EMOTIONAL LABOUR AND PSYCHOLOGICAL WELLBEING: MODERATING ROLE OF SOCIAL SUPPORT AMONG NURSES

TABLE OF CONTENTS

Title Page                                                                                                                          i

Dedication                                                                                                                       iii

Acknowledgement                                                                                                          iv

List of Tables                                                                                                                   v

List of Graph                                                                                                                   vi

Table of Contents                                                                                                             v

Abstract                                                                                                                          vii

CHAPTER ONE: INTRODUCTION                                                                         1

Statement of the Problem                                                                                              14

Purpose of Study                                                                                                           14

Operational Definition of Terms                                                                                    15

CHAPTER TWO: LITERATURE REVIEW                                                         17

Theoretical Review                                                                                                        17

Empirical Review                                                                                                           27

Summary of Literature Review                                                                                      39

CHAPTER THREE: METHOD                                                                                42

Participants                                                                                                                     42

Instruments                                                                                                                    42

Procedure                                                                                                                       44

Design and Statistics                                                                                                      44

CHAPTER FOUR: RESULTS                                                                                  45

CHAPTER FIVE: DISCUSSION                                                                              48

Implications of the study                                                                                               52

Limitations of the study                                                                                                 53

Suggestions for further study                                                                                        54

Conclusion                                                                                                                     55

REFERENCES                                                                                                            56

APPENDIXES

Abstract

This study investigated the moderating role of social support on the relationship between  emotional labour strategies (emotion related role requirements, deep acting and surface acting) and psychological wellbeing. Three hundred and fifty nine nurses participated in the study.  They were drawn from four hospitals in Enugu State, namely; University of Nigeria Teaching Hospital, Ituku-Ozalla; Enugu State University Teaching Hospital, Enugu; Bishop Shanahan Hospital, Nsukka and General Hospital, Nsukka. Three instruments were used in this study, namely, Emotional Labour Scale, Social Provisions Scale and Psychological Wellbeing Scale. Pearson’s correlation and multiple regression were used to analyse the data. There was no significant relationship between emotional related role requirements and psychological wellbeing. Deep acting was not also significantly related to psychological wellbeing. Association of surface acting and psychological wellbeing was negatively significant. Social support was significantly and positively related to psychological wellbeing. Of the emotional labour strategies, only the association of deep acting and psychological wellbeing was moderated by social support. Awareness of emotional labour difficulties and improvements in social provisions could diminish the negative impacts of emotional labour on psychological wellbeing thereby facilitating efficient patient care among nurses.                

CHAPTER ONE

INTRODUCTION

The concept of psychological well-being originated from one of the two basic components of well-being known as ‘eudaimonia’, the other being ‘hedonism’.  Hedonism as the first perspective of well-being (Kahneman, Diener & Schwarz, 1999), defines well-being as the presence of positive affect and the absence of negative affect. Whereas eudaimonia which is the second perspective contend that well-being does not entail maximizing positive experiences and minimizing negative ones (Ryan & Deci, 2001), but refers to living fully and thus allowing one to attain the richest human potential (Ryan, Huta & Deci, 2008).  In the field of contemporary psychology, a concept which stem from this hedonism is popularly known as subjective well-being which has two major components: affective balance and perceived life satisfaction.

In contrast to the concept of subjective well-being, other researchers emphasizes the concept of eudaimonia which establishes that well-being lies in the performance of action that is coherent with deep values that imply a full commitment with which people feel alive and real. One of the authors within the eudaimonia perspective notably Ryff (1989, 1995) introduced the concept of psychological well-being as an off shoot from the concept of eudaimonia. She argued that measurement for well-being have historically suffered from a lack of theoretical basis and have forgotten important issues of positive functioning. By proposing the term psychological well-being to distinguish the concept from that of subjective well-being, which is more typical of the hedonistic concept, Carol Ryff  has tried to overcome such limits and defines well-being as the development of a person’s real potential (Ryff, 1989, 1995). In this way, psychological well-being is not the main motivation of a person, but rather the result of a well-lived life (Ryff & Keyes, 1995; Ryff & Singer, 1998).

According to Ryff (1995), psychological well-being is a multidimensional construct consisting of six different dimensions of optimal well-being at a psychological level. Each of these dimensions posits different challenges that people discover in their efforts to function positively. The following are the six dimensions of psychological well-being. Self-acceptance entails a positive evaluation of oneself and one’s past life.  It is the ability to have positive self-regard that comprises of one’s conscious knowledge of his or her limitations. Personal growth is a sense of continued growth and development as a person. Purpose in life is the belief that one’s life is purposeful and meaningful. Persons who have purpose in life have a sense of direction in life that unifies their efforts and challenges. Positive relations with others: It refers to the possession of quality relations with others. Environmental mastery is capacity of manage effectively one’s life and surrounding world. Autonomy means a sense of self-determination. People with autonomy have developed a strong sense individuality and personal freedom.

The dimensions of the psychological well-being imply that psychological well-being embraces the totality of a human person.  Thus, an individual who possess this aspect of wellness is psychologically and emotionally good enough. Such a person will be able to adjust to the challenges of living.  Each of these dimensions posits different challenges that people discover in their efforts to function positively. According to Fredrickson (2004), psychological well-being plays an important role in health and biology because it appears to serve as a buffer or protector in the face of adverse effects of negative experiences. This is to say that an individual who possesses psychological well-being will be capable of facing challenges of life through the use of effective coping strategies.

Psychological well-being consists of cognitive components, like satisfaction with one’s life (Ryan & Diener, 2003) or having purpose in life, and emotional components like happiness (proportion of positive and negative affects and moods (Veerhoven, 2000). Psychological well-being is an integrative concept that reflects not only objective life conditions but also subjective dispositions and values.  Thus, psychological well-being refers to how people evaluate their lives. According to Diener (1997), these evaluations may be in the form of cognitions or in the form of affects.  The cognitive part is an information-based appraisal of one’s life when a person gives conscious evaluative judgements about one’s satisfaction with life as a whole.  The affective part is a hedonic evaluation guided by emotions and feelings such as frequency with which people experience pleasant or unpleasant moods in reaction to their lives.

Well-being refers to our happiness, confidence, physical condition and general out look on life.  It is all about feeling good.  It is a state characterized of good and satisfactory condition of experience; state characterized by health, happiness etc.  it’s all about subjective experience.  Psychological well-being leads to desirable outcomes, even economic ones, and does not necessarily follow from them.  For example, Diener, et. al. (2003) reported that people who score high on psychological well-being later earn high income and perform better at work than people who score low in well-being.

Nursing jobs are among the occupations experiencing high levels of stress. The level of psychological well-being and coping style with stressful situations among nurses has large impact on their job performance. Limited information exists about the relationship between copying styles and psychological well-being among nurses, so the present study investigated the moderating role of social support on the relationship of emotional labour strategies and psychological wellbeing among nurses.

Emotions are feelings that people experience, interpret, reflect on, express and manage (Thoits, 1990). They arise through social interaction and are influenced by social, cultural, interpersonal, and situation. In life, people often display particular emotions (which may not correspond with the emotions they are actually experiencing). In response to social expectations of appropriate behavior, for example, there are times we suppress anger when being cut off by someone in waiting line. This is the process in which people regulate and display their emotions to comply with social norms (Hochschild, 1990) people also regulate their emotions (displaying particular ones and suppressing others) in response to job-related expectations of appropriate emotional behaviour or for a wage.

Emotional labour is the forced emotion management in work for a wage.  In such a situation, employees are no longer able to exercise control over their emotions as their emotions become the commodities of the companies (Fineman, 2000; Hochschild, 1983). As a result, it is possible that the workers’ feeling is separated from the displays (Hochschild, 1983). Such an emotional dissonance may cause self-estrangement, depersonalization, dehumanization, and emotional exhaustion

In the recent decades, the educational reforms all over the world tend to transform education to be a service-like industry.  In such a context, schoolteachers are similar to service workers who have to respond to the demands and needs of the “educational consumers”, including students and parents (Smyth, Dow, a.; Hattam, Reid & Shacklock, 2000). In this sense, teachers may also need to perform emotional labour. Accordingly, they are potentially alienated and this may also affect their job performance, commitment and enthusiasm (Hü Isheger, Lang & Maler, 2010). However, some researchers disagree that emotional labour is negative because they find emotional labour may contribute to job satisfaction, commitment, and effectiveness (Hargreaves, 1998).

With the increasing trend of service-oriented  healthcare systems, where internal clients and co-workers are equally treated as important client – like constituencies, the role of emotional labour has gone beyond the traditional focus on only service provider – client interaction to universally applied phenomenon in the work place (Liv, Perrerve, Hochwarter & Kacmer, 2004). Hence, employees as emotional beings play the key roles and must be instructed by the organization to present themselves according to certain emotional rules.

Emotional labour refers to the “effort, planning, and control required to display organisationally desired emotions during interpersonal transactions” (Morris & Feldman, 1996, p .987). According to Hochschild (1983) who first introduced the concept of emotional labour, expectations exist regarding the appropriate or inappropriate emotional display of employees whose jobs involve a considerable degree of contact with the public. These expectations are translated into “feeling rules” (norms specifying the type of emotions that should be experienced) and “display rules” (norms concerning the type of emotions that should be expressed and those that should be suppressed). Hochschild’s (1983) original conceptualisation of emotional labour maintains that jobs involving extensive interpersonal contact with clients or clients necessarily involve emotional labour. Hochschild considered such jobs to be inherently dehumanising and distressing, as opportunities for autonomy over emotional expression are constrained.

More recently, however, it is recognised that emotional labour should be conceptualised as a subjective phenomenon encompassing different dimensions (Mann, 1999; Morris & Feldman, 1996). Emotional labour is generally considered to include an external component (employees’ perceptions of organisational emotional display rules, and the demands made upon them to comply with these rules) and an internal component (the effort involved in regulating emotions in order to display emotions that are required by the job role but not genuinely felt, or to suppress inappropriate emotions that are felt) (Grandey, 2000).

The presence of emotional display rules may not necessarily have a negative impact on employees, as there may be congruence between the required emotional display and the emotions that are actually experienced. Research findings suggest, however, that wellbeing will be compromised where the level of dissonance between felt emotions and those that should be displayed or suppressed require employees to engage in extensive emotional regulation (Brotheridge & Grandey, 2002; Lewig & Dollard, 2003). Although performing emotional labour can have benefits for employee health (Zapf, 2002), the effort involved in regulating “true” emotions with those that are organisationally desired can lead to emotional exhaustion and job dissatisfaction (e.g., Grandey, 2000). Across a number of occupational roles, the ‘act of expressing socially desirable emotions’ (Ashforth & Humphrey, 1993, pp. 88–89) during service transactions is the basis for emotional labour (EL).

Employees perform EL when they regulate their emotional display in an attempt to meet organizationally-based expectations specific to their roles. Such expectations determine not only the content and range of emotions to be displayed (Hochschild, 1983), but also the frequency, intensity and the duration that such emotions should be exhibited (Morris & Feldman, 1996,). In expressing the desired emotions, employees may experience emotional dissonance. This occurs when feelings differ from expressed emotions owing to incompatibility between organizationally based expectations and actual feelings held by the workers (Morris & Feldman, 1996; Zerbe, 2000). Hochschild’s (1983) groundbreaking study found that workers dealt with this dissonance either by simply altering their displayed feelings (surface acting) or by ‘conjuring up’ the appropriate feelings within themselves (deep acting).

More recent conceptual work suggests that EL should be operationalized as a multidimensional construct that could have differential impact on employee outcomes. This is exemplified in the four-facet model of Morris and Feldman (1996, 1997) and the six-dimensional model by Brotherlidge and Lee (2003). The most commonly used facets of emotional display in the workplace, includes the frequency, intensity and variety of emotional display, the duration of interaction, and surface and deep acting. The dimensions of variety, frequency and intensity were highly interrelated in Botherlidge and Lee’s (2003) study, suggesting that the respondents did not perceive these aspects of EL to be highly distinct from each other. Specifically, the duration of interactions, frequency, intensity and variety of emotional display are collectively labeled emotion-related role requirements (Brotherlidge & Lee, 2003). Thus in the present study, emotional labour is conceptualized to occur in three major dimensions of deep acting, surface acting and emotion-related role requirements.

In surface acting, the employee modifies out ward displays to be consistent with display rules without shaping inner feelings.  In other words, employees hide felt emotions or fake unfelt emotions.  Surface acting increases emotional dissonance (a gap between felt and expressed emotions) (Grendey, 2003).  Furthermore, surface acting is also detrimental to the organization in a way that employees conform to the organizational display roles in order to keep their jobs, but not to help clients or organization (Grendey, 2003). Employees use their training or past experience to help conjure up appropriate emotions or responses (empathy, cheerfulness) for a given sense (Kruml & Geddes, 2000). Hence, surface acting is termed as “faking in bad faith” (Refaeli & Satton, 2002). For example, a cashier maintains a simile and social demeanor even though internally he might be feeling sad.  The expression of positive emotion is cutting for the client-service content, but negative emotion is being experienced.

In deep acting, employees attempt to deeply modify internal feelings to match the required organizational display rules.  Deep acting involves changing inner feelings by altering something more than outward appearance. Employees engaged in deep acting make an effort to understand people, be empathetic to their circumstances, and internalize their feelings. Rafaeli and Sutton (2000) referred to this as “faking in good faith” because employees’ intent is to seem authentic to the audience.  Deep acting occurs when employees’ feelings do not fit the situations. They use their training or past experience to work up appropriate emotions. By practicing deep acting, emotions are actually induced, suppressed or shaped. For example, a cashier tries to look concerned by feeling what a demanding client is experiencing (from within the frame of reference of that particular client).

Emotions are displayed with very little effortful prompting.  However, Kruml and Geddes (2000a) argued that these assertions about Hochschild’s acting classification are incorrect because she described the genuinely expressed emotions of service employees as passive deep acting or genuine acting (Kruml & Geddes, 2000a).  As the competition becomes more intense in the healthcare industry, many healthcare organisations challenge their employees to strive for “world class service”.  This striving for service excellence makes organisations no longer content with their employees engaging in surface acting: they are seeking to achieve genuine acting or deep acting in employees.  Clearly, by encouraging employees to engage in genuine acting or deep acting, organisations hope to enhance the authenticity of the service performance and reduce the possibility that service providers might break the service “norms” and express emotions incongruous with the role they are expected to play.

The link between emotional labour and psychological well-being has its theoretical foundation in the concept of happiness. Happiness is a construct characterized by indicative of pleasure, content or gladness (Hosie & Sevatos, 2010). Research into the construct of happiness proceeded into psychological well-being. Happiness is an emotional state and job related well-being is currently the closest available expression of happiness in the work place (Hosie & Sevastos, 2010). Therefore, emotional or psychological well-being is unarguably the fundamental drive of human endeavour. It has a critical role in thought and individual success (Hosie & Sevastos, 2010) War’s (2012) finding showed that greater employee psychological and emotional wellbeing is significantly associated with better job performance, lower absenteeism, reduced probability of leaving an employer and the occurrence of more discretionary work behaviours (like organizational commitment).

Humans are emotional being (Crider, Geothals, Kadneough, & Solomon, 1983; Charmine, Wilfred & Neal, 2005). All organizations make at least some decisions that hurt their employees and cause some levels of distress or disruption. For instance, jobs may need to be cut or high performance levels may be demanded, without recognition of emotions.  However, organizations cannot deal effectively and humanely with the pain caused (Frost, 2003). For the most part, organizational research tends to rest on the assumptions that human beings are rational creatures and that emotions are irrational and unproductive (Styhrie, Ingelgard, Beausang, Castenfors, Mulec & Roth, 2002). Therefore, to act in emotional or unpredictable ways in organizations is “unacceptable” (Antonacopoulon & Gabriel, 2001).

Yet the concept of emotional labour (emotional dissonance, surface acting, deep acting and genuine acting) in organizational setting has proved to be of far more enduring interest to psychologists.  Some reasons may be provided for this upsurge of interest. Emotion is hugely and intricately related with motivation (Crider, et al., 1983), significantly related to job performance, effective service delivery (Grendy, 2003),  organizational  conflict and employee psychological well-being (Asforth & Humphrey, 1993).  Also, it features as a work place stressor (Cartwright & cooper, 1997, as cited in Haslam, 2004) and implicitly operates in decision-making (Hosie & Sevastos, 2010). Taken together, emotional labour serves for much purpose when properly harnessed.  It leads to work motivation, job performance, effective survive delivery and moderates the impact of organizational conflict. Further, it increases employee psychological well-being serves as a workplace stressor and enhances decision-making.

Few researches have linked surface emotion with enhanced psychological well-being. Factors that might have contributed to this include employee perception, being committed to the organization, personality type, values and identity. Besides whether employees indulging in surface emotion regulation are affected negatively or positively depends on job requirement; their level, range and duration of the emotional labour required in the role (ie. Intense, extensive and prolonged or low, narrow and brief, or some other combination); the person’s ability to disengage (switch off) from the job after leaving the workplace; and finally the degree of autonomy the individual had in performing the job. Deep emotion occurs before an emotion develops and it aims at changing the situation or the perception of a situation (Gradey, 2000; Gross, 1998).

In emotion alignment (ie between required ad true feelings) employees can involve in distraction or attraction seeking (attentional deployment) reappraisal of the situation or cognitive change, situation selection, situation modification and memories which is effective in inducing positive mood. Deep acting changes the physiological arousal and results in genuine emotional displays of the required emotions. It elicits reappraisal, a form of cognitive cost which in turn diminishes mental resources only at the onset of an emotion when an alternative reality is construed. Debate ensures on amount of cognitive (e.g attention) and motivationally (eg. drive, resilience) resources invested, and it is considerably lower for deep acting than for surface acting (Sideman & Grendey, 2007; Jotterdell & Holman, 2003). However, recently, Liv, Preatt, Perrewe, and Femis (2008) suggested that in contrast to the reappraisal manipulations in typical laboratory studies, actually deep acting might require great deal of mental energy in form of motivation.

Emotional intelligence, engagement and role internalization and might therefore be even more psychologically demanding than surface acting.  Nevertheless, deep acting is an effortful regulatory process that drains mental resources to a certain extent. Unlike surface emotion, deep acting is emotionally rewarding. Since there is no discrepancy between felt and displayed emotions, when employees engage in deep acting, they reserve their worth of authenticity. On the other hand, authenticity attracts rather than dispel genuine positive emotions and as required by the organizational norms. This equally buffers the employee social interaction level with his or her client.

Social support may be described as a network of family, friends, neighbours, and community members that is available in times of need to give psychological, physical and financial help. It can also be conceptualized as the extent to which individuals perceive that provisions of social relationships exist and are available to them, or they are being cared for, particularly in times of adversity.

Social support may be in the form of tangible (or material/financial assistance) support, informational support (e.g. advice) and emotional support (e.g. nurturance) from friends, family members, romantic partners, professional colleagues/co-workers, support groups and significant others. According to Stice (2004), the optimal source of social support largely depends on the developmental stage of the recipient. For instance, research has shown that the perception of social support in the elderly is related to the extent of their social interaction, while in younger adults it is associated to instrumental support. Furthermore, it has been shown that the form of social support received by individuals is important in the conferment of resilience to stress.

The relationship between social support and general well –being has been established by various researchers. For instance, studies have shown that social support was negatively related to Posttraumatic stress disorder among victimized and maltreated youths. Similarly, it has been reported that social support mediates or moderates the relationship between youth’s exposure to violence, victimization and maltreatment and Posttraumatic Stress Disorder (Wu, Chen, Weng & Wu, 2009). People with lower social support have been reported to have higher rates of major mental disorder (including posttraumatic stress disorder) than those with higher social support.

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