The present study was conducted with the aim of investigating the relationship between emotional intelligence and the level of moral performance of nurses. In the present study, nurses had almost average emotional intelligence, which is consistent with the results of the study by Ghaedamini et al. (
23). The highest and lowest means were related to the subscales of “self-awareness" and “social skills," respectively. This is despite the fact that in the study conducted by Masoudi and Alavi, nurses had more than average emotional intelligence, but still, the highest and lowest averages were related to the “self-awareness" and “social skills" subscales, respectively (
13). It must be mentioned that the difference in the mean score of emotional intelligence in different studies may be caused by different research communities because emotional intelligence can be related to people's personal and social lives (
18). Therefore, the emotional intelligence levels of nurses are still discussed, and it is recommended that more studies be conducted in this field in different research communities. High emotional intelligence can play an important role in effective clinical communication between patients and nurses (
10,
13). Therefore, the lack of nurses with high levels of emotional intelligence is worrying, so it seems that measures such as training nurses to recognize the dimensions of emotional intelligence and applying them at the bedside can be effective.
In the present study, most nurses had a high level of moral performance. The highest and lowest averages were assigned to the “nurse and professional commitment" and “nurse and colleague" subscales, respectively. In this regard, in some studies, most of the nurses considered their level of performance in accordance with nursing ethics to be favorable (
24,
25). Meanwhile, patients often stated that nurses' level of adherence to ethical principles was lower (
24,
26). This difference may indicate that nurses have a weaker moral performance in reality. This issue is very worrying because, in this case, nurses may not take action to improve their moral performance (
21,
24). One of the reasons for this can be the completion of questionnaires as self-reported. In this way, a person may have a desire to show his moral performance. Based on the findings of this study, the high ethical performance of nurses is promising; however, it is recommended that the views of patients receiving services also be evaluated in this regard.
The results of the study indicated that the emotional intelligence of nurses has a direct and meaningful relationship with the level of their moral performance. Thus, improving nurses' emotional intelligence can lead to an improvement in their moral performance. In this regard, the study of Deshpande and Joseph showed that nurses' emotional intelligence can significantly affect their ethical behavior (
16). Alizadeh’s study showed a significant relationship between emotional intelligence and its dimensions and employees' ethical behavior (
18). Improving emotional intelligence in nurses has been shown to lead to various positive outcomes, including enhanced management of emotions and feelings, improved moral decision-making abilities, and improved overall performance (
6,
10,
16). As the results of the study by Nouri and Dehghani showed, emotional intelligence training is significantly effective in increasing the work ethic of nurses (
6). On the other hand, Austin et al. reached the conclusion that emotional intelligence is not directly related to the moral performance of nurses. The reason for this contradiction can be explained by the differences in the studied society, the cultural differences of the samples, and the number of samples studied (
27). In the research community of the current study, it seems that nurses with high emotional intelligence and the ability to control emotions in the face of moral dilemmas provide better moral performance and are more successful in making decisions.
In the present study, there was no significant difference in the emotional intelligence of nurses according to characteristics such as marriage, education level, and gender. In this regard, previous studies have shown different results. In the study conducted by Masoudi and Alavi, the emotional intelligence of nurses did not differ in terms of gender, but it did differ significantly in terms of education level (
13). In the study of Khan et al., emotional intelligence did not differ according to the level of education, but it showed a significant difference according to gender (
28). Emotional intelligence is a multifactorial concept of interrelated emotions, social competencies, skills, and facilitators that lead to wise decisions and responsible behavior in an individual (
10,
13). Therefore, the difference in the results of the studies is somewhat expected. Despite this issue, it is recommended that future research be conducted focusing on demographic factors affecting the emotional intelligence of nurses.
In our study, in addition to emotional intelligence, nurses' gender was also an effective factor in their moral performance; thus, female nurses had higher moral performance than male nurses. However, the study by Hosseinzadegan et al. showed no significant relationship between the score of professional behavior and the gender of nurses (
29). This difference may be due to the use of different tools or differences in the training of human forces (
21). In addition, in the present study, the number of female nurses was higher than that of male nurses, which may be influential in this issue. In addition, in some studies, it has been shown that the professional moral score of people in different hospital departments is different (
17,
29). In the present study, nurses with high work experience had higher moral performance than others. In the study by Hosseinzadegan et al., nurses' professional ethics were not related to their work experience (
28). Studies have shown that factors such as family, organizational variables, the effect of nursing work, nurses' concern about ethics, and past experiences can play an important role in nurses' responses to ethical problems (
29,
30). Also, the working environment of this profession may cause moral dilemmas that make nurses perceive the working environment as morally unstable. Therefore, nurse managers should think of measures to create a suitable bed for a stress-free work environment (
29,
31).
5.1. Limitations and Strengths
One of the limitations of the present study is the inappropriate understanding of some questionnaire questions by the samples, which the researchers solved by being with the samples and giving appropriate explanations. In Iran, no study has been conducted so far with the aim of investigating the relationship between emotional intelligence and the moral performance of nurses. Therefore, the present study is new. The findings of this study can be used as a basis for future research. Since this study was conducted only on nurses working in hospitals affiliated with Qazvin University of Medical Sciences, the results may not be generalizable to other societies and other periods. Therefore, it is recommended that similar studies be conducted in other research communities with a larger sample size.
5.2. Conclusions
The findings of the present study indicated the existence of a direct and significant relationship between nurses' emotional intelligence and their moral performance. According to the findings of the present study, it seems that nurses with higher emotional intelligence are more successful in this profession. Because high emotional intelligence leads to the recognition and management of people's feelings and relationships, these people will also have a higher moral performance. Since professional nursing is in the direction of high moral values, nurses with higher moral performance will make better decisions when faced with moral dilemmas. In addition, considering the unfavorable levels of emotional intelligence in nurses, it seems that the implementation of educational interventions on knowing and how to use emotional intelligence in facing moral dilemmas will help in improving the decisions and moral performance of nurses. According to the findings of this research, researchers can conduct studies on the implementation of interventions aimed at improving the emotional intelligence of nurses and investigating their effects on their moral performance. The performance of nurses based on moral values is essential to providing care to patients. Therefore, paying attention to individual factors affecting it, such as emotional intelligence, is one of the things that nurses and nursing managers should pay special attention to. In this regard, nursing students, as future nurses, should receive the necessary training in nursing schools in the field of recognizing emotions, managing relationships, and improving their emotional intelligence. This will improve their moral performance in clinical environments. Also, knowing the effective or confounding factors in the relationship between emotional intelligence and moral performance can help to improve ethics in the process of nursing care. In this regard, it is recommended that similar studies be conducted in other research communities with a larger sample size.