The mediating role of social support in promoting physical activity among children in South Africa.

Background: Low physical activity (PA) participation levels and increasing non-communicable diseases in children are concerning in South Africa and globally. Objectives: We sought to assess the mediating role of perceived social support factors on the relationship between PA enjoyment and PA levels among rural, peri-urban and urban school children. Method: A cross-sectional study was adopted to assess peer, family and teacher encouragement as mediators on the relationship between perceived PA enjoyment and perceived physical activity participation among children, using the Physical Activity Questionnaire for Older Children (PAQ-C). The sample comprised a random sample of primary school learners aged 9-14 years. Results: The sample consisted of 870 primary school learners with a mean age of 11.0 ± 1.49 years. Most participants were girls (n = 519; 59.7%). The findings suggest low levels of perceived PA participation (mean = 2.33, standard deviation [s.d.]: 0.43). Peer (ß = 0.0187, 95% confidence interval [CI]: 0.0088, 0.0307), family (ß = 0.0280, 95% CI: 0.0155, 0.0425) and teacher (ß = 0.0242, 95% CI: 0.0127, 0.0378) encouragement partially mediates the relationship between perceived PA enjoyment and perceived PA participation. Family encouragement (ß = 0.0158, 95% CI: 0.0017, 0.0311) has the most considerable mediating effect, followed by teacher encouragement (ß = 0.0125, 95% CI: 0.0010, 0.0269). Conclusion: The findings demonstrated low levels of perceived PA participation in school learners. Therefore, we recommends including social factors as mediators in PA intervention programmes in primary schools. Clinical implications: Social support factors as mediators on the relationship between PA enjoyment and PA participation among children may improve children's PA participation levels and help prevent non-communicable diseases in future.

Family needs during critical illness in the Emergency Department: A retrospective factor analysis of data from three countries.

AIMS AND OBJECTIVES: To examine underlying factor structure of the Critical Care Family Needs Inventory-Emergency Department across three countries to identify similarities and differences. BACKGROUND: Understanding family needs assists nurses to provide family-centred care to deliver optimal outcomes for critically ill patients and their families in Emergency Departments. DESIGN: Retrospective secondary analyses of data collected in three cross-sectional surveys. METHODS: Convenience samples involved recruitment of family members accompanying a critically ill relative into four Emergency Departments in Australia (2), South Africa (1) and Taiwan (1). Item-matched raw data from 374 responses to 40 items from the surveys were collated and analysed using confirmatory factor analysis methods. Reporting adhered to an adapted STROBE checklist. RESULTS: The factor structure of the 40-item Critical Care Family Needs Inventory-Emergency Department differed between countries. Analyses of the Australian data revealed a four-factor solution comprised of 18 items across four categories of family need (support, communication, participation and comfort); the Taiwanese data also demonstrated a four-factor solution comprised of 13 items (support, communication, participation and comfort); alternatively, the South African data revealed a two-factor solution comprised of nine items (communication and participation). Fifteen items did not match across the countries. However, loading for four items common across all three countries was related to family participation (3) and communication (1). CONCLUSIONS: The findings suggest family members from different countries responded to Critical Care Family Needs Inventory-Emergency Department items in different ways. Consistent with concepts of family-centred care, the study identified participation and communication needs that were common across the countries. The outcomes illustrate the challenge of providing appropriate care for family members during critical illness of a relative in the ED. RELEVANCE TO CLINICAL PRACTICE: Family perceptions of important needs during critical illness in the Emergency Department differ across countries; hence, the Critical Care Family Needs Inventory-Emergency Department has limited utility. Participation and communication needs emerged as common family needs.