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.

The State of the Evidence about the Family and Community Nurse: A Systematic Review

Introduction. The increase in chronic degenerative diseases poses many challenges to the efficacy and sustainability of healthcare systems, establishing the family and community nurse (FCN) who delivers primary care as a strategic role. FCNs, indeed, can embrace the complexity of the current healthcare demand, sustain the ageing of the population, and focus on illness prevention and health promotion, ensuring a continuous and coordinated integration between hospitals and primary care ser. The literature on FCNs is rich but diverse. This study aimed to critically summarise the literature about the FCN, providing an overall view of the recent evidence. Methods. A state-of-art systematic review was performed on PubMed, CINAHL, and Scopus, employing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist to guide the search and reporting. Results. Five interpretative themes emerged from the 90 included articles: clinical practice, core competencies, outcomes, Organisational and educational models, and advanced training program. Conclusions. FCNs can make a major contribution to a population’s health, playing a key role in understanding and responding to patients’ needs. Even if the investment in prevention does not guarantee immediate required strategies and foresight on the part of decisionmakers, it is imperative to invest more political, institutional, and economic resources to support and ensure the FCNs’ competencies and their professional autonomy.

Expectations of family nurses among residents of a midsize eastern European city: A population-based cohort study in Poland

To improve the quality of care, patients' needs and expectations must be understood, and this can be achieved through learning their attitudes and expectations connected with using health services. The main aim of this study was to describe and analyse Białystok residents' expectations of family nurses. This cohort study was carried out in association with the ongoing project "Bialystok PLUS" in Poland. The respondents (n = 412) were administered a multiple-choice questionnaire concerning family nurses and the responses were analysed in association with the respondents' socio-demographic data and health self-evaluation results. Data were collected between September 2017 and September 2019. Our research found that the respondents' socioeconomic status was associated with their expectations concerning the use of prevention services offered by family nurses. A statistically significant association was found between marital status and knowledge of their family nurses. The demand for medical counselling from family nurses (concerning diet, coping with stress, physical activity) was significantly negatively correlated with age, with younger persons expecting that service more often than older persons. A significant association was also observed between respondents' age group and their opinions concerning the need for home visits by family nurses. The respondents who expected home visits by family nurses declared lower self-evaluated health compared to the other respondents. Findings suggest that services by family nurses should include an assessment of each patient's situation, including their health self-evaluation and socioeconomic status. The fact that younger persons expect family nurses to provide counselling on health matters obliges nurses to learn how to provide health information tailored to patient needs.

Perspectives of older patients on the qualities which define a "good family nurse": A qualitative study

Aim

To explore what the term "good family nurse" means to older patients.

Design

A descriptive qualitative study design was used, and a purposive sampling method was adopted.

Methods

Semi-structured interviews were conducted with 21 patients aged 65 years and older who were receiving primary care in Bialystok (Poland). The interviews were recorded and then transcribed in verbatim. The data were analysed using content analysis. Data were collected between February 2017 and December 2018.

Results

We identified six main categories of qualities that define a "good family nurse". These are as follows: (a) personal traits and attributes (sex and individual characteristics and behaviours not directly related to nursing); (b) providing care (caring attitude and patient support); (c) communicating with the patient (the ability to listen and inform the patient); (d) professional competence (knowledge, professional experience and good technical skills); (e) ethical attitude (respect, patience and vocation); and (f) availability (the frequency and duration of home visits, organization of the doctor's appointments).

Attitudes of medical doctors and nurses towards the role of the nurses in the primary care unit in Italy

AimAim of the present study was to assess the knowledge of the potential role of nurses in the primary care setting and to analyse the attitudes towards their utilization by nurses and General Practitioners (GPs) in a region of Italy.

BACKGROUND

Nowadays, in Italy, the role of the nurse in primary care is still under-recognized and most primary care medical offices are managed individually by a physician.

METHODS

The study consists of a questionnaire-based cross-sectional survey carried out in Piedmont, Italy, between February and September 2015.FindingsWe included 105 participants, 57 nurses and 48 physicians. The presence of a nurse working together with the GP was defined as 'useful' by 54.4% of nurses (versus 60.4% of physicians), as 'essential' by 45.6% of nurses (versus 25.0% of physicians), as 'marginal' by no nurses (versus 14.6% of physicians) and as 'unimportant' by none (P=0.002). Thus, physicians seemed to be less favorable towards a full collaboration and power-sharing with nurses. Furthermore, GPs and nurses showed a different attitude towards the role of nurses in primary care: while nurses highlighted their clinical value, physicians tended rather to recognize them a 'supportive' role. Moreover, only 20.8% of the physicians interviewed stated that they worked with a nurse. At the multivariate analysis, the age class resulted to be a significant predictor of the perception that the presence of a nurse working with the GP is essential: participants >50 years had an OR of 0.03 (P=0.028). Although the primary care organization appears still largely based on a traditional physician-centric care model, the positive attitude of nurses and young GPs towards a more collaborative model of primary care might represent a promising starting point.

Predictors of caregiver burden in Iranian family caregivers of cancer patients

BACKGROUND

Caregiver burden threatens the psychological, emotional, functional and even physical health of caregivers. The aims of this study were to determine caregiver burden and family distress and the relationship between them, also to explore predictors of caregiver burden in a sample of Iranian family caregivers of cancer patients.

MATERIALS AND METHODS

This is a cross-sectional study with correlational design. A total of 104 family caregivers of cancer patients were asked to respond to the Caregiver Burden Inventory (CBI) and the Family Distress Index (FDI) together with a sociodemographic questionnaire. For evaluating the relationship between CBI and FDI scores, the Pearson's product-moment correlation was used. In addition, multiple linear regression analysis was applied to explore the predictive factors of caregiver burden.

RESULTS

A high burden was experienced by almost half of the caregivers (48.1%). The FDI mean score was 9.76 ± 5.40 ranged from 0 to 24. A strong positive correlation was found between the caregiver burden and family distress (r = 0.76). Multiple linear regression results showed the predictive role of FDI score (β = 0.71, P = 0.001), patient's gender (β = -0.25, P = 0.001), and early cancer diagnosis (β =0.13, P = 0.027) in caregiver burden. They could explain 65% of variance in the level of burden in family caregivers.

CONCLUSION

Family nurses should consider the caregivers burden and vulnerability of families with cancer patient, especially if the patient is a male or has a new diagnosis. They should also design special programs for the whole family as a system that family can adapt to the new situation.