Mappatura delle competenze degli Infermieri di Famiglia o Comunità (IFOC): uno studio a metodi misti.

Background Profound demographic changes, particularly population ageing and the rising prevalence of chronic diseases, demand a rethinking of community-based care models. The Family and Community Nurse (FCN) has emerged as a key professional in coordinating and delivering integrated care. In Italy, the country with the highest median age and among the highest rates of multimorbidity in Europe, recent national reforms have formally recognised the FCN role, while European initiatives such as ENhANCE have proposed a core competency model. However, relevant gaps remain between training and the real-world implementation of these competencies in daily practice. Aim To map and analyse the FCN professional competencies in Italy in order to identify current training and professional development gaps and to inform the effective implementation of the FCN role within territorial care services. Methods A sequential exploratory mixed-methods design was adopted. Competencies were first identified through: (i) a systematic literature review, (ii) an analysis of 16 Italian FCN Master’s curricula, and (iii) qualitative data collection comprising semi-structured interviews and focus groups. The resulting preliminary competency framework was subsequently refined and validated through a three-round e-Delphi process with an expert panel. In Round 2, experts rated each competency on a 10-point Likert scale. Consensus was defined a priori as an interquartile range (IQR) ≤ 2 and ≥ 80% of ratings ≥ 8. In Round 3, experts provided a binary judgement on the indispensable nature of each competency. Results The e-Delphi process yielded a validated framework comprising 43 core competencies for the FCN role. Overall, 71.7% of the competencies reached a consensus of ≥ 80% “Yes” responses, and 26.7% reached a consensus of ≥ 90%. The core competencies clustered around three main pillars: care management (case management and continuity of care), relational skills (education, empowerment, health coaching), and strategic leadership (innovation, quality improvement, and evidence-informed decision-making). Conclusions This study provides the first validated competency framework for FCNs in Italy. The framework offers a reference to guide curriculum development, professional training, competency assessment and workforce planning, and supporting the alignment of FCN training with community health needs and national territorial care reforms. A forthcoming national survey among FCN Master’s graduates will further assess the framework’s perceived acquisition and application of these competencies in clinical practice.