Identifying Role Functions of Primary Health Care Nurses in China: A Mixed-Methods Study in Three Northeastern...

With global aging and the increasing burden of noncommunicable diseases (NCDs), the primary health care (PHC) system plays a pivotal role in disease prevention and management of NCDs. Nurses, as key PHC members, significantly influence health equity and service quality.

To examine tasks and role functions of Chinese PHC nurses.

A mixed-methods convergent study was conducted and reported in accordance with the Good Reporting of a Mixed Methods Study (GRAMMS) framework. A cross-sectional survey and focus group interviews with nurses from 10 PHC institutions in Northeast China were conducted. The Chinese Nurses' Task Survey Questionnaire was used to collect data on the tasks of nurses. Face-to-face semistructured focus group interviews were conducted to explore the nurses' perceptions, understandings, and attitudes toward their tasks. Quantitative data were collated and analyzed using EpiData 3.1 and SPSS 27.0 software, and qualitative data were analyzed through natural language processing (NLP)-based BERTopic topic modeling and conventional content analysis. The quantitative and qualitative results were integrated, merged, and refined to construct the role functions of PHC nurses in China.

A total of 123 PHC nurses (n = 123) completed the survey, and 10 focus group interviews were conducted with 75 participants (n = 75). The results indicated that the current tasks of PHC nurses in China were mainly focused on providing basic medical services, health management, and health education. Three core role functions of Chinese PHC nurses were summarized and refined: guardian of family health, early warner of major diseases, and facilitator of health promotion.

Compared with previous studies, the scope of role functions of PHC nurses in China has expanded, with a greater emphasis focus on the management of common NCDs among residents. However, the roles of PHC nurses could not be fully fulfilled, and functional deficiencies still existed.

Healthcare managers should fundamentally clarify the role positioning and job responsibilities of PHC nurses. Relevant policies and regulations should be formulated, standardized training systems established, financial compensation mechanisms provided, and professional title promotion pathways optimized to maximize the potential of PHC nurses, thereby enhancing the accessibility of medical services.