Nursing perception and work effectiveness evaluation relating to a novel nursing role in the Italian scenario: the family nurse The Italian family nurse
Main Article Content
Keywords
Family, Nurse, Nursing, Perception, Work Effectiveness
Abstract
The present study aims to understand the Italian nurses’ perceptions on this new figure-role, specifically to understand the effectiveness level nurses attribute to this novel professional figure. Furthermore, perceptions are differentiated according to some socio-demographic variables considered in the interviewed nurses, as: gender, age, years of work experience and nursing education level. The questionnaire was administered online and was made up of two sections: the first section referred to some socio-demographic characteristics and the second part included the Work Effectiveness questionnaire, which contained a total of 19 items divided into 6 sub dimensions, as: access to opportunity, to information, to support, to resources, to informal and formal power. The results obtained showed a mild level in perception on work effectiveness in all the six sub dimensions considered, as: access to opportunity, access to information, access to support, access to resources, access to informal and formal power, respectively. By considering all the work effectiveness sub dimensions differentiating by socio-demographic variables, it was highlighted that nurses who reported higher educational level in nursing registered also higher perception in family nursing role in the access to opportunity (p=.001), to information (p=.001), to support (p=.024) and to resources (p=.002), respectively. While no socio-demographic variable was considered determinant in the access to formal power sub dimension and as regards the access to informal power females reported significantly higher levels than males (p=.025), respectively. Nurses referred their clinical positive results to the intensive educational chances to acquire and implement knowledge which were established to improve nursing development for family nurses by being in a role that kept professional development and success.
References
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38. Groenewegen P, Heinemann S, Gress S, et al. Primary care practice composition in 34 countries. Health Policy 2015; 119(12): 1576-83.
39. Laurant M, Harmsen M, Wollersheim H, et al. The impact of nonphysician clinicians: do they improve the quality and cost-effectiveness of health care services? Medical Care Research and Review: MCRR 2009; 66(6): 36S-89S.
40. Poghosyan L, Lucero R, Rauch L, et al. Nurse practitioner workforce: a substantial supply of primary care providers. Nursing Economics 2012; 30(5): 268-94.
41. Martínez-González NA, Rosemann T, Djalali S, et al. Task-shifting from physicians to nurses in primary care and its impact on resource utilization: a systematic review and meta-analysis of randomized controlled trials. Medical Care Research and Review 2015; 72(4): 395-418.
42. Martínez-González NA, Rosemann T, Tandjung R, et al. The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review. Swiss Medical Weekly 2015; 145: w14031.
43. Martínez-González NA, Tandjung R, Djalali S, et al. Effects of physician-nurse substitution on clinical parameters: a systematic review and meta-analysis. PLoS One 2014; 9(2): e89181.
44. Martínez-González NA, Tandjung R, Djalali S, et al. The impact of physician-nurse task shifting in primary care on the course of disease: a systematic review. Human Resources for Health 2015;13(1): 55.
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47. Campbell JL, Fletcher E, Britten N, et al. Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster randomized controlled trial and cost-consequence analysis. The Lancet 2014; 384: 1859-68.
48. Dierick-van Daele AT, Metsemakers JF, Derckx EW, et al. Nurse practitioners substituting for general practitioners: randomized controlled trial. Journal of Advanced Nursing 2009; 65(2): 391-401.
49. Shum C, Humphreys A, Wheeler D, et al. Nurse management of patients with minor illnesses in general practice: multicenter randomized controlled trial. BMJ 2000; 320:1038-43.
50. Venning P, Durie A, Roland M, et al. Randomized controlled trail comparing cost effectiveness of general practitioners and nurse practitioners in primary care. BMJ 2000; 320: 1048-53.
51. Lattimer V, George S, Thompson F, et al. (the South Wiltshire Out of Hours Project (SWOOP) Group). Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial. BMJ 1998; 317: 1054-9.
52. Chambers LW, West AE. St John’s randomized trial of the family practice nurse: health outcomes of patients. International Journal of Epidemiology 1978; 7(2): 153-61.
53. Hemani A, Rastegar DA, Hill C, et al. A comparison of resource utilization in nurse practitioners and physicians. Effective Clinical Practice 1999; 2(6): 258-65.
54. Mundinger MO, Kane Rl, Lenz ER, et al. Primary care outcomes in patients treated by nurse practitioners or physicians. A randomized trial. JAMA 2000; 283(1): 59-68.
55. Chan D, Harris S, Roderick P, et al. A randomised controlled trial of structured nurse-led outpatient clinic follow-up for dyspeptic patients after direct access gastroscopy. BMC Gastroenterology 2009; 9:12.
56. Houweling ST, Kleefstra N, van Hateren KJJ, et al. Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial. Journal of Clinical Nursing 2011; 20:1264–72.
57. Larsson I, Fridlund B, Arvidsson B, et al. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. Journal of Advanced Nursing 2013; 70(1):164–75.
58. Lewis CE, Resnik BA. Nurse clinics and progressive ambulatory patient care. New England Journal of Medicine 1967; 277: 1236-41.
59. Moher M, Yudkin P, Wright L, et al. for the Assessment of Implementation Strategies (ASSIST) Trial Collaborative Group. Cluster randomised controlled trial to compare three methods of promoting secondary prevention of coronary heart disease in primary care. BMJ 2001; 322: 1338-42.
60. Ndosi M, Lewis M, Hale C, et al. The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial. Annals of the Rheumatic Diseases 2014; 73: 1975-82.
61. Sanne I, Orrell C, Fox MP, et al. CIPRA-SA Study Team. Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. The Lancet 2010; 376(9734): 33-40.
62. Henderson Betkus M, MacLeod MLP. Retaining public health nurses in rural British Columbia. Can J Public Health. 2004; 95(1):54–8.
63. Yeager VA, Wisniewski JM. Factors that influence the recruitment and retention of nurses in public health agencies. Public Health Rep Wash DC 1974. 2017;132(5): 556–62.
64. Curtis EA, Glacken M. Job satisfaction among public health nurses: A national survey. J Nurs Manag. 2014; 22(5): 653–63.
65. World Health Organization. Nursing and midwifery 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery Accessed on 20 November 2021
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2. Castaldi S, Luconi E, Rivieccio BA, Boracchi P, et al. Are Epidemiological Estimates Able to Describe the Ability of Health Systems to Cope with COVID-19 Epidemic? Risk management and healthcare policy 2021; 14: 2221–2229.
3. Vitale E, Galatola V, Mea R. Exploring within and between gender differences in burnout levels in Italian nurses engaged in the Covid-19 health emergency: a cohort observational study. Minerva Psychiatry 2020; 61(4): 162-70.
4. Van Loenen T, Van den Berg MJ, Westert GP, et al. Organizational aspects of primary care related to avoidable hospitalization: A systematic review. Fam Pract. 2014; 31(5): 502–16.
5. Hildebrandt H, Hermann C, Knittel R, et al. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract. International Journal of Integrated Care 2010; 10(2).
6. Maresova P, Javanmardi E, Barakovic S, et al. Consequences of chronic diseases and other limitations associated with old age - a scoping review. BMC public health 2019; 19(1): 1431.
7. Petrelli F, Cangelosi G, Nittari G, et al. Chronic Care Model in Italy: A narrative review of the literature. Primary Health Care Research & Development 2021; 22: E32.
8. Mattioli B, Bucciardini R, Falzano L, et al. A health equity focused National Prevention Plan 2020-2025 and related capacity building (CCM, 201), European Journal of Public Health 2020; 30(5): 165-172.
9. Coster S, Watkins M, Norman IJ. What is the impact of professional nursing on patients’ outcomes globally? An overview of research evidence. Int J Nurs Stud. 2018; 78:76–83.
10. Ellner AL, Phillips RS. The Coming Primary Care Revolution. Journal of general internal medicine 2017; 32(4): 380–386.
11. Contrera KJ, Wallhagen MI, Mamo SK, et al. Hearing Loss Health Care for Older Adults. Journal of the American Board of Family Medicine: JABFM 2016; 29(3): 394–403.
12. Bogardus ST Jr, Yueh B, Shekelle PG. Screening and management of adult hearing loss in primary care: clinical applications. JAMA 2003; 289(15): 1986–1990.
13. Cohen SM, Labadie RF, Haynes DS. Primary care approach to hearing loss: the hidden disability. Ear, nose, & throat journal 2005; 84(1): 26–44.
14. Health Quality Ontario. Specialized nursing practice for chronic disease management in the primary care setting: an evidence-based analysis. Ont Health Technol Assess Ser. 2013;13(10):1–66.
15. Kraef C, Kallestrup P, After the Astana declaration: is comprehensive primary health care set for success this time? BMJ Global Health 2019; 4: e001871.
16. Okoro C. Primary Health Care in London: onwards from Alma Ata. London journal of primary care 2008; 1(2): 61–65.
17. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. The Milbank quarterly 2005; 83(3): 457–502.
18. Starfield B. Is primary care essential? Lancet. 1994; 344(8930): 1129-33.
19. Bagnasco A, Zanini M, Pozzi F, et al. Uno studio europeo e-Delphi per identificare le competenze fondamentali per la definizione del percorso formativo dell’Infermiere di famiglia e di comunità. L’Infermiere 2020; 5.
20. Freund T, Everett C, Griffiths P, et al. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?. International journal of nursing studies 2015; 52(3): 727–743.
21. Community health nursing. Report of a WHO Expert Committee. World Health Organization technical report series 1974; (558): 1–28.
22. McGinnis JM, Stuckhardt L, Saunders R, et al. (Eds.) Best care at lower cost: the path to continuously learning health care in America, 2013.
23. O'Connor AM, Bennett C, Stacey D, et al. Do patient decision aids meet effectiveness criteria of the international patient decision aid standards collaboration? A systematic review and meta-analysis. Medical decision making: an international journal of the Society for Medical Decision Making 2007; 27(5): 554–574.
24. Krajic K (Ed.). Pathways to a Health Promoting Hospital: Experiences from the European Pilot Hospital Project 1993-1997. Health Promotion Publications, 1998.
25. Zimansky M, Stasielowicz L, Franke I, et al. Effects of Implementing a Brief Family Nursing Intervention With Hospitalized Oncology Patients and Their Families in Germany: A Quasi-Experimental Study. Journal of family nursing 2020; 26(4): 346–357.
26. Institute of Medicine (US) Committee on the Health Professions Education Summit; Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US). Chapter 3, The Core Competencies Needed for Health Care Professionals, 2003.
27. Burl JB, Bonner A, Rao M, et al. Geriatric nurse practitioners in long-term care: demonstration of effectiveness in managed care. Journal of the American Geriatrics Society 1998; 46(4): 506–510.
28. Wholey DR, Burns LR, Lavizzo-Mourey R. Managed care and the delivery of primary care to the elderly and the chronically ill. Health services research, 33(2 Pt Ii) 1998; 322–353.
29. Karam M, Chouinard M-C, Poitras M-E, et al. Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review. International Journal of Integrated Care 2021; 21(1): 16.
30. Boyd CM, Shadmi E, Conwell LJ, et al. A pilot test of the effect of guided care on the quality of primary care experiences for multimorbid older adults. Journal of General Internal Medicine 2009; 23(5): 536–42.
31. Manuli A, Maggio MG, De Cola M, et al. Towards improving primary care: Considerations on a Sicilian population-based survey. Journal of family medicine and primary care 2019; 8(11): 3647–3652.
32. Wafa’a F, Al-Hammouri MM, Rababah JA, et al. Reliability and validation of the Arabic version of the Conditions for Workplace Effectiveness Questionnaire-II. International journal of nursing sciences 2021; 8(2): 215-220.
33. Freund T, Everett C, GriKiths P, et al. Skill mix, roles and remuneration in the primary care workforce: who are the healthcare professionals in the primary care teams across the world?. International Journal of Nursing 2015; 52: 727-43.
34. Roland M, Nolte E. The future shape of primary care. British Journal of General Practice 2014; 64(619): 63-4.
35. Kooienga SA, Carryer JB. Globalization and advancing primary health care nurse practitioner practice. Journal of Nurse Practitioner 2015; 11(8):804-11.
36. Maier CB, Barnes H, Aiken LH, et al. Descriptive, crosscountry analysis of the nurse practitioner workforce in six countries: size, growth, physician substitution potential. BMJ Open 2016; 6 (9): e011901.
37. NHS England. General Practice Forward View, 2016. Available from: https://www.england.nhs.uk/wp-content/uploads/2016/04/gpfv.pdf Accessed on 20 November 2021.
38. Groenewegen P, Heinemann S, Gress S, et al. Primary care practice composition in 34 countries. Health Policy 2015; 119(12): 1576-83.
39. Laurant M, Harmsen M, Wollersheim H, et al. The impact of nonphysician clinicians: do they improve the quality and cost-effectiveness of health care services? Medical Care Research and Review: MCRR 2009; 66(6): 36S-89S.
40. Poghosyan L, Lucero R, Rauch L, et al. Nurse practitioner workforce: a substantial supply of primary care providers. Nursing Economics 2012; 30(5): 268-94.
41. Martínez-González NA, Rosemann T, Djalali S, et al. Task-shifting from physicians to nurses in primary care and its impact on resource utilization: a systematic review and meta-analysis of randomized controlled trials. Medical Care Research and Review 2015; 72(4): 395-418.
42. Martínez-González NA, Rosemann T, Tandjung R, et al. The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review. Swiss Medical Weekly 2015; 145: w14031.
43. Martínez-González NA, Tandjung R, Djalali S, et al. Effects of physician-nurse substitution on clinical parameters: a systematic review and meta-analysis. PLoS One 2014; 9(2): e89181.
44. Martínez-González NA, Tandjung R, Djalali S, et al. The impact of physician-nurse task shifting in primary care on the course of disease: a systematic review. Human Resources for Health 2015;13(1): 55.
45. World Health Organization. WHO recommendations: optimizing health worker roles to improve access to key maternal and newborn health interventions through task shifting - OPTIMIZEMNH. Geneva: World Health Organization, 2012.
46. Voogdt-Pruis H, Beusmans G, Gorgels A, et al. Adherence to a guideline on cardiovascular prevention: a comparison between general practitioners and practice nurses. International Journal of Nursing Studies 2010; 48(7), 798-807.
47. Campbell JL, Fletcher E, Britten N, et al. Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster randomized controlled trial and cost-consequence analysis. The Lancet 2014; 384: 1859-68.
48. Dierick-van Daele AT, Metsemakers JF, Derckx EW, et al. Nurse practitioners substituting for general practitioners: randomized controlled trial. Journal of Advanced Nursing 2009; 65(2): 391-401.
49. Shum C, Humphreys A, Wheeler D, et al. Nurse management of patients with minor illnesses in general practice: multicenter randomized controlled trial. BMJ 2000; 320:1038-43.
50. Venning P, Durie A, Roland M, et al. Randomized controlled trail comparing cost effectiveness of general practitioners and nurse practitioners in primary care. BMJ 2000; 320: 1048-53.
51. Lattimer V, George S, Thompson F, et al. (the South Wiltshire Out of Hours Project (SWOOP) Group). Safety and effectiveness of nurse telephone consultation in out of hours primary care: randomised controlled trial. BMJ 1998; 317: 1054-9.
52. Chambers LW, West AE. St John’s randomized trial of the family practice nurse: health outcomes of patients. International Journal of Epidemiology 1978; 7(2): 153-61.
53. Hemani A, Rastegar DA, Hill C, et al. A comparison of resource utilization in nurse practitioners and physicians. Effective Clinical Practice 1999; 2(6): 258-65.
54. Mundinger MO, Kane Rl, Lenz ER, et al. Primary care outcomes in patients treated by nurse practitioners or physicians. A randomized trial. JAMA 2000; 283(1): 59-68.
55. Chan D, Harris S, Roderick P, et al. A randomised controlled trial of structured nurse-led outpatient clinic follow-up for dyspeptic patients after direct access gastroscopy. BMC Gastroenterology 2009; 9:12.
56. Houweling ST, Kleefstra N, van Hateren KJJ, et al. Can diabetes management be safely transferred to practice nurses in a primary care setting? A randomised controlled trial. Journal of Clinical Nursing 2011; 20:1264–72.
57. Larsson I, Fridlund B, Arvidsson B, et al. Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. Journal of Advanced Nursing 2013; 70(1):164–75.
58. Lewis CE, Resnik BA. Nurse clinics and progressive ambulatory patient care. New England Journal of Medicine 1967; 277: 1236-41.
59. Moher M, Yudkin P, Wright L, et al. for the Assessment of Implementation Strategies (ASSIST) Trial Collaborative Group. Cluster randomised controlled trial to compare three methods of promoting secondary prevention of coronary heart disease in primary care. BMJ 2001; 322: 1338-42.
60. Ndosi M, Lewis M, Hale C, et al. The outcome and cost-effectiveness of nurse-led care in people with rheumatoid arthritis: a multicentre randomised controlled trial. Annals of the Rheumatic Diseases 2014; 73: 1975-82.
61. Sanne I, Orrell C, Fox MP, et al. CIPRA-SA Study Team. Nurse versus doctor management of HIV-infected patients receiving antiretroviral therapy (CIPRA-SA): a randomised non-inferiority trial. The Lancet 2010; 376(9734): 33-40.
62. Henderson Betkus M, MacLeod MLP. Retaining public health nurses in rural British Columbia. Can J Public Health. 2004; 95(1):54–8.
63. Yeager VA, Wisniewski JM. Factors that influence the recruitment and retention of nurses in public health agencies. Public Health Rep Wash DC 1974. 2017;132(5): 556–62.
64. Curtis EA, Glacken M. Job satisfaction among public health nurses: A national survey. J Nurs Manag. 2014; 22(5): 653–63.
65. World Health Organization. Nursing and midwifery 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery Accessed on 20 November 2021
66. Canadian Public Health Association, Community Health Nurses Association of Canada. Public health-community health nursing practice in Canada: roles and activities. Ottawa: Canadian Public Health Association 2010.
67. Armstrong-Stassen M, Cameron SJ. Concerns, satisfaction, and retention of Canadian community health nurses. J Community Health Nurs. 2005; 22(4): 181–94.
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Vitale E. Nursing perception and work effectiveness evaluation relating to a novel nursing role in the Italian scenario: the family nurse: The Italian family nurse. Med Histor [Internet]. 2023 Dec. 20 [cited 2024 Jul. 18];7(3):e2023047. Available from: https://mattioli1885journals.com/index.php/MedHistor/article/view/12776
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How to Cite
1.
Vitale E. Nursing perception and work effectiveness evaluation relating to a novel nursing role in the Italian scenario: the family nurse: The Italian family nurse. Med Histor [Internet]. 2023 Dec. 20 [cited 2024 Jul. 18];7(3):e2023047. Available from: https://mattioli1885journals.com/index.php/MedHistor/article/view/12776