A study of the correlation between residents' humanistic care skills and their level of emotional intelligence

doi:10.21203/rs.3.rs-3211516/v1

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Research Article

A study of the correlation between residents' humanistic care skills and their level of emotional intelligence

https://doi.org/10.21203/rs.3.rs-3211516/v1

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Background

There is variability in the structure of junior doctors' knowledge of humanistic medicine. The level of residents' emotional intelligence affects their professional development and the doctor-patient relationship. At present, there are few studies on the humanistic competence and emotional intelligence of medical residents in China and abroad. The purpose of this study was to investigate the current status of residents' humanistic competence level and emotional intelligence level and to confirm the correlation between humanistic competence level and emotional intelligence level.

Results

The mean score of residents' humanistic care competence was 188.82 ± 20.80, and the mean score of emotional intelligence was 87.08 ± 13.49. Pearson correlation results showed that the level of emotional intelligence (r = 0.400, p = 0.000) was significantly correlated with humanistic care competence. Multiple linear regression analysis showed that self-emotional appraisal, emotional appraisal of others, emotional control, emotional use, and school community work experience were independent predictors of humanistic care competence.

Methods

A cross-sectional survey using the Demographic Characteristics Questionnaire, the Humanistic Care Competence Scale, and the Emotional Intelligence Scale was conducted in September 2022 among residents of a tertiary general hospital in Sichuan Province. Pearson correlation analysis and multiple linear regression analysis were used to analyse the relationship between residents' humanistic care competence scores and emotional intelligence scores.

Conclusion

Residents' humanistic care competence scores were low and there were many factors influencing emotional intelligence and different levels of development. Emotional intelligence was positively associated with humanistic care competence. Emotional intelligence is an important consideration in the development, implementation, and evaluation of humanistic care interventions. Residency programs should provide education and training in humanistic competencies to improve residents' levels of emotional intelligence and promote the overall health of society.

Residents

Emotional Intelligence Level

Humanistic Care Competence

Correlation Study

Resident is the first few years after medical students graduate from university, which is a critical period for training qualified physicians. Residents are the main force responsible for a large amount of clinical work in hospitals[1]. For medical school graduates, residency training is a critical stage for them to acquire knowledge and skills[2]. Medical experts at home and abroad believe that the standardized residency training is very important for building a high-quality medical team and improving the overall medical service level[3]. In Europe and the United States, residency training has been developed for hundreds of years and has formed a relatively complete standardized management system[4]. In the last decade, China has been gradually promoting residency training throughout the country[5]. Residency training is a mandatory part of medical education and an important process in the career path of physicians[6]. It is important to ensure and improve the clinical skills and competence of residents through standardized training of residents. Practical experience in China proves that residency training has become the main mode of post-graduate education for medical students[7]. Residency training allows residents to be competent in skills in a variety of clinical settings[8].

Humanistic care is about listening to patients' needs and wishes, understanding their emotions and feeling the value of life[9] .Humanistic care is a necessary personality and psychological quality for medical staff, which not only improves the quality of health care services, patient satisfaction and professional recognition of residents, but also improves the physical and mental health of patients and influences medical outcomes [10]. In recent years, some researchers have suggested that humanistic care can have a positive impact on patients' postoperative recovery and quality of life [11–13]. Numerous factors influence the ability to provide humanistic care, such as individual personality, social support, psychological characteristics, and work [14]. Most of the existing studies have been conducted on nurses[15] or nursing students [13], but there is a paucity of research on the humanistic care competencies of residents[16].

Emotional intelligence is the ability of individuals to monitor their own and others' emotions and use this information to guide their thoughts and behaviour[17]. Some studies have shown that levels of emotional intelligence are negatively correlated with anxiety, stress and depression[18]. Developing emotional intelligence can improve the experience of inpatients[19]. Some studies on nurses have shown that the level of emotional intelligence affects well-being at work[20] and can also have a positive or negative impact on nursing behaviour[21]. Healthcare workers with high emotional intelligence are better able to communicate with patients or their families and to gain support and understanding from patients. Workers with negative emotions have a lower sense of well-being at work than those with positive emotions.

Therefore, it is important to study residents' humanistic care ability and emotional intelligence level, and to develop residents' emotional management ability to improve their professional quality and competence in clinical work. This study investigated the humanistic caring ability and emotional intelligence level of residents in an internship and standardised training in a tertiary care general hospital, and explored the correlation between the humanistic caring ability and emotional intelligence level of residents to provide a reference for the implementation of humanistic care interventions.

The study was conducted in accordance with the Declaration of Helsinki and related guidelines and regulations. The study was reviewed and approved by the Ethics Committee of Panzhihua Central Hospital, following the principles of informed consent and voluntary participation, and a cross-sectional survey was conducted from September to October 2022 in Panzhihua, Sichuan Province, China. Before the study was implemented, the investigators were informed of the significance of the study and signed an informed consent form, which clearly indicated that the survey would be completed anonymously, that their personal information would be protected, and that they had the right to choose whether or not to complete the questionnaire. All data were coded for research use only and only the research team had access to the data.

The study used the Demographic Characteristics Questionnaire (DQ), the Competence in Humanistic Care Inventory (CAI) and the Emotional Intelligence Inventory (WLEIS). The Demographic Characteristics Questionnaire was developed by the researcher to obtain information on socio-demographic variables such as age, gender, household registration, families with one child, level of education, time spent in clinical practice, experience in school clubs, experience in voluntary activities and whether they had received training in humanistic care.

The Competence Assessment for Human Caring ( CAI ) scale, developed by the American nurse scientist Nkongho, is used to test a person's ability to care for others [22]. The CAI has 37 items and is divided into three dimensions: awareness (14 items), which is the level of knowledge about caring; courage (13 items), which is the ability to take the initiative to care for oneself and others and to deal with unknown situations; and patience (10 items), which is patience and perseverance. "13 items were reverse scored. The total score of the CAI ranges from 37 to 259, with the cognitive dimension ranging from 14 to 98, the courage dimension from 13 to 91 and the patience dimension from 10 to 70. Higher total scores indicate greater caring capacity. The normative scores for this scale are: scores above 220.3 indicate high levels of caregiving; scores between 220.3 and 203.1 are moderate; scores below 203.1 indicate low levels of caregiving.

The English version of the WLEIS was developed by Wong and Law (2002) and has been translated and revised several times to form the Chinese version of the WLEIS, which consists of 16 items, including "Self-Emotional Appraisal", "Emotional Appraisal of Others", "Emotional Control", and "Emotional Appraisal of Others". "Each dimension contains 4 items and is scored on a 7-point Likert scale, where '1' means 'strongly disagree' and '7' means 'strongly agree'. The scores ranged from 16 to 112, with higher scores indicating higher emotional intelligence.

Data Source

The study was conducted among residents who were undergoing standardised training at Panzhihua Central Hospital. With 1,956 beds and nearly 2,000 staff, Panzhihua Central Hospital trains more than 300 residents each year and is the largest tertiary A general hospital in the Panzhihua region of western China.

The researcher created a standardised questionnaire with instructions on the Golden Data data collection platform and sent the questionnaire access QR code to the resident's WeChat group. Residents were not required to provide any personally identifiable information (name, ID, or contact information). During the survey, residents were informed about the purpose and significance of the study, and completion of the questionnaire was considered as the respondent's verbal consent to participate in the study.

Data analysis

Data were analysed using SPSS 26.0 statistical software, with differences considered statistically significant at P < 0.05. The study used descriptive statistics of residents' demographic characteristics, humanistic care competencies and emotional intelligence levels. Pearson correlation analysis was used to determine the relationship between humanistic care competencies and emotional intelligence scores. Multiple linear regression analysis was used to analyse the relationship between potential influences (i.e. socio-demographic characteristics, level of emotional intelligence) and the dependent variable, humanistic care competencies.

Sociodemographic characteristics of the residents

A total of 236 residents participated in this study. general information about the participating residents is shown in Table 1. the mean age of the participating residents was 25 ± 1.357 years, of which 110 (46.6%) were male and 126 (53.4%) were female.Of the respondents, 186 (78.8%) had a rural household registration and 173 (73.3%) had more than one child in the household. In terms of educational attainment, 177 (75%) had a bachelor's degree and 11 (4.7%) had a postgraduate degree. In terms of duration of clinical practice, 51 (21.6%) residents had been in clinical practice for less than 1 year, 95 (40.3%) had been in clinical practice for 1–2 years, 76 (32.2%) had been in clinical practice for 2–3 years, 8 (3.4%) had been in clinical practice for 3–4 years and 6 (2.5%) had clinical practice for more than 4 years.190 (80.5%) of the residents had experience working in clubs during school, 191 (80.9%) had experience volunteering, and 156 (66.1%) had participated in training related to humanistic care. Demographic information of the respondents is shown in Table 1.

Table 1

Demographic information characteristics of residents (N = 236)
Variable	groups	Number of participants (N = 236)	Percentage (%)
Gender	Male	110	46.6
	Female	126	53.4
Household registration	City	50	21.2
	Rural	186	78.8
One-child family	No	173	73.3
	Yes	63	26.7
Education level	junior college students	48	20.3
	undergraduates	177	75.0
	graduate student	11	4.7
Length of clinical practice	Less than 1 year	51	21.6
	1 year − 2 years	95	40.3
	2 years − 3 years	76	32.2
	3 years − 4 years	8	3.4
	More than 4 years	6	2.5
School community work experience	None	46	19.5
	Yes	190	80.5
Experience in volunteer activities	None	45	19.1
	Yes	191	80.9
Humanistic care related training	No	80	33.9
	Yes	156	66.1

Residents' humanistic competence and emotional intelligence scores

The humanistic competence and emotional intelligence scores of the 236 residents in the study were 188.82 ± 20.80 and 87.08 ± 13.49, respectively. The range of scores for each dimension of humanistic competence was 48.62–79.92, with Cognition scoring the highest at 79.92 ± 10.04, followed by Patience at 60.28 ± 6.29 and Courage at 48.62 ± 18.11. Emotional intelligence scores ranged from 21.51 to 22.29, with the highest score of 22.29 ± 3.81 for self-emotional appraisal and the lowest score of 21.51 ± 3.77 for emotional use, and intermediate scores of 21.64 ± 3.84 for emotional appraisal of others and emotional control, and 21.64 ± 3.50 points respectively. Dimension Score Indicator = average score obtained by the student for the dimension/total score for the dimension*100%. Details of the residents' scores on humanistic care competencies and emotional intelligence levels are shown in Table 2.

Table 2

Scores of Residents' Humanistic Care Competence and Emotional Intelligence Levels (N = 236)
Dimension	Entries number	Lowest Score	Highest score	Mean ± Standard deviation	dimension score
Cognition	14	56.00	98.00	79.92 ± 10.04	81.55%
Courage	13	13.00	79.00	48.62 ± 18.11	61.54%
Patience	10	39.00	70.00	60.28 ± 6.29	86.11%
Human Caring Skills	37	147.00	235.00	188.82 ± 20.80	80.35%
Self-Emotional Assessment	4	12.00	28.00	22.29 ± 3.81	79.61%
Emotional Assessment of Others	4	11.00	28.00	21.64 ± 3.84	77.29%
Emotion Control	4	13.00	28.00	21.64 ± 3.50	77.29%
Emotional Application	4	11.00	28.00	21.51 ± 3.77	76.82%
Emotional Intelligence Level	16	53.00	112.00	87.08 ± 13.49	77.75%

Relationship between humanistic care competencies and emotional intelligence levels

In the study, emotional intelligence levels were positively correlated with humanistic care competencies (r = 0.400, p = 0.000). The cognitive and patience dimensions of humanistic caring were positively and significantly correlated with levels of emotional intelligence and each of its dimensions. The courage dimension of human caring competence was negatively and significantly correlated with emotional intelligence and each of its dimensions. The results of the correlations between human caring competencies and levels of emotional intelligence are shown in Table 3.

Table 3

Correlation coefficients between residents' humanistic care competence and level of emotional intelligence (N = 236)
Dimension	Self-Emotional Assessment	Emotional Appraisal of Others	Emotional Control	Emotional Application	Emotional Intelligence Level
Cognition	0.771***	0.755***	0.762***	0.747***	0.838***
Courage	-0.183**	-0.220**	-0.271***	-0.226***	-0.248***
Patience	0.628***	0.660***	0.624***	0.617***	0.699***
Human Care Skills	0.402***	0.373***	0.320***	0.350***	0.400***
** Significant correlation at the 0.01 level (two-tailed).
***Significant correlation at the 0.000 level (two-tailed).

Analysis of factors associated with humanistic care competencies

The analysis of factors associated with residents' humanistic care competencies was carried out using the socio-demographic characteristics of the residents and the four dimensions of emotional intelligence (self-emotional appraisal, emotional appraisal of others, emotional control and emotional use) as independent variables in a multiple linear regression of humanistic care competencies. 0.001), emotional appraisal of others (P = 0.029), emotional control (P = 0.024), emotional use (P = 0.108) and experience of working in the school community (P = 0.001) were independent predictors of humanistic competence. People with good emotion management skills were more likely to have better humanistic care skills. Those with good emotional control skills were less likely to have humanistic competence. Of these, sociodemographic characteristics had the greatest predictive power for humanistic care competencies. Multiple linear regression analysis of factors affecting residents were shown in Table 4.

Table 4

Multiple Linear Regression Analysis of Factors Influencing Residents' Competence in Humanistic Care (N = 236)
Influencing Factors	B	SE	Beta	t	P
Self-assessment of emotions	1.817	0.565	0.333	3.214	0.001
Emotional appraisal by others	1.123	0.512	0.207	2.192	0.029
Emotion Control	-1.814	0.801	-0.305	-2.265	0.024
Emotional application	0.97	0.601	0.176	1.614	0.108
School community work experience	10.449	3.133	0.199	3.335	0.001

Current status of human caring capacity and emotional intelligence level

The study examined the factors that may influence residents' humanistic care competencies through a questionnaire that described their humanistic care competencies and emotional intelligence levels. The mean (standard deviation) score for humanistic care competencies among the 236 residents surveyed was 188.82 (20.80). The humanistic caregiving competency scores in our study were higher than the scores of 184.63 ± 19.88 in a previous study conducted in China[23]. This may be because humanistic care education has received more attention in recent years, with many universities offering humanistic care courses and residents' humanistic care skills being improved[24]. Some studies have also shown that internships are positively correlated with residents' humanistic care competencies and that residents' humanistic care competencies improve after internships. It has been suggested that the key to improving humanistic competencies is to improve care throughout the health care system[25], for example by using appropriate teaching concepts for caring education and helping students to improve their caring competencies in the teaching process. The study analyzed the dimensions of residents' humanistic caring ability, and the highest score among the 3 dimensions was "patience" (86.11%), followed by cognition (81.55%), and finally courage (61.54%). This result may be related to the fact that at the present stage of China's standardized residency training education focuses on theoretical education and the dissemination of health knowledge. The reason for the lowest score of "courage" (61.54%) among all dimensions may be related to the fact that the respondents of this study are residents who have just entered the clinic and lack the practice of "courage". On the other hand, humanities teaching in China is still based on the classroom lecture system, with classroom lectures as the basic form of teaching and lack of practical and experiential links, which results in the residents' high scores in theoretical knowledge of humanities and insufficient ability to solve practical clinical problems. The results of the study showed that the mean (standard deviation) of the emotional intelligence level of the surveyed residents was 87.08 (13.49) and the score index was77.75%, which is higher than the results of Suzanne Nightingale [26]who used this scale to investigate the emotional intelligence of secondary school students, which may be related to the fact that the respondents in this study had a higher age and education level.Beryl Mansel et al.[27] investigated the emotional intelligence of nurses and found that the scores of emotional intelligence increased with the increase of age, and that age and emotional intelligence were positively. Phillips et al.'s [28]survey on emotional intelligence of nurse managers showed that the group with a bachelor's degree scored significantly higher on "emotional recognition" than the group with a college degree or less.

Residents' level of emotional intelligence is positively associated with humanistic care competence

Emotional intelligence refers to a kind of social wisdom that an individual has to recognize and control oneself and others 'emotions, and can use this information to guide their thinking and actions, reflecting the ability of people's feelings, understand, understand, use, express, control and regulate self and others' emotions. The higher the emotional intelligence, the more sensitive to the needs of others. Residents' humanistic care competence was positively correlated with emotional intelligence (P < 0.00). Cognition and patience were highly correlated with emotional intelligence, with correlation coefficients of 0.838 and 0.699, respectively (P < 0.00). Courage was negatively correlated with emotional intelligence, with a correlation coefficient of -0.248 (P < 0.00). Residents with high emotional intelligence are able to identify patients' needs through keen observation, and at the same time are able to quickly sense patients' physical and mental pain, and meet their physical and mental needs in the interests of the patients, thereby alleviating their suffering. Residents with high emotional intelligence are able to control their emotions rationally, observe changes in the patient's condition and mood, and try their best to help the patient solve his or her problems and meet his or her needs. The higher the score of emotional intelligence level of the residents, the stronger the humanistic care ability, in line with a study by Ma Jingjing et al 2022[29]. Among the factors measured by emotional intelligence levels, those who can objectively self-evaluate their emotions, assess the emotions of others, and control and apply their emotions appropriately have higher levels of emotional intelligence and demonstrate higher emotional intelligence in learning and life. Highly emotionally intelligent healthcare professionals have lower levels of job burnout and are more conducive to a harmonious doctor-patient relationship[30]. Of the dimensions of emotional intelligence, self-emotional ratings correlated most strongly with humanistic care competencies (r = 0.402, p = 0.000). A stable mood and high work ethic have a positive appeal to patients and can lead to better treatment outcomes. On the contrary, if the resident's mood is low, his or her response to the patient is cold, and he or she cannot achieve emotional communication, he or she will be resistant and resentful, which is not conducive to the treatment. Therefore, the ability of residents to better control their emotions is key to improving treatment outcomes. Emotional control is an important component of emotional intelligence, and improving emotional control will help improve residents' humanistic care.

Residents' level of emotional intelligence is a significant factor in humanistic care competence

The connotation of emotional intelligence has deepened with the human understanding of emotional intelligence. Mansel, B et al. further define emotional intelligence as the ability to rationally recognize one's own, other's, and society's emotions and to apply them appropriately[27]. Emotional intelligence has a positive effect on enhancing residents' humanistic competence and instilling faith and hope. Residents with high emotional intelligence are not only able to recognize adverse emotions in patients, but also able to change patients' emotions through positive and positive guidance, and instill beliefs and emotions in patients to overcome their illnesses.In the study, multiple linear regression analysis indicated that residents' level of emotional intelligence was a significant factor influencing humanistic care competencies. Multiple linear regression analysis showed that self-emotional appraisal, emotional appraisal of others, emotional control, emotional use and experience of working in the school community were independent predictors of humanistic care competencies. A study by Papathanasiou Ioanna V et al. showed that as overall emotional intelligence increased, so did the frequency and importance of caring behaviours [21]. Patients can be better served through objective self-emotional appraisal, accurate assessment of others' emotions, and appropriate emotional control. It is recommended that the level of emotional intelligence of residents is improved and that humanistic care skills be enhanced through training in humanistic literacy courses. In this study, school community work experience was identified as a significant determinant through multiple linear regression analysis. It was found that residents with school community work experience scored higher on emotional intelligence levels. Therefore, residents should be encouraged to actively organise or participate in various school activities and social practices to enhance their emotional intelligence levels. Medical educators should guide residents to establish correct professional values and a proper outlook on life, improve self-efficacy, and enhance their humanistic nursing skills. Medical schools and hospitals should focus on creating a humanistic atmosphere and play an exemplary role of teachers caring for their students so that residents can gradually develop the awareness and ability of humanistic care in an environment where they fully feel and understand caring.

The findings suggest that residents' levels of emotional intelligence are related to humanistic care competencies and that little previous research has examined the relationship between them. The findings of the study help to raise the profile of emotional intelligence levels and humanistic care competencies among educators. Building on existing research, researchers can develop targeted, actionable intervention programmes to explore specific interventions to improve residents' humanistic care competencies from the perspective of enhancing emotional intelligence levels.

Humanistic care competence is one of the core competencies of residents. Residents' humanistic care competence scores are low and there are many factors influencing emotional intelligence and different levels of development. Emotional intelligence is positively correlated with humanistic care competencies. The level of emotional intelligence is an important consideration in the development, implementation and evaluation of humanistic care interventions. Residency training units should reform their educational models to integrate the enhancement of emotional intelligence levels with humanistic education, pay attention to the care of residents in their daily teaching, allow residents to develop in an environment of humanistic care, improve their humanistic care competencies, and promote the overall health of society.

Limitations

Two limitations to our study need to be addressed. Firstly, the sample size is small and hardly representative of a country or region, and the next study could expand the sample size. Secondly, as a cross-sectional survey, this study lacks an assessment of the dynamics of resident competence in humanistic care, which needs to be further explored.

Competing interests

The authors declare no competing interests.

Authors' contributions

PJ, XSW and YJ developed the theoretical, methodological and empirical basis for this project. XHM and XSW collected the data. LMW and PJ carried out the analysis. All authors participated in the discussion of the results and in drafting and revising the manuscript. All authors read and approved the final manuscript.

Acknowledgement

This study was funded by a grant (No. JJ2216) from Panzhihua City College in April 2022. The authors would like to thank all the residents who participated in this study and all the faculty members of the Academic Affairs Department for their valuable cooperation.

Funding

This paper reports some results of an experimental project funded by Panzhihua City College. Grant number: JJ2216.

Availability of data and materials

Due to data protection regulations and agreements between researchers and participants, the datasets generated and/or analysed during this study are not publicly available but are available from the corresponding authors upon reasonable request.

Ethics approval and consent to participate

All procedures were performed in accordance with relevant guidelines and regulations. Our study was approved by the Ethics Committee of Panzhihua Central Hospital. Informed consent was obtained from all study participants.

Consent for publication

All authors agree to publish our papers in accordance with the agreement proposed by the journal.

Author Details

1 Academic Affairs Section, Panzhihua Central Hospital,Sichuan China, 617067

2 Orthopedics department of Panzhihua City Central Hospital,Sichuan China, 617067

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A study of the correlation between residents' humanistic care skills and their level of emotional intelligence

Status:

Version 1

Abstract

Background

Methods

Data Source

Data analysis

Results

Sociodemographic characteristics of the residents

Residents' humanistic competence and emotional intelligence scores

Relationship between humanistic care competencies and emotional intelligence levels

Analysis of factors associated with humanistic care competencies

Discussion

Current status of human caring capacity and emotional intelligence level

Residents' level of emotional intelligence is positively associated with humanistic care competence

Residents' level of emotional intelligence is a significant factor in humanistic care competence

Conclusions

Limitations

Declarations

References

Additional Declarations

Status:

Version 1