The Relationship between Role Conflict and Stress in Intensive Care Unit Nurses in Hafr Albatin: The Mediating Role of Emotional Intelligence

The Relationship between Role Conflict and Stress in Intensive Care Unit Nurses in Hafr Albatin: The Mediating Role of Emotional Intelligence

Ohoud Abdulrahman M Alreshidi^*1, RN MCH Hafr Albatin², Dr Selwa Yousif Abdeldafie³

1,2. Master degree in  Critical Care Nursing University of HafrAlbatin.

3. Assistant Professor College of Nursing University of Hafralbatin.

*Correspondence to: Ohoud Abdulrahman M Alreshidi, Master degree in Critical Care Nursing University of Hafr Albatin.

Copyright
© 2025: Ohoud Abdulrahman M Alreshidi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received:  27 February 2025

Published: 17 March 2025

ABSTRACT

Background Nursing in the intensive care unit (ICU) is fulfilled with stressors that have a profound impact on the physical and mental health of nurses. A primary source of role stress is role conflict, resulting from ambiguous instructions and conflicting demands. Conflict situations directly affect the emotional intelligence of those involved, with outcomes ranging from positive to negative impacts.

Objective This study aims to investigate the influence of role conflict on stress levels among ICU nurses, with emotional intelligence as a potential mediator.

Methods Data were collected from two major hospitals in Hafr Albatin, Saudi Arabia, using a quantitative, descriptive, correlational design. The sample consisted of 69 ICU registered nurses meeting specific inclusion criteria. Instruments included demographic questions, the (PSS-10) for stress assessment, House and Rizzo's Role Conflict Scale, and (WLEIS). Data collection utilized an online questionnaire platform, ensuring anonymity and voluntary participation. Analysis involved descriptive statistics, Pearson correlation, linear regression, and mediation analysis using SPSS 26.0 software. Ethical considerations were addressed, with approval obtained from the NCBE.

Results The study revealed a significant relationship between role conflict and stress among ICU nurses. Higher role conflict, as indicated by the mean score of 24.86 (SD = 8.856), was associated with elevated stress levels (mean score: 22.14, SD = 8.919). Positive correlation between role conflict and emotional intelligence (r = 0.333, p < 0.01) suggests that nurses with higher emotional intelligence scores were better able to manage role conflict. Modrate positive correlation between emotional intelligence and stress (r = 0.307, p < 0.01).

Conclusion These findings revealed a significant correlation between emotional intelligence, role conflict, and stress, indicating a strong moderate level of influence. Particularly noteworthy was the strong relationship observed between emotional intelligence and both stress and role conflict. This relationship was found to strengthen as stress or role conflict decreased.

Keywords: ICU nurses, stress, role conflict and emotional intelligence.

Introduction

Nursing profession is filled with stress, and nurses face numerous stressors in their day- to-day work settings (Tehrani et al., 2013). Specifically, Nurses in the intensive care unit (ICU) have a significant responsibility for their critically ill patients. Although, the unique conditions stemming from the professional setting and patient care challenges, such as issues with management, and the care of critically ill and dying patients. This heightened stress contributes to the development of chronic physical illnesses and mental disorders (Parizad et al.,2021). Stress is referring to the condition resulting from a range of physical, social, and psychological pressures, perceived by individuals as either challenging or surpassing their ability to cope (Vashisht et al., 2018).

Stress is conceptualized as a complex construct consisting of various significant role stressors, including role conflict (Kim et al.,2009).(Rodríguez?Escudero et al.2010?defined role conflict as the degree of incongruity or incompatibility in the expectations or requirements communicated to the team. Also, Role stress predominantly appears as role conflict, which stems from unclear directives and conflicting or incompatible demands (Zhang & He.2022).

When conflict arises, it influences the emotional intelligence (EI) of the individuals involved, leading to either positive or negative Impacts. EI plays a crucial role in conflict situations, effecting employees with feelings of frustration, anger, stress, or even depression. Managing or resolving conflicts is a key aspect of EI (Michinov, 2022).

EI encompasses a range of abilities that allow individuals to recognize emotional that in themselves and others (Tang et al., 2022). These abilities include perceiving and handling emotional information, expressing emotions, self-awareness, regulating stress, and coping with work demands (Zhang HL et al., 2023). Numerous studies have found a close relationship between emotional intelligence, subjective well-being, and mental health (Husain et al., 2022; Sfeir et al., 2022) . While some studies have explored the relationship between role conflict and stress, there is a gap in research concerning the impact of role conflict and emotional intelligence on stress within an intensive care unit (ICU) environment.Also, Given the effects of role conflict on nurses' mental well-being, it is crucial to investigate the factors that can mitigate this impact. Hence, there is extensive research has been conducted to identify the different sources of stress for nurses . The aim of this study is to investigate the correlation between role conflict and stress in intensive care units in Hafr Al-Batin, Saudi Arabia, in 2024, while also examining the potential mediating role of emotional intelligence.

Research Hypotheses

H1: The emotional intelligence mediated the relationship between role conflict and ICU nurse stress.

H2: There is a negative relationship between stress and emotional intelligence.

H3: There is a negative relationship between emotional intelligence and role conflict. H4: There is a positive relationship between role conflict and stress among ICU nurses.

Methodology and Implementation Plan

Study design

This study used a quantitative, descriptive, correlational design, to explore the relationship between the study variables which are stress, role conflict and emotional intelligence among ICU nurses. The selected design is the most fitting for this study as it directly investigates the relationship between the variables under examination. (M. Setia.2016).

Study Setting

Data was carried out in Two Hospitals in Hafr Albatin, King Khaled general Hospital (KKGH) and Hafr Al batin Central Hospital (HCH), these hospitals are the major hospitals in Hafr Albatin, and they have Intensive Care Unit; from March to May 2024.

Study population

The target population Consist of ICU Registered Nurses (RN) working in Hafr Al-Batin hospital (KKGH &HCH).

Inclusion criteria

1-         RN working in ICU for 1 year and more.

2-         RN participating in critical care and have an employment contract with the hospital.

Exclusion criteria

1-         Nurses who were not at work during the survey period.

2-         Training nurses (nurses newly recruited or have a course training).

Sample and Sampling

The sample size was estimated using Steven K. Thompson (2012) equation, as the following formula:

n = ( Np1 p) /  (N1 d2 z2 p1 p)

Where n= Sample size (69), N= Population size (83), Z= Confidence level at 95% (1.96), d= Error proportion (0.05), and p= Proportion (47.8%).

Instrument of the study

Demographic data:Measured by multiple questions which included (Age, Nationality, Gender, Educational Qualifications, Work Experience, Marital Status and Monthly Income).

Stress:Used 10-item Perceived Stress Scale (PSS-10) to assess stress among nurses is a common and effective approach (PSS; Cohen, Kamarck, & Mermelstein, 1983). The scale's Likert scale format, ranging from 0 to 4, provides a quantitative measure of perceived stress levels.

Role conflict:Used instrument developed by House and Rizzo (1972), which consisted of eight questions, these questions suggest a potential source of role conflict where an individual receives conflicting requests from multiple parties.

Emotional Intelligence: Used 16-item Emotional Intelligence Scale (WLEIS) developed by Wong and, Hong Kong, China (Wong and Law, 2017).

Data collection process

An online questionnaire platform was utilized for data distribution and collection. Before the survey, collaboration with nursing directors in hospitals was established. With their assistance, an electronic questionnaire was anonymously distributed to a group of nurses via the electronic application. The initial page of the questionnaire reiterated the study's importance and purpose of the study, provided instructions for completion, and included correspondence detailing the voluntary participation. The questionnaire comprised four primary sections: section (1) Demographics, covering factors like economic status, marital status, and age; section (2) Assessment of role conflict experienced by the respondent nurses; section (3) Evaluation of stress levels among ICU nurses; and section (4) Examination of emotional intelligence in ICU nurses.

Data analysis

The data analysis was conducted using IBM SPSS 26.0 software. Participants' demographic characteristics, as well as their levels of role conflict, emotional intelligence, and stress, was presented using descriptive statistics such as mean ± standard deviation, frequency, percentage and univariate analysis. Pearson correlation analysis will be employed to examine the relationships between emotional intelligence, role conflict, and stress.

Ethical and administrative consideration

Approval for data collection obtained from Hafr Albatin Health Cluster , with decision issued on ( May 2024) and also obtained from National Committee of Bioethics (NCBE), with a decision issued on (Feb 2024). Participants was presented with a question regarding their voluntary agreement to participate in the study before completing the surveys, serving as informed consent. Additionally, submission of a complete survey was signifying their agreement to participate, as outlined in the information letter.

Results

The study revealed a significant relationship between role conflict and stress among ICU nurses. Higher role conflict, as indicated by the mean score of 24.86 (SD = 8.856), was associated with elevated stress levels (mean score: 22.14, SD = 8.919). Emotional intelligence, particularly the ability to appraise and regulate emotions, played a mediating role in this relationship.

Specifically, the positive correlation between role conflict and emotional intelligence (r = 0.333, p < 0.01) suggests that nurses with higher emotional intelligence scores were better able to manage role conflict. Furthermore, the moderate positive correlation between emotional intelligence and stress (r = 0.307, p < 0.01) indicates that emotional intelligence can help mitigate stress levels, even in the presence of role conflict. Therefore, enhancing emotional intelligence could serve as a valuable intervention to reduce the adverse effects of role conflict on stress among ICU nurses.

Figure (1) the distribution of the participants according to their age - years (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (2) the distribution of the participants according to their nationality (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (3) the distribution of the participants according to their gender (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (4) the distribution of the participants according to their qualifications (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (5) the distribution of the participants according to their experience in years (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (6) the distribution of the participants according to their marital status (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Figure (7) the distribution of the participants according to their monthly income (n = 71 Intensive Care Unit Nurses in Hafr Albatin)

Role conflict assessment using role conflict and ambiguity scale

Table (1) the distribution of the participants according to their Role conflict (n = 71 Intensive Care Unit Nurses in Hafr Albatin)