Role and function of public health nurses in Taiwan: review of current status and future perspectives

Abstract

Public health nursing is a core practice of primary health care. Public health nurses (PHNs) in Taiwan act both as individual/family-based primary care providers and as population-based community care providers. Previous studies in Western countries have shown the role preference of PHNs to be highly influenced by the structure of the healthcare system, policies and major programs, and health insurance reimbursement mechanisms. Thus, the impact of the health transition and related changes in the abovementioned systems should be taken into consideration when adjusting the roles and functions of PHNs. The rising prevalence of chronic diseases and the multiple burdens caused by diseases is making healthcare delivery increasingly complicated. With PHNs no longer able to provide "catch-all" services due to manpower shortages, several potential specialty areas have opened up to participation and development by community nursing. These include psychiatric care, long-term care and palliative care, school/workplace health promotion, and disease management in hospitals. It will be essential that community nurses bridge the gap in service left by PHNs so that PHNs may refocus their job role on the health needs of the community as a whole. PHNs should continue to build partnerships with primary care settings and perform the key functions of demonstration, support, collaboration, service, and surveillance in the community.