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Background The practice environment as experienced by community service nurses (CSNs) has not been explored in the South African context, and few studies have explored the influence of the practice environment on intrapersonal resources such as subjective well-being, compassion practice and psychological capital. Aim To describe the influence of the practice environment on CSNs’ subjective well-being, compassion practice and psychological capital, and the association between these variables and selected personal and situational demographic factors. Methods A cross-sectional design was employed with self-report questionnaires used to collect data from an all-inclusive sample of CSNs that studied in North West Province and began their community service year there in 2016 (N = 284; n = 60). Results CSNs perceive the practice environment as favourable (M = 2.60; SD = 0.65). CSNs are satisfied with life (M = 24.89; SD = 5.68), have high levels of positive affect (M = 39.13; SD = 7.97), compassion satisfaction (M = 5.44; SD = 0.71) and psychological capital (M = 5.67; SD = 0.95). Nurse foundations of quality of care and nurse participation in hospital affairs had the most influence on intrapersonal resources. The positive components of subjective well-being, compassion satisfaction and psychological capital were highly correlated. Situational demographic factors were associated with intrapersonal resources and perceptions of the practice environment. Conclusion Healthcare facilities should provide a positive practice environment for CSNs, that includes an orientation programme with formal organisational and supervision structures, in order to strengthen CSNs’ intrapersonal resources, improve their perceptions of the practice environment, and ultimately improve nurse and patient outcomes

This study aimed to describe intrapersonal characteristics (professional values, personality, empathy, and job involvement), work performance as perceived by nurses, and caring behaviors as perceived by patients, and to examine the relationships among these variables. A cross‐sectional design was employed. A sample was recruited of 218 nurses and 116 patients in four private hospitals and four public hospitals. Data were collected using self‐report measures. Data analysis included descriptive statistics, exploratory and confirmatory factor analyses, hierarchical linear modelling, correlations, and structural equation modeling. Nurses perceived their work performance to be of high quality. Among the intrapersonal characteristics, nurses had high scores for professional values, and moderately high scores for personality, empathy and job involvement. Patients perceived nurses' caring behaviors as moderately high. Professional values of nurses were the only selected intrapersonal characteristic with a statistically significant positive relationship, of practical importance, with work performance as perceived by nurses and with caring behaviors as perceived by patients at ward level. Managers can enhance nurses' work performance and caring behaviors through provision of in‐service training that focuses on development of professional values

Self-determination theory is a macrotheory of human motivation that describes fundamental matters such as personality development, goals and aspirations, and self-regulation. Basic psychological needs theory, a subtheory of self-determination theory, postulates that the needs for autonomy, competence, and relatedness are universal and the satisfaction thereof essential for human functioning. Despite the theory’s strong universality claim, almost no studies tested the assumption on the African continent. The present study addressed this by exploring the factorial validity of English, Afrikaans, and Setswana versions of the Basic Psychological Needs Scale (N = 1056). After incorporating a negative-worded method effect and removing several problematic items, the fit of the intended three-factor model was good for the Afrikaans version, marginal for the English version, and poor for the Setswana version. The resulting factors’ reliabilities were low. Configural, metric, and partial scalar invariance were established between the English and Afrikaans versions. Although these findings primarily highlighted problems with the particular scale, there is also the possibility that it could have implications for the validity of the universality assumption of basic psychological needs theory and/or assumptions about denotations or manifestations of the main constructs in various cultural contexts. The study indicated the conceptual and linguistic complexities involved in assessment across diverse and multicultural contexts

Aims and objectives To determine the incidence of medication administration errors, medication administration-related deviations from safe practice as well as factors associated with these errors in medical and surgical units of public hospitals in the Gauteng Province of South Africa. Background Several studies have been published on the incidence of medication administration errors, but only a few have studied the incidence of medication administration-related deviations from safe practice. Context-specific research on the incidence of medication administration errors and associated factors (patient acuity, bed occupancy, staffing levels, medication administrators’ qualifications, dose calculation skills, level of hospital, unit type, medication administration route and interruptions) within the continent of Africa is lacking. Design A cross-sectional, observational design. Methods Direct observation was conducted incorporating a previously validated checklist based on basic medication guidelines including the five rights, asepsis and medication documentation. In addition, a knowledge test on dose calculations was performed. Medication administration to 315 patients (1847 medications administered) was observed between February–August 2015 in medical and surgical units from eight public hospitals. Twenty-five medication administrators completed dose calculations. Results In total, 296 medication errors were identified, of which most were wrong-time errors and omissions. Interruptions and patient acuity were significantly associated with wrong-dose and wrong-route errors, respectively. Most medication administration-related deviations from safe practice were related to patient identification or asepsis. Sixteen of 50 dosage calculations were answered incorrectly. Incorrect answers most often occurred in the calculation of parenteral dosages. Conclusions Medication administration errors, especially wrong-time errors and omissions, are prevalent in public hospitals in

Background: Meaning in life is a key indicator of subjective well-being and quality of life. Further developments in understanding and enhancing the construct will depend inter alia on the sound measurement thereof. This study is at the forefront of applying modern psychometric techniques to the Meaning in Life Questionnaire, a scale widely used to assess meaning in life. Method: The Rasch rating scale model was applied to the Presence and Search subscales of the Meaning in Life Questionnaire using a sample of 601 adults from South Africa, Australia, and New Zealand. Results: The Presence subscale was insensitive at high levels of presence of meaning while the majority of the respondents fell in that range. Removal of item 9 (“My life has no clear purpose”) and collapsing the response categories indicative of low and medium levels of the latent construct significantly improved the subscale’s targeting and fit to the Rasch model, resulting in a subscale that exhibited differential item functioning on items 1 (“I understand my life’s meaning”), 4 (“My life has a clear sense of purpose”), and 5 (“I have a good sense of what makes my life meaningful”) for country, but none for gender, age group, or education level. The Search subscale yielded disordered category threshold calibrations, but after collapsing some of the response categories representing low and medium levels of the target construct, a subscale that demonstrated good fit to the Rasch model, good targeting, and no differential item functioning resulted. Conclusions: In terms of this particular scale, adaptation of the rating scale and removal of item 9 is recommended. Country-level parameter estimates may be needed for items that exhibited differential item functioning. The study also has significant implications for the theory, measurement, and practice of meaning in and quality of life in general. Reasons for and the far-reaching implications of the insensitivity of the Presence subscale for high levels of

Aim:To investigate the relationship between non-nursing tasks (NNTs), nursing tasks left undone (NTLU) and job satisfaction among professional nurses (PNs) in South Africa (SA). Background: This study adds to the international debate about the relationship between non-nursing tasks, nursing tasks left undone and job satisfaction by studying the variables at individual nurse and hospital unit level. Method: A cross-sectional survey design of 1166 PNs in 60 medical and surgical units in 55 private hospitals and seven public hospitals. Results: Nationally, the three main non-nursing tasks performed were clerical duties (M = 1.81), arranging discharge referrals and transport (M = 1.38) and performing non-nursing care (M = 1.31), while the main nursing tasks left undone were comfort/talk with patients (62.2%), educating patients and family (57.9%) and develop/update nursing care plans/pathways (51.6%). Nursing tasks left undone were only related to three non-nursing tasks, and job satisfaction correlated most highly with nursing tasks left undone. Conclusion: Professional nurses conduct many non-nursing tasks, and leave several important nursing tasks left undone. Nursing tasks left undone cause the greatest degree of job dissatisfaction amongst professional nurses. Implications for nursing management: Role overlapping and work performed by professional nurses below their skill level should be identified and re-organised; support services should be employed and efficiently used.

The methylenetetrahydrofolate reductase (MTHFR), cystathione-β-synthase (CBS) and methionine synthase (MTR) genes interact with each other and the environment. These interactions could influence homocysteine (Hcy) and diseases contingent thereon. We determined single nucleotide polymorphisms (SNPs) within these genes, their relationships and interactions with total Hcy concentrations within black South Africans to address the increased prevalence of diseases associated with Hcy. The MTHFR 677 TT and MTR 2756 AA genotypes were associated with higher Hcy concentrations (16.6 and 10.1 μmol/L; p b 0.05) compared to subjects harboring the MTHFR 677 CT/CC and the MTR 2756 AG genotypes (10.5, 9.7 and 9.5 μmol/L, respectively). The investigated CBS genotypes did not influence Hcy.We demonstrated interactions between the area of residence and the CBS T833C/844ins68 genotypes (p = 0.005) so that when harboring the wildtype allele, rural subjects had significantly higher Hcy than their urban counterparts, but when hosting the variant allele the environment made no difference to Hcy. Between the CBS T833C/844ins68 or G9276A and MTHFR C677T genotypes, there were two-way interactions (p = 0.003 and = 0.004, respectively), with regard to Hcy. Subjects harboring the MTHFR 677 TT genotype in combination with the CBS 833 TT/homozygous 844 non-insert or the MTHFR 677 TT genotype in combination with the CBS 9276 GA/GG displayed higher Hcy concentrations. Therefore, some of the investigated genotypes affected Hcy; residential area changed the way in which the CBS T833C/844ins68 SNPs influenced Hcy concentrations highlighting the importance of environmental factors; and gene–gene interactions allude to epistatic effects

Objective: To examine the practice environment, nurse reported quality of care and patient safety, and nurse workforce outcomes in medical and surgical units in private and public hospitals in South Africa (SA), and determine the association of modifiable features of the hospital such as the practice environment and patient to nurse workloads on these outcomes. Design: Cross-sectional survey of nurses. Setting and participants: Nurses were surveyed in medical and surgical units of 55 private hospitals and 7 public national referral hospitals in SA. A total of 1187 nurses completed the survey. Measurements: Practice environment, patient to nurse workloads, nurse reported quality of care and patient safety, and nurse workforce outcomes including burnout, job satisfaction and intention to leave. Results: On a national level, more than half, 54.4% (634/1166) of nurses intend to leave their hospital within the next year due to job dissatisfaction and 52.3% (600/1148) rate their practice environment as poor or fair, while almost half, 45.8% (538/1174) report high levels of burnout and 44.9% (517/1152) are not confident that management will resolve patient problems. Public hospital nurses report more negative outcomes than private hospital nurses. Some 71% (320/451) of public hospital nurses rate their practice environment as poor/fair, 62.9% (281/447) are not confident management will resolve patient problems, and 59% (272/461) intend to leave their hospital within the next year due to job dissatisfaction. On a national level, more favourable practice environments are significantly associated with more positive nurse reported quality of care, and nurse workforce outcomes. This is true for private and public hospitals. Patient to nurse workloads are also significantly associated with more positive nurse reported quality of care and patient safety, and nurse workforce outcomes, but primarily in public hospitals. Conclusions: Improving the practice environment, including pat

Objective: A waist:height ratio (WHtR) higher than 0.5 has been proposed as a cutoff point for abdominal obesity in both sexes and at all ages. It is unknown if this cutoff point is appropriate for previously undernourished adolescents. We assessed the cutoff value of the WHtR associated with an increased metabolic risk in 178 black South African 14- to 18-y-old adolescents (69 boys, 109 girls). Methods: We measured weight, height, waist circumference, fasting plasma glucose and insulin levels, serum high-sensitivity C-reactive protein, and blood pressure and calculated the WHtR and homeostasis model assessment of insulin resistance (HOMA-IR). Using receiver operating characteristics curve analyses, we assessed the WHtR with the highest sensitivity and specificity to discriminate adolescents with increased fasting plasma glucose, HOMA-IR, serum high-sensitivity C-reactive protein, and blood pressure from those with “normal” values. Results: The WHtR cutoff points derived from the receiver operating characteristics curves ranged from 0.40 to 0.41, with best diagnostic value at 0.41. A WHtR of 0.40 had 80% sensitivity and 38.5% specificity to classify adolescents with fasting blood glucose level higher than 5.6 mmol/L (area under the curve [AUC] 0.57). A WHtR of 0.41 had 64% sensitivity and 58.5% specificity for a HOMAIR higher than 3.4 (AUC 0.66), 55% sensitivity and 55.6% specificity for a high-sensitivity C-reactive protein level higher than 1 mg/L (AUC 0.57), and 64% sensitivity and 50.2% specificity for a blood pressure higher than the age-, sex-, and height-specific 90th percentiles (AUC 0.56). Adolescents with a WHtR higher than 0.41 had an odds ratio of 2.46 (95% confidence interval 0.96–6.30) for having a HOMA-IR higher than 3.4. Conclusion: The WHtR cutoff to indicate metabolic risk for black South African adolescents is 0.41, which is lower than the proposed international cutoff of 0.5. The WHtR can be used for screening adolescents with components of the m

This study aimed to explore the psychosocial health profiles of people with and without HIV before they learned their infection status. A total of 1,025 participants (males = 386, females = 639, age range = between 32 and 87, infected = 153) completed questionnaires on psychosocial well-being and were tested for HIV. Participants who were infected with HIV had a lower sense of coherence and a lower capacity to succeed in joint community activities than the participants infected with HIV. Some differences were detected between rural and urban areas. It is concluded that mental health and quality of life may be compromised in some ways even before HIV status is known and overt symptoms of infection noticed. Proactive interventions on community level to promote mental health and prevent problems are suggested focusing amongst others on coping skills, relationship building, and finding meaning and engagement in community activities.

The aim of this study was to determine the effect of leisure time physical activity participation (LTPA) on South African women presenting with some enhanced coronary heart disease (CHD) risk indicators (physical inactivity, hypertension, hypercholesterolemia, obesity and smoking). The respondents comprised 3 542 women, aged between 30 and 65 years (41.6 12.8 years) suffering from one or more of the primary risk factors for CHD. The cut-off points for the primary CHD risk factors considered were the following: systolic blood pressure > 140 mmHg, diastolic blood pressure > 90 mmHg, total cholesterol > 5.2 mmol.L-1, obesity (BMI > 30) and cigarette smoking. The following physical activity categories were selected viz: high physically active (> 2 000 kcal week-¹), moderate physically active (1 000 – 2 000 kcal week-¹) and low physically active (< 1 000 kcal week-¹). Data were collected by means of demographic and physical activity questionnaires as well as field tests, and assessing total cholesterol, blood pressure and obesity. The respondents were selected from two age groups (30-49 and 50-65 year) representing primarily the pre- and postmenopausal phases of female life. Leisure time physical activity participation does not alter the selected primary coronary heart disease risk factors in the pre- and post-menopausal women significantly. Physically inactive women, however, tend to present more health risks than those participants in the moderately and high physical activity group. The prevalence of health risks increases with age inspite of participation in LTPA. The number of health risk indicators can be reduced by increasing LTPA, thus contributing to the management of the women‘s general health. Women should be encouraged to take responsibility for managing their own health by engaging in a healthy lifestyle in order to manage their health risks properly. This may require a multidisciplinary approach.

A sample of 41 male student rugby players (mean age: 21.87 ± 1.39 years) completed the Recovery-Stress Questionnaire (Kellmann & Kallus, 2001), Athlete Burnout Questionnaire (Raedeke & Smith, 2001) and Stellenbosch Mood Scale (Terry et al., 2003) repeatedly over a five-month period. Independent t-tests, oneway analysis of variance and effect sizes were used to indicate significant differences between groups (categorised according to playing position, experience level and starting status). The group of forwards were shown to have significantly (d ≈ 0.5) better results than the backline players for 12 of the 39 tested variables. The group of less experienced players had significantly less General and Sport-specific Stress and negative Mood State scores than their very experienced and novice counterparts, whilst the novice players showed greater General and Sport-specific Recovery scores. Differences in starting status were also observed as the reserve players were shown to have significantly higher General and Sport-specific Recovery scores and better Mood State scores than the regular starters. These results suggest that playing position, experience level and starting status should be considered in player management strategies and during the psycho-social monitoring of players aimed at reducing the onset and development of overtraining and burnout

The objective of this study was to compile a profile of some selected health risk indicators (hypertension, hypercholesterolemia, obesity, smoking and physical inactivity) of South African women, aged 30-65 years (x = 41.6 ± 12.8 years) which can be influenced by lifestyle. The respondents comprised 3 818 women who were members of a comprehensive national health insurance in South Africa. Data were collected by means of a demographic questionnaire (including smoking habits), a physical activity questionnaire as well as field tests assessing non-fasting total cholesterol, blood pressure and obesity (BMI). The respondents were selected in two age groups (< 49 and > 50 year) primarily representing the pre and postmenopausal life stages of women. From the descriptive data it appears that the younger group (< 49) tends to be physically less active than the older group (> 50). In all the other parameters the older group revealed higher mean values. However, none of these differences are of practical significance. When a profile is constructed, results indicate that a higher percentage of the younger group fall into the poor category suggesting a more destructive lifestyle in this category. The only exception is smoking where the older group indicated that 5.2% and 9.3% are in the poor and moderate category in comparison with the 2.4% and 11.5% of the younger group respectively

Little is known about ethnic differences in developing countries such as South Africa, particularly with regard to prevalence of postural deviations and body composition profiles. The aim of this study is to compare the prevalence rate for postural deviations and body composition status among two racial groups in South Africa. The sample (n = 216) consisted of 89 African girls and 127 Caucasian girls. Anthropometric (BMI and percentage body fat) and body posture measurements were performed. A posture grid and the New York Posture test were used for all postural assessments. Independent t-tests and effect sizes demonstrated that in the 11 and 13 year old group the Caucasian group had a significantly higher (p<0.05) BMI and percentage body fat than the African group. There were no statistical and practical significant differences in prevalence rate between age groups. The African group had higher prevalence rates in most of the deviations, with winged scapulae, kyphosis, protruding abdomen and lordosis demonstrating a statistical significance (p<0.05) and practical significance (large effect) with regard to the Caucasian group. The higher prevalence rate for uneven shoulders in the Caucasian group was statistically significant (p<0.05) and also visible (medium effect) with regard to the African group. The higher prevalence rate for pronated feet in the African group was statistically significant (p<0.05), and also visible (medium effect) with regard to the Caucasian group. The prevalence rate was high in both groups and the lack of awareness and the results of this study should support the development of more responsible educational and screening programmes in both rural and urban school environments. The identification of postural deviations is important for prevention, to encourage a healthier posture for children and to prevent resulting painful syndromes.