| Keywords [eng] |
Keywords: Advance practice nurse, need and motivation of APN, barriers and facilitators of integration, healthcare system, quality of care. Raktiniai žodžiai: Išplastinės praktikos slaugytojas, IPS poreikis ir motyvacija, integracijos kliūtys ir pagalbininkai, sveikatos priežiūros sistema, priežiūros kokybė. |
| Abstract [eng] |
This thesis explores the integration of Advanced Practice Nurses (APNs) into the Lithuanian healthcare system, a process that aligns with global trends aiming to improve healthcare accessibility, efficiency, and patient outcomes. Despite the development of APN educational programs in Lithuania, the actual integration of APNs into practice remains limited. The study focuses on understanding the perceived need for APNs, their motivation, and the challenges and solutions to their integration from the perspectives of both APNs and healthcare administrators. A qualitative research design was employed, using semi-structured interviews with twelve participants—six APNs and six healthcare administrators. Purposeful sampling ensured representation from primary care, emergency, and intensive care settings. Interviews were conducted between February and March 2025, recorded, and transcribed by the researcher. Thematic analysis was used to identify key patterns across participant responses. Findings revealed a strong consensus among both groups about the need for APNs in addressing physician shortages, managing chronic diseases, improving rural healthcare access, and enhancing preventive care. APNs expressed high motivation to work more autonomously and contribute to systemic improvements. However, they reported frustration due to unclear legal status, limited role recognition, and institutional barriers. Administrators acknowledged the APNs’ potential and echoed the need for legal frameworks, proper role descriptions, and public awareness to support integration. The study concludes that while the need and motivation for APN integration are evident, progress is hindered by structural, legal, and cultural challenges. Both stakeholder groups support the development of APN roles but emphasize the importance of systemic reform and institutional readiness. Key recommendations include Health ministry of Lithuania and healthcare institutions should establish clear legislation defining APN competencies and autonomy; developing structured job descriptions; implementing public education campaigns to raise awareness and trust; ensuring fair remuneration and professional recognition; and fostering interprofessional collaboration through mentorship and shared care models. APNs should actively participate in discussions with management, policymakers, and professional organizations to advocate for their role and showcase their contributions. This research contributes valuable evidence to support policy and practice reforms that will enable APNs to fully contribute to the future of healthcare in Lithuania. |
