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International Journal of Nursing Studies 45 (2008) 888901


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The relationship between emotional intelligence, occupational


stress and health in nurses: A questionnaire survey
Jose Mar a Augusto Landa, Esther Lopez-Zafra, M. Pilar Berrios Martos,
Maria del Carmen Aguilar-Luzon
Department of Psychology, Faculty of Humanities and Sciences of Education, University of Jaen, Campus Las Lagunillas s/n,
Edificio D-2, 23071 Jaen, Spain
Received 28 September 2006; received in revised form 6 March 2007; accepted 16 March 2007

Abstract
Background: Nurses suffer from stress and health problems owing to the characteristics of their work and their contact
with patients and death. Since emotions can have an effect on work outcomes, emotional intelligence (EI) may explain
the individual differences in dealing with work stress.
Objectives: This study investigated the interrelationships among EI, work stress and health. We also examined the
impact of socio-demographic variables (e.g. age, gender, length of service,y) on stress and nurses health.
Design: A questionnaire survey (anonymous) has been carried out to detect these interrelationships.
Setting: A general public hospital in Spain
Participants: One hundred and eighty nurses.
Methods: Data was gathered on demographic information and work, stress, health and EI. Beyond descriptive
statistics, analyses of variance, mean differences and regression analyses were computed.
Results: Findings show a differential effect of the EI components in stress and health. As far as stress is concerned, the
results show that the nurses who score high in clarity and emotional repair report less stress, whereas those with high
scores in attention to emotions experience greater levels of stress. Furthermore, we nd a positive relationship between
age, length of service and stress, with younger nurses and those with a shorter length of service experiencing less stress.
However, EI and health are not related to age or to length of service. Also, we nd that married nurses report better
general health.
Conclusions: EI is shown for nurses as a protective factor against stress and a facilitative factor for health (especially
the Clarity and Repair dimensions). These comments could be especially important in training future professionals in
these abilities.
r 2007 Elsevier Ltd. All rights reserved.
Keywords: Health; Nurses; Occupational; Perceived Emotional Intelligence; Stress

Corresponding author. Tel.: +34 953 211994;


fax: +34 953 211881.
Also correspondence to.
E-mail addresses: jaugusto@ujaen.es
(J.M. Augusto Landa), elopez@ujaen.es (E. Lopez-Zafra).

What is already known about the topic?

 Nurses face a great amount of stress and their work

0020-7489/$ - see front matter r 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ijnurstu.2007.03.005

has a great impact on their personal life.

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J.M. Augusto Landa et al. / International Journal of Nursing Studies 45 (2008) 888901

 Emotional


intelligence (EI) is a relatively new


concept that helps to explain and understand the
signicance of emotions in nursing.
EI correlates with positive social relationships.

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organizational variables such as length of service and


position in the hierarchy at work, (Tummers et al.,
2002), and on individual characteristics such as the type
of personality and the ability to handle and control
emotions (Mann and Cowburn, 2005).

What this paper adds


2. The concept of emotional intelligence (EI)

 Results of empirical work exploring EI and stress.


 A clear effect of the dimensions of EI on stress and




health. For stress, results indicate that people with


high scores in clarity and emotional repair report less
stress, whereas those individuals with high scores in
attention to emotions experience greater levels of
stress.
EI emerges as a protective factor against stress and a
facilitative factor for health (specially the clarity and
repair dimensions) in nurses.
Of special interest is the training of future professionals in these abilities in order to improve their
ability to deal with stress.

1. Introduction
Health professionals frequently suffer from stress
owing, among other factors, to the characteristics and
working conditions typically found in hospitals. One of
the groups of workers most affected by this problem is
nurses, who, irrespective of the unit in which they work,
frequently suffer from stress. Several studies point out
that student nurses, ward nurses, renal care nurses and
psychiatric nurses report that they feel stress in their
work (Foxall et al., 1990; Hipwell et al., 1989; Piko,
2006; Ryan and Quayle, 1999; Sveinsdottir et al., 2006;
Tyson and Pongruengphant, 2004; Wheeler and Riding,
1994).
Several organizational stressors have been identied,
such as timetables, work overload and contact with
death. With regard to the rst, it should be noted that
shift work and night shifts inuence biological rhythm,
altering the sleep cycle and work-family relationships
(Piotrkowski et al., 1987). Also, work overload and
contact with death have been considered important
sources of stress (Hipwell et al., 1989; Cottrell, 2001;
Tyler et al., 1991). The main consequences of these are:
absenteeism (Wheeler and Riding, 1994), alcoholism
(McGrath et al., 2003), exhaustion and attempted
suicides (Jones et al., 1987), and somatic diseases
(Lindop, 1999). In line with these results, Jones (1987)
found that nurses are one of the groups of workers with
the lowest life expectancy.
We have to take these results into account, but we
should note that the consequences or/and effects of
stress also depend on socio-demographic variables
such as age and gender (McGrath et al., 2003), on

The concept of EI was introduced by Salovey and


Mayer (1990). However, it was Daniel Goleman who
promoted the topic in a book entitled Emotional
Intelligence (see Goleman, 1995). Following this early
publication, several authors explored the concept
with different theoretical models (e.g., Bar-On and
Parker, 2000; Ciarrochi et al., 2001; Mayer and Salovey,
1997; Parker et al., 2001). Two main approaches
emerged: a mixed model, which combines emotional
abilities with personality dimensions such as optimism
and self-motivation abilities (Bar-On, 1997, 2006;
Goleman, 1998); and an ability model, which focuses
on how individuals process emotional information
and the analysis of the capabilities that are required
for such processing (Brackett and Salovey, 2006;
Mayer and Salovey, 1997; Mayer et al., 1999). Mayer
and Saloveys (1997) model focused on emotional
constructs such as the ability to perceive, glean
information from, and manage ones own and others
emotions (Salovey and Mayer, 1990). In agreement with
Mayer and Salovey (1997); Salovey and Mayer (1990)
dene EI as the result of an adaptive interaction between
emotion and cognition that includes the ability to
perceive, to assimilate, to understand and to handle
ones own emotions and the capacity to detect and to
interpret the emotions of the others. In other words, it is
an ability or competency based as distinguished from
being rooted in personality attributes (Brackett and
Salovey, 2006).

3. EI and its relationship with other variables


These theoretical models have inuenced studies on
the relationship between EI and other psychological
constructs, such as mental health and physical wellbeing (Donaldso-Feilder and Bond, 2004), stress
(Mikolajczak et al., 2006; Salovey et al., 2002),
alexithymia (Parker et al., 2001) and life satisfaction
(Augusto et al., 2006b; Livingstone and Day, 2005;
Wolfradt et al., 2002).
3.1. EI and health
According to the World Health Organization (WHO),
health is dened as the bio- and psycho-social well-being
of the individual. With respect to the inuence of EI on

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J.M. Augusto Landa et al. / International Journal of Nursing Studies 45 (2008) 888901

health, Ciarrochi et al. (2002) indicate that IE has a


mediating role in the relationship between psychological
health and stress. These authors conclude that people
with high EI are able to deal with environmental
demands better than people who score low in this
variable. In addition, the factors that dene perceived EI
(Attention to the Emotions, Emotional Clarity and
Emotional Repair) also have differential effects on
health, strategies for dealing with stress and job
satisfaction. For example, people who score high in
the factor Attention to Emotions report more physical
symptoms, depression and anxiety (Salovey et al., 2002)
than individuals who obtain a low score in this factor,
since the latter do not consider their affective states
relevant and they do not use that information to carry
out effective regulation strategies (Gohm, 2003). On the
other hand, high scores in Clarity and Emotional Repair
are related to lower anxiety and depressive symptoms
and higher life satisfaction (Fernandez-Berrocal et al.,
2003). In addition, Emotional Repair is positively
related to perceived physical and mental health (Extremera and Fernandez-Berrocal, 2002; Mikolajczak
et al., 2006), to work satisfaction (Berrios et al., 2006)
and to life satisfaction (Augusto et al., 2006a, b). With
regard to the relationship between stress and burnout,
the study of Limonero et al. (2004) shows that Emotional
Clarity and Emotional Repair are negatively related to
stress; and Augusto et al.s (2005) study shows that
Attention to Emotions predicts two Burnout dimensions
(Emotional Tiredness and Depersonalization).
3.2. EI and stress
Work stress is a wide and complex process. This term
was introduced in Psychology by Selye (1956), and Cox
and Mackay (1981) have classied stress denitions with
regard to the conceptualization of stress as a stimulus,
answer or interaction stimulusresponse.
As a stimulus, stress refers to the different events able
to cause a stress reaction (e.g. death of a relative,
disease, accident, work overload,y). Appley and
Trunbull (1967), dene stress related to new situations,
which are intense and rapidly changing.
Stress as an answer makes reference to the physiological, emotional and behavioral changes found in
dealing with stressful situations. Selye (1956) considered
that any stimulus that elicits an unspecied answer may
be a stressor, although he did not include psychological
stimuli. Nowadays, psychological stimuli may provoke
important stress reactions. Matteson and Ivancevich
(1987) dene stress as an adaptive response for an
external action.
Finally, stress as transactional stimulusresponse
refers to the evaluation that the individual makes of
the t/unt that exists between environmental demands
and their capacity to confront them. This approach

emphasizes the perception that the individual makes


about the situation. Representative of this approach are
the contributions of Harrison (1978), Edwards (1988),
Lazarus and Folkman (1984a, b), McGrath (1970) or
Parkes (2001) (see also Peiro, 2000 for a revision about
the three approaches to stress). In this work we focus on
the stress as a stimulus approach.
Previous research also addressed the relationship
between EI and work-related variables such as stress
perceptions in the workplace (Bar-on et al., 2000),
satisfaction (Augusto et al., 2006a, b) or performance
(Boyatzis, 2006; Lam and Kirby, 2002; Lopes et al.,
2006). In general, results show that EI predicts success in
work, facilitating positive interpersonal relationships
(Brackett and Salovey, 2006; Fernandez-Berrocal and
Extremera, 2006; Fitness, 2001; Flury and Ickes, 2001),
increasing the ability to solve problems and nd suitable
strategies for dealing with stress (Gohm and Clore 2002;
Mikolajczak et al., 2006; Tsaousis and Nikolaou, 2005).
3.3. EI and socio-demographic variables
Researchers have analyzed several demographic differences in EI, stress and to a lesser extent, health. For
instance, several studies conducted by Mayer et al.
(1999) showed that women generally have higher scores
in EI than men (see also Extremera et al., 2006).
However, these differences occur mainly in the Perception of emotions subscale (and not in the overall EI
score), where females perform better than males
(Nikolaou and Tsaousis, 2002). These results are
conrmed by other studies such as those of Bar-on
et al. (2000) or Slaski and Cartwright (2002). As far as
occupational stress is concerned, no signicant differences between males and females were found in the
study carried out by Nikolaou and Tsaousis (2002), but
women showed a higher level of stress than men in
Oginska-Buliks (2006) study. In terms of health,
Extremera et al. (2003) found that women show lower
levels of mental health than men.
Regarding the relationship between age and EI,
Nikolaou and Tsaousis (2002) found that older individuals score higher on EI than younger ones, but that
older individuals are more stressed than younger ones.
This result is consistent with other studies (Bar-on et al.,
2000; Extremera et al., 2003; Garrosa et al., in press;
Goleman, 1995).
There are few studies considering length of service but
Extremera et al., (2003) found that this variable was not
a predictor for EI or stress.
In summary, EI may be considered as positively
related to the health and job satisfaction, and negatively
related to stress and/or burnout. However, research to
be carried out should develop more specic analyses to
give more information about the components that dene
EI, since it has been shown that each of these factors

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J.M. Augusto Landa et al. / International Journal of Nursing Studies 45 (2008) 888901

affects differently the bio- and psycho-social well-being


of the individual.
The main objective of this study is to examine the
relationships between EI, stress and health in nursing
professionals, since this group usually experiences stress
in their work and undergoes problems of physical and/
or mental health. Our main hypotheses are presented
below.

Hypothesis 1. We hypothesize a positive relationship


between EI and health and a negative relationship with
stress.
Specically, we predict a differential effect of the EI
components on health and stress. We anticipate higher
levels of health and lower levels of stress in people
scoring higher in Clarity and Emotional Repair than in
those whose scores are low in these dimensions; people
who obtain high scores in Attention to Emotions would
experience lower health and more stress than those that
obtain low scores.

Hypothesis 2. We think there would be signicant


differences in the EI, the stress and the health of nurses
when correlated with their socio-demographic and work
characteristics.
Specically, we hypothesize that the youngest individuals with shorter length of service would obtain higher
scores in EI, would suffer less stress and would have
better health than older individuals with a longer length
of service. Also, women would have higher scores in EI.
Despite organizational sources of stress and personal
stress, (i.e. caring for children and doing housework), we
hypothesize that women would experience less stress
than men, and would have better health than men.

4. Method
4.1. Participants and procedure
The participants were 197 qualied nurses from a
public hospital1 in southern Spain. Seventeen questionnaires were incomplete and eliminated from the nal
sample. The nal sample was made up of 180
participants (46 men and 134 women) with a mean age
of 40.14 (range 2358).2
1
The Spanish Health System is based on a public system
supported by the government. Nurses who work in public
hospitals have the same training as nurses in private hospitals.
They are recruited by means of a competitive entrance exam.
Most Spanish hospitals are public.
2
The higher proportion of women than men in our sample is
congruent with the study carried out by Komblit and Mendes
Diz (1998), which found that 75% of nursing professionals all
over the world are women.

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The researchers contacted the manager of the hospital


personally to ask for permission to use a questionnaire
in the hospital. One male and 2 female data collectors
asked qualied nurses in hospital locations to participate. Those who consented (197 out of 230, 85.6%)
completed a 20-min questionnaire. They completed the
questionnaire in their workplace and gave it back to the
data collectors at the end of the day.3
4.2. Variables and instruments
4.2.1. EI
On 5-point scales, participants evaluated their EI.
Specically, they lled in the Trait Meta Mood Scale
(TMMS; Salovey et al., 1995), which is a 24-item
questionnaire that identies three interpersonal factors:
emotional clarity, emotional repair, and emotional
attention.
Emotional clarity refers to an individuals tendency to
discriminate their own emotions and moods (8 items,
e.g., I often perceive my feelings clearly); emotional
repair refers to an individuals tendency to regulate their
own feelings (8 items, e.g., Although I am sometimes
sad, I generally have an optimistic viewpoint); emotional attention conveys the degree to which an
individual tends to observe and think about their own
feelings and moods (8 items, e.g., I think it is not worth
paying attention to your own emotions or moods).
The Spanish version of the TMMS was administered
by Fernandez-Berrocal et al. (2004). Cronbachs a was
0.90 for emotional clarity, 0.86 for emotional repair, and
0.86 for emotional attention. This instrument has
proved to have good reliability and is suitable to be
used in Spanish-speaker samples with an overall
reliability of 0.95 (see Extremera et al., 2006, for more
information).
4.2.2. Work stress
Our participants completed the scale of work stressors
for nurses Nursing Stress Scale (NSS), developed by
Gray-Toft and Anderson (1981) and validated in
Spanish by Escriba et al. (1999). This scale consists of
34 items referring to different situations that cause or
may cause stress in nurses. These situations have been
identied by the authors of the scale from reviewed
literature and from interviews carried out with different
healthcare professionals. Participants indicate the frequency with which each of the situations causes them
stress.
Hence, on a 4-point scale (from never 0, to very
frequently 3) participants answered this scale. This scale
measures nine sources of stress: service load, uncertainty
3

The nurses that participated in our study were volunteers


and they were working at the time the data collectors went to
the hospital.

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J.M. Augusto Landa et al. / International Journal of Nursing Studies 45 (2008) 888901

with respect to the treatment, problems with the


hierarchy, insufcient preparation, lack of support, not
knowing how to handle and operate specialized equipment, problems between staff and working temporarily
in other services owing to staff shortage.
Cronbachs a for the global scale is 0.92 and for each
component it varies from 0.83 to 0.49.
4.2.3. Health
We used the SF-36 questionnaire. This was developed
from the Study of Medical Results (Medical Outcome
StudyMOS, Ware and Sherbourne, 1992), and measures concepts that represent excellent basic human
values for health, and is applicable to the general
population as well as to clinical groups (McHorney et
al., 1994, 1992). This questionnaire has been adapted to
Spanish by Alonso et al. (1995). It is comprised of a
series of items that report positive and negative states of
physical health and emotional well-being. It identies 8
dimensions of health: Physical Function (PF), Physical
Role (PR), Physical Pain (P), General Health (GH),
Vitality (V), Social Function (SF), Emotional Role (ER)
and Mental Health (MH). Later, a new dimension has
been included, called Health Transition (HT), which
makes reference to the changes in the perception of the
present state of health with respect to how it was a year
ago. Altogether, the questionnaire is made up of 36
items whose scores are codied, added and transformed
into a scale ranging from 0 (bad state of health) to 100
(good state of health); high scores indicate a better state
of health and/or a better quality of life in its different
areas (e.g. physical, mental health, vitality,y) than low
scores. This instrument shows suitable levels of validity,
reliability and cultural equivalence with other versions
from other countries (Iraurgi et al., 2004), and the
coefcient a of Cronbach oscillates between 0.83 and
0.92 for the different dimensions.
4.3. Socio-demographic data
Finally, we have also collected information about
socio-demographic variables (e.g. age, sex, number of
children, whether they were married or living with
someone) and work variables (e. g. length of service,
choice of post and shift).

5. Results
In Table 1, we show descriptive statistics, standard
deviations and Cronbachs a for all variables in the study.

with an a level of 0.05. We used Tukeys honest


signicant difference (HSD) test in post hoc analyses.
Individuals were classied as high or low in emotional
clarity, emotional repair, and emotional attention
depending on whether their scores were above or below
percentiles 33 and 67, respectively. These cut-off points
were established according to Extremera and Fernandez-Berrocals (2002) procedure.
Our results show that people who score low in the
dimension Attention to emotions report greater
levels of stress when they do not know how to handle
and/or operate equipment (factor 7 of the stress scale)
X 1:12 than those whose scores are high in this
dimension X 0:84 (t-student(1, 112) 2.12; pp0.05).
On the other hand, nursing professionals who score low
in the dimension Emotional Clarity have signicantly
more stress owing to lack of support (factor 6 of the
stress scale) X 2:92 than those with high values in this
dimension X 2; 24 (t-student(1, 110) 1.98; pp0.05).
However, those who score high in the Emotional Clarity
dimension report more stress when they have to work
temporarily in other services owing to staff shortage
X 1:44 than those who score low in this dimension
X 1:04 (t-student(1, 111) 2.43; pp0.05).
Finally, nurses whose scores are low in the dimension
Emotional Repair are more stressed by problems
with colleagues (factor 8 of the stress scale) X 1:95
than those who obtain high scores in this dimension
X 1:51 (t-student1, 125) 1.95; pp0.05).
We carried out regression analyses to test the
predictability that EI subscales could have on stress
dimensions. Regression analysis results conrm previous
results, as 3% of the variance of the factor 7 of stress is
accounted for by Attention to emotions. Therefore,
individuals with high emotional attention show a low
level of knowing how to handle equipment (see Table 2
for regression analysis). Also our regression analysis
showed that this EI dimension accounted for 5% of
uncertainty with respect to the treatment, so individuals
with adequate attention are less certain of the treatment
they are giving to their patients.
Regression analyses also conrm that lack of support
is accounted for by Emotional Clarity and Repair (8%),
and individuals with high Clarity and Repair express
lower lack of support.
Also, the regression analysis conrms that individuals
with high emotional clarity deal better with temporary
posts in other areas than individuals with low scores, as
emotional clarity accounts for 10% of the variance of
this dimension.
5.2. The impact of EI on health

5.1. The impact of perceived EI on stress dimensions


To examine the possible differences in stress due to
differential levels of EI, we conducted t-test analyses

In order to examine the possible differences in health


due to differential levels of EI, we conducted t-test
analyses with an a level of 0.05.

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Table 1
Descriptive statistics, standard deviations and Cronbachs a for all variables in the study
Variable

Means (N)

S.D.

Emotional intelligence
Emotional attention
Emotional clarity
Emotional repair

24.30 (167)
26.68 (165)
27.69 (172)

5.50
6.03
6.06

0.83
0.87
0.85

Health dimensions
Physical function (PF)
Physical role (PR)
Body pain (BP)
General health (GH)
Vitality (VT)
Social function (SF)
Emotional role (ER)
Mental health (MH)
Health transition (HT)

28.94
7.58
9.35
18.99
16.63
8.51
5.50
22.38
3.26

(174)
(172)
(178)
(177)
(177)
(178)
(172)
(177)
(178)

2.08
1.04
1.66
3.05
3.14
1.60
0.94
3.63
1.69

0.85
0.86
0.67
0.66
0.74
0.67
0.81
0.72

8.25
8.29
5.65
3.40
6.37
2.71
0.98
1.76
1.23

(160)
(167)
(169)
(167)
(167)
(174)
(167)
(171)
(169)

3.15
3.18
2.98
2.15
3.12
1.80
0.69
1.26
0.86

0.74
0.72
0.78
0.74
0.75
0.51

Nursing stress scale


F1: Death and suffering
F2: Work overload
F3: Uncertainty with the treatment
F4: Problems with the hierarchy
F5: Insufcient preparation
F6: Lack of support
F7: Not knowing how to handle equipment
F8: Problems with colleagues
F9: Staff shortage

0.77

Note: Emotional intelligence subscale means are on a scale ranging from 8 to 40, in which higher numbers indicate greater emotional
attention, clarity of repair.
Stress Means are on a scale ranging from 0 to 15 in which higher numbers indicate greater stress.
Health dimension means are on a scale ranging from 1 to 100 in which higher numbers indicate greater levels of the variable.
All the variables were ordinal.

Our results show that individuals with low scores in


the Attention to Emotions dimension obtain higher
scores in the factor Physical Pain X 9:86 than those
who obtain high scores in this dimension X 9:28
(t-student(1, 112) 1.92; pp0.05). That is, they report
less pain or fewer limitations due to Physical Pain.
In addition, our results concerning the dimension
Clarity of emotions indicate that the individuals with
low scores in this dimension also obtain lower scores in
General Health and Mental Health (X 18:15 and X
21:16; respectively) than those with high scores
(X 19:90 and X 23:93; respectively). That is to
say, they evaluate their health negatively, they think that
they will probably get worse and they have a sensation
of nervousness and depression. In terms of general
health, the values of the differences found are:
t-student1, 111) 2.95; pp0.05):, and for mental health
t-student(1, 111) 4.31; pp0.05).
Finally, the Emotional Repair dimension has a
great impact on all Health dimensions except for
Emotional Role and Health Transition (see Table 3).

In summary, our results show that individuals with a


high ability to regulate emotions may perform all kinds
of physical activities without any restriction, they do not
have problems in their work and daily activities caused
by their health, do not usually feel in pain, perceive their
health as good or excellent, are full of energy, do social
activities without physical or emotional problems and
have sensation of peace, happiness and calm. Nevertheless, they experience some problems in their work
resulting from several emotional aspects and think that
their health is worse now than a year ago.
We carried out regression of analyses to see whether
EI dimensions could predict health.
In line with our previous results, our regression
analyses show that 22% of the variance of mental
health was accounted for by emotional factors such as
Attention, Clarity and Repair. That is to say, participants with average emotional Attention and high Clarity
and Repair report better levels of mental health. Also,
Emotional Repair accounted for 8% of the variance of
general health in such a way that those subjects with a

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J.M. Augusto Landa et al. / International Journal of Nursing Studies 45 (2008) 888901

Table 2
Regression analysis predicting scores on the nursing stress scale
Variable
(Criterion: Death and suffering)
Sep 1: Covariant
Age
Sex
Married
Length of service
Sep 2: TMMS
Attention
Clarity
Repair
(Criterion: Service load)
Sep 1: Covariant
Age
Sex
Married
Length of service
Sep 2: TMMS
Attention
Clarity
Repair

R2

0.01

0.47

0.06

0.00

0.02

(Criterion: Uncertainty with respect to treatment)


Sep 1: Covariant
0.02
Age
Sex
Married
Length of service
Sep 2: TMMS
0.07
Attention
Clarity
Repair
(Criterion: Insufficient preparation)
Sep 1: Covariant
0.04
Age
Sex
Married
Length of service
Sep 2: TMMS
0.08
Attention
Clarity
Repair
(Criterion: Lack of support)
Sep 1: Covariant
Age
Sex
Married
Length of service
Sep 2: TMMS
Attention
Clarity
Repair

0.02

0.10

(Criterion: Not knowing how to handle equipment)


Sep 1: Covariant
0.03
Age

0.13
0.02
0.09
0.15

0.41
0.85
0.30
0.37

0.16
0.05
0.04

0.09
0.67
0.66

0.05
0.03
0.02
0.00

0.73
0.70
0.85
0.95

0.10
0.01
0.12

0.30
0.88
0.22

0.07
0.08
0.07
0.03

0.62
0.35
0.39
0.84

0.19
0.18
0.04

0.05*
0.08
0.71

0.05
0.11
0.00
0.12

0.75
0.21
0.95
0.45

0.00
0.17
0.03

0.98
0.10
0.79

0.01
0.01
0.11
0.09

0.93
0.82
0.20
0.56

DR2

0.01

1.07

0.05

0.12

0.02

0.38

0.02

0.81

0.00

1.29

0.05*

1.52

0.02

1.54

0.04

0.80

0.01

2.21

0.08*
0.11
0.34
0.18

0.20
0.00**
0.05*

1.03

0.00
0.09

0.53

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895

Table 2 (continued )
Variable
Sex
Married
Length of service
Sep 2: TMMS
Attention
Clarity
Repair

R2

0.06

(Criterion: Problems with colleagues)


Sep 1: Covariant
0.05
Age
Sex
Married
Length of service
Sep 2: TMMS
0.09
Attention
Clarity
Repair
(Criterion: Staff shortage)
Sep 1: Covariant
Age
Sex
Married
Length of service
Sep 2: TMMS
Attention
Clarity
Repair

0.03

0.13

0.08
0.04
0.05

0.34
0.67
0.76

0.18
0.08
0.02

0.05*
0.42
0.85

0.22
0.04
0.11
0.05

0.13
0.67
0.19
0.76

0.11
0.10
0.05

0.25
0.33
0.61

0.00
0.00
0.02
0.16

0.98
0.98
0.78
0.30

0.05
0.35
0.13

0.59
0.00**
0.15

1.18

DR2

0.03*

1.86

0.02

1.90

0.04

0.98

0.00

2.85

0.10**

Note: **po0.01, *po0.05.

greater capacity of emotional repair report higher levels


of general health (see Table 4 for regression analyses).
As in our previous results, Emotional Repair
accounted for 6% of the variance of Physical Pain,
therefore people with greater capacity for emotional
repair indicated less Physical Pain. Also, 19% of the
variance of Vitality was accounted for by the Emotional
Repair dimension. That is, those people with one better
capacity for repairing their emotional states indicate a
higher level of vitality.
5.3. The impact of the socio-demographic variables
We conducted student t-tests and one-way ANOVAs
to test the possible differences in EI depending on the
socio-demographic data but there were no differences
between the individuals in EI related to gender, age or
marital status.
Also, we conducted analyses of variance for the work
stress dimensions and our results showed a principal
effect of age of the participant. Specically, age is an
important stressor when they have to work temporarily
in other areas owing to staff shortage (factor 9 of the

stress scale): F(7, 167) 2.39; pp0.05. Using a post-hoc


Duncan test it has been shown that the youngest
participants report higher levels of stress in this factor
(from 20 to 25 years X 1:86; SD 1.21) than older
participants (more than 51 years old X 0:81;
SD 0.65). Moreover, the interaction age  length
of service has a signicant effect on this stressor
(F(4, 160) 3.08; pp0.05); workers with shorter lengths
of service suffer more stress than those with longer
lengths of service when they have to work temporarily
in other areas owing to staff shortage (X 1:87;
SD 0.30 and X 1; SD 0.57, respectively).
In addition, our results indicate that length of service
has a signicant effect on uncertainty with respect
to the treatment (factor 3 of the stress scale):
F(3, 165) 2.8; pp0.05, on problems with hierarchy
(factor 4 of the stress scale): F(3, 163) 4.04; pp0.05, on
insufcient preparation (factor 5 of the stress scale):
F(3, 163) 3.47; pp0.05 and on having to work
temporarily in other areas owing to staff shortage
(factor 9 of the stress scale): F(3, 174) 4.26; pp0.05. In
all these cases, nurses with a shorter length of service
score higher in all the stressors mentioned above than

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Table 3
Differences in health dimensions depending on high or low emotional regulation
Health dimensions

Low emotional regulation

High emotional regulation

t-student

Physical function
Physical role
Physical pain
General health
Vitality
Social function
Emotional role
Mental health
Health transition

28.68
7.49
9.05
18.05
15.15
8.21
5.33
20.68
2.97

29.41
7.82
9.82
20.07
17.97
8.76
5.64
23.84
2.91

2.17*
1.98*
2.83**
4.0**
5.53**
2.01*
1.74
5.29**
0.55

Note: *po .05 and **po .001.

those who have a greater length of service (see Table 5


for means).
In addition, marital status inuences the level of
perceived stress. In this sense, people who are married or
are living with someone are less stressed by problems
with colleagues (factor 8 of the stress scale) than those
who are single (F(1, 38) 5.08; pp0.05).
Finally, in relation to Health dimensions our results
yielded an inuence of the variable married or living
with someone. Specically, being married inuences
the Physical Role (factor 2 of the health scale). Our
results indicate that people who are married have more
problems with work and other daily activities owing to
physical health (X 7:26; SD 1.29) than those who
are single (X 7:67; SD 0.94) (t-student 1.94;
pp0.05).

6. Discussion
In our study, we aimed to analyze the relationship
between EI, stress and health among nurses. Specically,
we wanted to check whether the effects of EI upon these
variables were positive. Therefore, we conducted a study
in which 180 nurses from a public hospital participated.
Our objective focused on two main aspects. On one
hand, to study the direction that this relationship
adopts, and on the other hand, to analyse whether this
relationship differs in socio-demographic and work
variables.
Our rst hypothesis is supported, since a differential
effect occurs in the components of IE in stress and
health. For stress, the results indicate that people with
high scores in clarity and emotional repair report less
stress, whereas those with high scores in attention to
emotions experience greater levels of stress. These results
are in line with others, such as those of Limonero et al.
(2004), Extremera et al. (2003), and may be due to the
emotional spiral that is created when excessive attention
is given to the emotions and ruminant negative thoughts

(Fernandez-Berrocal et al., 2001). On the contrary,


medium levels of attention followed by high clarity and
emotional repair would be more related to suitable
emotional information processing and to better adjustment (Extremera and Fernandez-Berrocal, 2005; Thayer
et al., 2003).
With regard to the second hypothesis, we do not nd
differences in EI depending on socio-demographic
variables. Previous studies (Extremera et al., 2006;
Fernandez-Berrocal et al., 2004; Mayer et al., 1999)
suggested that we should expect differences based on
gender, in particular, that women would show higher
scores in general EI. A possible explanation for the
absence of differences in our sample may be the fact that
in general nursing professionals have been associated
with communal characteristics that are generally feminine, so we might not expect so much difference between
men and women in this branch of healthcare. For this
reason, in the future we intend to study this question
more deeply from the perspective of Congruency Theory
(Eagly and Karau, 2002).
We also hypothesized that younger nurses with
shorter lengths of service would score higher in EI,
would undergo less stress and would enjoy better health
than older individuals with longer lengths of service. Our
results partially conrm this hypothesis since we only
found a positive relation between age, length of service
and stress; younger nurses with shorter lengths of service
experience less stress than older nurses. This result is in
line with those of Nikolaou and Tsaousis (2002) and
consistent with other studies (Bar-on et al., 2000;
Extremera et al., 2003; Garrosa et al., in press;
Goleman, 1995).
These results could be explained by the fact that
young individuals with shorter lengths of service are
more motivated and satised in their work
(Sanchez-Lopez and Quiroga, 1995; Varela-Centelles
et al. (2004) than older individuals with longer lengths of
service. These individuals have a wide work experience
but have increased their sources of stress (both

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897

Table 4
Regression analysis predicting scores in health survey SF-36
Variable
(Criterion: Physical functioning)
Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair
(Criterion: Physical role)
Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair
(Criterion: Emotional role)
Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair
(Criterion: Physical pain)
Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair
(Criterion: Vitality)
Sep 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair
(Criterion: Mental health)
Step 1: Covariant
Age
Sex

R2

0.03

0.91

0.06

0.04

0.06

0.02

0.04

0.01

0.07

0.01

0.20

0.02

0.11
0.13
0.06
0.03

0.47
0.14
0.51
0.82

0.05
0.01
0.20

0.60
0.91
0.04*

0.11
0.10
0.14
0.02

0.48
0.25
0.09
0.88

0.05
0.10
0.14

0.62
0.35
0.18

0.17
0.51
0.03
0.06

0.29
0.57
0.76
0.70

0.13
0.09
0.08

0.16
0.38
0.41

DR2

0.03

1.22

0.03*

1.42

0.01

1.12

0.02

0.64

0.01

0.81

0.02

0.34

0.02
0.17
0.01
0.03
0.17

0.27
0.92
0.77
0.30

0.06
0.09
0.29

0.49
0.35
0.00**

0.12
0.00
0.06
0.18

0.46
0.96
0.47
0.26

0.10
0.04
0.48

0.23
0.68
0.00**

1.47

0.06**

0.46

0.01

5.05

0.19**

0.57

0.01
0.20
0.00

0.89
0.94

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Table 4 (continued)
Variable

R2

Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair

B
0.82
0.71

0.24

0.34
0.65

6.12

0.22**
0.00**
0.00**
0.00**

0.23
0.34
0.29

(Criterion: Social functioning)


Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair

0.01

0.04

(Criterion: General health)


Step 1: Covariant
Age
Sex
Married
Length of service
Step 2: TMMS
Attention
Clarity
Repair

0.02

0.10

DR2

0.42

0.01
0.05
0.00
0.01
0.06

0.75
0.91
0.90
0.69

0.08
0.11
0.06

0.34
0.28
0.27

0.18
0.08
0.07
0.15

0.22
0.33
0.37
0.31

0.07
0.09
0.26

0.43
0.33
0.00**

0.82

0.03

0.74

0.00

2.37

0.08**

Note: **po0.01, *po0.05.

Table 5
Means and standard deviations for the stress dimensions by length of service
Stress dimensions

F1.
F2.
F3.
F4.
F5.
F6.
F7.
F8.
F9.

Length of service
p9 years

1020

2130

X31

8.67
8.11
6.31
3.55
7.40
3.03
1.23
1.92
1.55

8.39
8.75
6.02
3.85
6.73
2.84
.96
1.87
1.28

7.97
7.57
4.72
2.66
5.36
2.31
.94
1.60
1.08

6.5 (2.26)
8.43 (2.51)
4.50 (2.25)b
2.16 (1.72)c
5.43 (1.27)b
2.57 (1.62)
.57 (.53)
.66 (1.03)
.43 (.78)b

(2.92)
(2.84)
(3.37)a
(2.19)a
(3.57)a
(1.77)
(.93)
(1.24)
(1.03)a

(3.06)
(3.24)
(2.98)a
(2.23)b
(2.83)a
(1.94)
(.59)
(1.31)
(.82)a

(3.55)
(3.27)
(2.62)b
(1.77)a
(3.26)b
(1.54)
(.67)
(1.18)
(.74)a

Note: Means that do not share a common subscript differ at the .05 level or smaller by Duncan contrasts. F1: Death and suffering; F2:
Work overload; F3: Uncertainty with the treatment; F4: Problems with the hierarchy; F5: Insufcient preparation; F6: Lack of
support; F7: Not knowing how to handle equipment; F8: Problems with colleagues; F9: Staff shortage.

organizational and extra-organizational) and their


motivation and job satisfaction have decreased, a
situation that would favour the appearance of the
burnout syndrome (Guerrero and Rubio, 2006).

Finally, we did not nd that the youngest nurses with


shorter lengths of service reported worse health. However, the relationship between being young, married and
health does exist. Therefore, we nd that participants

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that are married report better general health than those


who are single. This may be due to the fact that these
people have social support from their partners that help
them deal with stress and enhance self-esteem (Argyle,
1990).
In summary, our study shows a clear effect of the
dimensions of EI on stress and health in the sense that
EI emerges as a protective factor against stress and a
facilitative factor for health (especially the Clarity and
Repair dimensions) in a specic group of workers:
nurses. These comments could be especially important in
training future professionals in these abilities.
It would be very positive for nurses to create in
hospitals training programs dealing with handling
emotions, support groups and networks that would
improve EI abilities and facilitate coping with job
stressors.
There are some limitations of the present study. The
research was focused on self-report measurements. The
adopted cross-sectional research design, as opposed to a
longitudinal or experimental methodology, does not
allow afrmative causal explanations. Furthermore, we
included nurses from different work environments but
did not code the work unit they were working in. It may
be of interest to see whether there were differences
depending on the work environment (emergency,
intensive care and ward).

Acknowledgment
We thank Mike Epps for editing the manuscript.

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