EI makes the nurse resistant to external demands and pressures. It involves both internal and external elements. The internal elements include self awareness, self-concept, independence, self-actualization, and decisiveness. The external factors include interpersonal relationships, empathy, and responsibility. Additionally, EI involves the ability of the nurses for accepting the realities of life and the ability to cope with stress and equipped with technical abilities. These abilities make the nurse self-aware composed, respectable, observant, supportive, participative, visionary, and receptive in confrontation with others or situations.The construct of EI as an inclusive theory was discussed by Salovey & Mayer in 1990. They clarified EI as an important component of social intelligence and it helps an individual to encourage self-feelings, to remain positive as well as nurture relationships. Goleman in 1995, and Freshman and Rubino in 2002 extended the work of Salovey and Mayer, and they identified five core skills or/ dimensions for EI as; self awareness, self regulation, motivation, empathy, and social skills.
First dimension is self-awareness; which is defined as knowing and having control on self in spite of adverse situations, maintaining calmness, and making a calculated decision. Second is self-regulation; means adaptability to changes and control over impulses. The third is motivation wherein the individual continuously moves towards his/her goal in spite of lack of resources and ability to enjoy and to be passionate toward work activities. The fourth is empathy wherein an employee is not only concerned about self but also understands the feelings of co-workers. The people under this category go out of the way to help those who are under frustration or feeling depressed. The final is social skills wherein an individual is expert in skills like networking, persuasion and can successfully convert an unfavorable situation into a favorable one by his/her social skills.
Emotional intelligence is an extremely important factor for decision making. Head nurses make stream decision, and communicate those decisions to other organizational members. As, decision making skill is deemed to be a key feature of the head nurse’s role in today’s health care organizations. Besides that, decision-making is an essential aspect of management, and a vital ability for the practice of nursing that enables head nurses to perform their complex responsibilities. Decision-making is a behavior displayed when selecting and implementing a course of action from among alternatives with the purpose of dealing with a particular situation or problem.
Moreover, decision-making skills are enhanced and developed through a process of decision-making. First step of the decision making process is the head nurse ability to identify the problem and recognize that a decision is necessary then, determine the suitable alternatives before selecting the “best” alternative, and putting it into action. Finally, the head nurse should implement and evaluate the chosen solution. To ensure the success of implementation, there is a need to do two things: plan carefully and be sensitive to those affected. While evaluating the decision made, if the action does not work, one can give it more time, change it slightly, try another alternative, or start over again.
Furthermore, every head nurse has a unique way of thinking and learning, as well has a unique style of making decisions. There are two theories of decision-making that have been used in the nursing as analytical– systematic and intuitive–interpretive decision-making theories. The analytical– systematic theory depicts the cognitive processing in clinical decision-making and presumes that persons can shift through a number of stages in the decision-making process. The analytical– systematic theory suppose that nurses use a hypothetical– deductive approach in clinical decision-making. On the other side, intuitive–interpretive decision-making theories center on the relationship between surmise, intuition and nursing knowledge .These theories suggested that the process of making decisions is grasped on a continuum from analysis to intuition, as it is based on analytical–systematic and intuitive–interpretive theories.
Moreover, there are three models of clinical decision-making that explain and clarify the decision making process nurses can use to reach choice. Three major models that found in the literature are the humanistic-intuitive model, the information-processing model, and the cognitive continuum theory. The humanistic-intuitive approach confirms personal, sense, and contextual elements in decision-making. The basic focus of this model is to explain the changes in making decision between novice and expert nurses . In the information-processing model, decisions are accomplish in an orderly and analytical pattern. They go ahead with a series of steps that portray cue acquisition, hypothesis generation, cue interpretation, and hypothesis evaluation. The cognitive continuum theory severs to bear down the totally differences between systematic-analytical and intuitive approaches by feigned that both are required to achieve most favorable decisions.
Significance of the study:
The continuous globalization has created a competitive environment which demands head nurses having responsibility to be good decision maker through managing their emotional intelligence to determine innovative behavior and perform their work accurately and in a timely manner because, delaying decisions can affect the organization negatively, there is no room for mistakes. The importance of emotions in organizational settings is pervasive. Both employers and managers need to learn to understand their emotions as well as others’ feelings, emotional intelligence is a predictor of success. Head nurses with higher EI have a greater potential to be successful in a leader role. Emotional intelligence can be developed and trained overtime and its skills has effect on head nurses behavior which ultimately affects his/her managerial skills as decision-making [19, 27].
Aim of the study:
This study was aimed to assess the effect of emotional intelligence program for head nurses on their decision making style.
There will be significant improvement of head nurses` knowledge related to emotional intelligence after implementation of educational program.
Head nurses’ decision making style will be improved after implementation of educational program than before.
There will be a positive correlation between head nurses` emotional intelligence and their decision making style after implementation of educational program.
Subjects and Methods
This study demonstrated quasi experimental design to achieve the aim of the present study.
The study was conducted in all units (57) at Benha University Hospital. All the available head nurses (57) who are working in the above mention study setting, at the time of study, and agree to participate after clarification of purpose of the study.
Three tools were used to collect the data of this study:
Emotional Intelligence Knowledge Questionnaire: A structured questionnaire developed by the researcher based on review of related literature. it is consisting of two parts, part one include personal characteristics of head nurses as age, sex, department, educational qualification, and experience years, part two: emotional intelligence knowledge questionnaire . It is consisting of thirty questions which are (fifteen questions multiple choice, and fifteen questions True and false questions)
Scoring system of emotional intelligence questionnaire’s tool: The questions were scored as “1” for correct answer, and “zero” for incorrect answer. The total scores were summed up and emotional intelligence knowledge expressed as follow;
Standardized Emotional Intelligence Questionnaire: adopted by  it includes 25-items closed-ended questionnaire. It was used to assess the level of emotional intelligence for head nurses in five dimensions, which are self awareness (3 items), self-regulation (5 items), motivation (4 items), empathy (5 items), and social skills (8 items).
Scoring system: using a five point Likert- scale ranging from (1-5) strongly disagree (1), disagree (2), neutral (3), agree (4) and strongly agree (5). The total score is ranging from 25 to 125, with a score ranging from 101 to 125 indicating high, from 50 to 100 indicating moderate, and below 50 indicating low emotional intelligence.
Nursing Decision-Making Instrument Scale Revised (NDMI): adopted by . It was used to assess level of decision making (style) among head nurses that reflect their actions It includes 24-item maintains the four stages, which are data collection (6 items), data processing and identification of the problem (6 items), plan of action (6 items), and Implementation, monitoring, and evaluation (6 items). Scoring system: using a five point Likert- scale range of responses from (1) almost never to (5) almost always. Head nurses are asked to mark the answer that best describes their own action. The lower the score, the more analytic the decision maker is. The higher the score, the more intuitive the decision maker is. The head nurse was considered low decision maker if her score on this scale ≤67 point “analytical”, moderate if her score on this scale 68 -78 point”qusai-rational” and high if her score on this scale >78 point “intuitive”.
Tools validity and reliability
The tools were reviewed by expert panel of different nursing departments. The panel ascertained the face and content validity of the tools. The reliability was done by Cronbach’s Alpha coefficient test. Cronbach’s alphas were (r= 0.90, 0.89& 0.94) emotional intelligence knowledge questionnaire, Standardized emotional intelligence questionnaire, Nursing Decision-Making Instrument Scale respectively.
The agreement for participation of the head nurses were taken after aims of the study have been explained to them, they were given an opportunity to refuse to participate, and they were assured that the information collected would be treated confidentially and used for the research purpose only.
A pilot study was carried out on 10% from the total number of head nurses (6) to assess the tools clarity, objectivity and feasibility as well as to estimate the time needed for filling the tools. The pilot study was included in the main study sample.
Educational program about emotional intelligence
This program was designed to provide head nurses an opportunity to develop level of emotional intelligence that affect decision making. It covers the following items; definition, components, factors, qualities, goal, advantages &disadvantage, theories, weakness & strength, impact, and challenges.
A written official letter was obtained from the dean of the Faculty of Nursing, Benha University and delivered to the director of Benha University Hospital in order to obtain their approval for conducting the study after explaining its purpose. The study was carried out for (10 months) from at the beginning of February 2016 to the end of November 2016 as the following:
The pre-intervention phase that took about two months from the beginning of February 2016 to the end of March 2016. The training strategy was developed based on the detected needs. As well, time schedule, teaching sessions, media included, and the handout were prepared.
The intervention phase was carried out from the beginning of April 2016 to end of June 2016. First grouped head nurses according to their empty times. The preprogram tests were fulfilled by the head nurses before beginning of the training program. The emotional intelligence knowledge questionnaire took from 30–35 minutes to be completed, and standardized trait emotional intelligence questionnaire took from 10–15 minutes to be completed, and 10-15 minute for completing NDMI. This pre-study test was designed to allow the researchers collect a baseline assessment of head nurses’ knowledge and skills in order to compare it with immediate post and follow-up program. The data collected two days/week in the morning and afternoon shift.
After the questionnaires were completed, the training program was implemented by the researchers. The time plan of the program implemented over the period from the mid of May 2016 to end of June 2016. The training program has taken 18 hours distributed as the following; 12 sessions, 1.5hour/session, 2days/week. Each researcher implements the program with one group in the days by using available resources, relevant contents and instructional strategies for each session. Different methods of teaching were used such as lectures, group discussion, and brainstorming. Instructional media included handout prepared by the researchers and distributed to all participants in the first day.
The post-intervention phase (Evaluation Phase). In this phase, the effect of the strategy was evaluated; it was carried out immediately after the program implementation and after 3 months of intervention by using the same tools which were used before the program implementation. The time of the data collection lasted for five months from the beginning of July 2016 to end of November 2016.
Data were collected, entered and analyzed by using SPSS (version 20) software computer package (special package for social science). Presented in tabular form. Descriptive statistics were applied (e.g., frequency, percentages, mean, and standard deviation). Test of significance Chi-square “X2” and correlation coefficient (r) were used. Statistically significant difference was considered at p-value p≤0.05.