Public Attitudes Towards Expanding the Role of Advanced Practice Nurses in Germany: A Cross-Sectional Survey Study

To assess public support and predictors of favourable or unfavourable views towards expanding Advanced Practice Nurse (APN) roles in Germany.

A quantitative, cross-sectional survey using Germany as a national case study.

Data came from the Politikpanel Deutschland, an online survey conducted 15-28 July 2024. After exclusions, 6733 respondents were included. Data were weighted by age, gender, federal state, and voting intention. Descriptive statistics, subgroup comparisons, and multinomial logistic regression were applied to analyse attitudes towards APNs, with results reported as average marginal effects and predicted probabilities.

Overall, 52.8% of respondents supported expanding APN roles, 25% opposed, and the remainder were undecided. Support was stronger among younger, male, and highly educated respondents, and those open to digital health technologies. Support was lower in East Germany and the city-states Berlin and Bremen, while it was higher in the south-west and north. Political ideology strongly predicted attitudes: supporters of right-wing parties were more likely to oppose, whereas left-leaning voters were more supportive.

Public support for expanding APN roles in Germany is moderate but uneven across demographic, regional, and political cohorts. Younger individuals and those favouring digital health technologies may drive future acceptance, while political resistance and regional disparities remain barriers.

This first, large-scale survey of German public attitudes towards APNs suggests that policymakers should (i) link APN role expansion with digital health innovations, (ii) address regional differences through tailored communication, and (iii) ensure that patients, physicians, and healthcare professionals perceive APN integration as enhancing, not diminishing primary care quality. Strengthening legal and educational frameworks and fostering collaboration between physicians and nurses will not only be essential to integrate APNs into Germany's healthcare system and, thereby, mitigate physician shortages, but also to foster public acceptance of APNs.

None.

CROSS-checklist.