Perceptions and Expectations of Advanced Geriatric Nursing Role Development in Primary Health Care: A Qualitative Study Exploring Staff’s Perspectives

Figures & data

Table 1 Interview Guide

Participants	Interview Topics
Registered Nurses	1.How long have you been working as a primary health nurse? 2.Can you describe your roles in the care of older people in primary care? 3.What factors do you think to affect the development of advanced geriatric nursing roles? 4.What roles do you think GNP could play in the primary health care system in the future?
General Physicians and Managers	1.Can you describe the RNs’ roles in the care of older people in primary care? 2.What factors do you think to affect the development of advanced geriatric nursing roles? 3.What roles do you think GNP could play in the primary health care system in the future?

Abbreviations: RN, registered nurse; GNP, gerontological nurse practitioner.

Table 2 Sociodemographic Characteristics of Participants

Variable	General Physician N (%)	Manager N (%)	Registered Nurse N (%)
Sex
Female	0 (0.00)	9 (90.00)	29 (100.00)
Male	6 (100.00)	1 (10.00)	0 (0.00)
Age
≤ 30	5 (83.33)	1 (10.00)	17 (58.62)
> 30	1 (16.67)	9 (90.00)	12 (41.38)
Education Level
Bachelor’s degree	2 (33.33)	2 (20.00)	4 (13.79)
College degree	2 (33.33)	7 (70.00)	20 (68.97)
Other	2 (33.33)	1 (10.00)	5 (17.24)
Work setting
Community Health center	0 (0.00)	0 (0.00)	16 (55.17)
Township Health center	6 (100.00)	10 (100.00)	13 (44.83)
Length of time in primary geriatric care
< 5	4 (66.67)	0 (0.00)	15 (51.72)
5–10	1 (16.67)	3 (30.00)	9 (31.03)
> 10	1 (16.67)	7 (70.00)	5 (17.24)

Table 3 The Themes, Subthemes, and Sample Quotes

Theme	Subtheme	Sample Quote
Current roles of RNs in the care of older people	Attending the physical examination programs for the older adults	“Every morning, the RNs’ main job is to help the elderly complete their medical checkup.” (RN6)
	Providing chronic diseases management support for older adults	“We will follow up these older adults with chronic diseases every quarter of the year.” (RN2)
	Providing healthy lifestyle guidance and counseling	“Our work usually includes health education for the elderly.” (RN28)
Factors affect the advanced geriatric nursing role development	Unclear role definition	“The lack of a clear role definition has resulted in nursing staff with different levels taking on the same job responsibilities … ” (RN1)
	Recruiting unqualified and inadequate numbers of geriatric nurses	“Most of us are unqualified in geriatric nursing and most cases, we can only provide some simple consultation for older adults.” (RN29)
	Professional autonomy of RNs is limited in caring for older adults	“The services that our nurses can provide are very limited. Because we nurses don’t have a prescriptive authority under the legislation.” (RN5)
Expectations of the GNPs’ roles in primary health care	Advocacy and support: establishing long-term relationships with older adults	“A GNP is expected to play an important role in improving their quality of life and calling on the government to pay attention to them or other vulnerable elderly in the remote area.” (RN29)
	Comprehensive assessment, communication, and case management: providing personalized care for older people	“I think GNP should conduct a comprehensive assessment through home visits to get more information of the older adults’ health status and family environment.” (RN12)
	Health information management and policy development: identifying the prioritization of health problems and supporting policy development	“I think a very important role for GNP is to analyze health information and identify priorities for health problems in older adults based on epidemiological knowledge.”(RN34)
	Leadership and coordination: promoting the construction of multidisciplinary care models	“I hope that RNs can play a better leadership, coordination, and communication role to facilitate the construction of a multidisciplinary collaboration model.” (GP4)

Abbreviations: RN, registered nurse; GP, general physician; GNP, gerontological nurse practitioner.

Figure 1 Expected role model of gerontological nurse practitioners (GNPs) in primary health care.