Perceptions of Community Nursing: A Comparative View Between Students and Professionals Through a Mixed-Methods Study

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Abstract

Background/Objectives: Background/Objectives: Community nursing is central to equitable, preventive care, yet its role is often underexposed in undergraduate training. We compared perceptions of community nursing between first-year nursing students and practicing community nurses, identifying convergence/divergence to inform education and workforce strategies. Methods: Explanatory sequential mixed-methods study in Spain. Phase I: cross-sectional online survey with sociodemographics, ad-hoc items, and the Scale on COmmunity care PErceptions (SCOPE). Phase II: Photovoice groups (two student groups, one professional group). Quantitative data used medians (IQR)/proportions with χ² and Mann–Whitney U (α=0.05). Qualitative data underwent participatory thematic analysis; integration used joint displays and follow-the-thread. Results: Sixty-seven participants (students n=48; professionals n=19). Students scored lower than professionals in SCOPE affective perception (6.2 [5.4–7.1] vs 8.3 [7.4–8.9]), perception of practices (5.4 [4.8–6.3] vs 7.8 [6.7–8.5]), and placement preferences (4.1 [3.5–5.0] vs 6.1 [5.3–7.2]) (all p<0.001). Knowledge and orientation also differed: asset-mapping knowledge (27.1% students vs 84.2% professionals; p<0.001), preference for hospital placements (89.6% vs 5.3%; p<0.001), and interest in community specialization (22.9% vs 57.9%; p=0.01). Photovoice generated seven categories (e.g., “More than techniques,” “The invisible nurse,” “Technology with a human face,” “Learning by doing,” “Care in teams”) that explained students’ uncertainty and professionals’ multifaceted, community-embedded role. Integration showed convergence on hospital preference and low institutional visibility, and divergence between high stated importance and superficial student knowledge. Conclusions: A marked perception gap separates students from community nurses. Earlier, mentored community exposures and participatory pedagogies, alongside institutional strategies to increase the visibility of community nursing, may narrow this gap.

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