title: [The family and community nurse: Health agent and model for the chronic patient within the community].
abstract: It is estimated that the chronic, fragile and complex patient represents 5% of the general population, but uses up to 65% of the total amount of health care resources. Older people who are dependent, with chronic illnesses and comorbidities need professional care that promotes self-care and self-management of their illnesses. Thus, new strategies need to be considered to channel those professional care services to focus on this group. Nurse practicioners are professionals who could lead this change to improve the sustainability of the health care system, since they are in a position to respond in an effective way to the demands of patients with chronic illnesses, dependency or fragility. For the nurse working force to provide an efficient and cost-effective response to the health needs of chronically ill and disabled persons, an analysis needs to be made of the factors that restrict professional growth, as well as those nursing services where nurses do not take part in the decision making, as well as how to correct them. The lack of goals or quality care indicators, the measurement of the problem, the lack of patients assigned to a nurse practicioners, lack of training, the disparity of the profession in Spain, and the inability of the system to lead a self-sufficient care system project, should also be taken into consideration.
authors.affiliation: Centro de Salud Trencadors S'Arenal de Llucmajor, Gerencia de Atención Primaria de Mallorca, Palma de Mallorca, España, Grupo de Crónicos de la Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria (FAECAP). Electronic address: angelicamiguelez@gmail.com.
authors.forename: Angélica
authors.initials: A
authors.lastname: Miguélez-Chamorro
authors.affiliation: Estrategia para el Abordaje de la Cronicidad en el Sistema Nacional de Salud, Hospital de Guadarrama, Madrid, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ferrer-Arnedo
mesh_terms: D002908:Chronic Disease / Q000451:nursing*; D003152:Community Health Nursing; D022143:Family Nursing; D006262:Health; D006801:Humans; D024802:Nurse's Role; D009726:Nurses; D011320:Primary Health Care; D012648:Self Care
keywords: Atención primaria; Chronic disease; Competencias enfermeras; Complejidad; Complexity; Enfermedad crónica; Nurse competencies; Nursing process; Primary health care; Proceso de enfermería