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Under a Creative Commons license Open access AbstractBackgroundKnowledge around emotional intelligence originated in the 1990s from research regarding thoughts, emotions and abilities. The concept of emotional intelligence has evolved over the last 25 years; however, the understanding and use is still unclear. Despite this, emotional intelligence has been a widely-considered concept within professions such as business, management, education, and within the last 10 years has gained traction within nursing practice. Aims and objectivesThe aim of this concept review is to clarify the understanding of the concept emotional intelligence, what attributes signify emotional intelligence, what are its antecedents, consequences, related terms and implications to advance nursing practice. MethodA computerized search was guided by Rodger's evolutional concept analysis. Data courses included: CINAHL, PyschINFO, Scopus, EMBASE and ProQuest, focusing on articles published in Canada and the United Stated during 1990–2017. ResultsA total of 23 articles from various bodies of disciplines were included in this integrative concept review. The analysis reveals that there are many inconsistencies regarding the description of emotional intelligence, however, four common attributes were discovered: self-awareness, self-management, social awareness and social/relationship management. These attributes facilitate the emotional well-being among advance practice nurses and enhances the ability to practice in a way that will benefit patients, families, colleagues and advance practice nurses as working professionals and as individuals. ConclusionThe integration of emotional intelligence is supported within several disciplines as there is consensus on the impact that emotional intelligence has on job satisfaction, stress level, burnout and helps to facilitate a positive environment. Explicit to advance practice nursing, emotional intelligence is a concept that may be central to nursing practice as it has the potential to impact the quality of patient care and outcomes, decision-making, critical thinking and overall the well-being of practicing nurses. KeywordsEmotional intelligence Concept analysis Nursing Cited by (0)© 2018 Chinese Nursing Association. Production and hosting by Elsevier B.V. Development of Personality Personality is the relatively stable way that a person thinks, feels, and behaves. Personality includes the psychosocial traits and characteristics (not
physical qualities) that make a person an individual. For example, an extrovert is a person who enjoys being with people and is usually outgoing. Eight key influences combine to form the personality of an individual (Friedman & Schusrack, 1999): • Unconscious aspects are parts of the personality not in the person's awareness. • Identity is a sense of self (ego). • The biology of personality is the unique generic, physiological, and temperamental nature of the person. • Conditioning shapes the personality through experiences that influence the person to react in certain ways. • The cognitive dimension reflects how thinking about and interpreting the world shapes personality. • Specific traits, skills, and predispositions are present in each individual. • The spiritual dimension is the part of personality that prompts people to contemplate the meaning of their existence. • Inreracrion between the individual and the environment is an ongoing process that affects personality Freud stated that personaliry is shaped largely by early childhood experiences and that people have no free will to control their destiny. Holism is a philosophy that considers the person
as a total being with psychosocial, spiritual, and physical needs. The focus of psychoanalysis is to find the root of unconscious thoughts and feelings that cause the client's anxiety. Freud had his clients "free associate" (talk freely about whatever came to their mind) about their early experiences. He believed that early experiences continue to influence people throughout their lives. He also analyzed clients' dreams. He theorized that dreams give clues to the person's unconscious mind, the part of the mind that is not accessible to conscious thoughts He divided the mind into three pares. He described the id as the part of the personality containing basic instincts and urges. The ego, according to Freud, is the "I." It is the part of the personality that develops to respond to the realities and problems of everyday life. The superego is a person's conscience and the internalized concept of the ideal self. freud's theory of development of personality is called psychosexNal development. The child progresses through the oral stage, the anal stage, the phallic stage, the latency period, and finally the
genital stage. Defense mechanisms are thoughts and behaviors that distort reality to protect the self. These processes are used to protect the ego from threatening impulses or the painful realities of life experiences. Altruism Dissociation Projection Rationalization Reaction Formation Repression Sublimation Suppression PSYCHOTHERAPY BY THE PSYCHOANALYSTS The psychoanalyse uses dream analysis, free association, and inrerprecarion of behavior. The idea is that if clients understand the reasons for their anxiety, their anxieties and conflicts will resolve. The behavior associated with defense mechanisms can be either adaptive behavior (positive, health promoting, problem solving) or maladaptive behavior (unhealthy and does nor promote problem solving) For example, the person with hypertension who rationalizes his high-sodium, high-fat diet to the nurse by saying, "It doesn't really matter what I eat, I'm taking medication," is using rationalization in an unhealthy or maladaptive way. The student who exercises after school to help manage the srress of college is using sublimation in an adaptive way Each of Erikson's stages represents a conflict or core problem that the individual strives to overcome at a critical period of development. A person muse successfully resolve each conflict in order
to master the next one The activities required for mastery of each of the eight stages in Erikson's psychosocial development theory are called developmental tasks. Each of Erikson's stages has two componems: the successful and unsuccessful sides of the core conflict Erikson's Stages of Psychosocial Development Trust versus Mistrust Autonomy versus Shame and Doubt Initiative versus Guilt Industry versus Inferiority Intimacy versus Isolation Generativity versus Stagnation Ego Integrity versus Despair PSYCHOTHERAPY BY THE EGO THEORISTS The goal of psychotherapy according to the ego theorists is to establish increasing levels of independence by assisting the ego or self to
overcome developmental obstacles. The therapeutic process includes the client talking with the therapist and working to develop insight into reasons for anxiery. The emphasis is on clients studying their own srories and understanding their own inner motivations and self-concept Play therapy is frequently used with
children who are experiencing trauma or grief. Melanie Klein, a British psychiatrist, developed play therapy. In this therapy, toys or arts and crafts are used in rhe same way that dream analysis or free association are used by the ego rheorists with adults. Children express their feelings and work our their conflicts in play. Erikson's psychosocial development theory is perhaps the most commonly accepted
theory of personality development For example, if a pediatric client in the stage of Industry versus Inferiority is hospitalized, what kind of activities would the nurse provide for this client? The activity should promote the child's achievement of the developmental task of Industry. This developmental task requires the child to do projects that provide a sense of accomplishment. A puzzle or a craft project
could promote this child 's development. Erikson's psychosocial stages are also used in nursing to understand the client's priority concerns. Consider the case of two different clients with the same medical diagnosis: fractured femur. One is a 2-year-old boy and the other is a 40-year-old man. The child's developmental stage is Autonomy versus Shame and Doubt. His developmental task is to be independent of his parents. Without the fracture he would be walking or running all over the place. So, mobility is a priority for this child. He may benefit from a specially made walker or other mobility device that enables him to be mobile. In contrast, the 40-year-old is in the stage of Generatively versus Stagnation. His developmental task (Generatively) requires that he get back to work. If he has a "desk" job, maybe work can be brought home for him. If not, perhaps his job can be modified until he recovers (maybe he can answer the phone). The adult has different priorities than the child because of his developmental tasks The 40-year-old man will probably be motivated to comply with any treatment that will help him get back to work The biological theorists believe that people are born with certain
predisposition(tendencies) and abilities that affect personality. The way people respond to stress, their susceptibility to developing mental disorders, even how they feel and act are caused by generic, chemical, and physiological forces. Eysenck's idea is that some people inherently have a relatively low level of brain
arousal. These people seek stimulation and are termed extroverts. Other people have a higher level of central nervous sysrem stimulation in general, so they tend to shy away from stimulating environments. These people are called introverts. Eysenck is a biological theorist because he thinks that human personality is rooted in our generics (our nature). The best evidence that biology affects thinking and behavior is found in psychopharmacology. The effectiveness of medication therapy for mental disorders has been a great breakthrough in the quality of life for the people involved, but medications are not the only answer. The facts are that Nurses administer medications, monitor the response of the client, and reach The client how to manage medications at home. Nurses take a holistic approach to client care, whatever the client's diagnosis. Nursing
theories recognize the client as a whole person made of mind, body, and spirit, who is influenced by internal (biological) and external (environmental) factors. Trait theories attempt to summarize and predict human behavior by identifying universal personality traits. Friedman and Schustack (1999) describe one well accepted perspective on personality traits called the Big Five. In this theory there are five basic and universal (true across culture, gender, and age) personality traits: • Ext·ro·version: Extroverted people tend to be energetic, enthusiastic, dominant, sociable, and talkative. The other side of this dimension is introversion. Introverted people tend to be shy, retiring, submissive, and quiet. • Agreeableness: Agreeable people tend to be friendly, cooperative, crusting, and warm. People low on this dimension, who are disagreeable, tend to be argumentative, cold, and unkind. • Conscientiousness: Conscientious people are steady, cautious, dependable, organized, and responsive. Impulsive people tend to be undependable, careless, and disorderly. • Emotional stability: Emotionally stable people are relaxed and contented. Emotionally unstable (formerly called neurotic) people tend to be nervous, anxious, high-strung, and worrisome. • Openness: Open people tend to be imaginative, creative, and witty. People low in this dimension, closed, are simple, plain, or superficial PSYCHOTHERAPY BY TRAIT THEORISTS Trait theory can be used to understand the client's abilities and uniqueness. For example, consider a
client who has been injured and must change careers. He asks the rehabilitation nurse for advice. The client is introverted, disagreeable, conscientious, emotionally stable, and closed. Since these traits are very difficult to change, the best advice for this client is not to pursue a career in child care, nursing, or retail sales because he does not enjoy or work well with people. He might be best suited for a job that requires skill with details (he is conscientious) but little contact with
people, such as data processing, accounting, or computer applications Behaviorist and Learning Theories The behaviorist theories are based on the idea that a behavior persists if it is positively reinforced. The behaviorists believe that personality is completely shaped by an individual's life experiences. Therapy intended to change a behavior
includes planning and practicing a new behavior that will be reinforced so the desired behavior will continue Desensitization is a behaviorist approach to treating phobias (persistent irrational fears). In this technique the client is exposed to the feared object in small stages, achieving success many times, until the fear is finally confronted fully. As an example, if a person has a phobia of snakes, the therapist may begin with a photograph of a snake. The client is reinforced with praise for looking at it and talking about it. They progress through seeing a toy snake, to seeing a real snake in a cage, and finally to actually touching a snake. Nurses use a behaviorist approach whenever they give positive reinforcement to clients for desirable healthy behavior. Behavior modification with positive
reinforcement is often used with children (the nurse may give a colorful sticker when rhe child is cooperative with a procedure) Negative reinforcement is not commonly used. One example of behavior therapy with negative reinforcement is the drug disulfiram (Antabuse), which makes people violently ill when they drink alcohol.
Cognitive Theories of Personality Cognition is the mental process by which knowledge is acquired and processed , including reasoning, judgment, memory, awareness, and perception. The cognitive theorists believe that it is human perception, thinking, and judgment that make us human. GestaLt (which means pattern in German) psychology is a
cognitive approach. The central idea in Gestalt psychology is that the complex pattern or arrangement of an experience is its essence. The essence of a complex experience is lost when it is taken apart for analysis of its parts. The main ideas in Gestalt theory are: Piaget's stages of cognitive development are summarized as follows: Sensorimotor Stage (Birth to 2 Years) They begin to understand object permcemence, which means that an object continues to exist even when it is not visible. Children begin to use language and representational thought at the end of the sensorimotor period. Preoperational Stage (2-7 Years) Concrete Operations Stage (7-11 Years) They are able to organize facts for use in problem solving. They develop conservation, the concept that physical factors (volume, weight, and number) remain the same even though the outward appearance is changed. (The same amount of water is in an 8-ounce cup as in an 8-ounce bowl.) Formal Operations Stage (11-15 Years) People who use formal operational thinking are no longer constrained by what is; they can consider what might be Self-efficacy is the belief that a person is able to cause a desired outcome (reach a goal) by his or her own efforts. All the cognitive approaches share the view that human perception and human cognition (thinking) are at the center of what it means to
be human. Cognitive therapists are not interested in unconscious or emotional motivations for behavior. Their goal is rational decision making through understanding thought processes. Gestalt therapy focuses on the overall general meanings of client situations and behavior. These therapists do not look for unconscious or
childhood meanings, but for the general significance of experiences to clients cognitive-behavioral therapy (CBT). CBT is one of the most effective psychotherapeutic approaches We can promote self-efficacy in clients by: Existential and Humanistic Theories Exisremial philosophy seeks the meaning of life or of human existence. The existentialists are more subjective than other
theorists. One aspect of existential thought is phenomenology, the study of people's subjective experiences or perceptions. Exisremial theories claim that physical laws are not enough to explain the complexities of human behavior. The existentialists consider creativity, individual initiative, and self-fulfillment as important personality facrors. , Abraham Maslow focused on human needs and the most highly evolved state of human development The base of the hierarchy is physiological needs. These needs muse be met before the person may work to achieve the next level. Physiological needs at their most basic include air, food, and water. Other physiological needs include sleep, exercise, elimination, and
sexual expression. The next level is safety and security needs. These needs are characterized by avoiding harm, freedom from fear, physical safety, and maintaining comfort. A person must feel safe from danger before being able to concentrate on higher needs. Love and belonging needs come next. These needs include
companionship, interpersonal relationships, giving and receiving affection, and affiliation with groups. Religious needs are part of this level. Esteem needs have both internal and external components. From others, people need respect, recognition, attention, and appreciation. From ourselves, we need self-esteem, confidence, a sense of freedom, dignity, and self-respect Maslow's ulcimace level of human development is self-actualizacion. He describes self-actualized people as those who have realized their own potential, who prefer being themselves rather than being pretentious or artificial. They are self-directed, creative, and flexible. Self-actualized people can transcend themselves and connect with something beyond the self or help others find self-fulfillment and realize their
potential Humanistic therapy encourages self-knowledge (insight) and authenticity in relationships. The goals of therapy are overcoming the crisis of discovering meaning in life and finding self-actualization, love, and dignity. Therapy is often conducted in groups. Humanistic therapists may encourage creative expression.
They may encourage public service to combat alienation. Clients engaged in humanistic therapy are expected to take responsibility for their own behavior. Maslow's hierarchy provides nurses with a basis for prioritizing client needs and nursing interventions. If a client has low self-esreem and also has inadequate nutrition, the nutritional needs must take priority because they are lower (more basic) on
Maslow's hierarchy. These needs must be met before the client is able to focus on esteem, and before nursing plans for esteem-building are implemented. CULTURAL PULSE POINTS Culture is beliefs, values, and behaviors that have been learned and passed down from one generation to the next. The definition sounds
tame, but people are willing to fight and die for these cultural issues. If you value your family, your religious beliefs, your political views and way of life, you understand the power of culture. Fortunately, Giger and Davidhizar have formulated a model for assessment of culture that includes the six characteristics affecting health behavior that are common to all cultures: 1. Communication (verbal and nonverbal language, use of silence, pronunciation, voice quality) 2. Space (degree of comfort with closeness to others, body movement, perception of space) 3. Social organization (ethnicity, family and gender roles, work, leisure, religion, friends) 4. Time (use of time, measures of time, definition, social time, work time, time orientation: future, present, or past) 5. Environmental control (values, definition of health and illness, attitudes about who controls health such as physician, God, or client) 6. Biological variations (body structure, skin and hair color, physical characteristics, genetics, susceptibility to illness, nutritional preferences and tolerances, psychological characteristics) INTERPERSONAL PSYCHOTHERAPY In the interpersonal approach the therapist helps the client
develop trusting relationships, first with the therapist then with others. The client shares anxieties with the therapist. The therapist uses empathy to perceive the client's feelings and uses the relationship as a corrective interpersonal experience. The relationship between the client and therapist helps develop feelings of security and relieve feelings of anxiety. Peplau's theory offers an explanation
about how nurses can help clients make positive changes in their health and well-being. She suggests that nurses must become participant observers in therapeutic interactions with clients. Peplau outlined three phases of the nurse-client relationship: • Working phase (identification of the problem and use of the process to enhance rhe client's personal growth) • Resolution or termination phase (relationship is terminated, outcomes summarized) She advocates a careful problem-solving approach to treatment. The nurse should first assist the client to identify and label current anxieties, encouraging self-understanding. The next step is for the nurse to help the client identify strategies to relieve the experience of anxiety. Third,
the nurse assists the client to determine the causes of the anxiety. The fourth step involves helping the client gain personal insight (understanding of client's own role) into the cause of the anxiety Neurotransmitters-Chemicals that transmit impulses from one neuron to the next • People feel, think, and behave in ways that are determined by a variety of internal and external factors. • There are several theories of personality development. Each theory has its own therapeutic strategies. Current psychotherapy integrates a variety of approaches from different theories for the benefit of the client. • Defense mechanisms distort reality to protect the self. Everybody uses them, adaptively or maladaptively. • People must accomplish developmental tasks before they can move on to the next developmental level. • Psychopharmacology (study of medications that affect thinking and behavior) is an important part of the biological theory of personality. • The five universal personality traits are extroversion, agreeableness, conscientiousness, emotional stability, and openness. Each individual has each of these traits to a greater or lesser degree. • Feelings, emotions, and behavior can be learned and changed. • The six aspects of culture that affect health behavior are communication, space, social organization, time, environmental control, and biological variations. • Because of the process of cognitive development, people learn differently at different ages. • It is human to search for meaning in life. • People are affected by relationships and interactions with other people. • The nurse-client relationship is the foundation of nursing care. • Everyone continues developing throughout life. Nurses can promote personal growth in clients of any age. • Nursing care is holistic: it is concerned with the body, mind, and spirit of the client. • Nurses must prioritize their actions, providing for the client's most basic needs first. As defined by Freud, the ego is that part of the mind that contains: A student who goes to the gym routinely after school to relieve the stress of studying is using the defense mechanism of: According to
Erikson's theory of psychosocial The successful use of antipsychotic medications indicates that there is validity to which theory of
personality development? When a client who has a phobia against flying is shown videos of airplanes taking off and landing and photos taken from the windows of planes in flight, that client is being treated with which approach of the behaviorists? Administering the drug disulfiram (Antabuse) to an alcoholic client to make him violently ill if he drinks alcohol while on the drug is an example of: When nurses encourage desirable behavior in their clients and discourage undesirable behaviors, they are promoting
A demanding client who is constantly putting the call light on for small, nonessential tasks, such as "fluffing" the pillow or straightening the covers, might be experiencing which human needs according to Maslow's hierarchy? A nurse who assists a client in discovering his own options for problem solving without telling him what to do is using which technique developed by Hildegard Peplau? The ego, as defined by Freud, is the "I", which develops to respond to the realities of
everyday life. The basic instincts and urges comprise the I'd. The conscience is the superego. All of these elements combine to form the total, or a holistic, person Children between the ages of six and 12 are working through the task of industry versus inferiority. It is important for children of this age to learn how to corporate and compete with others,following rules The success of antipsychotic medication lends support to the biological theory of personality development Antipsychotics affect the neurotransmitter amounts in the brain, which minimizes certain psychotic behaviors. Administering the drug disulfiram(Antabuse). Is a type
of behavior modification by negative reinforcement. This is a technique used to change drinking behavior. The believe is that if the client associate Alcohol with being violently ill, the behavior will stop. When ever a client feels insecure, having a staff person present is all things reassuring Hildegard peplau Develop
the interpersonal THEROY of nursing. She saw the nurse as a tool in assisting clients to see their options in life's decision-making process Physiological Safety and security Love and belonging
Esteem and recognition Self-actualization Abraham Maslow hierarchy of needs In planning care for clients, the nurse who applies the most current personality theories, should focus on which of the following ideas? A)Holism and the client as a total being A nurse has been working for a long time with a client whose bone scan has revealed osteopenia. The nurse has been unsuccessful in getting the client to take a calcium supplement or begin an exercise program. Which of the following actions would be most appropriate next? A)Repeat the educational material related to osteoporosis and osteopenia. B)Call the client's denial to the client's attention and discuss adaptive options. If the nurse were using Jung's analytic psychology theories in work with clients, s/he would provide care based upon the belief that the major influence in determining the course of a persons life is which of the following beliefs? A)Desire to be in control B)A person's motives and goals A nurse is using ideas developed by Karen Horney in parent education classes. This would indicate that the focus of the class would be teaching parents: A)To model the behavior they want to see in their children and provide a warm, nurturing environment. When clients complain of being stressed and unable to relax, the nurse may teach them relaxation exercises during which they relax the muscles of the body in a progressive fashion. The nurse understands if s/he wants clients to continue this exercise on their own later, s/he must add which behavior modification technique to the teaching? A)Positive reinforcement The spouse of a client in Hospice care, asks the nurse why his wife has to die before him. The nurse accepts the existential and humanistic personality theories, particularly the logotherapy of Viktor Frankl. Which of the following interventions by the nurse is most in keeping with this theory? A)Listen to the spouse and encourage him to reflect on this question and answer it himself through the magnitude of his love. When doing client teaching with a 6-year-old child about management of their illness, the nurse would most need to do which of the following things to help the child understand the instructions? A)Teach the material using puppets to tell the instructions B)Carefully avoid the use of abstractions and use concrete terms An elderly client in the long-term care facility says, "I am going to die, and none of my children will care. The only thing they care about is my money. My life was such a waste." The nurse recognizes that this client is in Erikson's ego integrity versus despair stage of psychosocial development. Which of the following actions by the nurse would be most helpful in assisting this client to resolve his developmental crisis? A)Work with treatment team to help this client record a story of his life. The nurse has enjoyed working with one of the assigned clients who is going home from the hospital soon. The client says to the nurse, "I wish you would visit me at my home. I am lonely and would love you to be my friend." Using Hildegard Peplau's theories, which of the following would be the nurse's best response? A)"If I visit, it must be as a friend and not as a nurse." B)"I can't visit you at home, but I want to work with you on this loneliness." Alfred Adler was interested in the need for a sense of autonomy and control. He was the first to use the term Inferiority complex to describe people who are so frustrated Adler studied the effects of birth order on personality development. He found that first-born children strive to regain the status they once had as only children. They tend to be leaders, nurturers, and high achievers. Second-born children experience rivalry from the beginning, so they seek competition and strive for greater achievements. Last-born children, according to Adler, are more pampered than the other children. They have more sibling role models for comparison and may feel overly pressured to succeed in every area achieved by their siblings Which concepts are included in the definition of personality?Personality embraces moods, attitudes, and opinions and is most clearly expressed in interactions with other people. It includes behavioral characteristics, both inherent and acquired, that distinguish one person from another and that can be observed in people's relations to the environment and to the social group.
What is the most important role of a nurse caring for a client with a mental health disorder?Therapeutic alliance is a core part of the nursing role and key to the attainment of positive outcomes for people utilising mental health care services.
Which relationship is the most concern to the nurse because of its importance in the formation of the personality?Which relationship is of most concern to the nurse because of its importance in the formation of the personality? Children view their own worth by the response received form their parents. This sense of worth sets the basic ego strengths and is vital to the formation of the personality.
Which relationship is the most important to the formation of personality?There are several mechanisms by which individual characteristics transact with the environment, including interpersonal relationships (Shiner & Caspi, 2003). On of the most important relationships for personality development is the parent relationship.
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