Clodig Majda, Magro Gaia, De Lucia Paola, Prezza Marisa, Dussi Gaia, Dentice Sara, Moreal Chiara, Chiappinotto Stefania, Palese Alvisa
Department of Medicine, University of Udine, 33100 Udine, Italy.
Regional Coordinating Agency for Health, 33100 Udine, Italy.
Healthcare (Basel). 2025 Apr 26;13(9):1001. doi: 10.3390/healthcare13091001.
Several Italian regions have started to introduce the Family and Community Nurse model. The aim of this study was to describe the facilitating and hindering factors that have influenced the implementation of the model by analyzing regional policies from the perspective of nurses appointed as Family and Community Nurses. : A qualitative study from 2023 to 2024 following the Standards for Reporting Qualitative Research. Nurses attending a training course were eligible (N = 68) and multi-method data collection was used. Mandatory written project works were requested at the end of the course, and interviews conducted after six months with 14 purposively selected nurses were used. The data were subjected to content analysis. The factors identified were categorized by level (nurse, microsystem, mesosystem, exosystem, and macrosystem) and by the domains of the Consolidated Framework for Implementation Research. : A total of 23 facilitating factors and 20 hindering factors were identified across all levels and four domains of the Consolidated Framework for Implementation Research. Implementation required nurses to shift from a task-oriented to a user-oriented approach to care that emphasizes accountability and citizen needs. Facilitating factors were the availability of advanced competencies, digital skills, familiarity with communities, and effective teamwork supported by leaders. Challenges arose from fragmented systems and unmet community expectations. Strengthening cross-sector collaboration, fostering trust, and engaging third sector resources were critical factors hindering holistic, patient-centred care. : The Family and Community Nurses model promotes integrated, patient-centred care through proactive approaches that require advanced competence and interprofessional collaboration. Training, leadership support, and the removal of systemic barriers are critical. Future research should focus on integrating the identified factors into strategies to optimize the implementation of the Family and Community Nurses model.
意大利的几个地区已开始引入家庭与社区护士模式。本研究的目的是通过从被任命为家庭与社区护士的护士视角分析区域政策，来描述影响该模式实施的促进因素和阻碍因素。：一项遵循定性研究报告标准的2023年至2024年的定性研究。参加培训课程的护士符合条件（N = 68），并采用了多方法数据收集。课程结束时要求提交强制性书面项目作业，并在六个月后对14名有目的挑选的护士进行了访谈。对数据进行了内容分析。所确定的因素按层次（护士、微观系统、中观系统、外部系统和宏观系统）以及实施研究综合框架的领域进行了分类。：在实施研究综合框架的所有层次和四个领域中，共确定了23个促进因素和20个阻碍因素。实施要求护士从以任务为导向的护理方法转变为以用户为导向的护理方法，强调问责制和公民需求。促进因素包括具备先进能力、数字技能、熟悉社区以及领导者支持下的有效团队合作。挑战来自碎片化的系统和未满足的社区期望。加强跨部门合作、培养信任以及利用第三部门资源是阻碍整体、以患者为中心护理的关键因素。：家庭与社区护士模式通过需要先进能力和跨专业合作的心方法促进综合、以患者为中心的护理。培训、领导支持以及消除系统障碍至关重要。未来的研究应专注于将所确定的因素纳入战略，以优化家庭与社区护士模式的实施。
