confrontive, distancing, self-controlling, seeking social support, accepting responsibility, escape-avoidance, planful problem solving, and positive reappraisal. Each subscale was measured by using four point Likert scale ranged as follows (0 = not used, 1 = used somewhat, 2 = used quite a bit, and 3 = used a great deal). Nursing students were asked to direct their ratings of real life stresses experienced during the last 7 days. The scoring system of total stress coping strategies was 0 to 150.

Tools Validity and reliability

The tools were submitted to a panel of five experts in the field of nursing administration at Minia and Assuit University confirmed its validity. Modifications on the tools were done according to the panel judgment in relation to appropriateness of the content and accuracy of items.

Reliability of the tools (tool І, ІІ) was performed to confirm consistency of tool. The internal consistency measured to identify the extent to which the items of the tool measure the same concept and correlate with each other by Cronbach’s alpha test.  (Tool I α=0.881, tool II α=0.908).  

Pilot study:

A pilot study was conducted on 10% of participants which equal 40 students to ascertain applicability of the tools: accessibility to study subjects and served to estimate the time required for filling the questionnaire sheets which was 30 minutes. The process of pilot study took two weeks.

Ethical consideration

A written initial approval was obtained from the research ethics committee of the Faculty of Nursing, Minia University. Approval to conduct the study was obtained from the dean, Vice Dean for Education and Student Affairs and heads of departments of Faculty of Nursing at Minia University. Participants were informed that their participation in the study was completely voluntary and acceptance of participants was obtained. Written informed consent was obtained from participating students after explaining the nature and benefits of the study. Each assessment sheet was coded and student names did not appear on the sheets for the purpose of anonymity and confidentiality.

Data collection procedure:

An official letter was granted from the dean, Vice Dean for Education and Student Affairs and heads of departments of Faculty of Nursing at Minia University. This letter was included a brief explanation of the objectives of the study. The researcher interviewed students to explain the nature and purpose of the study. Data collection tools were introduced to students to be filled. Data was collected on Sunday and Monday per week during the academic year 2016-2017.

Statistical design:

Statistical analysis was done by using Statistical Package for the Social Science (SPSS 20.0). Quality control was done at the stages of coding and data entry. Data were presented by using descriptive statistics in the form of frequencies and percentage for qualitative variables, and mean & standard deviation (SD) for quantitative variable. Correlation coefficient test was also used between emotional intelligence, stress coping strategies and academic achievement and statistical significance was considered at p < 0.05.

Results

Table (1): Distribution of nursing students according to their Socio-demographic data

Table (1) shows that about two third (65.4%) of nursing students gender were female. In relation to age, more than half (54.7%) of nursing students was ranged from (18-20) years old, with mean age (20.5 ±1.3 years).

Concerning the residence, it was noted that the majority of nursing students (79.9%) were from rural area. As regards to their academic year, the majority of students (30.5%) were at 1st academic year. About the last academic achievement, it was found that most high percent of students (40.9%) have got very good degree.

Figure (1): Levels on nursing students' emotional intelligence total scores

Figure (1) shows that more than half (52.6%) of nursing students had moderate level of EI, (45.8%) of nursing students had high level of EI, and (1.6%) of nursing students had low level of EI. The Figure also, shows that the highest level of EI components was for the empathy component with percentage (84.6%), followed by self-awareness (76.0%), self-motivation (75.5%), belonging to the relationship management (74.5%), and finally self-management component (48.4%) among nursing students.

Table (2): Mean scores of nursing students as regard to total scores of stress coping strategies

Table (2) displays that the nursing students had the highest mean scores, for the following stress coping strategies, escape avoidance (12.7±3.9), followed by positive reappraisal (12.2±3.6), then self-controlling (12.2±3.4), while the lowest mean score was for accepting responsibility strategy (7.9±2.3).This table also shows the relative scores of the eight coping strategies, as the higher score of using stress coping strategies was for accepting responsibility strategy (relative score 15%) but the  lower relative score was for distancing strategy (relative score 11%).

Figure (2) shows that the nursing students had higher mean scores (29.9±7.9) for problem focused coping strategies, than emotional focused coping strategies (28.7±6.9).

Table (3): Correlation between emotional intelligence and stress coping strategies among nursing students

**Correlation is significant at the 0.01 level (2-tailed).

* p≤0.05 (significant)

PCC: P – value based on Pearson correlation coefficient

Table (3) shows that there were highly statistically significances differences between seven stress coping strategies and EI scores (p= 0.000), while escaping avoidance strategy was the only one that had no statistically significant differences with EI and negatively correlation (r= -0, 060, p= 0.240).

Table (4): Correlation between emotional intelligence and last academic achievement among nursing students

                           * p≤0.05 (significant)                             **Correlation is significant at the 0.01 level                             

      PCC: P – value based on Pearson correlation coefficient

Table (4) shows that only self-management component of EI had statistically significant differences with academic achievement (r=0.101 & p=0.01). Also, there was no significant correlation between total EI scores and last academic achievement.

Table (5): Correlation between stress coping strategies and last academic achievement among nursing students

**Correlation is significant at the 0.01 level

* p≤0.05 (significant)

PCC: P – value based on Pearson correlation coefficient

Table (5) shows that there was only statistically significant difference and positive correlation between escaping avoidance strategy and last academic achievement (r= .125 & p= .040). Also, there was statistically significant positive correlation between total stress coping strategies and academic achievement (r= 0.125, P= 0.001).