Emotional quotient (EQ) – or emotional intelligence – means controlling the internal emotions to reduce stress and to have a positive relationship and be able to communicate with other people (Segal et al, 2019). In other words, EQ refers to how we categorise and control our emotions, as well as how we respond to the emotions and feelings of others. EQ contains five components, namely self-awareness, self-regulation, social skills, empathy and motivation (Craig, 2020).
Nowadays, EQ is more important than intelligence quotient (IQ) for success because with EQ, people can receive signals from others correctly and act in a timely manner (Bressert, 2018). Cotrus et al (2012) believe that 80% of people's success depends on EQ, with IQ only accounting for 20% of their success. In a stressful situation, EQ helps people to easily adapt to the situation and even recover faster (Lea et al, 2019). Tafazoli et al (2012) found that EQ is one of the most important factors in careers, like midwifery, that deal with emergency situations. A study by Rakhshani et al (2018) showed that there was a significant negative relationship between EQ and job stress. A study by Miri et al (2013) on medical students, including midwifery students showed that there was no significant relationship between EQ scores and educational stress but there was a significant relationship between EQ and domains of academic stress, including personal favorites, reaction to stress and performance in stressful situations.
The relationship between EQ and coping with stress was examined by Noorbakhsh et al (2010) and their results showed that EQ was positively related to problem-focused and positive emotional-focused coping styles, and negatively associated with a negative emotional-focused coping style. Another study by Moradi et al (2011) also showed that there was a significant relationship between EQ and five items of coping with stress strategies (problem-solving, social-support seeking, cognitive evaluation, somatic inhibition and emotional inhibition). Since there is paucity of published research on the relationship of EQ and coping with stress among midwives, this study was designed to evaluate this relationship among midwives employed in university hospitals in Ahvaz, Iran.
Methods
This was a cross-sectional study on 300 midwives employed in the university hospitals of Ahvaz, Iran. Midwives with an associate or higher degree in midwifery and with at least three years of service were recruited.
Participants
A total of 300 midwives from university hospitals in Ahvaz were recruited non-randomly and requested to complete the demographic, EQ and Endler and Parker's (1990) Coping Inventory for Stressful Situations (CISS) questionnaires.
Inclusion/exclusion criteria
Midwives with at least three years of service in the maternity ward as well as having at least an associate degree were recruited for this study. Midwives with known psychological diseases were excluded from the study.
Data collection
A demographic questionnaire, the Baron Emotional Quotient Inventory (BAR-ON EQ I) and CISS was used to collect data. The demographic questionnaire included questions regarding age, education, years of service, type of employment and marital status. The validity of this questionnaire was checked using content validity.
The BAR-ON EQI has 133 questions in five domains including positive impression, intrapersonal, interpersonal, stress management, adaptability and general mood. The five-item Likert scale ranging from one for ‘very seldom or not applicable to me’ to five for ‘very true or true for me’ was used for scoring. The questions were categorised into 15 subscales. The total score of BAR-ON questionnaire range from 50–150. The scores 50–85 indicate the area of enrichment, those ranging from 86–115 indicate effective functioning, and those between 115–150 indicate enhanced skills. This questionnaire takes 40–50 minutes to complete and is suitable for people who are 17 years old and above (BAR-ON, 1997). The psychometric evaluation of the Persian version of this questionnaire was done by Khodadady et al (2012) in Iran.
The CISS questionnaire was developed by Endler and Parker (1990), and consists of 48 items. This questionnaire covers three main areas of coping behaviour including emotion-oriented, task-oriented and avoidant. The avoidant area has two dimensions of distraction and social diversion. The Likert scale was used for scoring when ‘never’ scored one and ‘always’ scored five. The score of each domain varies from 16–80. The higher the score of behaviours, the more behaviours are considered as a way of coping. The psychometric assessment of this questionnaire in Iran was done by Ghoraishirad (2010).
Data analyses
All data were entered into SPSS version 22. The Pearson correlation coefficient and the linear regression analysis were used to investigate the correlation between EQ and CISS where p<0.05 was considered significant.
Results
The demographic characteristics of participants are presented in Table 1. More than half of participants (58%) were in the age range of 30–39 years. More than three-quarters of the participants (83.7%) had at least a bachelor's degree. The highest percentage of participants (29.7%) had 6–10 years of service.
| Variables | N=300 |
|---|---|
| Age (y) | |
| Mean ± SD | 35.8 ± 4.9 |
| 20−29 | 48 (16) |
| 30−39 | 174 (58) |
| >39 | 78 (26) |
| Education | |
| Associate degree | 42 (14) |
| Bachelor's degree | 251 (83.7) |
| Master's degree | 7 (2.3) |
| Years of service (y) | |
| Mean ± SD | 7.7 ± 3.7 |
| Marital status | |
| Married | 177 (59) |
| Single | 123 (41) |
| Employment status | |
| Permanent | 230 (76.7) |
| Contractual | 70 (23.3) |
Table 2 shows the relationship between the areas of EQ and CISS. As evident from this table, task-oriented area had a positive significant correlation with the domains of intrapersonal, interpersonal, management, adaptability and general mood. There was a significant negative correlation between emotion-oriented area and all domains of EQ. Also, there was a significant positive correlation between avoidant area and all domains of EQ.
| EQ domains | ||||
|---|---|---|---|---|
| Task-oriented | Emotion-oriented | Avoidant | p-value | |
| CISS domains | ||||
| Intrapersonal | 0.954 | -0.952 | 0.711 | <0.0001 |
| Interpersonal | 0.960 | -0.935 | 0.679 | <0.0001 |
| Stress management | 0.961 | -0.949 | 0.710 | <0.0001 |
| Adaptability | 0.954 | -0.953 | 0.717 | <0.0001 |
| General mood | 0.919 | -0.955 | 0.768 | <0.0001 |
| Total score EQ | 0.959 | -0.959 | 0.717 | <0.0001 |
Results of Table 3 show that with increasing of one unit in the score of EQ, the score of areas of coping with stress, such as task-oriented and avoidant, will increase by 1.28 and 0.31 respectively, while the score of the emotional area will decrease by 0.84 (p<0.001). With a unit increase in the score of intrapersonal skills, the score of task-oriented, emotional and avoidant areas will increase by 0.89, 0.37 and 0.105 respectively (p<0.001). Also, with a unit increase in the score of stress controls, the scores of task-oriented and avoidance areas will increase by 0.55 and 0.13 respectively, while the score of the emotional-oriented area will decrease by 0.28 (p<0.001).
| Independent variable | Dependent variables | B(SE) | Stand. beta | T statistic | p-value | R-Square |
|---|---|---|---|---|---|---|
| Interpersonal skills | Task-oriented | 1.28 0 (.069) | 18.677 | 0.525 | <0.001 | 0.958 |
| Emotional-oriented | -0.084 (0.064) | -13.130 | -0.426 | |||
| Avoidance | 31 (0.077) | 4.095 | 0.073 | |||
| Intrapersonal skills | Task-oriented | 0.89 (0.044) | 20.394 | 0.635 | <0.001 | 0.948 |
| Emotional-oriented | 0.379 (0.041) | -9.199 | -0.331 | |||
| Avoidance | 0.105 (0.049) | 2.131 | 0.042 | |||
| Stress control | Task-oriented | 0.55 (0.025) | 22.135 | 0.581 | <0.001 | 0.963 |
| Emotional-oriented | -0.28 (0.023) | -12.036 | -0.365 | |||
| Avoidance | 0.13 (0.028) | 4.955 | 0.082 | |||
| General mood | Task-oriented | 0.337 (0.03) | 0.349 | 10.872 | ||
| Emotional-oriented | -0.398 (0.02) | -0.510 | -13.738 | <0.001 | 0.944 | |
| Avoidance | 0.301 (0.035) | 0.178 | 8.715 | |||
| Compatibility | Task-oriented | 0.919 | 19.179 | 0.529 | ||
| Emotional-oriented | -0.902 | -12.905 | -0.411 | <0.001 | 0.959 | |
| Avoidance | 0.620 | 4.961 | 0.087 |
With a unit increase in scores of the general mood and compatibility, the scores of task-oriented and avoidance area increased significantly but that of the emotional-oriented area decreased significantly (p<0.001). The R-Square showed that EQ could predict more than 90% of midwives' ability for coping with stress.
Discussion
This study was designed to evaluate the relationship between EQ and coping with stress among midwives employed in university hospitals in Ahvaz. The results of this study showed that there is a significant positive correlation of the domains of intrapersonal, interpersonal, stress management, adaptability, general mood and total score of EQ with the task-oriented area of the CISS. Although the relationship between EQ and stress management among nurses have been studied and results show that there is an inverse relationship between EQ and job stress among nurses (Rakhshani et al, 2018), information about midwives who have their own stressful responsibilities is scarce. Therefore, the present study could add to our knowledge about the relationship of EQ and stress-coping strategies among an important group of healthcare professionals, namely midwives. Studies have shown that, in general, stress is more prevalent among females and people with a higher score of EQ can better cope with stress (Miri et al, 2013; Moghal et al, 2016).
The results of the present study showed a significant negative relationship between all domains of the EQ and the emotion-oriented domain of the CISS. Bikmoradi et al (2018) found that there was a significant correlation between EQ and people-oriented leadership style among nurses. Karvin et al (2005) found in their study that the perception of stress can predict the coping strategies of college students; they mostly had task and emotion-oriented coping strategies. Por et al (2011) reported that nursing students with the higher score in emotional intelligence were able to find better strategies for coping with stress. Also, results of Yamani et al's study (2014) on 142 faculty members of Isfahan (Iran) showed an inverse correlation existed between EQ and job stress (r=-0.235, p=0.005). As the results of the present study show and as evident from other studies, people with a higher score of EQ are better able to cope with stress.
The results of the present study showed that with a unit increase in the score of EQ domains such as interpersonal, intrapersonal, stress control, general mood, the score of area of coping with stress, such as task-oriented and avoidance will increase, while for the emotional area the score decreased. Banovcinova (2017) found that most midwives do not adopt a proper way of coping with stress and recommended an interventional education programme to improve coping with stress. Lee et al (2019) found that EQ may act as a buffer for stress and people who have higher scores of EQ may have better job-related success and total higher psychological well-being. Only a few studies have been conducted on the relationship between EQ and coping with stress among midwives. Midwifery is a stressful field and more studies are needed to investigate the factors that cause and control stress.
Limitations of the study
In this study, we only recruited midwives who worked in the university hospitals and did not recruit midwives from non-university or private hospitals that may have different job expectations from those working in university hospitals.
Recommendations
Midwifery is a stressful profession and in order to cope with this stress, an acceptable level of EQ is required to cope with this stress. Therefore, the candidates for midwifery, beside passing the entrance exam, should be evaluated regarding their EQ.
Conclusion
The results of this study showed a positive correlation of task-oriented and avoidant areas with intrapersonal, interpersonal, management, adaptability and general mood. There was a significant negative correlation between emotion-oriented area and all domains of EQ. EQ could predict more than 90% of stress management and coping among midwives. It is recommended that policymakers develop some programmes to enhance the EQ of midwives in coping with stress and also consider some screening programmes to enroll students with acceptable EQ to study midwifery.