Advanced practice nurses and their potential in home care for frail patients in rural France: A qualitative study

The ageing population in Europe, particularly in rural areas, creates new health challenges, including patients with multiple comorbidities and difficult access to care. Advanced Practice Nurses (APNs) could play a key role in improving access and care for frail older patients in France’s rural areas, although how to achieve this remains unclear. This study aimed to identify the healthcare needs of frail patients living at home in rural areas and those of their healthcare providers to assess the potential role of APNs in addressing these needs. This interpretive descriptive qualitative study was conducted from June to September 2023, using focus groups (FGs). Three FGs with 20 participants, including healthcare providers and frail older people, were conducted in two French rural areas. Data were analysed using thematic analyse to identify key needs and potential APN contributions. The healthcare needs identified were: improving access to care, maintaining human interactions, and providing coordinated, preventive care. Participants emphasised the importance of interprofessional collaboration and the central role of APNs, whose expanded skillset enables them to coordinate care with caregivers and professionals. However, challenges remain, including a lack of understanding of the APN’s skills and concerns about their integration within the care team. APNs could support access to person-centred, coordinated home care in rural areas by acting as key references for patients, caregivers, and teams. However, limited awareness of their role and concerns from other professionals remain barriers to their integration. Frail older adults in rural areas need better access to home care, social connection, and coordinated services. APNs can enhance care and collaboration through advanced skills, addressing rural healthcare challenges. Limited awareness of APN roles hinders integration, making education essential for their acceptance and effective use.