Community Nurses' Perceptions of Their Role as Health Promoters in Collective Prevention: A Qualitative Study in Dutch Community Nursing Care.

Abstract

Addressing the demands of an ageing population requires a shift from individualised to collective prevention. Collective prevention adopts a socio-ecological approach, mobilising communities to improve population health. This study explores community nurses' (CNs) perceptions of their role as health promoters. A qualitative study using participatory action research was conducted among 58 CNs from 18 community nursing care teams over 3 years. Data collection included 11 focus groups, a World Café session, and participant observations. Data were analysed through iterative thematic content analysis. From the analysis, 3 themes emerged: (1) CNs understanding of prevention, (2) their views on their roles and competencies, and (3)what are the facilitating and hindering factors to implement collective prevention. CNs' understanding of prevention evolved from individual "aversion" of disease to a community-based vision centred on social connection. Four key roles for CNs were identified: detector, motivator, facilitator, and organiser. While a shared vision within teams facilitated progress, significant barriers included time pressure, productivity-based funding, and a lack of training in nursing curricula. CNs role in collective prevention is important, transitioning from task-oriented nursing care to community empowerment. However, sustainable implementation requires integrating collective prevention into national policy funding, and nursing education.