The impact of Emotional Intelligence on job outcomes and turnover intention in Health Care

Abstract

Nursing turnover threatens the perform-ance of health care organizations. This paper examines the influence of Emotional Intelligence (EI), on job out-comes (Job Satisfaction (JS) and Organizational Com-mitment (OC)) on Turnover Intention (TI) of nursing staff working in the health care sector. Although in the relevant literature several studies have examined the direct relationships between any two of these factors, there is lack of an approach which investigates the combined relationships among all these factors. This paper presents a field survey conducted in five private health care organizations which operate in the city of Larisa, Greece. The statistical analysis based on 145 valid questionnaires, confirmed strong association among EI and TI as well as significant relationship be-tween JS and TI. In contrast with the results of other scholars, OC has not been found to be associated with TI.

Full text

The impact of Emotional Intelligence on job outcomes and turnover intention
in Health Care
Panagiotis Trivellas
‡
Vassilis Gerogiannis
†
and Sofia Svarna
†
‡ Technological Educational Institute of Chalkis, Department of Logistics, 32200, Thiva, Greece.
ptriv@tee.gr
† Technological Educational Institute of Larissa. Department of Project Management, 41110, Larissa, Greece.
gerogian@teilar.gr
Abstract: Nursing turnover threatens the perform-
ance of health care organizations. This paper examines
the influence of Emotional Intelligence (EI), on job out-
comes (Job Satisfaction (JS) and Organizational Com-
mitment (OC)) on Turnover Intention (TI) of nursing
staff working in the health care sector. Although in the
relevant literature several studies have examined the
direct relationships between any two of these factors,
there is lack of an approach which investigates the
combined relationships among all these factors. This
paper presents a field survey conducted in five private
health care organizations which operate in the city of
Larisa, Greece. The statistical analysis based on 145
valid questionnaires, confirmed strong association
among EI and TI as well as significant relationship be-
tween JS and TI. In contrast with the results of other
scholars, OC has not been found to be associated with
TI.
Keywords: Emotional Intelligence, Job Satisfaction,
Organizational Commitment, Turnover Intention,
Health Care.
I. INTRODUCTION
Human resources are, without doubt, the core of the
health care industry and an effective health care system
depends mainly on their adequacy, quality and their
right distribution (Firth et al., 2004). Nursing shortages
are proved to be related with adverse incidents and as-
pects of hospital inefficiency (Sellgren, Ekvall and
Tomson, 2007). In Greece, except from a plethora of
doctors, the health care sector presents human re-
sources’ shortages. Therefore, it comes of high impor-
tance to study turnover intention and its antecedents in
the health care sector.
High turnover turns out to be a global phenomenon
(Rana et al., 2009). Many studies have shown that the
intention of quitting a job stems from factors such as
leadership support, organization commitment, and job
satisfaction (Price, 2001; Chiu et al., 2005). In addition,
many researchers (Wong and Law, 2002; Carmeli,
2003; Vakola et al., 2004; Goleman, 1998; Kooker,
Shoultz and Codier, 2007) provided evidence of a nega-
tive relation between turnover intention and Emotional
intelligence.
Despite the fact that job satisfaction, emotional ex-
haustion and stress of nursing staff have been investi-
gated thoroughly, there is limited research upon turn-
over issues and particularly turnover intention of nurs-
ing staff. As illustrated in figure 1, this study investi-
gates the direct relationships between emotional Intelli-
gence (EI) and job outcomes (organizational commit-
ment (OC), job satisfaction (JS) and turnover intention
(TI)).
Figure 1. Conceptual Framework.
II. RESEARCH BACKGROUND
A. Emotional Intelligence in Health Care
Emotion research in health care is categorized into two
major areas: research related to emotional labor (Larson
and Yao, 2005) and research related to emotional intel-
ligence (Goleman, 1998). Referring to the latter, the
importance of emotional Intelligence has been widely
recognized for the case of nursing staff working in
health-care (Larson and Yao, 2005; Kooker, Shoultz
and Codier, 2007).
Emotion is central within health care organizations.
Every member of a hospital’s staff has to deal, in a daily
basis, with events highly related to emotions such as
birth, illness, death. Thus, the work climate becomes
stressful for the nursing staff, which, at the same time is
obliged to perform in the most effective way. High re-
sponsibility upon patients is of utmost importance, as if
not existing, may even cost their life. Moreover, it is
one of the most stressful factors within a heath care or-
ganization; as any other stressor usually moderates
staff’s job satisfaction and creates turnover intentions
(Kooker, Shoultz, & Codier, 2007; Chiu et al., 2005).
This is indeed not just a commonly accepted rational
theory but it has been proved by many researchers, es-
pecially in the last decade (Firth et al., 2004; Sellgren,
Ekvall and Tomson, 2007).
Concluding, there is evidence that EI plays a signifi-
cant role upon turnover intention -that will possibly lead
to the actual quitting (Chiu and Francesco, 2003) – and,
therefore, EI should be further examined as a predictor
of such a behavior. The previous argument becomes of a
greater importance, under the consideration that health
care departments try to prevent intentions of quitting
because the results are higher costs and poor quality of
services provided to patients (Schyns, Torca and
Gossling, 2007; Sellgren, Ekvall and Tomson, 2007).

B. Emotional Intelligence and JS
According to Goleman (1998), individuals that present a
high level of EI tend to experience more positive moods
and emotions in contrast to those with a lower overall
EI. This means that the latter usually translate their feel-
ings to disappointment, anger and infullfilment and by
this way their total satisfaction is reduced. In health care
sector, Guleryuz et al (2008) examined the effect of
emotional intelligence on job satisfaction and organiza-
tional commitment of nurses working in seven univer-
sity hospitals in Turkey. Their findings demonstrated
that Emotional intelligence had a strong positive rela-
tion to job satisfaction. By considering these results, the
first hypothesis of the research is defined as follows:
H1: EI is positively related to JS
C. Emotional Intelligence and OC
The associations between EI and Organizational Com-
mitment has been examined in the relevant literature
and in most cases has been found to be significantly and
positively related with it (Lee and Liu, 2007, Guleryuz
et al., 2008; Zeidner, Matthews and Roberts, 2004;
Wong and Low, 2002; Goleman, 1998; Mayer and Sa-
lovey, 1997). This can be explained from the fact that
people with high emotional intelligence have the ten-
dency to put themselves into positive emotional states
that will probably lead to positive affection towards
their organization (Wong and Law, 2002). Conse-
quently, the second hypothesis in this research is stated
as follows:
H2: EI is positively related to OC.
D. Emotional Intelligence and TI
Staff turnover is defined as “the number of employees
that have quit within a given time period, usually one
year, in relation to the total number of employees”
(Newman et al., 2002, the HSM Group 2002 cited in
Sellgren, Ekvall and Tomson, 2007, p.172). Employee’s
intention to quit is a situation that all managers try to
eliminate within their organization as the actual quitting
not only leads to higher costs as, for example, recruiting
new employees (Firth 2004; Schyns, Torca and
Gossling 2007) but also has negative consequences on
the quality of services provided. In the case of a health-
care industry this sometimes means the undermining of
the patients’ safety (Sellgren, Ekvall and Tomson,
2007).
According to past findings, turnover intention’ rela-
tionship with EI has been proved to be negative (Wong
and Law, 2002; Goleman, 1998; Kooker, Shoultz and
Codier, 2007; Carmeli, 2003; Lee and Liu, 2007; Fal-
kenburg and Schyns, 2007; Firth et al., 2004). Particu-
larly, Wong and Law (2002) have supported this argu-
ment and through their study they have highlighted the
fact that the higher the emotional labor in a particular
job, the stronger EI is negatively related to turnover
intention. By considering that health care sector is a
workplace with high emotional labor, the third hypothe-
sis in this study is stated as follows:
H3: EI is negatively related to TI.
III. RESEARCH METHODOLOGY
A. Sample
The field research was conducted in five private general
hospitals in the area of Thessaly, Greece. Structured
questionnaires were distributed to 266 nurses and 145
valid questionnaires were returned. Response rate was
54.5%. Most nurses were female (86.2%) and their
mean age was 34.3 years (SD=9.6). The average num-
ber of years of nursing experience was 12.3 (SD=7.3)
while mean organizational tenure was 9.4 years
(SD=4.2).
B. Questionnaire design
Emotional Intelligence was measured with the Meyer,
Salovey and Caruso (2002) Emotional Intelligence Test,
(MSCEIT), which has been proved to provide high va-
lidity (Brackett and Mayer, 2003; Brackett et al., 2006;
Rode et al., 2008). It was adopted a short version of 16
items from the 141 items of the MSCEIT instrument -
four items for each aspect of EI - to test identifying
emotions, understanding emotions, using emotions and
managing emotions, respectively.
Allen and Meyer’s (1990a,b) Organizational Com-
mitment scale is used to measure the aspects of OC. In
total, 12 items were adopted, related with two of the
three factors of Allen and Meyer’s model, that of Affec-
tive (AC) and Continuance Commitment (CC).
Job Satisfaction is measured using Melia and Peiro’s
S20/23 questionnaire (Melia and Peiro, 1989). It con-
sists of 23 items and assesses various specific factors of
satisfaction, such as intrinsic job characteristics, super-
vision, participation and physical environment which
are highly matched with the different dimensions of the
nursing job satisfaction. The questionnaire presents
high-level of validity, high internal consistency and
adapts adequately to different organizational contexts
(Saura et al., 2005; Gil et al., 2005). We adopted 16
items from this tool, which are relevant to our case.
Intention to quit was measured by using the three
item questionnaire of Kim et al. (1996) that is also con-
sidered to provide high validity. The instrument was
selected because it is a simple measure and very under-
standable for the respondents (Price, 2003). To ensure
the validity of the item translation, a (English/Greek)
translate/back translate procedure (Brisles, 1970; La-
roche et al., 2003) was used. Responses were assessed
on 5-point Likert scales.
C. Data Analysis
Initially, Principal Component Analysis (PCA) has been
conducted to examine the underlying factors of Emo-
tional Intelligence, Job Satisfaction, Organizational
Commitment and Turnover Intention scales. All scales
were proved to be one-dimensional. Cronbach’s Alpha
(Cronbach, 1960) has been calculated to assure internal
reliability and consistency. All scales exhibited well
over the minimum acceptable reliability level for alpha

coefficients of 0.7. Finally, multiple regression analyses
applied to test the hypotheses and provide conclusions.
D. Results
To test the hypotheses multiple regression analyses
were conducted. Demographic data (age, working ex-
perience, education level and marital status) were
treated as control variables. In the following tables, the
reciprocal of the tolerance known as the Variance Infla-
tion Factor (VIF) has been used to show how much the
variance of the coefficient estimate is being inflated by
multi-collinearity (i.e., to ensure that multi-collinearity
among independent variables is not an issue during re-
gression analyses). VIF coefficients of above 5 points
indicate a multi-collinearity problem (O'Brien, 2007).
The first regression model has tested if Emotional
Intelligence is related to Job Satisfaction (hypothesis
H1). In Table 1, the values of the standardized coeffi-
cients beta show that EI has a positive and significant
relation to job satisfaction (Std. beta=0.706, p<0.001).
Additionally, EI is positively and significantly related to
the demographic variable marital status (Std. beta
=0.199, p<0.05). Therefore, findings have demonstrated
that married nurses seem to have a greater level of EI.
The independent variables explain the 48.3 of the total
variation of nurses’ job satisfaction.
Both dimensions of Organizational Commitment (af-
fective-continuance) have been examined in regard to
their relationship with EI (hypothesis H2), and they
have not been found to be statistically significant (p>
0.05).
Table 1 presents the statistical analysis results for
testing hypothesis H3, also. EI has been proved to exert
a direct, strong and negative relation with turnover in-
tention (Std. beta=0.666, p<0.001). This means that
employees with a higher degree of EI seem to present a
lower intention to leave their organization. The inde-
pendent variables explain the 43.7 of the total variation
of nurses’ turnover intentions.
JS TI
Std. Beta VIF Std. Beta VIF
Age -0.136 4.357 0.082 4.357
tenure 0.155 2.029 -0.189* 2.029
Education level 0.089 1.728 0.010 1.728
Marital status 0.199* 2.664 -0.050 2.664
EI 0.706*** 1.044 -0.666*** 1.044
R square 0.483*** 0.437***
* Significant at the 0.05 level, ** significant at the 0.01 level,
*** significant at the 0.001 level, N=145
Table 1. Results of multiple regression analyses.
IV. DISCUSSION
This study has examined the impact of EI upon job out-
comes, such as organizational commitment, job satisfac-
tion and turnover intention.
Past literature has proven significant relationships
between EI and these outcomes (Sy, Tram and O’Hara,
2006; Chiva and Alegre, 2008; Guleryuz, Gney, Ay-
dın, and Asan, 2008; Chena, Chuc, Wange and Linf,
2008; Wong and Law, 2002; Carmeli, 2003). However,
in our study some of the hypothesized relationships
have been confirmed. Particularly, EI was found to have
significant and positive relationship with JS (H1) and
significant and negative relationship with turnover in-
tention (H3), as literature suggests. That means that
nurses presented a higher degree of EI tend to be more
satisfied with their work and also had a lower intention
to leave their jobs.
However, EI was not found to have any significant
relationship with neither of the two dimensions of OC.
In a relative study, Guleryuz et al. (2008) have exam-
ined the relations among emotional intelligence, job
satisfaction and organizational commitment of nurses
and also the mediating impact of job satisfaction be-
tween emotional intelligence and organizational com-
mitment. Questionnaires were distributed to 550 nurses
working at different departments of a hospital and from
these 267 questionnaires were analyzed. Their results
presented job satisfaction as a mediator between emo-
tional intelligence and organizational commitment while
OC had a direct, significant and positive relationship
with EI, contrary to the present study that has not re-
sulted in such a relationship.
To conclude, our research findings indicate strong
relationships between EI and TI as well as between EI
and JS, while OC was not found to be related with any
of the above variables.
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