Emotional intelligence approach as a predictor of job satisfaction among midwives in Northern Iran: A descriptive-correlational study

Abstract

BACKGROUND:

Emotional intelligence (EI) is an important skill for midwives. Our study aimed to understand EI as a predictor of job satisfaction among midwives.

MATERIALS AND METHODS:

This descriptive-correlational study was conducted on 143 employed midwives in maternity wards of government and private hospitals, as well as healthcare centers in Iran. The data were collected using demographic fertility characteristics, EI, and job satisfaction questionnaires. For the assessment of EI, Bar-On’s Emotional Intelligence questionnaire was used which consists of 90 items. For the assessment of job satisfaction, Herzberg’s Job Satisfaction Questionnaire was used, which consists of 72 items. The significance level of the tests was considered to be P < 0.05.

RESULTS:

The results of the study showed that the mean EI and job satisfaction of midwives were moderate (316.57 ± 33.64 and 278.58 ± 25.95, respectively). According to Pearson correlation coefficients, there was a significant positive correlation between total job satisfaction and total EI scores (r = 0.356, P = 0.0001). According to the results of multiple linear regression analysis after adjusting for other variables, job satisfaction of midwives had a significant positive association with total EI and friendly relationships with supervisors (β = 0.258, P = 0.022 and β = 0.267, P = 0.046, respectively).

CONCLUSION:

This study showed that high EI enhances midwives’ job satisfaction. Therefore, midwifery managers should create conditions that help enhance the EI and satisfaction of midwives.

Introduction

Emotional intelligence (EI) is one of the most important psychological factors of the 21^st century, and is closely related to biological sciences, psychology, management services, and academia.[1] EI is defined as the management of emotions and the ability to understand oneself and others. EI skills are essential for effective and healthy functioning, especially in critical situations.[2] It helps individuals to think about their own emotions and those of others and to differentiate between them to organize cognitive processes. EI establishes a strong relationship between knowledge and emotions and brings about a more responsible understanding.[3] Regulating and managing emotions leads to the enhancement of leadership qualities, critical thinking, professional development, interpersonal relationships, planning, and engagement in job performance.[4] EI is an important skill for midwives, enabling them to succeed in dealing with patients, colleagues, and families, and to make intelligent decisions in various aspects of their work.[5]

Job satisfaction is a comprehensive concept that is formed by various components, and overall satisfaction is the cumulative result of these elements.[6] Job satisfaction refers to the pleasurable or positive emotional state resulting from job evaluation or job experiences. Additionally, job satisfaction can be characterized as features that an employee perceives as rewarding and fulfilling.[7] Low job satisfaction is associated with poor health and negative organizational outcomes.[8]

Midwives are considered healthcare professionals, and their job satisfaction is an important factor that affects personal well-being, work commitment, and job outcomes. Making efforts to improve midwives’ job satisfaction is, in fact, an effective way to retain them in the midwifery profession and address the shortage of midwives in the community.[9,10] The utilization of care models by midwives and healthcare managers has a positive impact on the job satisfaction and performance of midwives, and it leads to cost reduction, staff retention, and job burnout prevention.[11] Studies show that there are various approaches to improving job satisfaction among midwives, including important motivational factors that have a positive impact on their job satisfaction, fostering good relationships with colleagues, team support,[12,13] appreciation and support from supervisors,[14] autonomy, interaction with women, and support for normal delivery.[9,15,16] Heavy workload, staff and resource shortages, work-life imbalance, and low wages are factors that reduce job satisfaction.[15,17,18] Improving job satisfaction among midwives is crucial to ensuring their retention in the workforce and the provision of high-quality midwifery care.[19] Job satisfaction has a positive relationship with job performance. Furthermore, job satisfaction plays a positive mediating role in the relationship between EI and job performance. There is a positive relationship between EI, person-environment fit, and intrinsic job satisfaction.[20]

Despite the growing evidence that has been investigated in previous studies to predict the factors of midwifery job satisfaction, attention to the potential capabilities of the EI structure in the dimensions of general mood, adaptability, stress tolerance, communication, as well as the use of problem-solving strategies and its flexibility satisfaction and professional quality of midwives in their job position, evaluation of EI as a predictor of job satisfaction is very important. Our goal in this study was to investigate the relationship between the sub-components of EI and job satisfaction, and the novelty of the study is that we want to investigate which of the sub-components of EI can be a better and stronger predictor of job satisfaction. Therefore, this study was performed to examine the EI approach as a predictor of job satisfaction among midwives in Northern Iran.

Materials and Methods

Study design and setting

This descriptive-correlational study was conducted on 143 employed midwives in maternity wards of government and private hospitals, as well as healthcare centers in Babol City, from June 2020 to April 2022. The study was conducted with the ethics code IR.MUBABOL HIR. REC. 2020.083. The sampling method used was non-random, and convenience sampling was employed based on the available participants. To initiate the study, informed written consent was obtained from all participants. After explaining the objectives of the study and providing information about the procedures and questionnaire completion, voluntary participation, confidentiality of information, the right to withdraw from the study, and non-participation were ensured. The inclusion criteria for the study included a minimum of one year of service experience in the mentioned units and having no physical or mental illness that would interfere with completing the questionnaires. The criteria for withdrawal from the study included a lack of willingness to continue participation, incomplete responses to the questionnaires, migration, and death.

Measurements

The data were collected using demographic fertility characteristics, EI, and job satisfaction questionnaires.

Demographic fertility characteristics

The demographic questionnaire used in this study included age, educational level, years of work experience, marriage duration, relationship with spouse, and relationships with supervisors and subordinates.

EI questionnaire

For the assessment of EI, the Bar-On’s Emotional Intelligence questionnaire was used. This questionnaire consists of 90 items that are answered using a Likert scale ranging from strongly agree to strongly disagree.[21] The questionnaire comprises five dimensions: intrapersonal, interpersonal, stress management, adaptability, and general mood, which collectively measure overall EI. These dimensions include scales such as independence, self-liking, emotional self-awareness, self-esteem, self-regard, empathy, responsibility, interpersonal relationships, stress tolerance, impulse control, reality testing, flexibility, problem-solving, optimism, and happiness. Scoring is done on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree), and for some negatively worded questions, the scoring is reversed from 1 (strongly agree) to 5 (strongly disagree). The total score for each dimension is the sum of the scores for each item within that dimension, and the total score for the questionnaire is the sum of the scores for all 15 dimensions, ranging from 90 to 450. A higher score in this assessment indicates greater success in the specific dimension or overall assessment, and vice versa. The score ranges of 90–209, 210–330, and 331–450 correspond to low, moderate, and high levels of EI, respectively.[21] The reliability of the questionnaire has been reported with Cronbach’s alpha coefficients of 0.76 and 0.75 in various studies.[22,23]

Job satisfaction questionnaires

For the assessment of job satisfaction, Herzberg’s Job Satisfaction Questionnaire was used. This questionnaire consists of 72 items, and for each item, there is a 7-point Likert scale ranging from 1 to 7. The scale represents degrees of agreement, with 1 indicating the lowest level of agreement and 7 indicating the highest level of agreement. The questionnaire includes 36 items related to job satisfaction and 36 items related to job dissatisfaction. The score ranges of 72–214, 215–359, and 360–504 correspond to low, moderate, and high levels of job satisfaction, respectively.[24] The reliability of the test, as measured by Cronbach’s alpha coefficient, is 0.83 for the first section and 0.95 for the second section.[25] Based on a study conducted in Iran, the test validity using Cronbach’s alpha coefficient for the 36-item job satisfaction questionnaire was 0.93, and for the 36-item job dissatisfaction questionnaire, it was 0.92.[26]

Ethics approval and consent to participate

The Ethics Committee of Babol University of Medical Sciences approved the study (ID: IR.MUBABOL HIR. REC. 1399. 083). Before participating in the study, all participants signed a written informed consent form in accordance with the recommendations of the Declaration of Helsinki.

Statistical analysis

The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 25.0. software. Descriptive statistics (mean, standard deviation, frequency distribution table, and relative frequency) were used for quantitative and qualitative variables such as demographic fertility characteristics and components of EI. The Pearson correlation coefficient was used to correlate the total job satisfaction with the total EI and its dimensions and with the demographic fertility characteristics. Multiple linear regression analysis was used for predicting factors of job satisfaction. The significance level of the tests was considered to be P < 0.05.

Results

The results of the study showed that the majority of midwives were in the age group of >35 years and had more than 10 years of work experience. Most of them had friendly relationships with supervisors and subordinates (90.2% and 92.3%, respectively). The average EI and job satisfaction of midwives were moderate (316.57 ± 33.64 and 278.58 ± 25.95, respectively) [Table 1]. The components of EI are presented in Table 2. As observed in the table, the components of independence and realism had the highest and lowest means, respectively (23.00 ± 3.66 and 19.59 ± 3.11) [Table 2].

Table 1.

Demographic fertility characteristics and some variables of midwives (n=143)

Variable		Number		Percent
Age (years)
≤5		55		38.46
>35		88		61.54
Work experience (years)
≤10		60		41.96
>10		83		58.04
Education
< Bachelor’s degree		9		6.3
≥ Bachelor’s degree		134		93.7
Relationship with spouse
Satisfied		75		52.4
Relatively satisfied		13		9.1
Unhappy		1		0.7
Friendly relationship with subordinates
Yes		132		92.3
No		10		7.0
Friendly relationship with supervisors
Yes		129		90.2
No		12		8.4
Variable		Mean		SD
Marriage duration (years)		15.48		9.41
Total EI		316.70		33.73
Total job satisfaction		278.58		25.95

Table 2.

EI components of midwives (n=143)

Components		Min		Max		Mean		SD
Independence		12.00		29.00		23.00		3.66
Self-actualization		12.00		30.00		22.27		3.84
Self-esteem		14.00		28.00		21.16		3.15
Self-instrumental		14.00		30.00		21.69		3.44
Sympathy		13.00		26.00		21.13		2.70
Responsibility		12.00		30.00		21.57		3.50
Interpersonal relationships		12.00		30.00		21.82		3.40
Tolerating mental stress		12.00		27.00		20.52		2.85
Impulse control		7.00		28.00		19.75		3.38
Realism		6.00		28.00		19.59		3.11
Flexibility		6.00		29.00		19.74		3.63
Problem-solving		10.00		29.00		20.99		3.85
Optimism		11.00		30.00		21.29		3.93
Happiness		12.00		29.00		20.19		3.35

According to Pearson correlation coefficients, there was a significant positive correlation between total job satisfaction and total EI scores (r = 0.356, P = 0.0001). The EI domains, including intrapersonal (r = 0.327, P = 0.0001), interpersonal (r = 0.317, P = 0.0001), compatibility (r = 0.229, P < 0.006), and public mood (r = 0.343, P = 0.0001), also had significant positive correlations [Table 3]. Furthermore, based on the Pearson correlation coefficients, job satisfaction had a significant positive correlation with age (r = 0.172, P < 0.041), work experience (r = 0.170, P < 0.045), and marriage duration (r = 0.320, P < 0.005).

Table 3.

Correlation coefficient matrix between job satisfaction with EI and its dimensions in midwives (n=143)

		Intrapersonal		Interpersonal		Stress control		Compatibility		Public mood		Total EI		Total job satisfaction
Intrapersonal		1
Interpersonal		0.779 0.0001		1
Stress control		0.239 0.004		0.291 0.0001		1
Compatibility		0.187 0.026		0.304 0.0001		0.724 0.0001		1
Public mood		0.591 0.0001		0.715 0.0001		0.318 0.0001		0.469 0.0001		1
Total EI		0.826 0.0001		0.855 0.0001		0.599 0.0001		0.643 0.0001		0.810 0.0001		1
Total job satisfaction		0.327 0.0001		0.317 0.0001		0.041 0.633		0.229 0.006		0.343 0.0001		0.356 0.0001		1

Statistical significance was determined by calculating Pearson’s correlational analysis

Regarding the association between EI and its dimensions with job satisfaction of midwives, based on the results of multiple linear regression analysis, 10.07% of the variance of job satisfaction could be interpreted by intrapersonal (β = 0.327, P = 0.0001), 10.1% by interpersonal (β = 0.317, P = 0.0001), 5.3% by compatibility (β = 0.229, P = 0.006), 11.8% by public mood (β = 0.343, P = 0.0001), and 12.7% by total EI (β = 0.356, P = 0.0001) [Table 4].

Table 4.

Linear regression model for EI and its dimensions with job satisfaction in midwives (n=143)

Model		Dependent variable		Independent variable		β*		R 2		95% CI**		P †
1		Job satisfaction		Intrapersonal		0.327		0.107		0.30–0.89		0.0001
2		Job satisfaction		Interpersonal		0.317		0.101		0.47–1.42		0.0001
3		Job satisfaction		Stress control		0.041		0.002		−0.61–1.00		0.633
4		Job satisfaction		Compatibility		0.229		0.053		0.18–1.08		0.006
5		Job satisfaction		Public mood		0.343		0.118		0.72–1.95		0.0001
6		Job satisfaction		Total EI		0.356		0.127		0.15–0.39		0.0001

*β: Standardized coefficients, **CI: Confidence interval, ^†The data were assessed using multiple linear regression

According to the results of multiple linear regression analysis after adjusting for other variables, job satisfaction among midwives had a significant positive association with total EI and friendly relationships with supervisors (β = 0.258, P = 0.022 and β = 0.267, P = 0.046, respectively). This means that higher EI and a better relationship with supervisors were associated with higher job satisfaction [Table 5].

Table 5.

Factors related to job satisfaction of midwives in multiple linear regression analysis (n=143)

Variable		β*		95% CI**		P †
Constant				49.87–206.47		0.002
Work experience		−0.387		−2.73–0.754		0.261
Marriage duration		0.104		−0.79–1.31		0.626
Relationship with spouse		0.088		−9.16–21.83		0.418
Age		0.618		−0.32–3.36		0.104
Friendly relationship with supervisors		0.267		0.41–45.41		0.046
Friendly relationship with subordinates		0.086		−25.43–50.29		0.515
Total EI		0.258		0.02–0.31		0.022

R²=0.127. *β: Standardized coefficients. **CI: Confidence interval. ^†The data were assessed using multiple linear regression

Discussion

The results of this study showed that the mean EI of midwives and their job satisfaction were moderate. In line with our study, the results of the study by Khavayet et al.[13] demonstrated that midwives had a moderate level of job satisfaction. Cassano and colleagues examined the EI of master’s students in nursing and midwifery. The results of their study indicated that women had higher EI scores than men, indicating their excellent ability to express emotions in relationships with others. Additionally, female nursing students and midwifery students outperformed their male counterparts in academic performance. Furthermore, individuals who engaged in educational activities within the organizational domain demonstrated high levels of EI.[5] Another study on the impact of training sessions on EI and job satisfaction among nurses revealed that the average scores of the experimental group increased in the post-test phase. Therefore, training sessions can be used as an important educational component for the mental well-being of employed individuals.[27]

In a study, researchers reported that the highest level of satisfaction among individuals was related to their relationships with supervisors and other nurses, as well as social interactions in the workplace. The lowest level of satisfaction was associated with retirement and reward-related factors. Therefore, internal factors contribute to increased satisfaction, while external factors can lead to dissatisfaction.[28] Employees with high EI generally have lower levels of job stress. They can also provide a high level of job satisfaction.[29] Both internal and external factors play a fundamental role in job satisfaction. Therefore, maternity management should address a set of internal and external factors based on the needs of midwives and organizational commitments to improve their job satisfaction.

The results of our study showed based on the results of multiple linear regression analysis that there was a significant association between the total job satisfaction score and the total EI score, as well as the dimensions of EI, including intrapersonal, interpersonal, compatibility, and public mood. In line with our study, the results of other studies have shown a significant and positive correlation between EI and job satisfaction.[30,31] Bano and colleagues[32] reported a significant and positive correlation between all components of EI, as well as the total EI score, with job satisfaction. Therefore, they suggested that medical colleges should strive to enhance EI among academic individuals. In a study, the results showed that the average scores of EI and self-esteem in students were above average. Furthermore, there was a significant and positive relationship between EI, self-esteem, and all its subscales.[33] Findings from another study indicated a moderate positive correlation between EI and job satisfaction. Additionally, there was a moderate positive correlation between all the subscales of EI and job satisfaction, except for emotional stability.[34] Fashami and colleagues[35] reported a positive correlation between EI and self-management with career field and job outlook. However, there was a negative relationship between the years of education of the spouse and their attitude toward the field of study. Individuals who succeed in understanding and controlling their own and others’ emotions focus on job responsibilities and utilize their emotions constructively in their paths.[36] Therefore, hospital managers should take action to enhance the level of EI among midwives and provide professional psychological training to promote empathy and relational satisfaction, which ultimately leads to job well-being.

The results of this study demonstrated a significant positive correlation between job satisfaction and age, work experience, and marriage duration. In a study, researchers reported a significant relationship between work experience and job satisfaction, while no significant relationship was found between job satisfaction and other demographic variables.[13] The results of a study showed that job satisfaction had a significant correlation with professional values in all subscales.[37] The results of another study showed that the level of job satisfaction among academic individuals varied significantly due to differences in their birthplace.[38] Brayer and colleagues[28] also reported a significant relationship between job classification and the level of job satisfaction. The study conducted by Alheet and colleagues[39] demonstrated a significant relationship between EI and job performance among employees. Additionally, the results showed that EI did not differ based on the gender or age of the employees, but it varied according to their work experience. Hajibabaee and colleagues[40] reported a strong positive correlation between empathy and EI. However, age had a strong negative correlation with EI. The study conducted by Ibrahim and colleagues[41] showed a positive correlation between the EI of students and all their clinical skills in relation to women and midwifery. However, their EI did not have a significant relationship with demographic characteristics. On the other hand, the study conducted by Uchmanowicz and colleagues[42] showed that the level of job burnout among nurses and midwives was low, indicating that determining factors such as life satisfaction, job satisfaction, and life orientation did not allow the development of job burnout in them. Midwives with higher EI perform better at establishing constructive relationships with patients and effectively managing their emotions. Therefore, opportunities should be provided for midwives to develop their communication and emotional skills.

The results of this study, based on the multiple linear regression test after adjustment for other variables, showed that job satisfaction among midwives had a significant positive association with intrapersonal and compatibility aspects but a significant negative association with stress control. Furthermore, based on the results of multiple linear regression tests after adjustment, the job satisfaction of midwives had a significant positive association with total EI and a friendly relationship with supervisors. The results of a study showed a significant and direct correlation between job satisfaction and organizational commitment. Regression analysis further demonstrated that organizational commitment could significantly predict job satisfaction and satisfaction with promotion based on the dimensions.[43] In another study, there was a significant and positive correlation between job well-being and satisfaction with relationships, EI, and empathy. Mediation analysis revealed that empathy and satisfaction with relationships played a mediating role in the relationship between EI and job well-being.[44] The results of a study showed that age, marital status, education level, and job position predicted professional values, while the type of hospital, insurance, and income predicted job satisfaction.[37] Based on the results of another study, job motivation demonstrated a significant and direct relationship with workplace spirituality. According to the findings of this research, promoting spirituality in the workplace can lead to increased motivation and job satisfaction.[45] In a systematic review, 38 studies were selected for examination. The results of the study indicated that the physical work environment, autonomy, and freedom were the most significant factors affecting nurses’ job satisfaction.[46] In the study conducted by Suleman and colleagues, dimensions of EI such as relationship management, emotional stability, self-motivation, honesty, and friendly behavior were significant predictors of job satisfaction. Therefore, focusing on actions that enhance EI is essential.[34] Furthermore, in a study, EI was identified as a strong predictor of professional success.[5] The results of the study conducted by Lartey and colleagues showed that EI did not predict emotional exhaustion. However, age and organizational support had an impact on emotional exhaustion.[1] The results of a study showed that emotional skills could predict employees’ satisfaction with organizational activities.[30] In another study, the findings indicated that EI significantly influenced the level of job satisfaction among healthcare providers. The moderated regression analysis revealed that the relationship between EI and job satisfaction was significantly moderated by gender.[47] Alsughayir and colleagues[48] reported that EI had a significant and positive impact on job satisfaction. Furthermore, job satisfaction acted as a mediator, exerting an indirect effect on the relationship between EI and organizational commitment. In a study, the results showed that self-evaluation was the strongest predictor, while pessimism was the weakest predictor of job satisfaction.[49] The findings of another study indicated that 84% of the variance in job satisfaction was significantly explained by health and motivational factors. Furthermore, the results of the study showed that, in addition to salary, working conditions, interpersonal relationships with subordinates, and personal growth opportunities, other health and motivational factors did not significantly predict job satisfaction.[50] Masrek and colleagues reported that out of the four subscales of EI, including self-awareness, self-management, social awareness, and relationship management, only three were significant predictors of job satisfaction. The self-awareness subscale did not have any impact on job satisfaction.[51] On the other hand, the results of another study showed that employee performance did not have a mediating effect on the relationship between leadership, EI, role conflict, and job satisfaction.[52] EI significantly predicts creative self-efficacy, and self-esteem plays a partial mediating role in this relationship.[53] EI is a strong predictor of success. High levels of EI lead to improved performance, quality of life, self-awareness, relationship management, and decision-making.[5] Excellent organizational policies and positive working conditions create a higher level of job satisfaction among employees, resulting in better performance compared to those with lower levels of EI.[4] It is positively associated with knowledge-related behaviors. Additionally, job satisfaction and organizational commitment play a mediating role in the relationship between EI and knowledge-related behaviors. Maternity management should implement human resource management programs that promote positive work attitudes and behaviors among employees and develop tools for identifying employees’ EI.[54] In a study examining the applicability of Herzberg’s theory and its relationship with job satisfaction in the hospitality industry in Egypt, it was found that hygiene factors have a positive impact on job satisfaction, while motivators have a negative impact. Hygiene factors, such as salary and working conditions, were significant contributors to job satisfaction. However, job satisfaction was not statistically associated with motivators. Additionally, job involvement played a mediating role in the relationship between motivators and job satisfaction.[55]

Therefore, midwives' mental health plays an essential role in providing high-quality care to mothers in hospitals and healthcare centers.[56] Individuals with high EI can maintain a reasonable balance between emotions and intellect. Therefore, multiple workshops should be conducted to enhance the EI of midwives. Ultimately, considering the crucial role of midwives in formulating national policies to promote maternal and child health, it is recommended that human resource managers create conditions to increase their satisfaction and job motivation, including providing appropriate rewards based on genuine performance evaluations and increasing salaries based on their capabilities to enhance organizational commitment. Health policymakers should provide better working conditions for midwifery personnel. Furthermore, by establishing trust among midwives, enhancing job security, setting professional standards, and utilizing the capabilities of midwives, effective steps can be taken to address their job dissatisfaction and foster positive relationships with colleagues. In today’s competitive world, the performance of an organization is crucial. Employees and their performance play a key role in the success of an organization. Therefore, one of the main roles of organizational managers is to increase employee productivity. Job satisfaction has a positive impact on employee performance, ultimately leading to increased organizational credibility and contributing to economic growth.

Limitations and strengths

Our study had some limitations, including the fact that it was descriptive and conducted in only one city. To address these limitations, we recommend that a more intervention-based approach be taken and that the study be conducted on a larger scale to include all midwives in the province. However, our research had several strengths as well. For instance, the study was conducted in both educational and private hospitals, as well as healthcare centers.

Conclusion

Although most midwives are interested in the field and profession of midwifery, some decision-making and inappropriate policies may disappoint them. Therefore, changing policies and making important decisions are necessary. This study showed that high EI enhances midwives’ job satisfaction. Midwifery managers should create conditions that help enhance the satisfaction of midwives, especially in interpersonal relationships, appreciation, recognition of their work, and understanding and strengthening the impact of their work.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.