Hospital Topics

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/vhos20

The Influence of Emotional Intelligence on

the Work Engagement of Clinical Leadership:
Resilience as a Moderator

Emelia Danquah

To cite this article: Emelia Danquah (2021): The Influence of Emotional Intelligence on the
Work Engagement of Clinical Leadership: Resilience as a Moderator, Hospital Topics, DOI:
10.1080/00185868.2021.1922113

To link to this article: https://doi.org/10.1080/00185868.2021.1922113

Published online: 01 Jun 2021.

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HOSPITAL TOPICS
https://doi.org/10.1080/00185868.2021.1922113

RESEARCH ARTICLE

The Influence of Emotional Intelligence on the Work Engagement of Clinical

Leadership: Resilience as a Moderator
Emelia Danquah
Koforidua Technical University, Koforidua, Ghana

ABSTRACT KEYWORDS
This study examined the moderating influence of resilience on the association between emo- Emotional intelligence; work
tional intelligence and work engagement in clinical leaders. The study population was leaders engagement; clinical
working in the emergency wards of some health facilities in Accra. A total of 310 leaders partici- leadership; resilience;
healthcare; Ghana
pated in the study by completing a self-reported questionnaire. The analysis of data showed
that emotional intelligence makes a positive influence on work engagement in clinical leaders
working in emergency departments. The moderating influence of Health facilities can improve
work engagement in emergency settings by utilizing training programs to improve both emo-
tional intelligence and resilience.

Introduction requires emotionally intelligent leaders capable of

The outbreak of Coronavirus 2019 (COVID-19) understanding the emotional needs of subordi-
may make employee engagement more important nates, employees, and patients. This reasoning is
than ever. This is the case because the strong consistent with studies (N
astas
a and F
arcaş 2015;
engagement of frontline and administrative per- Perez-Fuentes et al. 2018; Alabdulbaqi, Banjar,
sonnel in clinical responses to COVID-19 emer- and Felemban 2019) which have demonstrated
gencies is considered a necessary way to reduce that emotional intelligence is relevant to leader-
COVID-19-related fatalities (Anderson et al. ship in clinical emergencies. Leaders who, as a
2020; Armitage and Nellums 2020; Lewnard and result of their emotional intelligence, can under-
Lo 2020; Pung et al. 2020). With many similar stand the needs of traumatized patients are in a
epidemics expected to break out in the future better position to coordinate personnel and
and COVID-19 expected to stay with humans for resources to provide quality healthcare in a
a relatively long time, it is necessary to take steps timely and desperate manner (Long and Kowang
to enhance the engagement of hospital staff in 2015; Prezerakos 2018). Thus, emotional intelli-
clinical practice, especially in developing African gence is a skill needed by leaders to carry out
countries where health facilities and governments basic job tasks and respond to emergency situa-
are already grappling with high turnover in the tions in their health facilities.
healthcare sector (Asiamah, Mensah, and Azinga The above arguments have formed the basis of
2019; Azinga, Asiamah, and Mensah 2018; empirical assessments of the influence of emo-
Asiamah, Opuni, et al. 2018). Thus, personnel tional intelligence on work engagement in health-
well engaged in healthcare are needed to make a care workers (Perez-Fuentes et al. 2018). While
difference during normal and emergency emotional intelligence can positively influence
care situations. work engagement in a hospital, the researcher
Arguably, successfully treating patients with argues that resilience is a personality trait that is
conditions such as COVID-19 and other infec- more important in clinical emergency settings. As
tious diseases does not only require personnel recent reports have indicated (Armitage and
who are well engaged in clinical practice but also Nellums 2020; Lewnard and Lo 2020; Pung et al.

CONTACT Emelia Danquah addom123.ed@gmail.com Africa Centre for Epidemiology, Accra, P. O. Box AN 16284, Accra North, Ghana
ß 2021 Taylor & Francis Group, LLC
2 E. DANQUAH

2020), clinical personnel who spend more hours using a 33-item scale borrowed from Schutte
with COVID-19 patients have a high resilience et al. (1998). This scale was preferred because it
score. Drawing on these reports and the above was based on the mixed emotional intelligence
arguments, the influence of emotional intelligence model and produced satisfactory psychometric
on work engagement in a health facility would be properties in similar populations in Ghana
positively moderated by personnel resilience. (Asiamah 2017a; Asiamah 2017b). It was associ-
Currently, many health facilities and governments ated with five domains and descriptive anchors
are attempting to enhance the emotional intelli- (i.e. strongly disagree
1; disagree
2; some-
gence of their healthcare personnel (Paterson how agree
3; agree
4; strongly agree
5).
et al. 2014; Samsuddin et al., 2014), but they are Work engagement was measured using a 17-item
unaware of the unique role played by personnel standard scale from Basit and Chauhan (2017).
resilience in emergency care. As a consequence, This scale applies five descriptive anchors ranging
resilience has not been incorporated into current from strongly disagree (1) to strongly agree (5).
training programs. The current study was there- This study also produced satisfactory internal
fore conducted to assess the moderating influence consistency scores (Basit and Chauhan 2017) and
of resilience on the relationship between emo- therefore promised to serve as a reliable measure.
tional intelligence and work engagement in hos- The researcher utilized a 10-item scale from
pital leaders. This study is expected to encourage Str€umpfer (2001) to measure resilience. This scale
the incorporation of resilience into training mod- was preferred to others because it was developed
els under consideration in many health facilities for use in clinical settings. In the current study,
and countries. the above scales had satisfactory internal consist-
ency. All scales produced Cronbach’s alpha coef-
Methods ficient a  0.81.
Other variables measured as covariates are
Design, Sample and Participants gender, education, work experience, income, and
This study was a cross-sectional survey. The frequency of training. These measures were
population was managers and leaders in four pri- chosen based on some guidelines (Asiamah
mary care facilities in Accra. To address the 2017a; Asiamah 2017b; Asiamah, Mensah, and
research goal, the study focused on participants Azinga 2019; Asiamah and Danquah 2019).
acting as leaders of departments, units, and Education was measured as the highest formal
teams. The inclusion criteria used were having at education acquired by the individual, work
least a basic education (which signified the ability experience as the number of years the participant
to read and write in English, the medium in had worked as a health worker, income as the
which questionnaires were administered), having gross monthly salary of the individual, and fre-
served in the facility for at least six months, and quency of training as the number of training pro-
consent to participate. A total of 332 personnel grams the individual had participated in since he
who met these criteria were made to participate or she started working as a health worker.
in the study. To recruit participants, a database Gender was measured as a dichotomous categor-
of employees was taken from the management of ical variable (i.e. male
0; female
1) which
the health facilities. Employees were then con- was dummy-coded for data analysis.
tacted via a phone call to know those who were
willing to participate. The selection criteria were Ethics and Data Gathering Procedures
then used to select from those who volunteered.
This study was approved by the participating
health facilities and the regional review commit-
Measures and Operationalization
tee (# 00112020). Participants recruited were
The main variables measured in this study were made to sign an informed consent form to signify
emotional intelligence, work engagement, and their voluntary participation in the study.
resilience. Emotional intelligence was measured Questionnaires were administered with the
 HOSPITAL TOPICS 3

support of three field assistants through hand Table 1. Descriptive statistics of participants.
delivery at the hospitals. Some participants Variable Level Frequency Percent
Gender Male 108 35%
responded instantly but most of them returned Female 202 65%
completed questionnaires in two weeks. Data col- Total 310 100%
Education Diploma 94 30%
lection was carried out over a month (November Degree 158 51%
5 to December 24, 2019). Of the 332 workers Master’s degree 58 19%
Total 310 100%
selected, 14 did not return their questionnaires Job tenure Up to 2 yrs 132 43%
whereas 8 questionnaires had at least one full 3-5 yrs 99 32%
6-10 yrs 23 7%
scale not responded to. Hence, 310 questionnaires Above 10 yrs 56 18%
Total 310 100%
were analyzed. Training frequency None 61 20%
One 59 19%
Two 39 13%
Data Analysis Method Three 32 10%
Four 19 6%
Five 44 14%
Data were analyzed using SPSS version 25 (IMB More than 5 56 18%
SPSS Inc., NY, USA) and its inbuilt Amos soft- Total 310 100%
ware. Data were analyzed in two phases. In the
first phase, descriptive statistics were used to workers who participated had a diploma; 51%
summarize the data and identify potential out- (n ¼ 158) had a first degree; and 19% (n ¼ 58)
liers. Questionnaires with missing items were also had a Master’s degree. Summary statistics associ-
removed in accordance with Garson (2012), since ated with the other variables are shown in Table
structural equation modeling (SEM) does not 1. In Table 2, the average number of training
support missing items. The internal consistency programs the individual had participated in was
of the scales was confirmed through reliability about 4 (Mean ¼ 3.79; SD ¼ 2.21). There is a
analysis in SPSS. In the second phase of the ana- strong positive correlation between resilience and
lysis, Pearson’s correlation test was used to assess work engagement (r ¼ 0.849; p ¼ 0.000; two-
bivariate correlations as a precursor to fitting two tailed). Emotional intelligence is also positively
structural SEM models. The first SEM model correlated with work engagement (r ¼ 0.512;
examined direct associations whereas the second p ¼ 0.000; two-tailed) and resilience (r ¼ 0. 393;
tested the moderating influence of resilience on p ¼ 0.000; two-tailed). That is, work engagement
the association between emotional intelligence increases with emotional intelligence, whereas
and work engagement. The interaction between emotional intelligence increases with resilience.
emotional intelligence and resilience (i.e. EIRES) Table 3 shows the coefficients of the two
was created in line with methods recommended regression models. The first model examined the
(Garson 2012). Since multivariate normality of influence of emotional intelligence on engage-
the data is a requirement for structural equation ment while the second tested the moderating
modeling, the structural model through which influence of resilience on the influence of emo-
the relationships were tested was used to assess tional intelligence on work engagement. In the
and confirm multivariate normality of the data. first model, emotional intelligence is confirmed
In this regard, the probability values of the to make a positive influence on work engagement
Mahalanobis distance test were not significant at (b ¼ 0.21; t ¼ 6.97; p ¼ 0.000) after adjusting for
p > 0.05. The statistical significance of the results the individual characteristics. In the second
was detected at p < 0.05. model, the interaction between emotional intelli-
gence and resilience makes a positive influence
on work engagement (b ¼ 0.83; t ¼ 24.66;
Findings
p ¼ 0.000). The coefficients of the interaction
Table 1 indicates that 35% (n ¼ 108) of all per- term (0.83) is larger compared to the effect of
sonnel were men while 65% (n ¼ 202) were emotional intelligence on work engagement,
women. Thus, a majority of participants were which is b ¼ 0.21. This means that resilience
women. In addition,30% (n ¼ 94) of all healthcare increases the influence of emotional intelligence
4 E. DANQUAH

Table 2. Descriptive statistics and correlation matrix of variables.

Variables # Mean SD 1 2 3 4 5 6 7
Resilience 1 41.03 5.52 1 .849 .393 .164
0.055 .221 .286
Work engagement 2 69.56 11.08 1 .512 .115 0.002 .147 .210
Emotional intelligence 3 125.66 14.18 1 .152 0.039 .126 0.091
Gender 4 0.65 0.14 1 -.113 .172 0.044
Education 5 1.88 0.69 1 0.078 .244
Tenure 6 2.10 1.29 1 .588
Training 7 3.79 2.21 1
¶p < 0.001; p < 0.05. SD – standard deviation

Table 3. The moderating influence of resilience on the relationship between EI and employee performance.
Coefficients
DV Path Predictor B S.E. Beta CR P value 95% CI
Interaction effect
Employee performance <— EIxRES 0.10 0.01 0.78 21.73 0.000 ±0.02
Covariate effect
Employee performance <— Gender a
0.18 0.99 0.01 0.18 0.455 ±3.90
Employee performance <— Education 2.40 0.69 0.13 3.51 0.000 ±2.69
Employee performance <— Tenure
0.03 0.44 0.00
0.07 0.619 ±1.74
Employee performance <— Training 0.17 0.27 0.03 0.64 0.309 ±1.05
ƚp < 0.001; ¶ DV – dependent variable; S.E. – standard error (of B); B – unstandardized coefficients; CR – critical ratio; CI – confidence interval; a.
refer-
ence – male.

on work engagement. The first model produced a between leaders and subordinates. Moreover,
good fit represented by a variance of 76.5% communication plays a crucial role in the leader’s
whereas the second model produced a total vari- effort to maintain a cohesive relationship with
ance of 68.6%. Both models produced a signifi- subordinates and workmates. Individuals in a
cant F-test. Since the tolerance values of the team are tied to each other by communication
predictors are greater than 0.1 as recommended and a sense of trust and reciprocity. Asiamah’s
(Garson 2012), multi-collinearity was not of con- (2017a) adaptation of the job characteristics the-
cern. More so, the Durbin Watson statistic of ory adds that emotional intelligence is one of the
each model is approximately 2 as recommended. skills that employees need to improve perform-
As such, the independence-of-errors assumption ance outcomes, including work satisfaction, com-
was met. mitment, and engagement. These theoretical
connotations indicate that effective communica-
tion facilitated by emotional intelligence contrib-
Discussion
utes to team spirit, cohesion, and a sense of
This study examined the moderating influence of attachment to organizational practices.
resilience on the association between emotional Worth adding is the fact that the positive
intelligence and work engagement in leaders influence of emotional intelligence on work
working in clinical emergency settings. Data ana- engagement is supported by several studies. In
lysis revealed that emotional intelligence makes a Iran, for example, Aghdasi, Kiamanesh, and
positive influence on work engagement, suggest- Ebrahim (2011) found that emotional intelligence
ing that work engagement in leaders working in makes a positive influence on organizational
emergency wards improves as emotional intelli- commitment, which is an indicator of work
gence in these leaders increases. In other words, engagement (Deshwal 2015; Extremera et al.
the extent to which leaders are engaged with clin- 2018). In Spain, Extremera and colleagues found
ical practices in emergency wards increases as that emotional intelligence was positively associ-
their emotional intelligence increases. This result ated with work engagement in clinical staff. This
is consistent with two theories, the first being the result is corroborated by the study of
emotional intelligence theory of Goleman (1997). Karamustafa and Kunday (2018) carried out in
According to this theory, emotional intelligence Turkey. With these findings in view, it can be
is a requirement for effective communication said that the current study’s finding is consistent
 HOSPITAL TOPICS 5

with the empirical literature. Even so, it remains management in clinical settings. Thus, this study
a unique contribution to knowledge and aca- affirms that improving the resilience of leaders
demic debate for a couple of reasons. First, this working in an emergency clinical setting would
study is the first to confirm the relationship in not only translate in high individual performance
the context of clinical emergency management but can also enhance the impact of emotional
and leadership, which connotes that clinical intelligence on staff engagement. For this reason,
emergency practice can be improved by using improving investment in training programs
training programs to enhance the emotional aimed at improving both emotional intelligence
intelligence of personnel, specifically leaders. This and resilience is worthwhile. As demonstrated by
study is also unique because it is the first in some researchers (Asiamah 2017b; Asiamah and
Ghana and Africa to examine the relevance of Danquah 2019), specialized training programs
emotional intelligence to work engagement in must be adopted to enhance emotional intelli-
clinical emergency settings. gence and resilience as they are more effective at
What can be considered the most important increasing these competencies.
result of this study is the positive moderation The researcher would want to admit that the
influence of resilience on the association between
current study has some limitations despite mak-
emotional intelligence and work engagement.
ing unique contributions to the literature and
This influence implies that emotional intelligence
practice. As a cross-sectional design, the study
improves work engagement in emergency settings
did not establish causation between the variables.
more strongly in the light of increasing leaders’
The use of stronger designs such as the random-
resilience. This result is again supported by
ized controlled trial to establish causation in
Goleman’s (1995) theory as the mixed emotional
intelligence model includes abilities closely future will benefit the improvement of this study.
related to resilience. For instance, ’motivation’ is Despite this limitation, this study sets the founda-
a major skill within emotional intelligence that tion for future research and contributes to the
represents fortitude, tenacity, and the ability to evidence regarding the role of resilience and
withstand the devastating outcomes of work. In a emotional intelligence in maintaining the com-
clinical setting where extreme situations can pose mitment of leaders to clinical emergency manage-
daunting responsibilities and challenge leaders, ment and practice. This study demonstrates that
this skill can interact with resilience to activate investment toward improved resilience in clinical
courage, persistence, and the ability and willing- settings can reduce turnover, particularly in
ness to withstand challenging job tasks. Similarly, emergency departments.
resilience qualifies as one of the skills that the job
characteristic theory recognizes as an outcome of Conclusion
a variety of skills. Per Asiamah’s (2017a)
adaptation of this theory, therefore, resilience is Work engagement in the health facilities
an outcome of having emotional intelligence as a increases as emotional intelligence increases. It is
pro-performance ability. thus concluded that increasing emotional intelli-
The foregoing theoretical support for the mod- gence can enhance work engagement in health
erating influence is supported by some studies. workers working in emergency wards and situa-
Manomenidis, Panagopoulou, and Montgomery tions. More importantly, the influence of emo-
(2019), for example, reported that resilience is tional intelligence on work engagement increases
needed by staff working in a clinical emergency in emergency care situations as the resilience of
ward to overcome overwhelming situations. They personnel increases. It is therefore concluded that
added that emotional intelligence is the founda- training programs aimed at equipping employees
tion of the ability to evoke one’s resilience. In with both emotional intelligence and resilience
Malaysia, Samsuddin et al. (2018) also discovered can improve work engagement and possibly per-
that resilience facilitated by emotional intelligence formance in emergency wards and situations in a
is a key skill for disaster preparedness and healthcare setting.
6 E. DANQUAH

Ethical Approval workers: A scale validation approach. Journal of Global

Responsibility 9 (2):141–59. doi: 10.1108/JGR-03-2017-
This study was approved by participating hospi- 0014.
tals. Every participant was given an informed Asiamah, N., F. F. Opuni, and S. K. Frimpong. 2018.
consent prior to data collection. The informed Leveraging word-of-mouth as a payback from patients of
consent form detailed the purpose and potential private hospitals: the role of healthcare quality delivery.
risks of the study. Participants were given the International Journal of Behavioural and Healthcare
Research 6 (3/4):251–67. doi: 10.1504/IJBHR.2018.101575.
opportunity to withdraw from the study any time
Azinga, S. A., N. Asiamah, and H. K. Mensah. 2018.
before publication of results. Eschewing love of money and materialism: a potential
step towards avoiding nurses’ intention to quit.
Disclosure statement International Journal of Behavioural and Healthcare
Research 6 (3/4):225–36. doi: 10.1504/IJBHR.2018.101573.
No potential conflict of interest was reported by Basit, A. A., and M. A. H. Chauhan. 2017. Psychometric
the author(s). Properties of the Job Engagement Scale: A Cross-Country
Analysis. Journal of Management and Research 4 (1):
1–18. doi: 10.29145/jmr/41/040101.
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