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The Relationship Between Emotional Intelligence and Communication Skills in Healthcare Staﬀ

Introduction: Emotional intelligence (EI), also known as Emotional Quotient, is deﬁned as an individual’s alertness on his or her own emotions, together by an alertness of the emotions in other people and the capacity to manage them and act appropriately. Objectives: The purpose of this study was to investigate the relationship between the EI (Emotional Intelligence) and communication skills of healthcare staﬀ working at ambulatory clinics in Shiraz. Methods: 108 healthcare staﬀ was selected using simple random sampling. To assess the EI, a valid and reliable Persian version of Goleman’s questionnaire was used. To assess the communication skills, a questionnaire was designed based on previous questionnaires. For each healthcare staﬀ, ﬁve patients were selected randomly to complete the questionnaires. Results: The total score of the EI was 76.49 ± 2.83 out of 112. The mean total score of the communication skills was 96.80 ± 11.63 out of 120. Therewasasigniﬁcantrelationshipbetweenthetotalscoreof EIandcommunicationskills. TheR2coeﬀcientwas0.74. There was also a signiﬁcant relationship between EI dimensions and the total score of communication skills (P < 0.001). Conclusion: Having a higher level of EI leads to better communication with patients and better health outcomes.


Background
According to Goleman, EI (Emotional Intelligence) consists of multidimensional structures including four important parts: Self-awareness, self-regulatory, self-motivation, and communication/relationship management. Self-awareness is the cognition of emotions. Self-regulatory is defined as emotional balance while self-motivation deals with effectiveness (1). Communication/relationship management deals with the cognitive ability to be sympathetic with others, listen deeply, ask the right questions, cooperate, care for, communicate effectively with the patients, and speak eloquently. Patient communication is a necessary skill for healthcare staff. Communication is a two-way method of verbal and nonverbal components. A fair communication can improve patient satisfaction and outcome (2). It seems that the high level of EI in healthcare staff leads to better communication with the patient. Healthcare staff that possesses the necessary abilities of EI would probably present services that lead to patients' satisfaction (3).
Research on EI and communication skill has been usually carried out in the field to determine the features of this ability (4-7). Despite its importance for all healthcare staff, previous studies have not investigated the relationship between communication skills and EI in all health care staff and only focused on physicians and nurses. The purpose of this study was to investigate the relationship between the EI and communication skills of healthcare staff working at teaching ambulatory clinics as affiliated university centers (8).

Methods
This study is a descriptive-analytical study that was done in two teaching outpatient clinics in Shiraz: Imam Reza and Motahari. 108 persons were selected using simple random sampling.
To assess the EI, Goleman's questionnaire was used. This questionnaire included four main dimensions of selfawareness, self-management, social awareness, and communication/relationship management. The questionnaire To assess the communication skills, a questionnaire was designed based on the communication skills components of other questionnaires (10,11). Its content validity was confirmed by 10 medical education experts by using the CVR method, showing a value of higher than 0.62 for all the questions. The reliability of the questionnaire was determined in a pilot study (r = 0.85).
Each question had a score ranging from one to five, showing very weak communication skills and excellent communication skills, respectively. For each healthcare staff, five patients were selected randomly to answer the questionnaires. The mean score of five patients for each healthcare staff was considered as a mean for the communication skills score.
For checking the normality of data, Kolmogorov-Smirnov test was used that was not significant and showed data had a normal distribution. Descriptive statistics, Pearson's correlation coefficient, and Cronbach's alpha were used in analyzing the data using SPSS software.
This study was approved by the Ethics Committee of Shiraz University of Medical Sciences.

Results
108 staff participated in the study. The EI questionnaire consisted of 28 questions scoring in the range of one to five. A score of less than 28 showed a completely inappropriate status, a score of 25 -52 showed an inappropriate status, a score of 57 -84 showed an appropriate status, and a score of over 84 showed a completely appropriate status of the EI (12). The total score of the EI was 76.49 ± 2.83 out of 112. The score of each part of the questionnaire is shown in Table 1.
The mean total score of the communication skills of the staff was estimated to be 96.80 ± 11.63 out of 120. There was a significant relationship between the total score of EI and communication skills (Pearson correlation coefficient = 0.589, P < 0.001, R 2 = 0.74).
There was a significant relationship between other EI dimensions and the total score of the communication skills (P < 0.001).

Discussion
EI is an important factor for patients' satisfaction. In a study on the correlation between EI of nurses and patient's satisfaction, the results showed that as the level of EI in nurses increases, the satisfaction in the patients increases, as well. Therefore, the patient satisfaction was affected by the EI level of the health care providers (13).
The mean total score of Goleman's questionnaire in the present study was equal to 76.49, indicating an appropriate level. Other studies using the same questionnaire showed lower scores (11,14).
The mean score of the communication skills was estimated to be 96.80 ± 11.63 out of 120. Vaghee and colleagues assessed the total score of the communication skills as 87.78 by using a 27-question checklist scoring from 0 to 108, which was similar to the results of the present study (15).
The main aim of this study was to determine the relationship between EI and the communication skills of the staff. A significant, strong, and positive relationship was observed between the EI and the communication skills that was in accordance with the determined coefficient computed in this study (R 2 = 0.74). This showed that more than 70 percent of variances related to the EI were explained by the communication skills, i.e. individuals with a higher level of the EI have a higher score on the communication skills. The same results were reported in other studies (11,16,17).

Conclusion
It can be concluded that having an appropriate level of EI is necessary for ideal communication.
The limitations of this study were the small sample size and the use of questionnaires for measuring communication skills; thus, it was not possible for the researchers to observe the behavior of the staff.

Footnote
Ethical Considerations: All names remained confidential. The ethics commitee of Shirz University of Medical Sciences approved the manuscript. 2 Shiraz E-Med J. 2019; 20(4):e80275.