Abstract

To discuss the development of the family and community health nurse (FCHN) in Italy by focusing on three levels: organisational, political and theoretical. The role of the FCHN in Italy is not yet embedded evenly across the Italian National Health System (INHS) and does not have formal recognition, either contractually or organisationally. Although complementary post-basic training has been available for over a decade, the FCHN's role in Italy currently exists only in pilot form. In some regions, the FCHN has operated for longer, thanks to which a clearer understanding of the functions and responsibilities required by the FCHN has emerged. Proposals for professional and social policies have emerged, as the FCHN's role may be an answer to health problems and a contributor to the construction of social capital, capable of influencing both individual and collective well-being. A mixed method investigation via a parallel concurrent design to identify the organisational models for the FCHN was conducted across Italy. In this paper, two profiles are discussed - family and community health nursing and FCHN - but each with its different connotations. The former refers to the practice of nursing and the latter to the nursing practitioners working with family and the community. We describe the expected future outcomes for FCHNs as elements of social innovation for the development of a new welfare system.

Highlights

  • The new European health policy framework – Health 2020, issued by the World Health Organization (WHO) – identifies primary health care (PHC) as a cornerstone of health systems and as a key factor for addressing welfare challenges.According to the WHO European region (Büscher et al, 2009), nurses are the most important group providing health care in European communities

  • We present a brief overview of the current situation of the family and community health nursing in Italy, focusing on three levels: organisational, political and theoretical

  • We found that the family and community health nurse (FCHN) has been gradually introduced into regional PHC systems through a range of initiatives, legislative actions, deployments in local projects and experimental introductions into local healthcare agencies

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Summary

Introduction

The new European health policy framework – Health 2020, issued by the World Health Organization (WHO) – identifies primary health care (PHC) as a cornerstone of health systems and as a key factor for addressing welfare challenges.According to the WHO European region (Büscher et al, 2009), nurses are the most important group providing health care in European communities. Despite recognition of the family health nurse (FHN) as a key figure in PHC and a professional capable of making a very substantial contribution to health promotion and disease prevention, in addition to being a caregiver (WHO, 1999), PHC in Italy has traditionally been managed by physicians. This model is similar to other European countries like Germany (Kendall and Bryar, 2017). The family and community health nurse (FCHN) still lacks specific contractual or organisational recognition from the Italian health system (Marcadelli and Bertolazzi, 2017)

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