State of the Art on Family and Community Health Nursing International Theories, Models and Frameworks: A Scoping Review

A Family and Community Health Nursing (FCHN) model was first conceptualized by the WHO approximately 25 years ago in response to the epidemiological transition leading to major changes in the population health needs. To date, no study has comprehensively explored the adherence of current applications of FCHN to the WHO original framework. We carried out a scoping review on PubMed, Scopus and CINAHL with the aim to compare the main features of FCHN models developed at the international level with the WHO's framework. We identified 23 studies: 12 models, six service/program descriptions, four statements and one theoretical model. The FCHN models appear to focus primarily on sick individuals and their family, mainly providing direct care and relying on Interaction, Developmental and Systems Theories. While these features fit the WHO framework, others elements of the original model are poorly represented: the involvement of FCHN in prevention activities is scarce, especially in primary and secondary prevention, and little attention is paid to the health needs of the whole population. In conclusion, current applications of FCHN show a partial adherence to the WHO framework: population approaches should be strengthened in current FCHN models, with a stronger involvement of nurses in primary and secondary prevention.

Changing the current health system's vision for disease prevention and health promotion

AIM

Using the case of Israel, we examine the confluence of current philosophies of health care along with the historical trends of health promotion/disease prevention services to consider strategies for increasing inclusiveness and for updating and improving their service delivery.

BACKGROUND

Health services in Israel are at a crossroads. Plans to integrate the historic, nurse-operated, nationwide programme, providing health promotion/disease prevention services to pregnant women and young children for all residents (Tipat Halav) into the National Health Service System's existing Sickness Funds are under discussion.

SOURCES OF EVIDENCE

Using a discourse approach, this paper examines the current and historical context of health promotion/disease prevention services. Our history shows an increasingly treatment-based perspective and dwindling support for inclusive services. In the current health system, Tipat Halav nurses solely provide inclusive health promotion/disease prevention services to pregnant women and young children. Informed by the World Health Organization, a reorientation to health promotion/disease prevention is essential in an ageing society where chronic rather than infectious diseases are the reigning health problems.

CONCLUSION

Israel needs to reorganize the health system using a public health approach that both incorporates existing structures and establishes new ones, such as creating a network to elicit community input, and instituting nurse-operated clinics designed to provide health promotion/disease prevention services for all ages and all residents.

IMPLICATIONS FOR HEALTH AND NURSING POLICY

The newly created health system framework demands activism among all health professionals to legislate for an inclusive, holistic orientation. Master's level clinical programmes in community health nursing are vital to ensure the provision of optimal health promotion/disease prevention services.