{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:17:42Z","timestamp":1788412662483,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Qualitative Nursing Research"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>In Italy, the Family and Community Nurse (FCN) was officially recognized with Legislative Decree 34\/2020 and redefined by Ministerial Decree 77\/2022. The introduction of the FCN has been inconsistent across the nation, leading to fragmented experiences and challenges in fully integrating the role into the healthcare system. Based on Cohen\u2019s hermeneutic approach, this phenomenological study explores the lived experiences and meaning of being an FCN in Italy. Semi-structured interviews were conducted from December 2023 to June 2024. Interviews were transcribed, read in-depth and analyzed. Thirty-seven FCNs from four Italian regions were interviewed. Four main themes were identified: (a) Navigating elderly care complexity; (b) Education as a core function; (c) Being a node in the healthcare network; (d) Establishing the FCN identity through role differentiation. Being a FCN means managing complex needs, ensuring continuity of care, and collaborating effectively with the other primary care providers. FCNs distinguish themselves from task-oriented home care nurses by embracing a proactive approach, gaining greater organizational autonomy and actively shaping their professional identity. The implications for practice suggest the need to support FCNs in this consolidation phase through health policies that enhance their contribution to community care.<\/jats:p>","DOI":"10.1177\/23333936251384438","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T07:17:29Z","timestamp":1761203849000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Becoming a Family and Community Nurse: Navigating Role Identity in a Fragmented System. A Phenomenological Study"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1003-1239","authenticated-orcid":false,"given":"Isabella","family":"Santomauro","sequence":"first","affiliation":[{"name":"University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-1271","authenticated-orcid":false,"given":"Erika","family":"Bassi","sequence":"additional","affiliation":[{"name":"University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1960-2912","authenticated-orcid":false,"given":"Erica","family":"Busca","sequence":"additional","affiliation":[{"name":"University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9283-236X","authenticated-orcid":false,"given":"Ines","family":"Basso","sequence":"additional","affiliation":[{"name":"University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Ambrosi","sequence":"additional","affiliation":[{"name":"University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5710-1229","authenticated-orcid":false,"given":"Melania","family":"Stedile","sequence":"additional","affiliation":[{"name":"University of Verona, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1034-5988","authenticated-orcid":false,"given":"Angela","family":"Durante","sequence":"additional","affiliation":[{"name":"Tuscany Foundation \u201cG. Monasterio\u201d, Pisa, Italy"},{"name":"Scuola Superiore Sant\u2019Anna, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2263-1340","authenticated-orcid":false,"given":"Alberto","family":"Dal Molin","sequence":"additional","affiliation":[{"name":"University of Piemonte Orientale, Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"crossref","unstructured":"Andrews C. S. Steller J. V. Friedman A. K. (2021). Development of collaborative family nurse practitioner education using physician preceptors: A focused critical ethnographic study. Nurse Education Today 107 105110. https:\/\/doi.org\/10.1016\/j.nedt.2021.105110","DOI":"10.1016\/j.nedt.2021.105110"},{"key":"#cr-split#-e_1_3_5_3_1.1","doi-asserted-by":"crossref","unstructured":"Barisone M. Busca E. Bassi E. De Luca E. Profenna E. Suardi B. Dal Molin A. (2023). The family and community nurses cultural model in the times of the COVID outbreak: A focused ethnographic study. International Journal of Environmental Research and Public Health 20","DOI":"10.3390\/ijerph20031948"},{"key":"#cr-split#-e_1_3_5_3_1.2","doi-asserted-by":"crossref","unstructured":"(3) 1948. https:\/\/doi.org\/10.3390\/ijerph20031948","DOI":"10.3390\/ijerph20031948"},{"key":"e_1_3_5_4_1","doi-asserted-by":"crossref","unstructured":"Brownwood I. Lafortune G. (2024). Advanced practice nursing in primary care in OECD countries: Recent developments and persisting implementation challenges (OECD Health Working Papers No. 165). OECD Publishing. https:\/\/doi.org\/10.1787\/8e10af16-en","DOI":"10.1787\/8e10af16-en"},{"key":"e_1_3_5_5_1","doi-asserted-by":"crossref","unstructured":"Brzozowski S. L. King B. Steege L. M. (2023). Nurses\u2019 perception of identity practice and support needed in primary care: A descriptive qualitative study. Journal of advanced nursing 79(9) 3337\u20133350. https:\/\/doi.org\/10.1111\/jan.15640","DOI":"10.1111\/jan.15640"},{"key":"e_1_3_5_6_1","doi-asserted-by":"crossref","unstructured":"Busca E. Savatteri A. Calafato T. L. Mazzoleni B. Barisone M. Dal Molin A. (2021). Barriers and facilitators to the implementation of nurse\u2019s role in primary care settings: An integrative review. BMC Nursing 20(1) 171. https:\/\/doi.org\/10.1186\/s12912-021-00696-y","DOI":"10.1186\/s12912-021-00696-y"},{"key":"e_1_3_5_7_1","doi-asserted-by":"crossref","unstructured":"Chen H. Y. Boore J. R. (2010). Translation and back-translation in qualitative nursing research: Methodological review. Journal of Clinical Nursing 19(1-2) 234\u2013239. https:\/\/doi.org\/10.1111\/j.1365-2702.2009.02896.x","DOI":"10.1111\/j.1365-2702.2009.02896.x"},{"key":"e_1_3_5_8_1","doi-asserted-by":"crossref","unstructured":"Cohen M. Kahn D. Steeves R. (2000). Hermeneutic phenomenological research: A practical guide for nurse researchers. Routledge. https:\/\/doi.org\/10.4135\/9781452232768","DOI":"10.4135\/9781452232768"},{"key":"e_1_3_5_9_1","unstructured":"Conti A. Albanesi B. Busca E. Martini L. Costa C. Campagna S. (2021). Family and community nursing: Overview of practice in Europe. Assistenza Infermieristica e Ricerca 40(3) 131\u2013136. https:\/\/doi.org\/10.1702\/3694.36821"},{"key":"e_1_3_5_10_1","doi-asserted-by":"crossref","unstructured":"Dellafiore F. Caruso R. Cossu M. Russo S. Baroni I. Barello S. Vangone I. Acampora M. Conte G. Magon A. Stievano A. Arrigoni C. (2022). The state of the evidence about the family and community nurse: A systematic review. International Journal of Environmental Research and Public Health 19(7) 4382. https:\/\/doi.org\/10.3390\/ijerph19074382","DOI":"10.3390\/ijerph19074382"},{"key":"e_1_3_5_11_1","unstructured":"International Council of Nurses (ICN). (2020).Guidelines on advanced practice nursing 2020. https:\/\/www.icn.ch\/sites\/default\/files\/2023-04\/ICN_APN%20Report_EN.pdf"},{"key":"e_1_3_5_12_1","unstructured":"International Council of Nurses (ICN). (2024). Nursing and primary health care: Towards the realization of universal health coverage. https:\/\/www.icn.ch\/system\/files\/2024-06\/ICN_PHC-Report-2024_EN_FINAL.pdf"},{"key":"e_1_3_5_13_1","unstructured":"International Council of Nurses (ICN). (2025). Renewing the definitions of \u2018nursing\u2019 and \u2018a nurse\u2019: Final project report. https:\/\/www.icn.ch\/sites\/default\/files\/2025-06\/ICN_Definition-Nursing_Report_EN_Web_0.pdf"},{"key":"e_1_3_5_14_1","unstructured":"Italian Republic. (2020). Decreto-Legge 19 maggio 2020 n. 34. Misure urgenti in materia di salute sostegno al lavoro e all\u2019economia nonch\u00e9 di politiche sociali connesse all\u2019emergenza epidemiologica da COVID-19. [Urgent measures on health employment and economic support and social policies related to the COVID-19 epidemiological emergency]. Gazzetta Ufficiale della Repubblica Italiana Serie Generale (128) 19 maggio 2020. https:\/\/www.gazzettaufficiale.it\/eli\/id\/2020\/05\/19\/20G00052\/sg"},{"key":"e_1_3_5_15_1","unstructured":"Italian Republic. (2022). Decreto del Ministero della Salute 23 maggio 2022 n. 77. Modelli e standard per lo sviluppo dell\u2019assistenza territoriale nel Servizio sanitario nazionale. [Models and standards for the development of community care in the National Health Service]. Gazzetta Ufficiale della Repubblica Italiana Serie Generale (144) 22 giugno 2022. https:\/\/www.gazzettaufficiale.it"},{"key":"e_1_3_5_16_1","doi-asserted-by":"crossref","unstructured":"Janghorban R. Latifnejad Roudsari R. Taghipour A. (2014). Skype interviewing: The new generation of online synchronous interview in qualitative research. International Journal of Qualitative Studies on Health and Well-being 9 24152. https:\/\/doi.org\/10.3402\/qhw.v9.24152","DOI":"10.3402\/qhw.v9.24152"},{"key":"e_1_3_5_17_1","doi-asserted-by":"crossref","unstructured":"Kalu M. E. (2019). Using Emphasis-Purposeful Sampling-Phenomenon of Interest\u2013Context (EPPiC) framework to reflect on two qualitative research designs and questions: A reflective process. The Qualitative Report 24(10) 2524\u20132535. https:\/\/doi.org\/10.46743\/2160-3715\/2019.4082","DOI":"10.46743\/2160-3715\/2019.4082"},{"key":"e_1_3_5_18_1","doi-asserted-by":"crossref","unstructured":"Kerr L. Macaskill A. (2020). The journey from nurse to advanced nurse practitioner: Applying concepts of role transitioning. British Journal of Nursing 29(10) 561\u2013565. https:\/\/doi.org\/10.12968\/bjon.2020.29.10.561","DOI":"10.12968\/bjon.2020.29.10.561"},{"key":"e_1_3_5_19_1","doi-asserted-by":"crossref","unstructured":"MacLean L. M. Meyer M. Estable A. (2004). Improving accuracy of transcripts in qualitative research. Qualitative Health Research 14(1) 113\u2013123. https:\/\/doi.org\/10.1177\/1049732303259804","DOI":"10.1177\/1049732303259804"},{"key":"e_1_3_5_20_1","doi-asserted-by":"crossref","unstructured":"Manning E. Gagnon M. (2017). The complex patient: A concept clarification. Nursing & Health Sciences 19(1) 13\u201321. https:\/\/doi.org\/10.1111\/nhs.12320","DOI":"10.1111\/nhs.12320"},{"key":"e_1_3_5_21_1","doi-asserted-by":"crossref","unstructured":"Marcadelli S. Stievano A. Rocco G. (2019). Policy proposals for a new welfare: The development of the family and community nurse in Italy as the key to promote social capital and social innovation. Primary Health Care Research & Development 20 e109. https:\/\/doi.org\/10.1017\/s146342361800083x","DOI":"10.1017\/S146342361800083X"},{"key":"e_1_3_5_22_1","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Riera J. R. Rodr\u00edguez F. J. C. (2019). Enfermer\u00eda familiar y comunitaria cronolog\u00eda de una especialidad. [Family and community nursing chronology of a specialty] Enfermer\u00eda Cl\u00ednica 29(6) 352\u2013356. https:\/\/doi.org\/10.1016\/j.enfcli.2019.09.011","DOI":"10.1016\/j.enfcli.2019.09.011"},{"key":"e_1_3_5_23_1","unstructured":"Martini L. Addesso D. Di Falco A. Costa C. Mantoan D. (2021). Gli infermieri di famiglia in Italia: Indagine esplorativa [Family nurses in Italy: An exploratory survey]. Assistenza Infermieristica e Ricerca 40(3) 137\u2013142. https:\/\/doi.org\/10.1702\/3694.36819"},{"key":"e_1_3_5_24_1","doi-asserted-by":"crossref","unstructured":"Mathews M. Ryan D. Buote R. Parsons S. Lukewich J. (2021). Family practice nursing in Newfoundland and Labrador: Are reported roles reflective of professional competencies for registered nurses in primary care? SAGE Open Nursing 7 1\u201311. https:\/\/doi.org\/10.1177\/23779608211053496","DOI":"10.1177\/23779608211053496"},{"key":"e_1_3_5_25_1","doi-asserted-by":"crossref","unstructured":"Morse J. M. (1991). Evaluating qualitative research. Qualitative Health Research 1(3) 283\u2013286. https:\/\/doi.org\/10.1177\/104973239100100301","DOI":"10.1177\/104973239100100301"},{"key":"e_1_3_5_26_1","unstructured":"National Agency for Regional Health Services (AGENAS). (2023). Linee di indirizzo infermiere di famiglia o comunit\u00e0. https:\/\/www.agenas.gov.it\/images\/2023\/primo-piano\/infermieri\/Documento_Tecnico_Linee_di_Indirizzo_IFoC_-_def.pdf"},{"key":"e_1_3_5_27_1","unstructured":"National Institute of Statistics (ISTAT). (2023). BES 2023 report. Equitable and sustainable well-being in Italy. https:\/\/www.istat.it\/wp-content\/uploads\/2024\/10\/BES-2023-Report.pdf"},{"key":"e_1_3_5_28_1","doi-asserted-by":"crossref","unstructured":"Parker C. Scott S. Geddes A. (2019). Snowball sampling. SAGE Research Methods Foundations. https:\/\/doi.org\/10.4135\/9781526421036831710","DOI":"10.4135\/9781526421036831710"},{"key":"e_1_3_5_29_1","doi-asserted-by":"crossref","unstructured":"Ploeg J. Matthew-Maich N. Fraser K. Dufour S. McAiney C. Kaasalainen S. Markle-Reid M. Upshur R. Cleghorn L. Emili A. (2017). Managing multiple chronic conditions in the community: A Canadian qualitative study of the experiences of older adults family caregivers and healthcare providers. BMC Geriatrics 17 40. https:\/\/doi.org\/10.1186\/s12877-017-0431-6","DOI":"10.1186\/s12877-017-0431-6"},{"key":"e_1_3_5_30_1","doi-asserted-by":"crossref","unstructured":"Rasku T. Kaunonen M. Thyer E. Paavilainen E. Joronen K. (2021). Community nurse-paramedics\u2019 sphere of practice in primary care: An ethnographic study. BMC Health Services Research 21(1) 710. https:\/\/doi.org\/10.1186\/s12913-021-06691-y","DOI":"10.1186\/s12913-021-06691-y"},{"key":"e_1_3_5_31_1","doi-asserted-by":"crossref","unstructured":"Roberts R. (2020). Qualitative interview questions: Guidance for novice researchers. The Qualitative Report 25(9) 3185\u20133196. https:\/\/doi.org\/10.46743\/2160-3715\/2020.4640","DOI":"10.46743\/2160-3715\/2020.4640"},{"key":"e_1_3_5_32_1","volume-title":"Infermiere di famiglia e di comunit\u00e0: Proposte di policy per un nuovo welfare","author":"Rocco G.","year":"2017","unstructured":"Rocco G., Mercadelli S., Stievano A., Cipolla C. (2017). Infermiere di famiglia e di comunit\u00e0: Proposte di policy per un nuovo welfare [Family and community nurse: Policy proposals for a new welfare]. Franco Angeli."},{"key":"e_1_3_5_33_1","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Mu\u00f1oz F. Fern\u00e1ndez-Medina I. M. Ventura-Miranda M. I. Ortega-Gal\u00e1n \u00c1. M. Jim\u00e9nez-Lasserrotte M. D. M. Ru\u00edz-Fern\u00e1ndez M. D. (2024a). An overview of family and community nurse specialists\u2019 employment situation in Spain: A qualitative study. Healthcare (Basel) 12(22) 2268. https:\/\/doi.org\/10.3390\/healthcare12222268","DOI":"10.3390\/healthcare12222268"},{"key":"e_1_3_5_34_1","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Mu\u00f1oz F. Ruiz-Fern\u00e1ndez M. D. Ventura-Miranda M. I. Ortega-Gal\u00e1n \u00c1. M. Jim\u00e9nez-Lasserrotte M. D. M. Fern\u00e1ndez-Medina I. M. (2024b). Nurse managers\u2019 perceptions of family and community nurse practitioners joining primary care teams in Spain: A qualitative study. Nursing & Health Sciences 26(4) e13170. https:\/\/doi.org\/10.1111\/nhs.13170","DOI":"10.1111\/nhs.13170"},{"key":"e_1_3_5_35_1","doi-asserted-by":"crossref","unstructured":"Sandelowski M. (1995). Sample size in qualitative research. Research in Nursing & Health 18(2) 179\u2013183. https:\/\/doi.org\/10.1002\/nur.4770180211","DOI":"10.1002\/nur.4770180211"},{"key":"e_1_3_5_36_1","doi-asserted-by":"crossref","unstructured":"Taddeucci L. Barchielli C. Vainieri M. (2023). The challenge of community care: Evidence from the family and community nurse model in Tuscany. European Journal of Public Health 33 ckad160. https:\/\/doi.org\/10.1093\/eurpub\/ckad160.1377","DOI":"10.1093\/eurpub\/ckad160.1377"},{"key":"e_1_3_5_37_1","doi-asserted-by":"crossref","unstructured":"Teggart K. Neil-Sztramko S. E. Nadarajah A. Wang A. Moore C. Carter N. Adams J. Jain K. Petrie P. Alshaikhahmed A. Yugendranag S. Ganann R. (2023). Effectiveness of system navigation programs linking primary care with community-based health and social services: A systematic review. BMC Health Services Research 23(1) 450. https:\/\/doi.org\/10.1186\/s12913-023-09424-5","DOI":"10.1186\/s12913-023-09424-5"},{"key":"e_1_3_5_38_1","doi-asserted-by":"crossref","unstructured":"Thompson W. McNamara M. (2022). Constructing the advanced nurse practitioner identity in the healthcare system: A discourse analysis. Journal of Advanced Nursing 78(3) 834\u2013846. https:\/\/doi.org\/10.1111\/jan.15068","DOI":"10.1111\/jan.15068"},{"key":"e_1_3_5_39_1","doi-asserted-by":"crossref","unstructured":"Torrens C. Campbell P. Hoskins G. Strachan H. Wells M. Cunningham M. Bottone H. Polson R. Maxwell M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies 104 103443. https:\/\/doi.org\/10.1016\/j.ijnurstu.2019.103443","DOI":"10.1016\/j.ijnurstu.2019.103443"},{"key":"e_1_3_5_40_1","doi-asserted-by":"crossref","unstructured":"Van Manen M. (2023). Phenomenology of practice: Meaning-giving methods in phenomenological research and writing (2nd ed.). Routledge. https:\/\/doi.org\/10.4324\/978100322807","DOI":"10.4324\/9781003228073"},{"key":"e_1_3_5_41_1","unstructured":"World Health Organization (WHO). (2000). The family health nurse: Context conceptual framework and curriculum. World Health Organization. Regional Office for Europe. https:\/\/iris.who.int\/handle\/10665\/107930"},{"key":"e_1_3_5_42_1","unstructured":"World Health Organization (WHO). (2018). Integrated care for older people (ICOPE): Realigning primary health care to respond to population ageing. World Health Organization. https:\/\/iris.who.int\/handle\/10665\/326295."},{"key":"e_1_3_5_43_1","unstructured":"World Health Organization (WHO). (2022). Primary health care measurement framework and indicators: Monitoring health systems through a primary health care lens. World Health Organization & United Nations Children\u2019s Fund. https:\/\/iris.who.int\/handle\/10665\/352205."}],"container-title":["Global Qualitative Nursing Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23333936251384438","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23333936251384438","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23333936251384438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:13:18Z","timestamp":1777446798000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23333936251384438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":43,"alternative-id":["10.1177\/23333936251384438"],"URL":"https:\/\/doi.org\/10.1177\/23333936251384438","relation":{},"ISSN":["2333-3936","2333-3936"],"issn-type":[{"value":"2333-3936","type":"print"},{"value":"2333-3936","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"article-number":"23333936251384438"}}