Barriers to community healthcare delivery in urban China: a nurse perspective

ABSTRACT

Purpose

There is considerable research on China’s community healthcare, but little examining its delivery from a nurse perspective. This article, set in the context of Shenzhen, elicits community nurses’ views on barriers to healthcare delivery, providing an initial evidence framework to improve community nursing practice at organizational and policy levels.

Methods

We used qualitative methods. Data from semi-structured interviews with 42 community nurses in Shenzhen underwent inductive content analysis. Consolidated criteria for reporting qualitative research were consulted to structure our reporting.

Results

Our analysis suggests four elements discouraging community nurses in care delivery: lack of equipment, stressful work environments, staff incompetence, and patient distrust. Centralized means of procurement, management indifference to nurses’ well-being, unsystematic training and reluctance to enter the community healthcare sector, and public prejudices against nursing contributed to these constraints, preventing community nurses from performing patient-centred care, devoting energy to caring, freeing themselves from heavy workloads, and building trust-based care relationships.

Conclusions

Delivery barriers devalued community health services systematically and undermined nurses’ professional advancement and psychological well-being. Targeted management and policy inputs are necessary to reduce caring barriers and enhance the ability of community nursing to safeguard population health.

KEYWORDS:

• Community healthcare
• healthcare delivery
• community nursing
• inductive content analysis
• China

Acknowledgments

We are grateful to the nurses for their active participation in this study. We also thank two anonymous reviewers for their helpful comments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

The research reported was ethically approved, on 21 April 2021, by The Hong Kong Polytechnic University Institutional Review Board (reference HSEARS20210417003).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2023.2220524.

Additional information

Funding

This work was supported by The Hong Kong Polytechnic University Mental Health Research Centre (Project ID: P0040455) and Department of Applied Social Sciences (funding for research students).

Notes on contributors

Bo Li

Bo Li is a PhD student in the Department of Applied Social Sciences at The Hong Kong Polytechnic University. His research centres around medical sociology, nursing management, and health systems and policy.

Juan Chen

Juan Chen is a professor in the Department of Applied Social Sciences at The Hong Kong Polytechnic University. Her research focuses on migration and urbanisation, health and mental health, help-seeking and service use, social policy, and social service systems.