Valentina Urtubia-Herrera1
María Victoria Navarta-Sánchez2,3*
Ana María Palmar-Santos2,3
Azucena Pedraz-Marcos4Alberto García-Gomez5
Elkin O. Luis6,7
Elena Bermejo-Martins7,8- 1Medicine and Surgery Program, Doctoral School, Autonomous University of Madrid, Madrid, Spain
- 2Nursing Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
- 3Nursing and Health Care Research Group, Puerta de Hierro-Segovia Arana Health Research Institute, Madrid, Spain
- 4Health Care and Health Services Research Unit (Investén-ISCIII), Carlos III Health Institute (ISCIII), Madrid, Spain
- 5Nursing Department, Pediatrics Unit, La Paz University Hospital, Madrid, Spain
- 6Psychological Processes in Education and Health Group, School of Education and Psychology, University of Navarra, Pamplona, Spain
- 7Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- 8Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Introduction: Workplace Mental health promotion in healthcare sector, is a global priority due to the stress associated with caregiving environments and the increase of mental health problems among health professionals and students. The role of emotional intelligence (EI) and sense of coherence (SOC) have been identified as critical health protectors. However, the relationship between them as well as the underlying mechanisms of these relationships on health benefits in this population is still unclear.
Aim: To synthetize the existing literature on the relationship between emotional intelligence and sense of coherence, as well as their mutual impact on healthcare workers’ and student’s well-being.
Method: A scoping review was conducted following the Joanna Briggs Institute guidelines. A systematic search was conducted in PsyCINFO, CINHAL, SCOPUS and PUBMED databases, using key-terms such as students, health professionals, emotional intelligence, and sense of coherence.
Results: A total of 11 articles were included, with a range of years from 2014 to 2022. Evidence was found to support the positive relationship between sense of coherence and emotional intelligence. The use of EI as a training pathway to improve SOC and health promoting behaviors is suggested. The benefits of intervening on these factors contribute to improved health professionals’ and students’ general well-being and motivation for a better performance, either in their studies or clinical work.
Conclusion: The positive relationship between emotional intelligence and a sense of coherence has direct and indirect benefits on students’ and healthcare professionals’ well-being. Future studies should address longitudinal and experimental analysis to confirm these findings.
1 Introduction
The World Health Organization (WHO) recognizes that the demands of the work environment can pose a risk to people’s health, making it a concern for governments, employers, and workers worldwide (1). In view of these implications, the protection and promotion of mental health is proposed as a global objective in the latest WHO Comprehensive Plan of Action for Mental Health 2013–2030 (2). This was the basis for the proposal of the Guidelines on Mental Health in the workplace, which include the development of positive aspects in the work environment, as well as the qualities and skills of workers (1).
Healthcare workers are exposed to stressful contexts, where working conditions and occupational hazards in the health sector have consequences on their health due to occupational diseases or accidents. These situations generate a significant cost for the health of the professional and also for the patient, reducing the quality of health care and leading to increased costs for the organization (3), estimated at 2% of global health expenditure (4).
The practice of healthcare disciplines, the high emotional burden involved in providing care and attention, the characteristics of the health care environment, and the continuous complex decision-making, imply a high exposure to various types of risk factors that jeopardize the mental health of these groups. There is evidence that the risks to the mental health of these groups are observed from their formative stages (5).
As a consequence of the situations experienced by professionals, they may manifest mental health problems such as: anxiety, depression, psychological fatigue, increased substance abuse, sleep and eating disorders, burn-out syndrome, or even suicide (6, 7). This was particularly evident in the impact of the COVID-19 pandemic (8).
From a health promotion approach health and disease as a continuum, where people’s knowledge and skills are tools to exploit their resources and proactively achieve positive health (9–11). Therefore, focusing on available health resources such as Emotional Intelligence, self-care, social support network or development of a sense of coherence, represent a promising way to this effect (12, 13).
Within of these resources, emotional intelligence (EI) was originally defined by Mayer and Salovey (14) as: “the ability to monitor one’s own and others’ feelings and emotions, to discriminate between them, and to use this information to guide one’s thinking and actions.” The same researchers identified the relationship between EI and mental health, where people who develop EI-related skills regulate affect and use moods and emotions to motivate adaptive behavior (15).
In clinical practice, the development of EI skills by healthcare professionals enables them to be more empathetic, resilient and capable of caring for their patients and themselves (16). EI has many implications in the therapeutic relationship, facilitating communication with patients and families experiencing difficult situations due to health problems, and providing emotional support when needed (17–19).
For example, in psychology, nursing and social work students, EI is associated with a lower perceived stress, and the implementation of educational programs on these resources for coping with stress can be developed since their formative stage at university and then transferred to professional practice (20, 21).
On the other hand, a sense of coherence (SOC), is one of the critical elements in promoting health at individual level. It is defined as a global orientation that expresses confidence during the life course when facing stressors from the internal or external environment, in which the person has available resources to cope with such demands (22). A strong SOC helps the person to mobilize resources to cope with stressors and to manage stress successfully (23).
According to the current evidence, SOC is related to different aspects of positive health such as: quality of life, well-being, self-esteem, self-care and healthy lifestyles, among others (24). In university students, SOC is directly related to their mental health (25, 26).
Although the relationship between sense of coherence, emotional intelligence, and health has been demonstrated individually as a health-promoting resource, it is not clear how these variables interact with each other and would provide health benefits to this group.
Given the increased need for mental health promotion interventions among healthcare professionals and students, it would be critical to identify the relationship between sense of coherence and emotional intelligence, how they interact, and how they relate to health and well-being, as well as the potential benefits on other variables are associated with them in students and health professionals.
However, up to our knowledge no available evidence has covered this issue from a in depth review perspective. Therefore, a scoping review was conducted to systematically map the research conducted in this area and to identify existing gaps in knowledge and draw a road map for future research aimed to promote the mental health in this population group.
1.1 Aim
The present review seeks to explore the existing literature on the relationship between emotional intelligence and sense of coherence in healthcare workers and students, with the aim of answering the questions: What is the interrelationship between sense of coherence and emotional intelligence, in health professionals since their formative stage? and what are the health benefits driven by this relationship?
2 Methods
The review followed the guidelines set out by the Joanna Briggs Institute in “Guidance for conducting systematic scoping reviews” (27) and its subsequent update “Updated methodological guidance for the conduct of scoping reviews” (28). Likewise, the “Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist” (29) and the flowchart proposed in “The PRISMA 2020 statement: an updated guideline for reporting systematic reviews” (30) were used.
2.1 Search strategy and data sources
From December 15, 2022 to January 10, 2023, a systematic search was conducted using the electronic databases CINAHL (Cumulative Index of Nursing and Allied Health Literature), Latindex, LILACS (Latin American and Caribbean Literature in health Sciences), Psycinfo, Pubmed, Scopus, Science Direct and Web of Science, to identify research that explored emotional intelligence and sense of coherence in university students, as well as health science professionals. The search was updated in January 2024.
Searches were conducted using the following terms ([Students, College Students, University students] OR [Health Personnel, healthcare workers, health professionals, health care settings, professional caregivers] OR [Adults, youth, young people, adolescents]) AND (Emotional Intelligence, emotional competences, emotional education, socio-emotional skills, emotional management, emotional leadership, emotional skills) AND sense of coherence.
The search was constructed based on the first strategy and adapted for the corresponding databases, without the application of additional filters.
2.2 Inclusion and exclusion criteria
Basic inclusion criteria were established and adapted as we became more familiar with the literature, so that they were applied to the totality of results obtained (31).
- Types of participants: articles focused on health science university students or professionals were included.
- Concept: the central focus of the articles was emotional intelligence and sense of coherence, as well as their related spheres and concepts.
- Types of articles: primary articles (quantitative and qualitative) and review articles were included. In addition, bibliographic references from leading articles on the topic, as well as from key journals, were reviewed.
- Characteristics of the studies: publications in the last 10 years and available in Spanish or English.
Exclusion criteria included articles on the older adult population, children and participants with special/concrete pathologies.
The selection of the final database of articles was made according to the criteria proposed. One additional article was retrieved by consulting relevant authors and the bibliography of the documents.
2.3 Critical appraisal
For the studies selected according to the above criteria, critical appraisal tools will be used to assess the quality of the studies. Depending on the study design, the Joanna Briggs Institute tools (32) will be used, and in the case of mixed methods, the Mixed Methods Assessment Tool (MMAT) (33) will be used. These tools are expected to help assess the reliability, relevance, and results of published articles.
2.4 Data extraction
Data extraction was performed following the fields proposed by the Joanna Briggs Institute in “Guidance for conducting systematic scoping reviews” (27).
• Author(s), Year of publication and Country of origin.
• Aim(s) of the study.
• Population and sample (if applicable).
• Study design & Methodology.
• Type of intervention and comparison (if applicable).
• Main results.
• Duration of the intervention (if applicable).
• Measures used.
• Relevant conclusions.
3 Results
3.1 Descriptive information on studies
A total of 4,022 results were identified by searching databases (Figure 1). Once duplicate articles were removed, 2,703 articles were screened by title and abstract. After screening of titles and abstracts, there were 26 studies that met the inclusion criteria for full-text screening, and after full-text reading, 11 studies were included to be reviewed.
Figure 1. Search strategy and the study selection with PRISMA flow diagram (30).
The included studies range from the year 2014 to the year 2022. Most of the articles reviewed were original research studies involving primary data collection (91%) (see Table 1). One article used secondary data sets (9%). Most of the studies reviewed used a cross-sectional design (73%). Followed by another mixed-method study (9%) and an intervention study (9%) (see Table 1).
Table 1. Description of included studies.
More than half of the studies reviewed were from the fields of nursing or psychology (55%) (see Table 1). A considerable percentage of studies also belonged to the fields of psychology and/or nursing, but included authors or elements from the field of sociology and social science (27%). Finally, a smaller number of studies were interdisciplinary studies from medicine, nursing, as well as physiotherapy, behavioral sciences (9%), or social work and dietetics (9%). The half of the studies came from Spain (55%), followed by China with 2 articles (18%) and other European countries with 1 article each (9%) (see Table 1).
3.1.1 Sample size and description (health professional, student group or mixed group)
The vast majority of the articles had university students as their population (73%). This was followed by articles that only studied health professionals (18%). Only one article (9%) included as study population a mixed group (students and health professionals).
The sample size of the selected articles was, on average, 483 individuals, ranging from 65 to 960. In most studies, women represented more than 80% of the sample; In all samples, men were represented, with an overall mean of less than 20%. The average age of the sample of the studies with a student population was 23.77 years with a range of 16–57 years. For the professional population studies the average was 32.8 years, with a range of 21–60 years. For the mixed population, the sample had an average age of 24 years with a range between 21 and 49 years.
3.1.2 Studies methodological quality assessment
Quality assessment was performed for all 11 papers (Table 2). The Mixed-Methods Appraisal Tool (MMAT) (33) was used for the mixed methods study, and the JBI Critical Appraisal Tools Checklist (32) was used for the cross-sectional studies and the intervention study. Each paper was independently assessed and given an overall rating.
Table 2. Quality assessment tool.
Furthermore, adequate sampling frame was used by all studies to address the target population. Only 56% of the studies sampled participants properly, the rest were unclear about the sampling or included the entire population. However, 100% of the studies provided a detailed description of their sample and context.
All studies included used appropriate research methods to answer the research question, validated scales to measure the different variables, and used appropriate statistical analysis.
3.1.3 Scales and questionnaires to measure EI and SOC
The sense of coherence was measured using Antonovsky’s (1985) Life Orientation Questionnaire (OLQ) in its original or translated version in 55% of the studies. In the remaining 45% of the studies, the abbreviated version of the questionnaire, either OLQ-13 or SOC-13 (22), was used. Two scales were used to measure emotional intelligence, the Trait Meta- Mood Scale (TMMS) (34) both in its full and abbreviated version, and the emotional intelligence questionnaire (INTE) (35).
Other related dimensions were assessed, such as the level of burnout, which was measured with the MBI-SS (36). Daily hassles were assessed using the Revised Daily Hassles Scale in its French version (37) and the 64-annoyance scale developed by Maybery (38). Emotional exhaustion was assessed using the Emotional Fatigue Scale (ECE) for university students developed by Ramos, Manga, and Moran (39). Other instruments measuring variables other than emotional intelligence and sense of coherence were used in the studies reviewed. These instruments are listed in Table 3. Different strategies were used for the application of the questionnaires. In the vast majority of the studies (64%), the different scales and questionnaires were self-applied presentially. In the remaining studies (36%), online application of the questionnaires was used. The questionnaires were mostly applied in the university setting, and in the hospital setting in those with a professional population.
Table 3. Scoping review results.
Data from the included studies were extracted according to the above-mentioned fields. The results are summarized in Table 3. A summary of the results for each included source of evidence, according to the objectives of the review, is presented below.
3.2 Analysis domains found
3.2.1 Predictor and mediator role of emotional intelligence and sense of coherence on health benefits
The sense of coherence (SOC) and emotional intelligence (EI), are considered two variables that influence people’s health (40, 41). SOC is considered a protective factor against stress (41, 42), and a health-promoting resource directly related to the ability to use coping strategies to improve stress management (40).
EI on the other hand, is considered a set of skills that help people to process emotional information, which is developed through learning and experience (40, 43). Both variables are positively related to each other, enhancing their effect, but also mediating between other factors that influence individual well-being (43, 44).
The positive relationship between EI and SOC demonstrates that the development of individual SOC can be determined on the basis of temperament (genetic strengths) and mediated by the emotional resources (EI) of the individual. It is known that EI exerts the mediating role in the development of SOC, this effect may be due to the fact that EI allows monitoring and managing one’s emotions to guide thinking and actions (44).
In the relationship between EI, SOC and health, the direct influence of SOC on health was confirmed, where the improvement of SOC promotes individual health. Likewise, SOC has an indirect influence mediated by EI on health promotion. The mediating role of EI takes effect through emotional repair, which is considered a coping strategy for managing stress associated with problems in university and professional life (40, 41).
The SOC was identified as a mediator between daily stressful events (basis of student and professional stress) (45) and the development of burnout (46). In the role of mediator, SOC has a direct and negative relationship with emotional exhaustion being this a dimension of burnout (47).
The role played by SOC, is positively associated with increased emotional regulation skills (48). Emotional Intelligence interventions appear to be a protective factor, as they lead to an increase in SOC to ultimately benefit individual health (46).
3.2.2 Emotional intelligence training pathway to improve sense of coherence
The implementation of educational strategies related to mental health is mainly based on the salutogenic health model and aims to promote and strengthen the SOC (41, 47). However, according to Shankland et al. (46) it would only make sense to apply these interventions specifically to improve SOC before the age of 30. This would be justified because, according to Antonovsky, SOC as a construct tends to be established after this age, so intervening at earlier stages would be most appropriate.
The use of EI as a training pathway to improve the sense of coherence and health promotion, suggests implementing interventions focused on coping strategies and emotional regulation (45, 46). Increasing emotional regulation tools is considered to be a protective factor that leads to develop a deeper, clearer and more coherent meaning of internal and external challenges or strengthening SOC and that can be intervened through short formative strategies (43, 44, 46, 48).
The proposal arises the need to promote strategies to increase the level of sense of coherence in university students, in order to reduce their emotional exhaustion and improve their health (47). This is due to the fact, that responding successfully to academic and professional stress affects the health of students and future professionals, and is associated with the level of commitment, emotional intelligence and sense of coherence they develop (40).
The intervention selected by Zhan et al. (49) was the Smile-Sun Method developed by Kazue Takayanagi, consisted in four training sessions applied to different professionals from a hospital. They covered elements as laughter theory, practice of drawing natural laughter, and practical laughing training. The objective was to train health professionals on laughter, improving the healing environment through human support, enhancing the natural healing process, motivation and fostering a positive attitude.
As a result of the intervention carried out by the team of Zhan et al. (49), they consider that the young professional population also needs learning opportunities that strengthen their EI, improving their SOC and consequently improving clinical practice. The improvement of SOC seeks to have professionals, who care better and who are also agents of care that implement their tools in the patients they care for (41).
3.2.3 Benefits of SOC and EI on healthcare workers’ mental well-being and engagement
In regard to healthcare professionals, those with a strong SOC are more resistant to burn-out, have more internal professional development strategies, higher personal satisfaction and professional competence, where performance and motivation increase (41, 46, 49). Similarly, clinical performance in professionals is found to be related to EI, associated with high levels of empathy, psychological resilience and life satisfaction (40, 42, 44).
In specific nurse population, it was shown that the relationship between SOC and professional satisfaction is mediated by social support, and that social support has a direct predictive effect on perceived professional benefits, which acts as an internal motivator increasing individual well-being (49).
Within the same line Colomer-Pérez et al. (41) and Hochwälder and Saied (45), identified that in university students a strong SOC seems to contribute to greater resilience to stress, which would justify the motivation to study a profession with high demands and stressors. In students, the perception of a high level of health is associated with higher levels of engagement, EI, SOC and coping strategies (40).
According to Colomer-Pérez et al. (50) the use of a salutogenic educational strategy whose objective is to strengthen students’ SOC, allows them to dynamize their asset maps, reinforcing their sense of vocation, allowing professionals to fight against care stress and thrive in their profession.
4 Discussion
To our knowledge, this scoping review represents a first attempt to describe the literature on the association between SOC and EI and the potential mental health benefits of these mutual health assets in students and professionals from different health disciplines. Several key findings can be highlighted from the review.
First, this review found evidence that demonstrates the relationship between a sense of coherence and emotional intelligence, where the relationship between both variables is fundamental in health promotion. Each variable plays an important role, acting both as a mediator and as a predictor (44). Second, evidence suggests that using EI represents a key training pathway to improve SOC and health outcomes. EI is associated with the response to academic and clinical stress that affects healthcare students (45, 46). Likewise, it is identified that EI plays an important role in the training of students, for the development of skills and the strengthening of the SOC early on, seeking to obtain professionals with better tools for the management of stressful situations (51).
Third, the benefits obtained by healthcare professionals and students by intervening on EI and SOC, contribute to improve general well-being, commitment and motivation for a better performance in studies and clinical work (52). Consistent with the results, recent reviews highlight that EI and interventions on this variable have the benefit of improving productivity and clinical performance (53, 54).
The present review also highlights the existence of gaps and limitations in the literature. First, it shows the existence of studies, although few, on the relationship between SOC and EI. At the same time, it highlights the lack of studies that allow us to identify casual relationships of intervening in any or both of these variables to promote mental health in healthcare sector.
4.1 Limitations of the scoping review
This review has several limitations. Due to the heterogeneity of the results and despite the homogeneity of the study designs, we could only summarize the results narratively. And we could not aggregate the results regarding the association between SOC, EI, and mental health using meta-analytic techniques. However, this was not the aim of our review.
Furthermore, the exploratory nature of the scoping review (55) allowed us to capture a diverse range of evidence, thereby providing a more complete overview of the state of the literature to date. The current evidence on the subject is mostly focused on one of the two variables and its possible benefits on health care professionals’ health outcomes. More than half of the studies found have a cross-sectional (82%) design, which does not allow us to evaluate the effect on either variable or to identify changes and changing mechanisms. At the same time, the proportion of women in all the studies is over 65%, which would not allow us to identify significant gender differences in the variables studied.
With regard to the results, in all the studies they may be biased by the sampling method, since the sample of participants is limited to a single university or hospital, which may jeopardize the validity of the data obtained, leaving open the possibility that the participants are not representative of students and health professionals in general (42).
It should be noted that most of the samples in the studies included only one or two healthcare disciplines, such as nursing, social work, or psychology. Some studies included mixed samples of health science students. Therefore, it was not possible to make a direct comparison between these studies. Furthermore, future research with mixed samples of healthcare workers is needed to ensure representativeness. The available evidence is currently limited to specific samples, which may not be representative of health worker groups as a whole. To overcome these limitations, it is suggested that future research should use longitudinal and analytical studies to investigate the indirect and direct relationship between SOC and EI and their possible associated variables when exploring the impact of mental health promotion interventions in this sector.
It is also suggested that studies be conducted with mixed populations, as the current evidence focuses mainly on students or professionals. Likewise, it is suggested that the population be expanded to include different healthcare professions, since most of the evidence currently focuses on nursing and psychology, leaving out other professions that work in the healthcare context.
Similarly, the review assessed the methodological quality of each included study, but did not assess the risk of within-study bias, as this is generally considered less applicable to scoping reviews (29).
The current review included only quantitative evidence due to a lack of qualitative evidence on the topic. However, it is likely that qualitative data will provide a more nuanced picture of the relationship between SOC, EI and mental health, as well as important information about coping mechanisms and the context in which stress is experienced and managed.
The decision to limit the inclusion of articles and focus only on those that specifically used the terms SOC and EI with some related variables may have resulted in the omission of relevant literature on similar constructs that used different terminology.
4.2 Theoretical and practical implications
The present review aims to stimulate research-action-prevention aimed at promoting the mental health of students and health professionals. Although working conditions generally expose professionals to stressful situations, an increase in psychological distress, as was observed during the COVID-19 pandemic, it is now well-known that health workers’ sense of coherence and their EI skills can serve as critical individual protectors for health risks (56, 57). To ensure that healthcare professionals can effectively manage the effects of working in stressful circumstances, it is considered important to intervene to protect their mental health (58).
This becomes even more necessary in light of the limited evidence on psychosocial interventions aimed at strengthening EI and SOC. Interventions on EI based on the salutogenic approach during university studies are considered to strengthen the sense of coherence and thus promote their health (50). According to Fragkos and Crampton (59), interventions to develop empathy in a specific population of medical students are effective in those under 30 years of age.
However, the effectiveness of an educational program applied to students of other health professions has not been clearly demonstrated (60, 61). Therefore, it would be advisable to study this topic in depth in order to find the most effective methodology and educational program.
Regarding interventions for health professionals, the current evidence is considered uncertain, as the effectiveness of one intervention over another in reducing stress, increasing resilience, and improving health has not been demonstrated (62–64). According to Pollock et al. (65), there is a lack of quantitative and qualitative data from studies conducted during or after epidemics and pandemics that can inform the selection of interventions beneficial to the mental health of healthcare professionals.
5 Conclusion
This scoping review sought to explore the relationship between emotional intelligence and sense of coherence in healthcare professionals and students, to clarify the interrelationship between the two and how they influence their health.
The results of this review suggest that both factors influence health and that the relationship between them allows them to act as either mediators or predictors, both of which are fundamental for health promotion in health professionals and students. The data from the scoping review suggest that in order to intervene, it is necessary to use EI as a training pathway to improve SOC and thus impacting on other health outcomes. It also suggested that this mental health interventions should be done early in university students and young health professionals.
This study may highlight the need to intervene in EI to improve the well-being and engagement of students, as well as the clinical performance in their professional stage. However, it also highlights the lack of literature on this topic and the need for evidence of interventions’ efficacy and effectiveness.
5.1 Relevance for clinical practice
The purpose of this review was to identify and synthesize the available evidence on the relationship between these variables. By identifying the benefits of the relationship between these variables and the best way to intervene, we could lay the foundations for the design, implementation and evaluation plan of future mental health interventions in this population.
Intervening on these variables would allow the promotion of mental health and well-being in healthcare professionals from their early formative stage. It will allow them to develop mental health protectors’ factors, adopting effective coping skills to manage stress and reducing physical health risks in the context of work and study.
Author contributions
VU-H: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Validation, Visualization, Writing – original draft, Writing – review & editing. MN-S: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing, Project administration. AP-S: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Writing – review & editing. AP-M: Data curation, Investigation, Methodology, Supervision, Validation, Visualization, Writing – review & editing. AG: Conceptualization, Data curation, Investigation, Methodology, Project administration, Resources, Software, Writing – original draft. EL: Funding acquisition, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – review & editing. EB-M: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing, Funding acquisition.
Funding
The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was part of the project entitled “CONHECTATE: Caring Of iNterdisciplinary Health professionals’ Emotional Competences To Achieve The Excellence” which is funded by Plan de Investigación Universidad de Navarra (PIUNA 2020-27). The Autonomous University of Madrid and the Ministry of Universities of the Spanish Government (Recovery, Transformation and Resilience Plan) were the financing entities of the researcher M V Navarta-Sánchez (Grant number: CA2/ RSUE/2021-00854).
Acknowledgments
The authors would like to acknowledge the help of the University of Navarra and Autonomous University of Madrid.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
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References
1. World Health Organization. WHO guidelines on mental health at work. Geneva: World Health Organization (2022).
2. World Health Organization. Comprehensive mental health action plan 2013–2030. Geneva: World Health Organization (2021).
3. De Simone, S. Wellbeing at work: a survey on perception of health care workers. Riv Int Sci Sociali. (2015) 123:395–412.
4. World Health Organization. Occupational health: health workers. Geneva: World Health Organization (2022).
5. Snowden, A, Stenhouse, R, Duers, L, Marshall, S, Carver, F, Brown, N, et al. The relationship between emotional intelligence, previous caring experience and successful completion of a pre-registration nursing/midwifery degree. J Adv Nurs. (2018) 74:433–42. doi: 10.1111/jan.13455
6. Serrano-Ripoll, MJ, Meneses-Echavez, JF, Ricci-Cabello, I, Fraile-Navarro, D, Fiol-deRoque, MA, Pastor-Moreno, G, et al. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. J Affect Disord. (2020) 277:347–57. doi: 10.1016/j.jad.2020.08.034
7. Dosil Santamaría, M, Ozamiz-Etxebarria, N, Redondo Rodríguez, I, Jaureguizar Alboniga-Mayor, J, and Picaza, GM. Psychological impact of COVID-19 on a sample of Spanish health professionals. Psychiatry Ment Heal J. (2021) 14:106–12. doi: 10.1016/j.rpsmen.2020.05.002
8. Greenberg, N, Docherty, M, Gnanapragasam, S, and Wessely, S. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ. (2020) 368:m1211. doi: 10.1136/bmj.m1211
9. Antonovsky, A. The salutogenic model as a theory to guide health promotion. Health Promot Int. (1996) 11:11–8. doi: 10.1093/heapro/11.1.11
10. Golembiewski, JA. Salutogenic architecture in healthcare settings In: MB Mittelmark, S Sagy, M Eriksson, GF Bauer, JM Pelikan, and B Lindström, et al., editors. The Handbook of Salutogenesi. Cham: Springer (2017). 267–76.
11. Bauer, GF, Roy, M, Bakibinga, P, Contu, P, Downe, S, Eriksson, M, et al. Future directions for the concept of salutogenesis: a position article. Health Promot Int. (2020) 35:187–95. doi: 10.1093/heapro/daz057
12. Bermejo-Martins, E, Luis, EO, Fernández-Berrocal, P, Martínez, M, and Sarrionandia, A. The role of emotional intelligence and self-care in the stress perception during COVID-19 outbreak: an intercultural moderated mediation analysis. Pers Individ Dif. (2021) 177:110679. doi: 10.1016/j.paid.2021.110679
13. Luis, E, Bermejo-Martins, E, Martinez, M, Sarrionandia, A, Cortes, C, Oliveros, EY, et al. Relationship between self-care activities, stress and well-being during COVID-19 lockdown: a cross-cultural mediation model. BMJ Open. (2021) 11:e048469. doi: 10.1136/bmjopen-2020-048469
14. Salovey, P, and Mayer, JD. Emotional intelligence. Imagin Cogn Pers. (1989) 9:185–211. doi: 10.2190/DUGG-P24E-52WK-6CDG
15. Mestre, JM, Brackett, MA, Guil, R, and Salovey, P. Emotional intelligence: definition, assessment and applications from Mayer and Salovey’s skills model In: Motivation and emotion. New York: McGraw-Hill USA (2008). 407–38.
16. Nightingale, S, Spiby, H, Sheen, K, and Slade, P. The impact of emotional intelligence in health care professionals on caring behaviour towards patients in clinical and long-term care settings: findings from an integrative review. Int J Nurs Stud. (2018) 80:106–17. doi: 10.1016/j.ijnurstu.2018.01.006
17. Mayer, JD. What is emotional intelligence?. 8, University New Hamshire Personality Lab. New Hampshire; (2004). 1–10
18. Mayer, JD, Salovey, P, and Caruso, DR. TARGET ARTICLES: “Emotional intelligence: theory, findings, and implications”. Psychol Inq. (2009) 2014:37–41. doi: 10.1207/s15327965pli1503_02
19. Hajibabaee, F, Farahani, MA, Ameri, Z, Salehi, T, Hosseini, F, Ameri, Z, et al. The relationship between empathy and emotional intelligence among Iranian nursing students. Int J Med Educ. (2018) 9:239–43. doi: 10.5116/ijme.5b83.e2a5
20. Cobb, CD, and Mayer, JD. Emotional intelligence. Educ Leadersh. (2000) 58:14–8. doi: 10.2190/dugg-p24e-52wk-6cdg
21. Enns, A, Eldridge, GD, Montgomery, C, and Gonzalez, VM. Perceived stress, coping strategies, and emotional intelligence: a cross-sectional study of university students in helping disciplines. Nurse Educ Today. (2018) 68:226–31. doi: 10.1016/j.nedt.2018.06.012
22. Mittelmark, MB, Sagy, S, Eriksson, M, Bauer, GF, Pelikan, JM, Lindström, B, et al. The sense of coherence and its measurement In: M Eriksson and MB Mittelmark, editors. The handbook of Salutogenesis. Cham: Springer (2017). 97–106.
23. Moksnes, UK. Sense of coherence In: G Haugan and M Eriksson, editors. Health promotion in health care – vital theories and research. Cham: Springer (2021). 35–46.
24. Vega Martínez, MC d, Frías Osuna, A, and del Pino Casado, R. Validity and reliability of the sense of coherence scale among nursing undergraduate students from a Spanish university. Gac Sanit. (2019) 33:310–6. doi: 10.1016/j.gaceta.2018.02.009
25. Mato, M, and Tsukasaki, K. Factors promoting sense of coherence among university students in urban areas of Japan: individual-level social capital, self-efficacy, and mental health. Glob Health Promot. (2019) 26:60–8. doi: 10.1177/1757975917691925
26. Eriksson, M, and Lindström, B. Antonovsky’s sense of coherence scale and the relation with health: a systematic review. J Epidemiol Commun Health. (2006) 60:376–81. doi: 10.1136/jech.2005.041616
27. Peters, MDJ, Godfrey, CM, Khalil, H, McInerney, P, Parker, D, and Soares, CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Heal. (2015) 13:141–6. doi: 10.1097/XEB.0000000000000050
28. Peters, MDJ, Marnie, C, Tricco, AC, Pollock, D, Munn, Z, Alexander, L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. (2020) 18:2119–26. doi: 10.11124/JBIES-20-00167
29. Tricco, AC, Lillie, E, Zarin, W, O’Brien, KK, Colquhoun, H, Levac, D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. (2018) 169:467–73. doi: 10.7326/M18-0850
30. Page, MJ, McKenzie, JE, Bossuyt, PM, Boutron, I, Hoffmann, TC, Mulrow, CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. (2021) 372:n71. doi: 10.1136/bmj.n71
31. Arksey, H, and O’Malley, L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. (2005) 8:19–32. doi: 10.1080/1364557032000119616
32. Joanna Briggs Institute. Critical appraisal tools. JBI Manual for Evidence Synthesis. (2020). Available at: https://jbi.global/critical-appraisal-tools (Accessed April 19, 2023).
33. Hong, QN, Fàbregues, S, Bartlett, G, Boardman, F, Cargo, M, Dagenais, P, et al. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. (2018) 34:285–91. doi: 10.3233/EFI-180221
34. Salovey, P, Mayer, JD, Goldman, SL, Turvey, C, and Palfai, TP. Emotional attention, clarity, and repair: exploring emotional intelligence using the trait meta-mood scale. In Pennebaker, J. W. (Ed.) Emotion, disclosure, and health. Washington, DC, US: American Psychological Association; (1995). p. 125–154.
35. Schutte, NS, Malouff, JM, Hall, LE, Haggerty, DJ, Cooper, JT, Golden, CJ, et al. Development and validation of a measure of emotional intelligence. Pers Individ Dif. (1998) 25:167–77. doi: 10.1016/S0191-8869(98)00001-4
36. Schaufeli, WB, Martínez, IM, Pinto, AM, Salanova, M, and Barker, AB. Burnout and engagement in university students a cross-national study. J Cross-Cult Psychol. (2002) 33:464–81. doi: 10.1177/0022022102033005003
37. Holm, JE, and Holroyd, KA. The daily hassles scale (revised): does it measure stress or symptoms? Behav Assess. (1992) 14:465–82.
38. Maybery, D. Incorporating interpersonal events within hassle measurement. Stress Heal. (2003) 2:97–110. doi: 10.1002/smi.961
39. Moran Astorga, C, Ramos Campos, F, and Manga, RD. Escala de cansancio emocional (ECE) para estudiantes universitarios. Interpsiquis. (2005) 6:1–9
40. Fernández-Martínez, E, López-Alonso, AI, Marqués-Sánchez, P, Martínez-Fernández, MC, Sánchez-Valdeón, L, Liébana-Presa, C, et al. Emotional intelligence, sense of coherence, engagement and coping: a cross-sectional study of university students’ health. Sustain For. (2019) 11:6953. doi: 10.3390/su11246953
41. Colomer-Pérez, N, Paredes-Carbonell, JJ, Sarabia-Cobo, C, and Gea-Caballero, V. Sense of coherence, academic performance and professional vocation in certified nursing assistant students. Nurse Educ Today. (2019) 79:8–13. doi: 10.1016/j.nedt.2019.05.004
42. Hori, M, Yoshikawa, E, Hayama, D, Sakamoto, S, Okada, T, Sakai, Y, et al. Sense of coherence as a mediator in the association between empathy and moods in healthcare professionals: the moderating effect of age. Front Psychol. (2022) 13:13. doi: 10.3389/fpsyg.2022.847381
43. Burguillos Peña, AI. Sense of coherence and emotional intelligence: effect on social anxiety of college students. Int J Dev Educ Psychol. (2014) 24:45–54. doi: 10.17060/ijodaep.2014.n1.v4.615
44. Szcześniak, M, and Strochalska, K. Temperament and sense of coherence: emotional intelligence as a mediator. Int J Environ Res Public Health. (2019) 17:219. doi: 10.3390/ijerph17010219
45. Hochwälder, J, and Saied, V. The relation between sense of coherence and daily hassles among university students. Heal Psychol Behav Med. (2018) 6:329–39. doi: 10.1080/21642850.2018.1538802
46. Shankland, R, Kotsou, I, Vallet, F, Bouteyre, E, Dantzer, C, and Leys, C. Burnout in university students: the mediating role of sense of coherence on the relationship between daily hassles and burnout. High Educ. (2019) 78:91–113. doi: 10.1007/s10734-018-0332-4
47. Fernández-Martinez, E, Liebana-Presa, C, and Moran, AC. Relationship between sense of coherence and emotional exhaustion in university students. Psychol Soc Educ. (2017) 9:393–403. doi: 10.25115/psye.v9i3.861
48. Manuel Blanco-Donoso, L, Moreno-Jimenez, B, Boada, M, Rodriguez-Carvajal, R, and Garrosa, E. Emotional regulation and positive affect: the mediator effect of sense of coherence. Rev Argentina Clínica Psicológica. (2018) 27:403–12. doi: 10.24205/03276716.2018.1053
49. Zhan, T, Li, H, and Ding, X. Can social support enhance sense of coherence and perceived professional benefits among Chinese registered nurses? A mediation model. J Nurs Manag. (2020) 28:488–94. doi: 10.1111/jonm.12931
50. Colomer-Pérez, N, Chover-Sierra, E, Gea-Caballero, V, and Paredes-Carbonell, JJ. Health assets, vocation and zest for healthcare work. A Salutogenic approach to active coping among certified nursing assistant students. Int J Environ Res Public Health. (2020) 17:3586. doi: 10.3390/ijerph17103586
51. Cleary, M, Visentin, D, West, S, Lopez, V, and Kornhaber, R. Promoting emotional intelligence and resilience in undergraduate nursing students: an integrative review. Nurse Educ Today. (2018) 68:112–20. doi: 10.1016/j.nedt.2018.05.018
52. Hernández-Vargas, CI, Llorens-Gumbau, S, Rodríguez-Sánchez, AM, and Chambel, MJ. Emotional intelligence and engagement in medicine students: a comparative study in three countries. Rev Psicol. (2021) 30:44–56. doi: 10.5354/0719-0581.2021.55261
53. Singh, N, Kulkarni, S, and Gupta, R. Is emotional intelligence related to objective parameters of academic performance in medical, dental, and nursing students: a systematic review. Educ Heal Chang Learn Pract. (2020) 33:8–12. doi: 10.4103/efh.EfH_208_17
54. Dugué, M, Sirost, O, and Dosseville, F. A literature review of emotional intelligence and nursing education. Nurse Educ Pract. (2021) 54:103124. doi: 10.1016/j.nepr.2021.103124
55. Tricco, AC, Lillie, E, Zarin, W, O’Brien, K, Colquhoun, H, Kastner, M, et al. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol. (2016) 16:15–12. doi: 10.1186/s12874-016-0116-4
56. Gomez-Salgado, J, Dominguez-Salas, S, Romero-Martin, M, Ortega-Moreno, M, Jesus Garcia-Iglesias, J, and Ruiz-Frutos, C. Sense of coherence and psychological distress among healthcare workers during the COVID-19 pandemic in Spain. Sustain For. (2020) 12:6855. doi: 10.3390/su12176855
57. Gómez-Salgado, J, Ortega-Moreno, M, Soriano, G, Fagundo-Rivera, J, Allande-Cussó, R, and Ruiz-Frutos, C. History of contact with the SARS-COV-2 virus and the sense of coherence in the development of psychological distress in the occupational health professionals in Spain. Sci Prog. (2021) 104:368504211026121. doi: 10.1177/00368504211026121
58. Gómez-Salgado, J, Arias-Ulloa, CA, Ortega-Moreno, M, García-Iglesias, JJ, Escobar-Segovia, K, and Ruiz-Frutos, C. Sense of coherence in healthcare workers during the COVID-19 pandemic in Ecuador: association with work engagement, work environment and psychological distress factors. Int J Public Health. (2022) 67:1605428. doi: 10.3389/ijph.2022.1605428
59. Fragkos, KC, and Crampton, PES. The effectiveness of teaching clinical empathy to medical students: a systematic review and meta-analysis of randomized controlled trials. Acad Med. (2020) 95:947–57. doi: 10.1097/ACM.0000000000003058
60. Everson, N, Levett-Jones, T, and Pitt, V. The impact of educational interventions on the empathic concern of health professional students: a literature review. Nurse Educ Pract. (2018) 31:104–11. doi: 10.1016/j.nepr.2018.05.015
61. Cleary, M, Kornhaber, R, Thapa, DK, West, S, and Visentin, D. The effectiveness of interventions to improve resilience among health professionals: a systematic review. Nurse Educ Today. (2018) 71:247–63. doi: 10.1016/j.nedt.2018.10.002
62. Kunzler, AM, Helmreich, I, Chmitorz, A, König, J, Binder, H, Wessa, M, et al. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev. (2020) 2020:CD012527. doi: 10.1002/14651858.CD012527.pub2
63. Tement, S, Ketiš, ZK, Miroševič, Š, and Selič-Zupančič, P. The impact of psychological interventions with elements of mindfulness (PIM) on empathy, well-being, and reduction of burnout in physicians: a systematic review. Int J Environ Res Public Health. (2021) 18:1–12. doi: 10.3390/ijerph182111181
64. Venegas, CL, Nkangu, MN, Duffy, MC, Fergusson, DA, and Spilg, EG. Correction: interventions to improve resilience in physicians who have completed training: a systematic review. PLoS One. (2019) 14:e0210512. doi: 10.1371/journal.pone.0210512
65. Pollock, A, Campbell, P, Cheyne, J, Cowie, J, Davis, B, McCallum, J, et al. Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database Syst Rev. (2020) 2020:CD013779. doi: 10.1002/14651858.CD013779
Keywords: emotional intelligence, healthcare professionals, scoping review, sense of coherence, students
Citation: Urtubia-Herrera V, Navarta-Sánchez MV, Palmar-Santos AM, Pedraz-Marcos A, García-Gomez A, Luis EO and Bermejo-Martins E (2024) The relationship between sense of coherence and emotional intelligence as individual health assets for mental health promotion in students and healthcare professionals: a scoping review. Front. Public Health. 12:1304310. doi: 10.3389/fpubh.2024.1304310
Edited by:
Dolors Juvinya, University of Girona, SpainReviewed by:
Angel Belzunegui-Eraso, University of Rovira i Virgili, SpainCristina Liebana-Presa, University of León, Spain
Copyright © 2024 Urtubia-Herrera, Navarta-Sánchez, Palmar-Santos, Pedraz-Marcos, García-Gomez, Luis and Bermejo-Martins. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: María Victoria Navarta-Sánchez, maria.navarta@uam.es