The influence of the practice environment on community service nurses' subjective well-being and compassion fatigue

Abstract

Background: International and national research has established that a positive practice environment is associated with better nurse, patient and organisational outcomes. Although similar findings have been identified among new graduate nurses internationally, the practice environment of the community service nurses (CSNs) in South Africa has not been explored before. It is also well established that psychological capital (PsyCap) is correlated with positive nurse outcomes, also among new graduate nurses, and research conducted outside of the nursing discipline has shown that PsyCap predicts personal accomplishment and subjective well-being, and moderates negative outcomes. However, the influence of the practice environment on subjective well-being (SWB) and compassion fatigue has not been explored in the nursing discipline, and neither has the mediating effect of PsyCap among these variables. Aim: To test a model on the relationship between the practice environment and SWB, compassion fatigue and PsyCap, and the mediating effect of PsyCap among these variables. Method: This study applied a cross-sectional survey design. An all-inclusive sampling was applied to the population (N=284; n=60) that included all CSNs who completed a comprehensive nursing program and studied in any of the four higher education institutions in the North West province, and commenced their community service year in 2016. Demographics and the results of scales were presented with descriptive statistics. The reliability of the instruments was established by Cronbach's alpha, and validity through confirmatory factor analysis. The hypotheses of the study, and the relationships between demographics and the study variables were tested utilizing inferential statistics. The model was tested using structural equation modelling (SEM). Results: A response rate of 21% was obtained. Results showed that CSNs experience the practice environment as favourable except for staffing and resource adequacy. Their perspectives of the practice environment were however significantly influenced by the presence and acceptability of an orientation program. CSNs had an average satisfaction with life, and greater levels of positive affect. Choice of placement for the community service year was significantly linked to satisfaction with life. CSNs experience compassion stress, which was linked to staffing and resource adequacy. PsyCap, specifically hope, was correlated with more positive perceptions of the practice environment, positive affect and decreased levels of compassion fatigue. However, the only paths In the model that were significant at the 10% level were those between the practice environment and PsyCap, and between PsyCap and subjective well-being, indicating that PsyCap acts as a mediator between the practice environment and subjective well-being, but not the paths between practice environment and compassion fatigue. The percentage of the total effect that is mediated is 86.6%. Conclusions: Aspects of the practice environment influence aspects of both subjective well-being and compassion fatigue in CSNs. PsyCap acts as a mediator between the practice environment and subjective well-being but not between the practice environment and compassion fatigue