Student Research Committee, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Public Health. 2022 Jun 27;10:899211. doi: 10.3389/fpubh.2022.899211. eCollection 2022.
In recent decades, nursing has witnessed many changes in Iran. Despite the numerous advances in nursing, the health system faces many challenges in community health nursing. This study aims to review the challenges in community health nursing in Iran and provide an evidence-based solution as well.
This article is an integrated review of the literature regarding the challenges in community health nursing published between 2000 and 2021 in the databases Scopus, Medline, Cochrane Database of Systematic Reviews, Science Direct, Google Scholar, Scientific Information Database (SID). After performing searches, 20 articles were selected and studied. Data analysis was done using Russell approach (2005).
The results of this study were summarized in 6 themes consisting of challenges in community health nursing education, practical challenges in community health nursing, policy-making challenges in community health nursing, management challenges in community health nursing, and infrastructural and cultural challenges. Solutions were also proposed to address each of the above issue.
The results of the study showed that diverse challenges exist in community health nursing in Iran, considering that community health nurses play an important role in providing primary health care and community-based care. In order to solve these challenges, the authors have some recommendations: modifying the structure of the health system with the aim of moving toward a community-oriented approach from a treatment-oriented one, developing laws to support community health nurses, creating an organizational chart for nurses at the community level, modifying nursing students' training through a community-based approach, and covering community-based services and care under insurance.
近几十年来，伊朗的护理领域发生了诸多变化。尽管护理领域取得了诸多进步，但在社区卫生护理方面，卫生系统仍面临诸多挑战。本研究旨在回顾伊朗社区卫生护理面临的挑战，并提供相应的循证解决方案。
这是一篇关于 2000 年至 2021 年期间在 Scopus、Medline、Cochrane 系统评价数据库、Science Direct、Google Scholar、科学信息数据库（SID）发表的有关社区卫生护理挑战的文献综合回顾。搜索后，选择了 20 篇文章进行研究。数据分析采用 Russell 方法（2005 年）。
本研究结果总结为 6 个主题，包括社区卫生护理教育中的挑战、社区卫生护理实践中的挑战、社区卫生护理政策制定中的挑战、社区卫生护理管理中的挑战以及基础设施和文化方面的挑战。针对上述每个问题，还提出了解决方案。
研究结果表明，伊朗社区卫生护理存在多种挑战，因为社区卫生护士在提供初级卫生保健和社区为基础的护理方面发挥着重要作用。为了解决这些挑战，作者提出了一些建议：改变卫生系统的结构，旨在从以治疗为导向的方法转向以社区为导向的方法；制定支持社区卫生护士的法律；在社区层面为护士创建组织结构图；通过以社区为基础的方法修改护理学生的培训；以及将社区为基础的服务和护理纳入保险范围。
