Necessity for adaptation of flora and fauna of Galapagos; geological Essay

Necessity for adaptation of flora and fauna of Galapagos; geological formations, invasive species, numbers of species, % of species and calculating the effects - Essay Example Ever since this incredible land was discovered, it has captured the imagination of many. The unique and exotic inhabitants of the island have always mesmerized me. In this document I have endeavored to present an in-depth understanding of the ecosystem of the Galapagos Islands. By the end of this presentation you will have a clear idea about the ecosystem of the Islands and also about flora and the fauna that thrives there. I have documented the necessity for adaptation for the floral and the faunal populations of the islands, their interactions and adaptations. I shall also discuss about the geological formations, introduction and negative impacts of invasive species on the synchronized equilibrium of the Galapagos ecosystem. I consider myself qualified to present such an important documentation to you because, with the help of professional tour guides, I have gained a broad understanding of the culture of Ecuador and they provided me the chance of successfully immerging myself in to their culture. Experiencing the islands from such a close distance, my attention was immediately drawn towards its ecosystem and its plight which lured me to conduct an in-depth research on the issue. I gained a complete understanding of the ecosystem and the threat posed by the invasive species that have been introduced in the islands. I consider that it is necessary for me to share this information with my audience because of the simple fact that they need to understand that there are very fragile and sacred environments in this planet that are worth fighting for. The Galapagos have been a conceptual landmark since its discovery and continues to grant us insight into concepts of evolutionary biology. The true essence of these islands lies in their biodiversity which is under threat; however, researchers believe that Galapagos is standing at cross roads and though the degradation rate is increasing, but

Hotel Quality Management Research Paper Example | Topics and Well Written Essays - 750 words

Hotel Quality Management - Research Paper Example Customers who request for a room change spend several minutes before they are reallocated another room. This has proven to be ineffective to customers and hotel departments. Other room services such as newspaper delivery and baggage storage also require improvements. Most of the processes that take place in the hotel are done manually, and there is minimal use of technology. Guests have to call for transport at the check-out time since there are no prior arrangements or contracts with transport companies. These activities and processes compromise the quality of services offered by the hotel, and may drive away some customers. Automating the check-in and check-out process would greatly improve the hotel services. A quality system empowers workers at several levels in the hotel in order to establish guest service expectations and device the best way to meet or exceed these expectations. An online check-in system would prove effective in providing quality system. This would help custome rs conduct booking processes via the internet and make payments online. Currently, the hotel uses a manual identification process, which involves checking identification documents. A computerized check-in process would enable hotel attendants verify the identity of customers automatically. Online services can also conduct room changes before they check-in to the hotel. Room change processes usually consume a lot of time before the new room is prepared. Conducting these requests before the guests check-in would save the amount of time spent. The check-out process is also conducted manually by checking the identification of the customer and retrieving customer accommodation information manually. Guests have to line up at the front desk to clear from the hotel. A computerized system would automate the confirmation process, and guests could check-out of their room without lining up at the front desk. Guests are presented with their bill at the front desk, which increases the amount of t ime spent. An efficient system would enable guests receive their bills before leaving their rooms. The hotel does not conduct a customer satisfaction survey about their services. Collecting customer feedback would enable the hotel improve different areas of their services, which did not please the customers. A guest email service would facilitate the collection of customer feedback and assist the hotel management to process the collected data. The core of quality management is to steer the business towards an improved performance. It has three main components, which include quality assurance, quality control, and quality improvement. Consistent quality is achieved by not only improving the condition of services, but also by improving the processes (Jones and Lockwood, 2004). This involves eliminating or minimizing defects present at the business processes and type of services offered. Customer and investor satisfaction are directly linked to the quality of services provided in the h otel. A hotel quality system would reduce competition from other hotels with the help of benchmarking. The hotel would have a mechanism of measuring the degree of customer needs and expectations through the customer feedback system. The hotel would then match these expectations and needs against the perceived quality. Automating the

Interpersonal Management Assignment Example | Topics and Well Written Essays - 2000 words

Interpersonal Management - Assignment Example in an independent manner including being aware of how I can be able to manage time, do presentations and express my views and opinions to other people. These skills are vital as they assist in the development of the aspects that a person needs for the workplace in future. They are integral in the development of confidence as well as self-esteem as they allow a person to learn to be assertive and develop an awareness of the needs of other people. The interpersonal skills learnt are also important as far as teamwork and responsibility is concerned as they make it easier for an individual to manage particular situations. The interpersonal skills that I have learnt have assisted me to understand that I should not be judgmental towards other people and to share ideas while working as a team through communicating with each other (Sen, 2007). All this aspects are integral and important in any workplace, particularly as far as social care is concerned. I have learnt to appreciate the concepts that are necessary for successful and efficient group work and to enjoy group sessions while contributing. I am now more confident that I am able to contribute positively to the success of any workforce while helping others to appreciate the significance of contributing their perceptions and ideas that are relevant to the prevailing situation. I have learnt to understand that every person has a point and there are always people who are willing to learn from what I have to offer. I have developed skills that assist me to work and collaborate with various individuals in different groups where I can listen to the ideas of others while giving my own. However, I have also learnt that some people are selfish with their ideas and do not contribute much in a group settings, instead, they soak up information that has been contributed by other people and add their own ideas from there. Knowledge that is acquired from subjects such as social policy and considering the manner in which different

Moroccan Islamic Combatant group Profile Essay Example | Topics and Well Written Essays - 1250 words

Moroccan Islamic Combatant group Profile - Essay Example Aligning itself with al-Qaeda in the aftermath of the attacks of September 11th in the United States of America, the GICM is a Sunni Islamist jihadist organization which seeks the overthrow of the reining institutions of the Moroccan state and the imposition of dogmatic Islamic rule in the country. Seeking to explore the Moroccan Islamic Combatant Group, this essay will define the term terrorist and explore the ideology behind this militant organization. An analysis of its targets, tactics and capabilities will conclude with a summary of its overall goals. Finally, we will conclude with a precise overview of this organization and its links to the global terror phenomenon. What is a terrorist and how does one define terrorism? The age old adage that â€Å"one man’s terrorist is another man’s freedom fighter† (Bergesen & Lizardo 39) remains true and the term terrorist has been notoriously difficult to define. Despite the definitional challenges surrounding the terrorist phenomenon, a definition of â€Å"terrorism† is integral to this essay and this term must be defined so as to provide a theoretical basis to this analysis of the GICM. Bruce Hoffman, world renowned terror scholar and expert of the use of terror as a political tool, understands the slippery nature of defining the term and argues that first and foremost, terrorism is a political concept. Secondly, terror is about power and the use of this power to enact political change (Hoffman 14-15). Another prominent international terror theorist, Gà ©rard Chaliand, terror is a tool which targets the mind. From this perspective, terror is â€Å"the most violent form of ps ychological warfare† (Chaliand et al. 2007) and terrorism is a means to power and control through violent means. While both of these definitions shed insight into the terrorist phenomenon, Dr. Mia Bloom, the world’s foremost expert on

Good vs Evil Dr. Jekyll and Mr. Hyde Essay Example for Free

Good vs Evil Dr. Jekyll and Mr. Hyde Essay The world as we know it is constantly moving and changing; events occur that can affect people’s lives even if they are thousands of miles away. Whether or not these happenings are good or evil can shape one’s mindset and outlook on the actions they take themselves. Both have distinct strengths and weaknesses; however, the real question one must ask is which side of the spectrum is more capable of influencing humanity. In Dr. Jekyll and Mr. Hyde written by Robert Louis Stevenson, a wealthy and well-respected doctor by the name of Henry Jekyll, who believes that man is not one but two separate people, constructs a potion which unearths his inner evil (Mr. Edward Hyde), and in the end is engulfed by the strength of his malevolent persona. Although good is a preferred in society, the power of evil has more ability to spread over a larger scale and influence the minds of many; it is omnipresent, inevitable, and extremely easy to surrender to. As much as people would like to conceal their impure intentions and corrupt ways of life, somehow they are revealed and it is impossible to resist what truly lies inside. What classifies a person as either good or evil depends on what side of their soul they decide to let be in control. Once the bad side takes over it takes an immense amount of effort to get the good back. In Dr. Jekyll and Mr. Hyde, Dr. Jekyll is consumed by the evil that lies within him. When Jekyll first consumes the potion he feels elated. Edward Hyde provides an alternate life for Jekyll. He is liberated of all cares and expectations. Nearing the end of the book, the reader gets a close look inside Jekyll’s mind and what was occurring when he switched between himself and Hyde. He tells about the early stages of his experiment: â€Å"I felt younger, lighter, happier in body†¦ a solution of the bonds of obligation, an unknown but not an innocent freedom of the soul. I knew myself, at the first breath of this new life, to be more wicked, tenfold more wicked, sold a slave to my original evil; and the thought, in that moment, braced and delighted me like wine† (Stevenson 67). Throughout his life, Henry has always been a man of respect. He is known to have integrity and good ethics. When he rids of his burdens and gives into the side of himself that does whatever it wants, he is rejuvenated. It’s as if he is given two paths, and the easier one to take is the one with â€Å"do not cross† tape across it. The temptation lingers over Jekyll to constantly transform into the devilish version of him. He is aware of the wrongness of the situation because Hyde is a danger to the community, but the feeling of being free is an addiction to him. It takes restraint to hold Hyde inside, and in the end it becomes impossible because he overpowers any will to salvage the morality of Jekyll. It is further explained that the switch between personalities was not caused by the drug, but by a choice that was made. Jekyll explains in his confessions, â€Å"The drug had no discriminating action; it was neither diabolical nor divine; it but shook the doors of the prison-house of my disposition†¦my evil, kept awake by ambition, was alert and swift to seize the occasion; and the thing that was projected was Edward Hyde† (Stevenson 67). It is said that evil is inside of everyone just as much as good is, and depending on what one faces one may be more present than the other. The potion was just a key which opened the lock that held Jekyll’s wicked spirit. The potential was always inside of him, but he needed that push to help him express it. In the real world, there are no potions that can turn one evil; however, certain events can trigger feelings or thoughts that completely go against one’s morality. It is a personal decision to act upon those thoughts, but it is particularly simple to do so, and once it is made a chain reaction occurs that becomes more frightening as it continues. That sparks one to ponder how the evil gets into a soul, and if there is anything to that can prevent the chaos it ensues. The question of where evil comes about is one that has been argued for a long time. Some believe that it is influenced by the world surrounding them, or perhaps by personal experiences. It could be that we are exposed to the concept of it at such an early age that we are given our lives to ponder what we prefer. It is also said that depravity is laced in our genetics, passed on through generations. Whatever the case, the demons inside us can at times be inescapable. If it is true that somewhere in our destiny lies evil, it is impossible to hold back. It is a natural instinct for those who are given that gene to do horrible things, and that overpowers the choice they are given not to. In an article addressing the source of evil which discusses well-known figures such as Adolf Hitler, it is written that recent studies have shown the evidence of behavior and personality in DNA. The author of the article believes that it is impossible to attain such tendencies through inheritance. He states, â€Å"The fact that one child may turn into a bully or become a criminal and another not remains a tantalising mystery, and one that scientists cannot possibly explain in simple terms of DNA† (Masters). Masters is suggesting that the transformation from good to bad is a complicated process that involves many elements. It is an intriguing thought, how a mind can shift from one side to the other. The influence of evil is all around and it becomes a task to ignore what is being so aggressively thrown upon a person. One incident can have the power to spoil a pure soul. Bad behavior is directly linked to selfishness; one can convince themselves that a decision that hurts others is what is right for them. Adolf Hitler can be used as an example of this; his greed for the perfect Germany drove him to do things which are appalling to imagine. With the article being based off of Hitler, it debates, â€Å"Vice is the easy option, whereas virtue denotes difficulty and sweat. As the great Roman philosopher and dramatist Seneca wrote: Nature does not give a man virtue, the process of becoming a good man is an art. † (Masters). Human beings are always searching for an easy way out. It can be applied to everyday life, taking an escalator rather than the stairs for example. When faced with the decision between good and evil, one is swayed towards evil simply because it is the easier decision to make. To be good and pure is to ignore impulses for revenge or selfish acts, which give one a sense of satisfaction and are hard to resist. It is a natural instinct to be bad, and one must work hard to escape the evil of their own self. Once somebody defeats the demons that lie inside of them, it is a whole other battle to face the evil that lay in front of them in their life. No matter where one may try to go, it is near impossible to escape the constant influence of bad people and bad things. No matter age, race, or sex, corrupt people are out there that can hurt and destroy. Evil is something that has the ability to spread like a wildfire, and affect all who crosses its path. In an ABC News article titled â€Å"‘Depraved’ Behavior in Ordinary Life† the subject of wickedness is brought into perspective with real-life situations. It is typical to connect evil to war and politics, but one may be surprised at the small accounts of evil they may encounter on a daily basis. Michael Welner, a psychologist who studies depraved behavior, believes that evil has a broad spectrum which any person can fit inside. He states, â€Å"’The American public regardless of [geographic] state, regardless of opinion, regardless of orientation, in a variety of issues can achieve an agreement about a number of qualities of crimes that make them beyond-the-pale depraved’† (Libaw). Welner challenges that there are standards that must be met for a person to be considered evil; however, it is fairly easy to meet the criteria. Anybody and everybody can do sinister acts; it doesn’t just apply to dictators and murderers. Looking further into the mind of an evil-doer, one may ask what makes a mind hostile. The subject is also addressed in this article, when Welner’s study is revealed to include 14 traits that can define a human as evil. Libaw sums up Welner’s research with this statement, â€Å"The common thread is that evildoers dont just commit bad acts. They choose to make their actions even worse by behaving sadistically and deliberately ignoring or intensifying the damage and suffering they cause† (Libaw). It is one thing to do something that is bad, and another thing to dedicate one’s life to making sure all surrounding them are in misery. Evil people have the power to ruin so many things with the blink of an eye, where it takes an army of good to defeat the power that the wicked ones hold. To make a difference for the better is much more difficult to do than destroying is. It takes too much effort and determination for any average person to accomplish. Evil is something that is all around us; it has the strength to overcome almost everything and destroy many aspects of society, even when there are the few that attempt to maintain the good. Connections can be made extremely easily, from those one might be close to or as far away as a person they learn about in school. Evil is something that carries on throughout the years and can have lasting effects while good deeds can only stay in the spotlight for so long. Humans have the choice to fight for good or to give into evil, and it requires inner strength of an individual to fight against the strength of evil if they wish to attain purity. If that can be achieved then it will stay and one less person will be affected; however if they fail, they may be a victim of the grasp of evil for as long as they shall live. Works Cited Libaw, Oliver. Looking for Evil in Everyday Life. ABC News. ABC News Network, n. d. Web. 09 Apr. 2013. Masters, Brian. Are Some People Born Evil? Mail Online. Associated Newspapers Ltd, 7 Feb. 2007. Web. 26 Apr. 2013. Stevenson, Robert Louis. Dr. Jekyll and Mr. Hyde. New York: Bantam, 1981. 67-69. Print.

Elderly Demographics Research Study

Elderly Demographics Research Study Topic Background Health seeking behaviour is becoming more popular in the field of research study at present time. The use of this, somehow, became the window of opportunity to policymakers in delivering a better health system especially in developing countries1. (Shaik, 2015). This is true among the elderly population since a shift in the pattern of morbidity and mortality was observed in recent years. Non-communicable diseases have become the top leading cause of morbidity. Furthermore, the emergence of lifestyle diseases in urban areas also adds up to the list of morbidity causes. This change contributes to the reluctance of elderly in seeking wellness therefore an obstacle to achieving good health. Health seeking behaviour plays a major role in the effect of their health status and not solely attributed to advancing age 2 (Sangmee Ahn Jo, 2007). A review literature 3(Grundy, 2010) indicated contributing factors that affect decisions of elderly on health. An identified hindrance is the preference of alternative or traditional therapies over formal health care which reportedly delay consultations, and in effect, cause delay of treatment accordingly 4-14. Grundy (2010) further emphasized that despite the variation in health seeking behaviour across regions, continuing studies of this aspect in health care is essential to provide a better picture of the disease process outcome. In this study health-seeking behaviour is defined as the following: the use of alternative or traditional therapies, reported delays in consultation and compliance of prescribed medicine among elderly population. Review of Related Literature Even though the growing population in the Philippines was dominated by the young we cannot ignore the needs of the increasing population of the elderly. The elderly were not given as much attention in the government health programs but the incidence of health problems play a part to the economic burden of households15. (Cecilia Santos-Acuin, 2013). In the 2010 national census it was stated that there were about 92.34 million Filipinos and approximately 5.8M (6.8%) of these belongs to the elderly population. Philippine population projected to increase to 142 million by 2045 and a span of 35 years around 50million people will be added16. (PSA:Population Projection Statistics, 2014)World Health Organization defined elderly according to the three main categories namely chronology, change in social role and change in capabilities .To standardized UN agreed a cutoff of 60 years old and above17. (World Health Organization:Health Statistics and information system, 2015). Health-seeking behaviour among elderly patients varies from each country. In the event of non-consultation or delay consultation among elderly it is obvious that the outcome was associated with adverse medical consequences. In one of the study conducted about managing nutrition among the elderly they pointed out the importance of prevention and early intervention because of the difficulty in treating an individual once the disease was already established4. (Damian Flanagan, 2012). This was also supported by cross-sectional study done in Namibia which the outcome resulted in higher treatment delays. In the study they determined the cause and categorized delay in the treatment as longer delay based on older age, urban residence, and longer walking distance to the nearest public facility, and doing a chest x-ray while having HIV seropositive and formal education determined the shorter delays5. (Kingsley Ukwaja, 2013). One significant Malaysian study focusing among elderly which utilized CAM for natural and safer use found out that non-consultation would contribute to the increasing undiagnosed cases of chronic diseases6.(Shahid Mitha, 2013). Further studies for different ways of treatment were done to substitute for complementary and alternative medicine especially common amongst Asians with elderly multiple co morbidities6 (Shahid Mitha, 2013).A study on DM conducted in Uganda showed that the unavailability of medicines prompted the people to use CAM for treatment and consulted a faith healer especially to those failures to manage DM causing an increase in DM related complications7. (Katarina Hjelm, 2011). Moreover, the elderly in the Philippines use medicinal plants before consulting to health professionals because of its availability, cheaper price than Western drugs, and usefulness in the treatment of various illnesses and to alleviate milder form of illnesses8. People who had chronic multiple morbidity took their medicines in a daily basis to survive, to work normally and to fulfil social work or obligations in the family. Taking multiple tablets in a day is a burden to them9. (Anne Townsend, 2003). One of the study conducted in Malaysia showed that the presence of a particular symptom will only start the usage of prescribed medicine. However, once these symptoms are resolve, medication would also be terminated giving them reason not to take drugs religiously. This will just worsen the disease process and later will lead to multiple admittance. Other studies also pointed out that noncompliance of medicine are due to the fear of drug dependency, multiple side effects and interaction with other drugs.(10). Thus, being more cautious and elaborative in giving instructions to patients who are taking multiple drug regimens should be practiced by health practitioners11. (Isacson D, 2002). A house-hold survey done among elderly Nigerian revealed that regardless of age and sex, family consultation is their first choice of treatment for their illnesses. This somehow increases the morbidity among the elderly population since family members know little about the safety and appropriate treatment for them12. (Abdulraheem, 2007) A cohort study in South Korea using AGE found out that the increase level of awareness and concern about the health of elderly women increases health-care consultation thus, resulted to increased risk of morbidity.2 (Sangmee AhnJo, 2007). In Myanmar, a study conducted to elderly women concluded that low-level of education and income play great role in skipping treatment and self-care13. (Soe Moe, 2012). Similarly, in Bangladesh, younger adult and elderly age group were compared in terms of health seeking behaviour (self-care/self-treatment). It showed no significant difference in health-seeking pattern. Both age group opted self-care/self-treatment as the first line of prevention due to poverty which would explain the increase in morbidity pattern of both.14(Syed Masad Ahmed, 2005). The growing trend of non-communicable diseases is the common cause of morbidity in today’s modern world. This lifestyle related disease can be altered in the future by determining the source of it. Also, health seeking behaviour plays a major role in determining the outcome of health status of an individual. No study on health seeking behaviour and factors that influence the behaviour of our elderly in our locality so a research study would be beneficial in gathering new information. Added to that, our elderly may have different factors towards health seeking behaviour and different morbidity pattern than the others. Research Question This study aims to determine what are the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour? Significance of the study Since health care programs to the elderly is not yet well established in Davao Regional Hospital, the outcome of this study will be the basis of the future recommendation of programs for the elderly in the DRH outpatient department. With this study we will be able to deliver better health services to our elderly patients such as: a. Creating a geriatrics club that would exclusively cater the needs of the elderly patient so that they don’t need to line-up with other patients. This would somehow help lessen their delay in consultation at the same time will increase the need to seek consult to a physician as their first choice of health care giver. b. By incorporating a primary giver as a potential treatment partner for the elderly patients that would monitor and check the elderly patients’ compliance to medicine and assure treatment success. C.Enrolling those elderly patient’s ages 70 years and above residing within 5 km of the hospital premises to a family oriented program .This would benefit those elderly patient’s that cannot visit the hospital due to old age, too sick to move and avoiding too much crowd. A home visit from the assign physician will help lessen their delay in consultation, correct the use of alternative medicine and affect their first choice of care giver. Objective of the study This study general objective is to identify the demographic and clinical characteristics of elderly patient 60 years old and above of the Davao Regional Hospital FAMED outpatient department that are associated with their health seeking behaviour. Specific Objectives To determine respondents socio-demographic and clinical profile. To determine the health seeking behaviour among elderly patients in terms of: Delay in consultation of chief complaint Use of alternative and traditional therapies Compliance of prescribed medicine First choice of health care provider To identify the socio-demographic and clinical characteristics of patient that would determine their health seeking behaviour. II. Methodology A. Research Design A cross-sectional study will be conducted among elderly patient of Davao Regional Hospital outpatient department. B. Setting This will be done at Davao Regional Hospital outpatient department of Family Medicine sometime in September 1, 2015 to October 31, 2015. The triaging system of Davao Regional Hospital outpatient department starts with a priority number to all with special considerations to the elderly population. All elderly on the senior citizen lane will be distributed to the different departments based on their chief complaint. In this study all respondents triage to the Family Medicine department will be invited to participate. C. Participants The respondents of this study include elderly patients ages 60 years and above willing to participate in this study. All those who are critically ill will be excluded from the study. D. Sampling Procedure A convenience sampling will be done. E. Interventions and Comparisons: Not applicable F. Randomization: Not applicable G. Data Gathering Approval of the CERC board will be obtained first prior to the collection of data. Data will be collected using a three-part standard questionnaire which will be administered through a one on one interview by the FAMED residents rotating at the outpatient department. Independent Variables Part 1 will consist of information about socio-demographic profile like age, sex, highest educational attainment, place of origin and source of funds. Part 2 will consist of the clinical profile of the respondents which includes presence of concomitant chronic diseases and current chief complaint. Dependent Variables Part 3 will be the information about the respondents’ health seeking behaviour and the outcome to be measured. In this study the following health seeking behaviours are explored. First health seeking behaviour is according to delay in consultation which in this study refer as the time from onset of chief complaint to first consult in Davao Regional Hospital FAMED outpatient department. For this study, a delay of 14 days or more from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"longer delay† and a delay of 7 days to 14 days from the time of onset of chief complaint to the time that the patient goes to the hospital will be considered as â€Å"shorter delay† 18-19(Fact sheet Diarrhoel disease, 2013) (Blanca Ochoa, 2002). The second health seeking behaviour is the use of alternative or traditional therapies which are define in this study as the use of herbal medicines, over the counter drugs, acupu ncture, reflexology, hilot and others not part of the conventional medicine before the initial consult referable to the chief complaint. Another health seeking behaviour is the compliance of prescribed medicine which in this study defines as the correct usage of drugs as to dosage, frequency, duration, and timing as prescribed by licensed physician of Davao Regional Hospital in relation to its chief complaint. Last health seeking behaviour is according to the first choice of health care providers. For this study, the first choice of health care providers in relation to its chief complaint. H. Sample size computation Sample size of this study was computed using the software StatCalc from EpiInfo 7. Calculations were based on the following assumptions: [1] 40% of patients aged 70 years (exposure) consult 2 weeks after onset of their chief complaint (outcome); and, [3] there are as many patients aged >70 years as there are patients aged 60-70 years. In a computation of odds ratios of getting the outcome, carried out at a 5% level of significance, a total sample of 194 patients will have 80% power of rejecting null hypothesis (no significant increase or decrease in odds ratio) if the alternative holds. An interim analysis will be done halfway through the recruitment (97%) in order to recompute the ideal sample size. I.Data handling and analysis Data for the study will be encoded in the Microsoft Excel and analyzed using EpiInfo 7. Categorical data will be summarized as frequencies and percentages, and compared. Continuous data will be summarized as means and standard deviations, and compared. Odds ratios of having particular health seeking behaviours will be computed. Level of significance will be set at 5%. Ethical Consideration Prior to participating in the study, the consent of the participant must be obtained. Ethics Review The proponent of the study will secure an approval from the Cluster Ethics Research Committee of Southern Philippines Medical Center prior to doing the research. Informed Consent: Form A written consent is obtained from the potential participants prior to conducting the study. Informed Consent: Signatory The signature of the participant should appear in the consent form. Informed Consent: Witness No witness will be required in order for the informed consent to be binding. Informed Consent: Proxy Consent There will be no proxy consent aside from that of the participant will be allowed. Informed Consent: Process Prior to signing the consent form, the potential participants are informed about the study rationale and objectives. Informed Consent: Timing and Venue The informed consent will be taken prior to the administration of the questionnaire. It will be done in the assigned area of the participant within DRH premises during office or duty hours. Disclosure of Study Objectives, Risks, Benefits and Procedures The participants will be informed of the study objectives, its purpose, its benefits and what is expected of them. They will also be told that there are no risks involved in the study. Remuneration, Reimbursement and Other Benefits No remuneration or reimbursement will be given to the participants. Privacy and Confidentiality The researchers will not disclose the identities of the participants at any time. Only the main proponent of the study has the personal information of the participants. The researchers will not contact the participants after this one time interview. Investigator’s Responsibility It is the investigator’s responsibility to ensure the confidentiality of any information obtained during the research. Specimen Handling N/A Voluntariness and Alternative Options The respondent’s participation in the study will be entirely voluntary. In case the participants wish to withdraw from this study the researchers will respect that decision and there will be no effect in the present and succeeding consultations. Information on Study Results The participants will have access to their data. After the data has been analysed, the overall results will also be made known to the participants. Extent of Use of Study Data At present there are no intended plans to use the data aside from the objectives stated in the protocol. Authorship and Contributorship Jacqueline N. Nuenay, M.D. is the principal investigator and the main author of the study. Dr. Chrysteler Clet is the co-author. Conflicts of Interest The principal investigator and the co-author declare no conflict of interest. Publication The research may be submitted for national and/or international presentation or publication. Funding The main proponent of the study is using personal funds to conduct the study. Duplicate Copy of the Informed Consent Form A duplicate copy of the informed consent form will be provided to the participants of the study. Additional copies can be made on request. Questions and Concerns Regarding the Study The participants will be encouraged by the principal investigator to voice out concerns about their participation in the study. Contact Details The participants of the study will be provided with the cell phone number of the principal investigator. The principal investigator is also available for questions, comments and concerns about the study.

A Look At Burnout Psychology Essay

A Look At Burnout Psychology Essay CHAPTER 2 LITERATURE REVIEW 2.1 Introduction This study examined the relationship between emotional intelligence (EI) and burnout among nurses working in private hospitals in Malaysia. Theoretical literature related to this relationship will be presented in the first part of this chapter. The existing literature on the topics was examined and key pieces were brought together to establish a foundation for this study. The next part of the review explores the literature which has supported the proposed relationship between EI and burnout among the nurses in Malaysia. 2.2 Burnout The term burnout has its roots in the medical and nursing disciplines. It was first defined by a psychiatrist, named Herbert Freudenberger in 1974. The theory of burnout was developed through his clinical experience by exploring the turmoil that people experience every day. According to Maslach and Jackson (1981a), burnout occurs in the helping professions, such as nursing due to the chronic stress associated with doing work that involves people. Basically burnout occurs as feelings of emotional exhaustion, negative feelings, and attitudes within the job and the increase of negative self-concept. The earliest use of the burnout term in nursing literature was found in the articles published by Seymour Shubin in 1978. Shubin described burnout as hazardous to nursing and all other helping professions. The study of burnout, although not exclusive to nursing, continues to be an important occupational issue for the nursing profession. 2.2.1 Definition of Burnout There are many definitions of burnout, however most definitions share a view of burnout as a state of fatigue and emotional exhaustion, as a result of emotional depletion and loss of motivation. The term burnout that was first coined by Freudenberger in 1974 refers to wearing out from the pressures of work. It was used to describe the experience of employees in professions that needs high degree of people contract. Freudenberger in 1975 further defined burnout as wearing out, failing, becoming exhausted, and it occurs when excessive demands on energy, strength or resources are made. Cherniss (1980) was among the first to describe burnout within human service field who defined burnout as a process that leads to an individuals attitudes and behavior change in negative ways in response to work stress. On the other hand, Maslach (1982) who has extensively researched about burnout has provided the most commonly accepted definition of burnout as a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do people work of some kind. Maslach identified three related themes: (1) painful emotional experiences often resulted in clinical practitioners feeling emotionally exhausted and drained; (2) as a result, they developed negative and cynical attitudes towards their clients; and (3) personal competence suffered resulting in feelings of failure about their ability to work in the health care profession. These three themes were summarized as emotional exhaustion, depersonalization, and reduced personal acc omplishment and later operationalized to measure burnout using the Maslach Burnout Inventory (MBI) (Maslach, Jackson Leiter, 1996). Garrosa, Moreno-Jimenez, Liang and Gonzalez (2008) pointed out that burnout is a specific form of chronic and occupational stress in the professional social services. According to Westman and Eden (1996), studies have shown a strong relationship between work stress and burnout in many occupations. Especially, burnout has been repeatedly linked to job stress in the human service field due to the frequent and intense interactions with clients (Cordes Doughery, 1993; Lee Ashforth, 1996). Additionally, studies have also shown that nurses who experience occupational stress experience greater burnout (Stechmiller Yarandi, 1993). Thus, burnout is related to stress whereby burnout is a reaction to stress. Prolonged and unrelieved work stress often leads to burnout which results in negative attitudes towards work. Freudenberger (1975) postulates that burnout involves physical and behavioral symptoms. Behavioral consequences of burnout include decreased interaction with care recipients, ine ffective absenteeism, and high levels of job turnover (Maslach, 1982; Maslach Leiter, 1997). 2.2.2 Models of Burnout The burnout literature provides several models of burnout. This section describes four models constructed in the early eighties which proceed from the simplest to the most complex model. 2.2.2.1 Cherniss transaction model of burnout Cherniss (1980) was a significant figure of the first wave of burnout researchers and offered a burnout model that articulate transactional imbalance between the personal resources of the giver and the demands of the recipient or situation. Cherniss described burnout as a transactional stress process that involves three stages. The first stage is stress whereby demands placed exceed individual resources for coping. The second stage is strain, the initial emotional response to stress which usually includes feelings of anxiety, tension, fatigue, and exhaustion. Finally, defensive coping occurs which leads to changes in attitudes and behavior such as the tendency of burnout individuals to treat clients in depersonalized way. Two years later, Cherniss modified his model and elaborated on the model that the causes of stress can either be internal or external demands. Additionally, the limited resources contributing to stress can also be external (e.g. availability of time, work space, and equipment) or internal (e.g. skills, knowledge, energy, and personality). In summary, Cherniss theorized that burnout is a coping response in a transactional process that begins with excessive and prolonged exposure to job stress. The uncontrollable stress causes strain in the individual which influences the coping process. If the stress is prolonged or becomes more intense, it will deplete the coping resources of an individual and force the individual to withdraw psychologically. 2.2.2.2 Edelwich and Brodsky: Five stages of burnout Edelwich and Brodsky (1980) suggested five stages of burnout: (1) enthusiasm; (2) stagnation; (3) frustration; (4) apathy; and (5) intervention. At the first stage, employees have great enthusiasm for their new jobs. They do not know much about their job and have unrealistic expectations about outcomes of their effort. Therefore, when the outcome is not as expected, they become disillusioned. During the period of stagnation at stage two, realities of the job become evident. The job is no longer satisfying as it first appeared. Employees are now more concerned with meeting personal needs, working hours, and career development. The third stage is called the period of frustration. Employees begin to question their job effectiveness and the value of their job. The limits imposed by bureaucracy frustrate the individuals and they become dissatisfied with the job situation. At this stage, employees begin to develop emotional, physical, and behavioral problems. Proceed to stage four; employees frustration turns to apathy because individuals feel trapped. On one hand, they feel frustrated by the job situation but on the other hand, they need the salary. The emotional and physical responses of individuals become worse whereby they would avoid clients whenever possible. The final stage is intervention. Nevertheless, it cannot be determined whether this stage would occur in an organization or the individual who is experiencing burnout would recognize their psychological state as undesirable. In summary, Edelwich and Brodsky viewed burnout as an evolutionary process that begins with idealistic enthusiasm and commitment. Subsequently, the loss of idealism, vigor, and purpose is triggered largely by work conditions (Edelwich Brodsky, 1980). 2.2.2.3 Maslach: Burnout caused by social interaction Maslach, a social psychologist, who became a stellar figure in the emerging research of burnout, has provided the conceptual definition that begun the second wave of research. Maslach (1982) described burnout as a three-dimensional syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. Another specific contribution Maslach made was the theoretical emphasis on the relational causes of burnout which linked to the social roots of emotional expenditure (Leiter Maslach, 1988; Maslach Leiter, 1997). Maslach (1982) saw that emotional overload and subsequent emotional exhaustion is the heart of the burnout syndrome. Thus, the first response to a stressful interaction with other people is emotional exhaustion. As people become emotionally depleted, they cope by cutting back on their involvement with others. This detached response which called depersonalization is the second aspect of burnout and leads to various negative attitudes and behaviors. At this stage, individuals who experience burnout feel more emotional distress and guilt about how they have treated those that they are trying to help. Finally, the feeling of reduced personal accomplishment which is the third aspect of burnout appears. At this point, the individuals feel inadequate about their ability to treat or help others. They tend to believe that they have failed professionally and chosen the wrong profession. A major contribution by Maslach was the development of the Maslach Burnout Inventory (MBI). Maslach and Jackson (1981a, 1981b) developed the MBI, which was one of the first reliable instruments for valid measurement of burnout. MBI is still the most widely-used measure of burnout in current research. MBI assesses psychological burnout and has three different versions, which include one general survey, one for human service professionals, and one for educators. The most commonly used measure of burnout is the Maslach Burnout Inventory-Human Services Survey or MBI-HSS (Maslach, Jackson Leiter, 1996) which was developed to measure occupational burnout among people working in the field of human services. 2.2.2.4 Golembiewski, Munzenrider and Carter: Rigorous scientific research While other models focused on the order in which burnout aspects occur and the helping professions, Golembiewski, Munzenrider and Carter (1983) were concerned to make the study of burnout more rigorous and to broaden the population in which burnout was examined. Golembiewski et al. noticed that research was lacking in terms of empirical investigation of the stages of burnout. To rectify both the lack of empiricism and extend the study of burnout to wider work settings, the authors used Maslach and Jacksons MBI (1981a, 1981b) to measure burnout among nursery school teachers and nurse educators. Golembiewski et al.s results in 1983 suggested that depersonalization occurs first and increases greatly before reduction in personal accomplishment occurs and finally emotional exhaustion follows. Their argument was based on the fact that when people sense a loss of control and autonomy, their self-image is threatened. Initially, individuals may seek constructive ways out of the situation such as leaving the job. However, if the situation persists, they may begin to treat others as objects resulting in depersonalization. This will lead to diminished personal accomplishment and ultimately worsening emotional exhaustion. Based on Golembiewski et al.s findings and discussion of the burnout model in 1983, it can be classified that their model is similar to the earliest version of burnout model proposed by Cherniss (1980). Additionally, based on their model, Golembiewski et al. used a modified version of MBI and administered the instrument to a small population. The results allowed them to propose a model of burnout with eight stages. However, their model did not clarify or simplify the understanding of burnout. They moved to more rigorous methods of data collection and analysis using MBI as measurement instrument and expanded the population of employees to which results can be generalized. 2.2.3 Burnout and Nursing Employees in general experience burnout on the job, especially those in jobs with high contact with people. Nevertheless, nurses are considered at high risk of work-related stress and particularly susceptible to burnout among the different healthcare providers (Keane, Ducette Alder, 1985; Kilpatrick, 1989; Schaefer Moos, 1993; Schaufeli Janczur, 1994; Duquette, Kerouac Sandhu Beaudet, 1994; Farrington, 1995; Decker, 1997; Marsh, Beard Adams, 1999; Koivula, Paunonen Laippala, 2000; Taormina Law, 2000; Shimizu, Mizoue, Kubota, Mishima Nagata, 2003; Jenkins Elliott, 2004; Piko, 2006). This is also proven by the fact that burnout in nursing has received world-wide attention (Demerouti, Bakker, Nechreiner Schaufeli, 2000). Several studies have identified nurse burnout rates are as high as 40-50% (Hapell, Martin Pinikahana, 2003; Vahey, Aiken, Sloane, Clarke Vargas, 2004). Nurses are particularly susceptible to the development of burnout, mainly because of the nature and the em otional demands of their profession. Nurses experience considerable stress in their job because they have long working hours, a wide range of tasks, interpersonal conflict with patients and their families, doctors, and other co-workers, exposure to death and dying, and noise pollution (Schmitz, Neuman Opperman, 2000; Maslach, Schaufeli Leiter, 2001; Shimizu et al., 2003). Studies have also confirmed that stressful circumstances for hospital nurses are escalating and including work load (Foxall, Zimmerman, Standley Bene, 1990; Healey McKay, 2000; Koivula et al., 2000). Basically, nurses are subjected to many demands in the workplace which include physical demands and the psychological/emotional demands. The physical demands are related to the physical energy required to perform the daily duties of nursing such as transferring patients in and out of bed and lifting patients onto a bed. On the other hand, psychological/emotional demands are related to the emotional energy required to care for patients with chronic illn ess (Van Servellen Leake, 1993). Therefore, nurses who feel overloaded perceive a lack of meaningful connection with the patients. 2.3 Emotional Intelligence (EI) Emotional intelligence (EI) is complementary to cognitive abilities (IQ) (Devrim, Nadi, Mahmut, Mustafa Mustafa Kemal, 2005). Goleman (1995) stated that EI is significant to success. Goleman further explains the difference between people with high IQs who experience difficulties in their personal and professional lives and people with moderate IQs who are very successful in all their endeavours. Emotions are separated from that of the rational mind having independent views and a mind of their own (Freshwater Stickley, 2004). Therefore, one has two minds, a rational mind that thinks and an emotional mind that feels. In conclusion, both the rational mind and emotional mind, store memories and influence our responses, actions, and choices. Furthermore, EI such as academic intelligence can be learned and developed with age (Mayer, Caruso Salovey, 2000). Research has shown that people with high EI understand their own and others feelings, know how to manage themselves, deal successfully with others, and respond effectively to work demands (Dulewicz Higgs, 2003; Goleman, 2005). Cooper (1997) stated that people with high levels of EI experience more career success, build stronger personal relationships, lead more effectively, and enjoy better health than those with low EI. Hence, developing EI competencies in existing employees or finding individuals who posses these skills will enhance the organizations bottom line (Goleman, 1998a, 1998b) and ensure long-term success for the company. 2.3.1 Background and Definition of Emotional Intelligence (EI) The idea of EI has its roots in the social intelligences. EI was first proposed by Thorndike in 1921, who noted that it was of value in human interactions and relationships. Gardners (1983) multiple intelligence theory later also contributed to the theory of EI through the identification of intrapersonal and interpersonal intelligences. Interpersonal intelligence comprised of the ability to understand others and to co-operate with them, whereas intrapersonal intelligence comprised of the ability to be self-aware, to recognize ones own feelings, and to use this to operate successfully in life. However, the term EI was not brought into mainstream psychology until 1990s (Mayer, DiPaolo Salovey, 1990; Salovey Mayer, 1990). Hence, EI is a new construct since the first peer-reviewed article that was published in 1990 (Salovey Mayer, 1990). The concept is also described as a new theory which is still in the initial stage of development and testing (Ashkanasy, Hartel Daus, 2002; Cherniss , Extein, Goleman Weissberg, 2006). As a result, definition of EI varies. Salovey and Mayer (1990) first coined the term of EI and defined EI as the ability to monitor ones own and others feelings and emotions, to discriminate among them, and to use this information to guide ones thinking and actions. Mayer et al. (2000) further defined EI as an ability to recognize the meanings of emotions and their relationships, and reason and problem-solve on the basis of them. EI is involved in the capacity to perceive emotions, assimilate emotion related feelings, understand the information of those emotions, and manage them. However, the concept of EI was popularized by Goleman (1995) through his book Emotional Intelligence, which became a best-selling book for business and education leaders. Goleman (1998a) identified EI as the capacity for recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships. In addition, Bar-On (2005) defined EI as a cross-section of interrelated emotional and social competencies, skills, and facilitators that determine how effectively we understand and express ourselves, understand others and relate with them, and cope with daily demands. In conclusion, recognizing feelings and controlling emotions are described as the core competencies of EI. Individuals who are emotionally intelligent can understand one another and each others views to overcome conflict and avoid damaging the relationship. Therefore, EI is about sensing what others are feelings and handling relationships effectively (Dulewicz Higgs, 2000). Previous research also addressed the relationship between EI and work outcome variables such as stress perceptions in the workplace (Bar-On, Brown, Kirkcaldy Thome, 2000; Nikolaou Tsaousis, 2002), job satisfaction (Wong Law, 2002), job commitment (Nikolaou Tsaousis, 2002), leader effectiveness (Higgs Aitken, 2003), and performance (Lam Kirby, 2002; Van Rooy Viswesvaran, 2004; Lopes, Grewal, Kadis, Gall Salovey, 2006). 2.3.2 Theories of Emotional Intelligence (EI) Since the emergence of the concept of EI in 1990s, many theories have been proposed. Nevertheless, three theories have gained acceptance among scholars and practitioners (Dulewicz, Higgs Slaski, 2003). These three major theoretical constructs each focused on understanding the roles of skills, traits, and abilities in EI (Emmerling Goleman, 2003). EI has been defined as an ability (Salovey Mayer, 1990), a set of traits and abilities (Bar-On, 2005) or a combination of skills and personal competencies (Goleman, 1995). The ability model is based on an individuals ability to use emotion as part of the reasoning process (Mayer et al., 2000). Mayer et al. asserted that EI depends on the ability to process emotional information and to use core abilities related to emotions. Bar-On (2005) conceptualized EI as a set of personality traits and abilities that predict emotional and social adaption within environments. Bar-On also affirmed that EI is teachable and learnable. According to Goleman (1995), EI is a set of learned skills and competencies and this conceptualization is most widely accepted outside academia. Golemans ideas have contributed to the development of leadership models that outline skills and competencies related to emotionally competent leadership (Emmerling Goleman, 2003). Additionally, the literature has evolved into two main categories of EI models: (1) ability model; and (2) mixed model (Feyerherm Rice, 2002). The Salovey and Mayer theory is considered an ability model of EI, while the Bar-On and Goleman theories are considered mixed model of EI (Mayer et al., 2000). Basically, the ability model encapsulates EI as a skill and the mixed model go beyond ability by including additional personality characteristics that leads to certain behavior. 2.3.2.1 Ability Model The ability model of EI is the Salovey and Mayer (1990) model which officially launched the field of EI. Salovey and Mayer viewed EI as an ability that exists, interacts, and complements an individuals cognitive capabilities. Ability theory promotes the relationship between cognition and emotion based on mental abilities (Mayer, Salovey Caruso, 2004). Salovey and Mayer conceptualized EI as a set of interrelated skills composed of four branches of abilities, which include: (1) perception and expression of emotion; (2) using emotions to facilitate thought; (3) understanding and analyzing emotions; and (4) managing emotions (Mayer et al., 2004). The four branches can be described as follows: (1) the perceiving emotions branch relates to the ability to detect emotions in oneself and in others; (2) the using emotions branch relates to the ability to use emotions in cognitive activities such as problem solving; (3) the understanding emotions branch relates to the ability to comprehend the complexity of emotional language and emotional relationships; and (4) the managing emotions branch relates to the ability for one to regulate emotions in oneself and in others. The ability model of EI is different from other theories because the model is the only one which utilizes an instrument designed to measure ability (Dulewicz et al., 2003). This model operationalizes EI using ability-based measures: the Mayer-Salovey-Caruso Emotional Intelligence Test (MECEIT) (Mayer, Salovey Caruso, 2002) and its predecessor, the Multifactor Emotional Intelligence Scale (MEIS) (Salovey Mayer, 1990). The ability tests measure how well people perform tasks and solve emotional problems, as opposed to other EI scales which rely on the individuals subjective assessment of his or her perceived emotional skills. However, ability tests are expensive and require more resources to administer and score. MSCEIT instrument is difficult to score and lacks workplace applicability (Brackett, Rivers, Shiffman, Lerner Salovey, 2006). Consequently, self-report assessment outnumbers ability tests are more widely used in the mixed models. 2.3.2.2 Mixed Models EI mixed theories highlight the emotional and social functioning of individuals (Goleman, 2005; Bar-On, 2006). Therefore, Bar-On categorizes his model of EI as a key of emotional-social intelligence (ESI). Bar-On (2005) asserted five key competencies are associated with ESI, whereby the five domains of this mixed model are: (1) intrapersonal capacity (the ability to be aware and understand ones own emotions and to express ones feelings and ideas); (2) interpersonal skills (the ability to be aware, understand, and appreciate others feelings as well as to build and maintain effective and satisfying relationships with others); (3) adaptability (the ability to adapt to various situations by effectively managing personal, social, and environmental changes by employing various skills such as problem solving, reality testing, and flexibility); (4) stress management strategies (the ability to manage emotions and to use those emotions to stay motivated and persistent); and (5) motivational an d general mood factors (the ability to be optimistic, to enjoy oneself and others, and to maintain positive feelings) (Bar-On et al., 2000). The Emotional Quotient Inventory (EQ-i), a self-report measure is considered as the most widely used measure of ESI (Bar-On, 2005). The EQ-i analyzes the concept of emotional and social functioning by measuring a persons ability to deal with daily demands and pressures. People who are taking EQ-i answer questions based on five competencies: (1) intrapersonal skills such as emotional self-awareness, self-regard, self-actualization, or independence; (2) interpersonal skills such as interpersonal relationships, empathy, and social responsibility; (3) adaptability, including problem solving, flexibility, and reality testing; (4) stress management, including tolerance and impulse control; and (5) general mood of optimism and happiness. Goleman developed his mixed model theory of EI by building on the work of Salovey and Mayer, in addition to other researchers in the field (Emmerling Goleman, 2003). Basically, Golemans model of EI can be grouped into personal competencies and social competencies that affect personal success in the workplace. Goleman (2005) stated that a personal competence is the ability to keep self-awareness and manage ones behaviors while a social competence is the ability to understand the behaviors of others and manage relationships effectively. These competencies are described in detail as: (1) self-awareness (knowing ones internal states, preferences, resources, and intuitions); (2) self-management (managing ones internal states, impulses, and resources); (3) motivation (emotional tendencies that facilitate reaching goals); empathy (awareness of others feelings, needs, and concerns); and (4) social skills (adeptness at inducing desirable responses in others) (Goleman, 1998a). Based on the emotional competencies identified by Goleman (1998a), the Emotional Competence Inventory (ECI) was designed to assess EI. ECI is a 360-degree scale which gathers self, subordinate, peer, and supervisory ratings on social and emotional competencies of individuals in organizations. Subsequently, Boyatzis (2007) designed Emotional Social Competency Instrument (ESCI), a multi-rater assessment in real organizational contexts which comprised of four emotional and social competencies, which include: (1) self-awareness; (2) self-management; (3) social awareness; and (4) relationship management. In general, EI mixed models stress performance based on behavioral competencies and personality traits suitable for a wide range of work contexts, job roles, and job levels (Petrides, Furnham Martin, 2004; Goleman, 2005; Boyatzis, 2007). The mixed model is also comprised of other measurement instruments. For examples, measures such as the Schutte Self-Report Emotional Intelligence Test (SSEIT) (Schutte, Malouff, Hall, Haggerty, Cooper, Golden Dornheim, 1998), and Wong and Laws (2002) leadership-focused measure of EI. Many studies in the literature utilize self-report measures of EI based on mixed model perspective that incorporates both disposition and ability (Chan, 2006). According to MacCann, Matthews, Zeidner and Roberts (2003), mixed model scales vastly outnumber ability tests at the stage of EI development, meaning that EI is more commonly assessed as a disposition, rather than as an ability. Additionally, self-report or peer-report measures require less amount of time to com plete and are most cost-effective than the ability based measure. 2.3.3 Emotional Intelligence (EI) and Nursing There is a large body of knowledge related to EI exists outside nursing whereas EI theory and research within nursing is scarce and a more recent phenomenon (Akerjordet Severinsson, 2007; Smith, Profetto-McGrath Cummings, 2009). Smith et al. (2009) conducted a literature review related to EI and nursing during 1995-2007. Smith et al. found only 21 theoretical and 9 empirical articles related to the subject and concluded that although the body of theoretical literature in nursing is growing, scientific research about EI and nursing is just beginning. Apart from that, researches that link EI and nursing are mostly correlation designs using small sample sizes. Akerjordet and Severinsson (2007) asserted that EI has significant implications for nurses quality of work in healthcare. Therefore some qualitative studies have been conducted to explore the concepts and ideas of EI in nursing (Akerjordet Severinsson, 2004; Freshwater Stickley, 2004; Kooker, Shoultz Codier, 2007; Hurley Rankin, 2008). Akerjordet and Severinsson (2004) used qualitative interviews to gain insight into mental health nurses emotional experiences in practice and sought to understand the connection between nurses articulations of emotions in practice and EI concepts. Four main themes emerged from the study, which include: (1) relationship with the patient; (2) the substance of supervision; (3) motivation; and (4) responsibility which are related to different aspects of EI. For instance, relationship with the patient which was a central research finding is linked to EI through the ability to interpret and communicate emotional information. Akerjordet and Severinsson co ncluded that EI implies important personal and interpersonal skills in nurses therapeutic use of self, critical reflection, and stimulates the search for a deeper understanding of professional nursing identity. Additionally, quantitative studies in nursing have linked EI with coping strategies (Rochester, Kilstoff Scott, 2005; Montes-Berges Augusto, 2007) and burnout (Gerits, Derksen, Verbruggen Katzko, 2005). Montes-Berges and Augusto (2007) investigated links between nursing students EI, coping with stress and success at school or work. They indicated that nursing students who possess EI competencies are more likely to manage the pressures of school and continue throughout the nursing programs. The findings further pointed out a moderate correlation between nurses EI and coping within work-related environments. Another study found a clear link between EI and burnout in nurses measured at two different points in time (Gerits et al., 2005). Gerits et al. conducted a two-year longitudinal study on the EI profiles with 380 nurses working in 56 Dutch residential facilities for people with mental retardation. The fewest symptoms of burnout were reported by female nurses with relatively high EI profiles and relatively low social skills. EI has been identified as important for leaders in healthcare environments (Vitello-Cicciu, 2002; Cummings, 2004; McQueen, 2004). Organizational literature supports the notion that strong leaders who know how to manage emotions within complex healthcare systems is needed and will further benefit patient care, nurses, and organizations (Snow, 2001; Herbert Edgar, 2004; Feather, 2009). Emotionally intelligent leaders use emotionally intelligent skill to recognize the professional and emotional needs of colleagues, establish positive relationships with nurses, motivate passion and dedication in the workplace and ultimately influence patient care practices (Vitello-Cicciu, 2003). In a nutshell, emotionally intelligent leaders secure a commitment for excellence in practice through emotionally intelligent relationships that promote improvements in thinking, critical decision making, and care delivery (Strickland, 2000; Snow, 2001; Goleman, 2005). In summary, EI concept is increasingly recognized and is making an appearance in nursing journals (Cadman Brewer, 2001; Evans Allen, 2002; Freshman Rubino, 2002). The literature revealed EI is important and relevant to nursing from both an empirical and a theoretical perspective. EI influences emotion within caring relationships, quality of care and stress management. Emotionally intelligent leaders influence employees retention, quality of patient care, and pati