Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.
Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
Int Nurs Rev. 2024 Jun;71(2):309-317. doi: 10.1111/inr.12866. Epub 2023 Aug 3.
Advanced practice nurse (APN) roles bring great added value to health systems. However, their integration into the health workforce and the sustainability of the role depend on contextual factors surrounding their implementation.
To explore the contextual factors that influence the organization, implementation, and performance of clinical practice among oncology APNs in Catalonia (Spain).
This is a descriptive qualitative study. A framework of contextual factors was applied to explore the perspectives of 14 oncology APNs in public hospitals in Catalonia by means of semistructured interviews. Data were analyzed according to the thematic analysis approach. The COREQ checklist was used to report the study.
APNs in cancer care strongly depend on the hospital environment where they are introduced. Recognition by the multidisciplinary team, the existence of mentoring experiences, and networking between APNs are critical factors that can help or hinder the development and autonomy of the APNs. Likewise, support from nursing managers and directors is decisive in defining the professional profile, establishing accountability mechanisms, and securing financial resources, including economic recognition. Factors related to the external environment can also contribute, including a standardized national APN model and scientific societies.
Contextual factors around clinical practice, institutional structures, and professional networks are crucial determinants for adequately integrating APNs at the health system level.
Professional bodies and national nursing organizations should lay the groundwork for defining standards of practice and advocate for specific regulations. In addition, financial recognition and accountability mechanisms to assess the impact of their contribution should be a priority to ensure sustainability and APN satisfaction.
高级实践护士（APN）的角色为卫生系统带来了巨大的附加值。然而，他们能否融入卫生劳动力队伍以及角色的可持续性取决于实施过程中的环境因素。
探讨影响加泰罗尼亚（西班牙）肿瘤学 APN 临床实践的组织、实施和绩效的环境因素。
这是一项描述性的定性研究。应用一个环境因素框架，通过半结构化访谈，探讨了加泰罗尼亚公立医院 14 名肿瘤学 APN 的观点。根据主题分析方法对数据进行分析。使用 COREQ 清单报告研究。
癌症护理中的 APN 强烈依赖于引入他们的医院环境。多学科团队的认可、指导经验的存在以及 APN 之间的网络联系是帮助或阻碍 APN 发展和自主性的关键因素。同样，护理经理和主任的支持对于确定专业形象、建立问责机制和确保经济认可等财务资源也至关重要。外部环境因素也可能有贡献，包括标准化的国家 APN 模式和科学协会。
围绕临床实践、机构结构和专业网络的环境因素是在卫生系统层面充分整合 APN 的关键决定因素。
专业团体和国家护理组织应奠定实践标准的基础，并倡导具体的法规。此外，应优先考虑经济认可和问责机制，以评估其贡献的影响，以确保可持续性和 APN 的满意度。
