Professional competence in community health nursing practice: a concept analysis

Professional competence in community health nursing practice (CHNP) is essential for enhancing the quality of care and the effectiveness of interventions. However, the absence of a clear and universal definition of professional competence in CHNP poses a significant challenge across healthcare systems. Thus, this study aimed to clarify the concept of professional competence in CHNP. We used Swartz-Barcott and Kim’s hybrid model in three phases for concept analysis. The theoretical phase involved a systematic literature review. In the fieldwork phase, we conducted 13 semi-structured in-dept interviews with key participants. The analytical phase included comparison of the data from the first two phases to validate and refine the concept. Common codes reported as categories and themes in the study results. From the systematic review phase, 18 articles were selected. Five key areas were identified from these articles, including competency dimensions, role-based competence, challenges, proposed frameworks, and future research directions. In the next phase, from the analysis of interviews, 245 initial codes were extracted. They were then grouped into 14 subcategories and two main categories, consisting of core and non-core competencies. Our final analysis yielded a three-level diagram that illustrates the multi-layered nature of this concept. This model depicts the concept of professional competence in CHNP as the foundation that shapes nursing roles within role-based competence and guides the key practices of community health nurses (CHNs). Professional competence in CHNP is a dynamic, multidimensional, and context-dependent concept shaped by dimensions of clinical, communication, educational, cultural care, ethical, managerial, technology and digital, structural and policy making as well as research. Its development requires structured, competency-based education and sustained collaboration between nursing schools and healthcare centers. This conceptual model provides a comprehensive framework to enhance capabilities of CHNs, enabling them to deliver high-quality, equitable, and effective healthcare services, while adapting to the evolving needs of the healthcare system.