This presentation highlights the latest research into the emotional intelligence differences between three direct patient care nurse groups, from different cultures - Saudi, Phillipino and Western.

1. Desmond Williams
Executive Consultant to the Chief Operating Officer KFSHRC (Gen. Org.)
Jeddah Branch
5th March 2014
CULTURAL ASPECTS OF EMOTIONAL INTELLIGENCE
A Research Study of three Culturally Distinct Nursing Groups, in a Saudi Arabian Tertiary
Hospital.

2. • Dr. Tariq Linjawi
• Dr. Sandy Lovering
• Dr. Estelle Bester
• Dr. Bakr Bin Sadiq
• Dr. Margareta Sjolund
• Mr. Wael Sherbini
• And most importantly…
…THE 60 RESEARCH PARTICIPANTS!
Acknowledgements

3. • The Research Concept & Overview
 Context, Culture and Research Motivation
• Methodology and Methods
• So what are the results, what do they tell us?
 The Similarities and Differences between the chosen cultures
• What can we conclude about the research?
 How does a Culturally Intelligent direct patient care Nurse look like in KFSHRC-J?
 To what degree are Western “Best Practice” behaviours suitable for KFSHRC-J?
 Possible Organizational applications
 What messages does this research reinforce?
Contents

4.  Required for a Masters Degree in International Management, with a Healthcare Specialisation.
 A hospital approved and funded management research project.
 Completed over 6 months.
• The Research Concept & Overview – Context

5.  The term emotional intelligence was officially coined in 1989 by Salovey and Mayer.
 Based on a threshold level of IQ.
 Emotional Intelligence/Quotient is “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. Emotional intelligence describes abilities distinct from, but complementary to,
academic intelligence.” - Daniel Goleman (1998)
 http://atrium.haygroup.com/ww/video/video_popup.aspx?id=1What_is_Emotional_Intelligence_48
0x360.flv&sc=y
• The Research Concept & Overview – What is Emotional Intelligence? (EI)

6.  Culture can be defined as a ‘pattern of values,
attitudes and beliefs that impact on the
behaviour of a set of individuals within a given
region’ (Hofstede 1985, cited in Ronen & Shenkar 2001).
 But values, beliefs and ethics are different across
cultures…
 Therefore it means the ability to modify
one’s/behaviour to that of a divergent culture.
(Hofstede & Minkov)
Essentially, Emotional Intelligence enables
someone to adapt behaviour to suit a divergent
culture.
• The Research Concept & Overview - What does Emotional Intelligence in a
Cultural context mean?
Hofstede’s Overview of National Cultures
http://geert-hofstede.com/countries.html

7.  ‘Cultural values are most
positively associated with
emotions, with attitudes then
behaviour following
thereafter.’ (Taras, Kirkman & Steel, 2010)
 Adaptation stress - more so
with divergent culture types.
 4 acculturation types:
Integration, Assimilation,
Separation and
Marginalisation.
The Research Concept &
Overview - What does the
existing research in this
area say?
10%
90%

8.  1st time this type of research has been undertaken in the Middle East.
 Improving our understanding of different cultural nurse behavioural preferences
allows for:
 A mitigation of acculturation stress – If part of an induction for example.
 More effective Leadership Development/Recruitment interventions.
 Better cross cultural understanding of behaviour.
 60 Nurse participants gain a better insight into themselves.
 To “unfreeze” the western concept of “best practice” management.
• The Research Concept & Overview -Why bother doing management research in
this area, what’s the benefit?

9. 1. Are there any EI correlations between three distinct cultural groups in a Saudi Arabian
tertiary hospital? – Saudi, Filipino & Western (US/Canada/EU/S.Africa/NZ).
2. To what degree are Western “best practice” behaviours are relevant with the Arabic
culture in the hospital environment?
• The Research Concept & Overview – What are the relevant research questions?

10. Methods
 60 Direct Patient care nurses, all
female, no age preference,
 Presentations, email,
advertising and visiting wards to
recruit participants.
 For each participant:
 Consent form Completion
 Psychometric Assessment –
EQi2.0 (35 Minutes)
 Follow up meeting (40-50
minutes)
Methodology
 Exploratory, descriptive management
research, using a mixed method
approach.
 Quantitative element to cater for
positivist considerations
 Qualitative element to cater for social
constructivist considerations.
• Methodology and Methods
Cross-Validation

11. Research Standards
 Institutional Review Board (IRB)
approved.
 University of Liverpool, England.
 Nursing Research Council approved.
 Detailed Consent form & F.A.Q. x 60
staff.
• Methodology and Methods - Research Standards & Researcher
Credentials
Researcher Credentials
 Certified psychometric assessor,
(Level A&B) – British Psychological
institute (2001).
 Certified EI Assessor for the EQi2.0
tool.
 US National Institute of Health
(NIH), certified for Ethical Human
research.

12. • Emotional Expression
• Interpersonal Relationships
• Empathy
• Social Responsibility
These were the behaviours where significant
similarities between the three cultural groups
occurred.
 Self Regard
 Self-Actualisation
 Emotional Self Awareness
 Emotional Expression
 Assertiveness
 Independence
 Interpersonal Relationships
 Empathy
 Social Responsibility
 Problem Solving
 Reality Testing
 Impulse Control
 Flexibility
 Stress Tolerance
 Optimism
 Happiness
These were the behaviours assessed
• What are the results and what do they tell us?
Interpersonal
Composite

13. EMOTIONAL EXPRESSION
Seems calm & collected, may
seem unaffected by Stressors but
also appears withdrawn.
Very easily expresses herself. An
open book. People know where
they stand but can be overly
expressive also.
= Saudi
= Filipino
= Western
= Average
Comfortable in expressing emotions, either verbally or non
verbally. Is able to find the most appropriate way of
expressing most emotions (e.g. Anger, Appreciation,
Empathy) in an appropriate way.
• What are the results and what do they tell us?

14. INTERPERSONAL COMPOSITE
= Saudi
= Filipino
= Western
= Average
Interpersonal Relationships
Empathy
Social Responsibility
Interpersonal Relationships – Generally seeks new relationships, yet maintains existing ones. Understands nature of interpersonal cooperation.
In unfamiliar/uncomfortable situations may be more hesitant.
Empathy – you are “tuned in” to how others are feeling. You generally care about the thoughts and feelings of others as much as you do your
own. In times of stress or moments of defensiveness, more likely to adopt a less empathic approach, possibly arguing your position without
considering the needs of others.
Social Responsibility – are socially conscious and generally concerned with others’ well-being. See yourself as part of your team, your
organization, and your community. Generally feels a sense of fulfillment from helping others.
• What are the results and what do they tell us?

15.  Assertiveness
 Independence
 Problem Solving
 Reality Testing
 Stress Tolerance
 Happiness
These were the behaviours where statistically*
significant differences occurred
(*i.e. that generated P-value of ≥0.05)
These were the behaviours assessed
 Self Regard
 Self-Actualisation
 Emotional Self Awareness
 Emotional Expression
 Assertiveness
 Independence
 Interpersonal Relationships
 Empathy
 Social Responsibility
 Problem Solving
 Reality Testing
 Impulse Control
 Flexibility
 Stress Tolerance
 Optimism
 Happiness
• What are the results and what do they tell us?

16. ASSERTIVENESS
• What are the results and what do they tell us?
Team thinking… Consultative
Inclusive…Collaboration
Self reliant in making
decisions… confident
…decisive…self determined
Preference for collaboration,
awareness that too
much/inappropriate
assertiveness would upset
the delicate relationship
balance. Sometimes favours
social/ward cohesion over
decisiveness.
Finds it easy to express
herself, although sometimes
not directly. Not controlled
or shy. Is assertive, but has
a tendency to use the social
landscape or informal
organisation to
communicate this
assertiveness.
Is seen as not being overly
controlled or shy. Self
directed. Sometimes
perceived as being slightly
too assertive for this
particular cultural context.
Strong tendency towards
assertive patient advocacy
Saudi’s and Filipino see this
group “go to” group in this
regard.
= Saudi
= Filipino
= Western

17. INDEPENDENCE
• What are the results and what do they tell us?
Prefers high levels of support and
protection. Loyal and is good at
following a clear structure. Defers to
others, often uncertain of own ideas.
Relies on own judgment, strong
perception in own ability. May
sometimes conflict with the group
“norm” behaviour.
Loyal to the organisation
and puts her trust in the
protective & supportive
aspects of the organisation.
Lets the group make final
decisions. Contributes to
social cohesion.
Has a strong affiliation
towards the social matrix.
Sometimes defers own
opinion to that of the group.
Will not directly challenge
seniors or those in authority,
even tough there may be a
strong reason to do so.
Anti-bureaucratic. Dislikes
limited professional
autonomy . Relatively
strong tendency towards
‘fresh thinking’, which
maybe deemed as
sometimes controversial.
= Saudi
= Filipino
= Western

18. PROBLEM SOLVING
• What are the results and what do they tell us?
Intuitive problem solver, rather than
methodical. Sees the potential of many
solutions and enjoys exploring these
solutions. May jump into solution
Systematic, Methodical.
Gather information first.
Weights up pros and cons
Engages “gut feeling” and a
strong intuitive sense of
what a solution might be.
Prefers to solve a problem
with much input from
others, not overly reliant on
systematic methods to
arrive at a solution.
Strong evidenced -based
perspective. Relies on
logical deduction and
favours less subtle nuance.
= Saudi
= Filipino
= Western

19. Reality Testing
• What are the results and what do they tell us?
Tends to be more abstract.
May display vision and be
able to look at things from a
unique perspective
Realistic, can assess life
situations more easily.
Values an abstract view in
the creation of a vision
whilst understanding the
possibilities and realities of
a given situation.
Is “tuned “into the
environment and has a
practical understanding of
life situations. Sometimes
sees things in black and
white.
Grounded, understands
what is possible and not
possible. Reads the
environment accurately.
= Saudi
= Filipino
= Western

20. STRESS TOLERENCE
• What are the results and what do they tell us?
Will think through potential stressors
and vocalise them. May find it difficult to
face unpleasant things. May be more
reactive than others. Often will be the
first to flag an issue.
Very calm in a crisis. Calms
others by being calm. May be
perceived by others as not
having a sense of urgency.
May react later than others.
Is perhaps not used to
“normal” stressful
situations and therefore
has not built up similar
coping mechanisms to
others. The role of the
family “shielding stress”
from females, may be
contributory from a cultural
perspective.
Is comfortable in most
stressful situations. Has well
defined mechanisms to deal
with this stress. Cultural
stress mitigators are derived
from the close cultural &
community support
network, often beyond the
organisation.
Calm in a crisis. Is open to
change and stressful
situations. Recognises that
cultural stress is a growth
cataylst. Main stress
stressor from feeling of
isolation due to small
western community.
= Saudi
= Filipino
= Western

21. HAPPINESS
• What are the results and what do they tell us?
Team thinking… Consultative
Inclusive…Collaboration
Is satisfied with ones life
situation and is able to enjoy
ones life and have fun. Not to
take oneself seriously
May be less concerned
with themselves than with
others (if they have a
strong social responsibility
score). Tendency to worry
about the future,
reasonably happy,
sometimes has more
frequent thoughts of life
dissatisfaction than others.
Content and enthusiastic
about life. Is fun loving and
has a general mood of
happiness. May seem
overly positive by those not
having the same levels of
happiness.
Derives pleasure from life.
Generally happy.
= Saudi
= Filipino
= Western

22.  The desire for social cohesion & maintaining individual relationships sometimes
outweighs the desire for performance in the Saudi and Filipino cohorts.
 The “Shielding” role of family has an influence on the Saudi nurse profile for
Independence, Problem Solving and Stress Tolerance.
 The Nursing drive for collaborative decision making has impacted the “standard”
Filipino profile – i.e. More assertive.
Are there any EI correlations between three distinct cultural groups in a Saudi Arabian
tertiary hospital? – Saudi, Filipino & Western (US/Canada/EU/S.Africa/NZ).

23.  Western “Assertive” behaviour does not work well in a collectivist, high power-distance
culture.
 However, patient advocacy requires assertive behaviour.
 Patients allow more assertive behaviour from Westerners than from other (collectivist)
cultures.
• To what degree are Western “best practice” behaviours relevant to the Arabic
culture in the hospital environment?

24. Therefore…[Nursing] Best Practice + Cultural Context = Best Fit

25.  Recruitment
 Principles can be applied to all roles in the organization, particularly relevant for leadership roles.
 Matches values of the organization with the values and behaviors of the candidates.
 More informed Cultural Adaptation interventions
 Induction training for Nurses and Nurse Leaders specifically.
 The ‘Cultural Preceptor’ model.
 Saudi Leader certified in Emotional Intelligence & 60 Nurses have had individual assessment
 Nursing Ethics & Cultural Advisory Council.
 Saudi Career & Development Program (SCDP) Direct Patient Care Nurse Graduate Program
 Talent Development Profiling…
• How has/can this research add value to the organisation?

26. Selection of Top
Performers e.g. Head
Nurses
Administer the EQi2.0
to 10-20 “Stars.”
Facilitated Focus Group
analyses results (e.g. Head
Nurses, Program Directors +
Psychometric Facilitator)
Organisation /Staff are
clear what behaviours
are needed for this
position.
Talent Development & Recruitment Profiling - “STAR” Behavioural Profiling
Head
Nurse
STAR
Profile

27.  That Cultural Diversity offers valuably different perspectives, allowing for a richer
working environment and “balanced behavior”.
 That Organisational Culture Change must take account of National Culture
preferences.
 Self Awareness and respect for others’ behavioural preferences is important to intra-
cultural empathy.
• Finally, what positive cultural elements does this research reinforce?

28. Thank you.
Questions?
deswilliams29@gmail.com