{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:58:07Z","timestamp":1785491887200,"version":"3.56.0"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nurs. Rep.","Nursing Reports"],"abstract":"<jats:p>Introduction\/Objective: Advanced practice nurses (APNs) play an increasingly important role in healthcare systems by expanding access to high-quality, patient-centred care. However, public understanding of the APNs\u2019 role remains limited, particularly regarding their autonomy, leadership, and scope of practice. In Lithuania, APNs represent a relatively new professional group, and to date, no quantitative study has examined public perceptions of their role, competencies, and professional identity. Understanding these perceptions is essential for supporting the successful integration of APNs into the Lithuanian healthcare system. The aim of this study was to examine public perceptions of the role and professional identity of advanced practice nurses (APNs) in Lithuania. Methods: A quantitative cross-sectional research design was employed. Data were collected between October 2025 and January 2026 through an anonymous online questionnaire survey. Participants were recruited using a non-probability convenience sampling strategy. A total of 518 respondents participated in the study (n = 518). Data were collected using the Nursing\u2019s Current Brand Position Scale (NCBPS) and the Nursing\u2019s Desired Brand Position Scale (NDBPS). Data were analysed using descriptive statistics, correlation analysis, and principal component analysis (PCA). Results: The findings revealed that the public evaluates the professional image of advanced practice nurses (APNs) positively. However, it is primarily associated with traditional nursing values, particularly the perception of nursing as \u201ca caring profession\u201d and patient-centeredness. A statistically significant difference was found between the current and desired APN professional image across all evaluated dimensions (overall mean scores: 6.61 \u00b1 1.67 vs. 7.68 \u00b1 1.67; t = \u221218.426; p &lt; 0.001), with the largest gap observed in perceptions of APNs as patient advocates, educational leaders, and research contributors. The desired image reflects public expectations for APNs to function as autonomous, decision-making professionals who actively represent patients\u2019 interests. A significant positive association was identified between professional image evaluation and trust in APN competencies (r = 0.66, p &lt; 0.001). Conclusions: Participants in the present study generally perceived the professional image of advanced practice nurses (APNs) positively, primarily associating it with caring and patient-centred care rather than leadership and strategic roles. The comparison between the current and desired professional images suggests that respondents expressed higher expectations for the APN role. Respondents reported moderately high trust in APNs, which was significantly associated with perceptions of their professional image.<\/jats:p>","DOI":"10.3390\/nursrep16080267","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:20:18Z","timestamp":1785486018000},"page":"267","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Public Perception of the Role and Professional Identity of Advanced Practice Nurses in Lithuania"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6082-8059","authenticated-orcid":false,"given":"And\u017eelika","family":"Zavackien\u0117","sequence":"first","affiliation":[{"name":"Republic Klaip\u0117da Hospital, S. N\u0117ries g. 3, LT-92231 Klaip\u0117da, Lithuania"},{"name":"Faculty of Health Sciences, Klaip\u0117da State University of Applied Sciences, Bij\u016bn\u0173 g. 10, LT-91223 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"\u0160tukova","sequence":"additional","affiliation":[{"name":"Republic Klaip\u0117da Hospital, S. N\u0117ries g. 3, LT-92231 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gintar\u0117","family":"Venckauskyt\u0117","sequence":"additional","affiliation":[{"name":"Republic Klaip\u0117da Hospital, S. N\u0117ries g. 3, LT-92231 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asta","family":"Ma\u017eionien\u0117","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Klaip\u0117da State University of Applied Sciences, Bij\u016bn\u0173 g. 10, LT-91223 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref_1","unstructured":"Boehning, A.P., and Punsalan, L.D. (2026, June 29). Advanced practice registered nurse roles, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK589698\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e13045","DOI":"10.1111\/inr.13045","article-title":"Advanced practice nursing in surgery: A scoping review of roles, responsibilities, and educational programs","volume":"72","author":"Assolari","year":"2025","journal-title":"Int. Nurs. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100319","DOI":"10.1016\/j.ijnsa.2025.100319","article-title":"International competencies of nurses with advanced practice in anesthesia nursing: An integrative review","volume":"8","author":"Pann","year":"2025","journal-title":"Int. J. Nurs. Stud. Adv."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.jopan.2024.07.016","article-title":"Global scope of practice of an APN anesthesia: A scoping review","volume":"40","author":"Vetter","year":"2025","journal-title":"J. Perianesth. Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Moghbel, G., Gardashkhani, S., and Soheili, A. (2025). Public image of nursing: An integrative review of challenges and solutions. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-03160-3"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Chair, S.Y., Kilpatrick, K., Heffernan, C., Hays, S.M., and Liu, H. (2024). Impact of the COVID-19 pandemic on clinical care and patient-focused outcomes of advanced nursing practice: A cross-sectional study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0313751"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/inr.12884","article-title":"Response and innovations of advanced practice nurses during the COVID-19 pandemic: A scoping review","volume":"71","author":"Ziegler","year":"2024","journal-title":"Int. Nurs. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e70033","DOI":"10.1002\/nop2.70033","article-title":"Public image of nursing in modern society: An evolving concept analysis","volume":"11","author":"Duan","year":"2024","journal-title":"Nurs. Open"},{"key":"ref_9","first-page":"e2021429","article-title":"The influence of media representations on citizens\u2019 perceptions towards nurses: A comparison between before and after the COVID-19 pandemic","volume":"92","author":"Foa","year":"2021","journal-title":"Acta Biomed."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1108\/IJPHM-09-2016-0052","article-title":"Development and testing of three unique scales measuring the brand image of nursing","volume":"12","author":"Godsey","year":"2018","journal-title":"Int. J. Pharm. Healthc. Mark."},{"key":"ref_11","unstructured":"Ministry of Health of the Republic of Lithuania (2026, June 29). Lietuvos Respublikos Sveikatos Apsaugos Ministro 2016 m. Vasario 10 d. \u012esakymas Nr. V-222 \u201eD\u0117l Nacionalin\u0117s Slaugos Politikos 2016\u20132025 Met\u0173 Gairi\u0173 Patvirtinimo\u201d [Order No. V-222 of 10 February 2016 on the Approval of the National Nursing Policy Guidelines for 2016\u20132025], Available online: https:\/\/www.e-tar.lt\/portal\/lt\/legalAct\/035852e0d09611e583a295d9366c7ab3."},{"key":"ref_12","unstructured":"Seimas of the Republic of Lithuania (2026, June 29). Lietuvos Respublikos Slaugos Praktikos ir Aku\u0161erijos Praktikos \u012estatymas Nr. IX-413 [Law on Nursing Practice and Midwifery Practice of the Republic of Lithuania No. IX-413], Available online: https:\/\/www.e-tar.lt\/portal\/lt\/legalAct\/TAR.369CF9E97755."},{"key":"ref_13","unstructured":"Ministry of Health of the Republic of Lithuania (2026, June 29). Lietuvos Medicinos Norma MN 160:2026 \u201eI\u0161pl\u0117stin\u0117s Praktikos Slaugytojas\u201d [Lithuanian Medical Norm MN 160:2026 \u201cAdvanced Practice Nurse\u201d], Available online: https:\/\/www.e-tar.lt\/portal\/lt\/legalAct\/cb17a116752111f1b53dfa020e517810."},{"key":"ref_14","unstructured":"National Audit Office of Lithuania (2026, June 29). Slaugos Specialist\u0173 Poreikio U\u017etikrinimas: I\u0161ankstinio Tyrimo Ataskaita Nr. ITE-2 [Ensuring the Nursing Workforce: Preliminary Study Report No. ITE-2], Available online: https:\/\/www.valstybeskontrole.lt\/LT\/Product\/24177."},{"key":"ref_15","first-page":"166","article-title":"I\u0161pl\u0117stin\u0117s Praktikos Slauga ir Visuomen\u0117s Informuotumas apie I\u0161pl\u0117stin\u0117s Praktikos Slaugytojo Teikiamas Pirmin\u0117s Sveikatos Prie\u017ei\u016bros Paslaugas [Advanced Practice Nursing and Public Awareness of Primary Healthcare Services Provided by Advanced Practice Nurses]","volume":"32","year":"2022","journal-title":"Sveik. Moksl.\/Health Sci. East. Eur."},{"key":"ref_16","first-page":"104","article-title":"I\u0161pl\u0117stin\u0117s praktikos slaugytoj\u0173 profesini\u0173 kompetencij\u0173 tobulinimo galimyb\u0117s [Opportunities for improving the professional competencies of advanced practice nurses]","volume":"32","year":"2022","journal-title":"Sveik. Moksl.\/Health Sci. East. Eur."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102220","DOI":"10.1016\/j.outlook.2024.102220","article-title":"Public perceptions of the brand image of nursing: Cross-cultural differences between the United States and China","volume":"72","author":"Zhou","year":"2024","journal-title":"Nurs. Outlook"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5056","DOI":"10.1002\/nop2.1742","article-title":"The psychometric properties of nursing image measurement instruments: A systematic review","volume":"10","author":"Zhou","year":"2023","journal-title":"Nurs. Open"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Bahari, Z., Vosoghi, N., Ramazanzadeh, N., Moshfeghi, S., and Aghamohammadi, M. (2024). Patient trust in nurses: Exploring the relationship with care quality and communication skills in emergency departments. BMC Nurs., 23.","DOI":"10.1186\/s12912-024-02241-z"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Rodriguez-Perez, M., Mena-Navarro, F., Dominguez-Pichardo, A., and Teresa-Morales, C. (2022). Current social perception of and value attached to nursing professionals\u2019 competences: An integrative review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031817"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12960-017-0237-9","article-title":"The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review","volume":"15","author":"Woo","year":"2017","journal-title":"Hum. Resour. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12960-024-00953-6","article-title":"Prestige of disciplines within the field of nursing: A cross-sectional study","volume":"22","author":"Zusman","year":"2024","journal-title":"Hum. Resour. Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"World Medical Association (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310, 2191\u20132194.","DOI":"10.1001\/jama.2013.281053"},{"key":"ref_24","unstructured":"Lithuanian Bioethics Committee (2026, June 29). Biomedicinini\u0173 Tyrim\u0173 Etikos Reikalavimai [Ethical Requirements for Biomedical Research], Available online: https:\/\/bioetika.lrv.lt\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100034","DOI":"10.1016\/j.ijnsa.2021.100034","article-title":"The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review","volume":"3","author":"Htay","year":"2021","journal-title":"Int. J. Nurs. Stud. Adv."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Kilpatrick, K., Savard, I., Audet, L.A., Costanzo, G., Khan, M., Atallah, R., Jabbour, M., Zhou, W., Wheeler, K., and Ladd, E. (2024). A global perspective of advanced practice nursing research: A review of systematic reviews. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0305008"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.1002\/nop2.847","article-title":"Effectiveness of the advanced practice nursing interventions in the patient with heart failure: A systematic review","volume":"8","year":"2021","journal-title":"Nurs. Open"},{"key":"ref_28","first-page":"103","article-title":"I\u0161pl\u0117stin\u0117s praktikos slaugytoj\u0173 kompetencij\u0173 tobulinimo ir savaranki\u0161kos praktikos i\u0161\u0161\u016bkiai Lietuvoje [Challenges of Competency Development and Independent Practice for Advanced Practice Nurses in Lithuania]","volume":"35","author":"Istomina","year":"2025","journal-title":"Sveik. Moksl.\/Health Sci. East. Eur."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040296"}],"container-title":["Nursing Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/8\/267\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:06:59Z","timestamp":1785488819000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4403\/16\/8\/267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["nursrep16080267"],"URL":"https:\/\/doi.org\/10.3390\/nursrep16080267","relation":{},"ISSN":["2039-4403"],"issn-type":[{"value":"2039-4403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}