Emotional Management and Personality in Medical Treatment

Introduction

In Western medicine, treatment is typically defined according to surgical, chemical, or mechanistic attention toward symptoms and the origins of ailment. This is an appropriate professional orientation for contending with the wide array of conditions that might afflict the human body. However, there is yet another level of medical attention — one which, when properly implemented, may offer compelling results. The emotional condition of the patient plays a significant role in the process of treatment, recovery, or persistence of illness. This, in turn, is a condition which often hinges on the personalities extended by healthcare providers such as nurses and physicians. There is a compelling body of research suggesting that these qualities invoke emotional comfort in patients, which can be a fundamental instrument in achieving quality healthcare.

The research here proposes that the utilization, extension, and persistence of emotional management and personality orientation in the process of treating patients — across all manner of treatment contexts — can be shown to have markedly beneficial outcomes for either the health or the emotional well-being of the patient. Still, there is a need for continued dialogue on the subject, as many perceived benefits remain unproven. One of the core problems is that too little has been established empirically to achieve a universality or best-practice approach to emotional management. While most healthcare practitioners can report with great confidence that emotional management is a critical part of their role, there remains a lack of decided evidence as to how this understanding might best be implemented as a formal part of the work itself.

This challenge is demonstrated by Landa et al. (2009), who remark on the complexity of the field and the need to formalize emotional management as other methods of professional orientation, integrity, and practical ability have been formalized. Accordingly, Landa et al. argue that "for a profession that requires not only technical expertise but also psychologically oriented care, knowledge about the self in nursing would be crucial to further development and growth of the profession. However, the role of emotions in the formation of nursing professionals has been scarcely studied" (Landa et al., p. 1). This suggests a core conflict between the opportunity — and even the demand — that should fall upon hospitals and public officials responsible for healthcare policy-making and the reality of the profession today.

In consideration of this need for clarity and the potential breadth of medical benefits, the literature review conducted here assesses a set of articles that offer both an endorsement of emotion-based treatment approaches and an assessment of specific ways — relating to the extension of optimism, personal support, and hope — in which emotional connectivity and the display of personality on the part of health professionals can and should be evaluated and implemented in a formalized manner.

Theoretical Foundations of Emotional Management in Healthcare

The value of interpersonal orientation to the process of treatment is rooted in the importance of managing emotion for members of the healthcare profession. This is a complex aspect of the occupation that demands the practitioner to command both the practical aspects of medical treatment and the emotional responses and propensities of the patient, the patient's family, and other healthcare providers. The inherently humanist nature of the occupation implicates emotional processes in all areas of treatment and practice.

Wilson and Carryer (2008) provide an examination of the nursing profession with direct consideration of emotional management. They contend that "effective nursing practice requires the ability to recognise emotions and handle responses in relationships with clients and their families. This emotional competence includes nurses managing their own emotional life along with the skill to relate effectively to the multiple colleagues and agencies that nurses work alongside" (Wilson & Carryer, p. 1). As the discussion turns to the personality displayed by the practicing nurse or physician and the impact this can have on patient response and treatment outcome, the argument posited by Wilson and Carryer provides important grounding.

Specifically, the indication is that the emotional response of the patient and the patient's surrounding family or support system will often hinge on the emotional fortitude and displays provided by healthcare workers. Nurses who are capable of presenting themselves with empathy and sensitivity will likely be those who have achieved the greatest internal emotional balance. This is a crucial aspect of survival in an occupation where negative treatment outcomes can impose a lasting emotional toll on the practitioner. The preservation and ability to display emotions such as optimism and empathy will be fundamental to the patient's likelihood of adopting a similar outlook.

In accordance with Wilson and Carryer's study, the practitioner who achieves the greatest success in this area will be one capable of responding with equanimity and, simultaneously, the appropriate level of humaneness, in the face of all possible patient conditions and outcomes. To this end, "it has been argued that there is a connection between a nurse's ability to accept another person's emotional distress and their capacity to accept themselves and their own distress. Peplau (1988) calls this caring neutrality. She suggests that nurses are required to develop a level of congruence between what they say and how they act toward the persons with whom they work. When nurses learn to process their own emotions, working with another person's emotion is made possible" (Wilson & Carryer, p. 1). The healthcare practitioner, Wilson and Carryer's argument denotes, must reflect those emotions which she wishes to cultivate in the patient. Therefore, the capacity to manage and rationalize the retention of hope on the part of the practitioner is tantamount to enabling the same in the patient.

The correlation between emotional intelligence and job success on the part of nurses and nurse practitioners is significant not only with respect to the quality of patient care, but also with regard to the nurse's capacity to endure the stressors and exhaustion that are frequently part of the field. This is reinforced in the findings by Fariselli et al. (2008), which establish a connection between high emotional intelligence, the ability to navigate the emotional rigors of the job, and career longevity and advancement. Fariselli et al. contend that "in a sample of 68 professional midwives and obstetricians in a large urban hospital, emotional intelligence is strongly predictive of performance (66%), stress is slightly predictive (6% to 24%), and emotional intelligence is predictive of stress management (6.5%)" (Fariselli et al., p. 1).

These findings are compelling insofar as the quality of healthcare and nursing today suffers unquestionably due to high turnover, understaffing, and low morale that are epidemic to nursing. The durability of healthcare practitioners under conditions largely outside their control depends on an emotional constitution that is absolutely crucial to effectiveness. Fariselli et al. go further to define what they refer to as core competencies, providing a basic framework for those behaviors and approaches to emotional management that can serve as recommendable practices in healthcare provision. The study contends that "of the individual competencies, these four are the most powerful predictors of performance as measured by the Stress & Performance survey. The four outcomes individually predict between 43–49% of the variation in performance scores: Consequential Thinking: 49%; Navigate Emotions: 48.4%; Intrinsic Motivation: 43.2%; Exercise Optimism: 43.2%" (Fariselli et al., p. 14). This framework is important for constructing a strategy to formalize healthcare workers' understanding of the emotional responsibilities that can benefit their patients and help practitioners endure the unique pressures, anxieties, and emotional trials of the healthcare field.

Hope and Optimism in Clinical Practice

For patients who are suffering from illness or injury, an emphasis on optimism constitutes a positive perception of recovery in some capacity — whether this is an aspiration to return to a state that existed before the onset of symptoms or simply to achieve personal milestones of recovery. This orientation toward the future is what distinguishes the presence of hope. A belief in the prospect of some improvement, whether to the extent that recovery is achieved or to the extent that one concedes to the embrace of death, may be understood as bearing the emotional characteristics that the healthcare practitioner is called upon to display.

The discussion provided by Clark (2002) offers an illuminating perspective on the subject of hope in medicine by focusing on its history in research and clinical investigation. Clark's review accounts for several points of inflection in the developing history of emotional orientation as part of an integrated strategy for medical treatment. A fundamental change in medical perspective had begun to transpire with the assumption of varying clinical research investigations on the subject.

This contributed to what Clark identifies as a major shift in the way physicians had begun to perceive and treat terminal illness. Rather than a straightforward preparation of the patient for the certainty of death, Clark points to a juncture in the mid-to-late twentieth century at which medical professionals had begun to adopt "an active rather than a passive approach to the care of dying people. This was promoted in which the fatalistic resignation of the doctor ('there is nothing more we can do') was supplanted by a determination to find new and imaginative ways to continue caring up to the end of life" (Clark, 2002). In addition to serving as a fundamental motivation for investigating ways to extend life expectancy even in the presence of supposedly terminal illness, the optimism reflected here also serves to improve the quality of life for those in its final phases. The simple expression of optimism — not unrealistic or patronizing, but conducive of an emotionally connected assurance that all possible measures will be taken to preserve life — can promote a sense of value and support for one on the cusp of death. Even where life cannot be preserved, the expression of optimism suggests that remaining moments of life can be made more tolerable by the perspective taken by healthcare providers.

This idea speaks to another fundamental inflection point in the way that healthcare professionals have begun to treat the emotional orientation of patients. Clark points to a "growing recognition of the interdependency of mental and physical distress [that] created the potential for a more embodied notion of suffering, thus constituting a profound challenge to the body-mind dualism on which so much medical practice of the period was predicated" (Clark, 2002). This period, late in the twentieth century, has led to the current consensus that there is a real and tangible value to the emotional fortitude of one enduring a physical breakdown. The presence of hope in the healthcare provider is likely to improve the prospect that even a terminally ill or age-advanced patient might adopt a similar hopefulness. This speaks to the opportunity for the healthcare provider to engage the patient's emotional disposition. The patient is likely to respond positively to indications of an interest that extends beyond the physical body — a reality with implications that reach beyond any single visit or hospital stay.

A study by Eliott and Olver (2006) likewise provides an important body of insight into the subject of emotional consequences in medical proceedings. Its emphasis on the relationship between hope in the medical context and coping with the end of life reveals the depths and persistence of hope as part of the human condition. The merit of the overarching argument is especially strengthened by the resolutions of this study, which demonstrate a fundamental value to hope in alleviating the pain, discomfort, fear, and loneliness that can otherwise characterize a recognition of the end of life.

The functionality of hope in the face of impending death is particularly significant. In cases of advanced age or advanced terminal illness, the physician's or nurse's responsibility shifts from curative focus or aggressive treatment methodology to a focus on the alleviation of suffering. In this context, healthcare professionals must be prepared to help ease patients into death with as little anguish and as much comfort as possible. Acceptance, realism, and a sense of support are therefore all crucial emotional aspects of the treatment process. The capacity in the patient to summon hope, and the ability of healthcare providers to offer humane support to the extent of instilling hope, will together be essential to assisting patients through the difficult final phase of the life cycle. Thus, "in the context of discussions about decision-making at the end of a terminal illness, when used as a noun, hope invariably referenced the medical domain — focusing either on the objective probability of medical cure (typically taking the negative form 'there is no hope'), or the subjective possession of the patient, needed to fight their disease" (Eliott & Olver, 2006). Without positive or negative connotation, this indicates that hope is a definite emotional presence as individuals face terminal conditions. Whether it is realistic for one to fight or to submit to illness, hope transitions from an abstract sentiment to a real and tangible emotion that may either be palpable in its absence or powerfully evident in its presence.

Conclusion and Recommendations

Fariselli, L., Freedman, J., & Ghini, M. (2008). Stress, emotional intelligence and performance in healthcare. Six Seconds: White Paper.

Landa, J. M. A., Lopez-Zafra, E., Aguillar-Luzon, M. C., & Ugarte, M. S. (2009). Predictive validity of perceived emotional intelligence on nursing students' self-concept. Nurse Education Today.

Miller, J. F. (2007). Hope: A construct central to nursing. Nursing Forum, 42(1).

Moore, S. L. (2005). Hope makes a difference. Journal of Psychiatric and Mental Health Nursing, 12, 100–105.

Stokes, L., & Turner, D. S. (2006). Hope promoting strategies of registered nurses. Issues and Innovations in Nursing Practice.

Wilson, S. C., & Carryer, J. (2008). Emotional competence and nursing education: A New Zealand study. Nursing Praxis in New Zealand.

Zerbe, W. J., Ashkanasy, N. M., & Hartel, C. E. (2006). Individual and organizational perspectives on emotion management and display. Emerald Publishing.