This study used Walker and Avant’s approach to analyze the concept of community-based nursing. Because conceptual analysis causes the objectification of a particular concept and its operationalization, [14], expressing an experimental interpretation of community-based nursing seems more quickly applicable in hospitals, communities, and education. Many studies provide positive evidence for community-based nursing practice. [2, 17, 24, 33, 40]. As previously mentioned, based on a review of research, community-based nursing has several characteristics listed below.
Community-based nursing is characterized by a person-centered, family-centered, and community-centered orientation. We provide care to individuals, families, and groups wherever they live, work, or school. Many studies consider this characteristic to be important in community-based nursing. [3, 16, 18]. Thus, even if the individual is a client of a community-based nurse, care should be family-oriented and consider the needs of the individual and her family. Family orientation means that the nurse believes in family empowerment and plans care based on the family’s needs and decisions. This increases independence and participation for individuals and families. This type of care is necessary for the community, as most clients live at home despite their health problems. [3].
Social participation is defined as an individual’s participation in activities that interact with others within a community. The concept is also defined as a group of people working with common goals, responsibilities, and authority for the betterment of a community and includes the participation of community members, government agencies, and government agencies. As non-governmental organizations, universities, health center staff, and other stakeholders work together and pay attention to the populations they serve, many studies have identified social participation as an essential feature of community-based nursing. mentioned. [3, 9, 11, 12, 16, 18, 22,23,24, 29, 37, 40, 41, 45,46,47,48,49] The success of community-based nursing performance is highly dependent on this factor, as it is impossible to achieve goals without the involvement of individuals, families, and communities. There should also be an emphasis on community-based nurse delivery of care. personal and family values ​​and preferences; Therefore, to achieve goals and support individuals and families, they must be involved. [18]. Community participation provides an opportunity for all members of the community to actively and effectively participate in the process of development and development, and health promotion programs seek the participation of communities and stakeholders as active partners. . Therefore, the category of participation is considered one of the important features of community-based nursing. [50].
Social justice means that local people benefit fairly and equitably from needs-based health care, and this is central to community-based health promotion measures to achieve health equity, and community-based is another important characteristic of nursing. [51].
Community-based nursing requires group and interprofessional collaboration, with nurses working with a diverse team of physicians, pharmacists, specialists, and assistants. Interdisciplinary collaboration is an essential component of the community-based nurse’s role, as nurses cannot achieve their patient support goals without collaborating with other health care team members. Through multidisciplinary collaboration with local denominations, nurses provide the care patients need throughout their lives, with an emphasis on improving health status and primary rehabilitation care. [2, 10]. In fact, community nursing requires collaboration among medical, administrative, welfare, and related professionals in order to provide comprehensive support and integrated services. This requires extensive cooperation between government agencies and relevant institutions such as welfare organizations, local governments, radio and television. Many studies highlight collaboration as an important attribute of community-based nursing. [10, 12, 16, 18, 22, 24, 29, 37, 40, 45, 49, 52].
The community is considered to be the main arena for community-based nurses’ activities. A higher proportion of community-based experiences are utilized than other clinical experiences.Most studies highlight this issue [8, 9, 11, 16, 23]. Another issue is that hospitals are considered part of the community. Still, nurses perform most of their activities at the community level, providing services that match the preventive level of healthy people in their natural living environments, from hospitals to rehabilitation. [16].
Another important attribute of community-based nursing is its sensitivity to cultural diversity. Cultural diversity exists within and between countries, and nurses are morally committed to providing culturally appropriate care. To provide appropriate care to clients from different cultural and ethnic backgrounds, nurses strive to understand the other person’s perspective regarding the cultural framework. When nurses are not successful in this area, the result is inequalities in care.Considering Iran’s ethnic diversity, understanding the beliefs of clients, patients, and families, and paying attention to their needs deepens the nurse-client relationship [53]. Nurses work individually with people and families from diverse ethnic or cultural backgrounds in a way that recognizes cultural differences, respects the patient’s culture, incorporates it into the care plan, and shows cultural respect. must be communicated with.This results in mutual satisfaction between nurse and client [3, 17]. The emphasis is that community is closely tied to cultural values. Many studies consider cultural diversity to be one of the key pillars of community-based nursing. [16,17,18, 29].
Because the community is the main arena of action, the provision of nursing care that takes into account the context, situation, and needs of the community depends on local, regional, and global community conditions, demographics, epidemiological developments, and the prevalence of mental illness. The prevalence, severity of changes, burden of disease, and the importance of developing care plans accordingly have highlighted this issue in many different studies. [26, 34, 41, 49].
The philosophy of community-based nursing is to support individuals, families with health problems, and other groups wherever they live, wherever they are, throughout their lives, and wherever they are. to guide nursing care.According to this definition, community is basic nursing is not a specialty, but a philosophy that guides all nursing care. [3] mentioned in various studies [3, 54].
Community-based nurses are responsible for the health needs of their communities. Must be able to provide necessary care to individuals and families and to investigate, plan, intervene, and assess community needs. In Iran, nursing services are mainly provided in hospitals, so the activities of nurses do not meet the needs of the community, which is one of the important things mentioned in many studies. [11, 16, 18, 34, 45, 49, 55, 56]. The findings of Baqhaei et al.’s study highlight the growing need to train competent and competent nurses to meet the changing needs of communities, for example, the growing elderly population, palliative care, preventive care, and medical services. It was also shown thatAcute care is more important [57].
Community-based experience and facing real problems in local contexts are an essential part of community-based nursing. Nurses need a wide range of experience to provide care to individuals, families, and communities, from preventive care to acute care to rehabilitation.This means they need to take the time to collaborate, communicate and have direct access to population groups to improve health outcomes, and many studies have highlighted this issue. [16, 22, 23, 37, 40, 42, 58].
Using problem-based and service-based approaches to problem solving is one of the hallmarks of community-based nursing. Solving problems and dealing with real-life problems requires using such an approach, and by focusing on the situation, nurses look for different solutions. We use critical thinking and evidence to provide the best solutions to meet the needs of our clients and families. [11, 16, 49] Serving communities, especially those that lack resources. Various studies have examined and highlighted the importance of these approaches in community-based nursing. [11, 16, 49, 55].
Nurses are exposed to the situations and realities of the lives of individuals and families and therefore need to be aware of the values ​​of the communities they serve. This issue makes them aware of social and cultural issues, injustices, and other factors that affect health. [9].
Appropriate care of individuals and families in social settings requires close attention to social risks such as poverty, mental illness, unsafe housing, past or present injuries, malnutrition, transportation problems, and low literacy rates. is needed. The care team assesses these areas comprehensively and responds in collaboration with social partners and colleagues (welfare, nursing homes, etc.), following the needs of the individual, family and community over time. Community-based nursing exposes nurses to social, economic, political, cultural, and other factors that affect the health of individuals, families, and communities. It is believed that this kind of experience deepens the understanding of social issues and allows nurses to acquire skills to deal with social issues. More importantly, it provides a comprehensive and complete perspective on health and illness, as such opportunities are lost when nurses only interact with patients within the hospital setting. [2, 3, 9, 16, 18, 30, 37].
To ensure the continued provision of essential services, community-based nurses must have a clearly defined position within the healthcare infrastructure [22, 39, 59]. Their roles and responsibilities must be clearly defined and the activity settings precisely defined. Equally important, these nurses must acquire the necessary skills through expert-led training programs to enable them to provide effective services. [39, 45]. Community support is critical to achieving these goals, so it is essential that policymakers adopt a community-oriented perspective. [36].
Nurses develop their abilities by immersing themselves in various situations and solving problems in the community [33]. The positive outcome of the presence of nurses in the community creates trust in the community and increases access to medical and treatment services so that community needs are met.Increasing access to health for all helps eliminate health inequalities [10, 12, 26]. As a result, more people use this type of service and fewer hospital visits. This will save a lot of costs and, as a result, policy makers will pay attention to the needs of local communities and try to solve problems and challenges in this area. [44, 60].