In brief
In a small exploratory study of 82 clients at a parish nursing agency in Italy's Marche Region, most users attended independently, had at least one chronic condition, and sought help with appointments, vital signs, and health information; satisfaction was very high (83% excellent, 17% satisfying), suggesting parish...
What this article is about
Quick Answer
In a small exploratory study of 82 clients at a parish nursing agency in Italy's Marche Region, most users attended independently, had at least one chronic condition, and sought help with appointments, vital signs, and health information; satisfaction was very high (83% excellent, 17% satisfying), suggesting parish nursing may offer accessible, person-centered community care worth considering in health policy.
Student takeaways
Key Takeaways
- Eighty-two clients of a parish nursing agency in Italy's Marche Region completed an anonymous questionnaire assessing socio-demographics, service use, and satisfaction.
- Most participants (77%) attended the parish nursing agency autonomously, while 23% were accompanied by a caregiver.
- Among clients without a caregiver, 24% were foreign-born, a proportion the authors describe as significantly higher than the regional average.
- Most users had a relatively high educational level and at least one chronic health condition, and the most frequently requested services were medical appointment scheduling, vital sign monitoring, and health information.
- Satisfaction was very high, with 83% of clients rating the service as "excellent" and 17% as "satisfying."
Student summary
Why This Research Matters
This study looks at parish nursing, a community-based care model that has recently been introduced in Italy's Marche Region as a way to help people reach healthcare services more easily. Parish nursing agencies are set up in local communities, often connected to faith organizations, and staffed by nurses who help residents navigate the health system, monitor basic health measures, and get information. The idea behind the model is simple: when a formal, hospital-centred health system is hard to access, a nurse working directly in the neighbourhood can close some of that gap. The researchers wanted to find out who actually uses this kind of service, what they use it for, and whether they are satisfied with it.
To answer these questions, the research team designed a quantitative, cross-sectional, exploratory study. They collected original data using an anonymous questionnaire that clients of one parish nursing agency in the Marche Region filled out. Because the data was gathered at a single point in time from clients of one agency, this is considered a snapshot study rather than one that tracks people over months or years. The responses were analyzed with descriptive statistics, meaning the researchers summarized patterns in the data (percentages, counts) rather than testing complex statistical models.
Eighty-two people took part. Most of them, 77%, came to the agency on their own without help, while 23% arrived with a caregiver. Among the group who came without a caregiver, 24% were foreign-born, a proportion the authors describe as significantly higher than the average for the surrounding region. This detail is important: it suggests the parish nursing agency may be reaching immigrant residents who might otherwise face extra barriers to care, such as unfamiliarity with the local health system or language differences. The study also found that most users had a relatively high level of education and that most were managing at least one chronic health condition, showing that parish nursing was not simply serving people with no other options, but a broad mix of community members with ongoing health needs.
When it came to what people actually wanted from the service, three needs stood out again and again: help booking medical appointments, having their vital signs checked (like blood pressure or blood glucose), and getting clear health information they could understand and use. These are all fairly simple, low-technology tasks, but they represent real, everyday obstacles for people trying to manage chronic illness or navigate a health system that can feel confusing or slow.
Satisfaction with the service was very high. Eighty-three percent of users rated their experience as "excellent," and the remaining 17% rated it as "satisfying." No one in the sample reported a negative or neutral experience, at least based on the categories the authors reported.
The authors are careful to describe these as preliminary findings rather than definitive proof that parish nursing works. Still, they argue that the results support the idea that parish nursing can offer accessible, person-centred, and well-received care to a socioeconomically and educationally diverse group of people, including some who might be considered vulnerable, such as newer immigrants and people managing chronic disease. The authors suggest that policymakers thinking about how to strengthen primary care and community health services could consider parish nursing agencies as one piece of that puzzle.
For Canadian nursing students, this study is a useful example of how community and faith-based nursing roles can extend the reach of primary care, something that is also relevant in Canada, where rural, remote, and underserved urban populations often face similar access barriers. It is also a good example of a small, exploratory study: it raises promising signals about a care model but does not, on its own, prove the model is effective at improving health outcomes. Reading this kind of research critically means noticing both what the data can tell us, such as who uses the service and how satisfied they are, and what it cannot tell us, such as whether health outcomes actually improved. That distinction is a core skill in evidence-based nursing practice.
Source abstract
Study Overview
Background and purpose Access to healthcare remains difficult for many, particularly in underserved areas. In Italy's Marche Region, parish nursing agencies have been introduced as a territorial care strategy for enhancing access to healthcare and strengthening community-based services. The aim of this study is to assess the socio-demographic characteristics, service utilization, and satisfaction of users attending a parish nursing agency in the Marche Region. Methods and procedures This quantitative, cross-sectional explorative study drew on original data collected through an anonymous questionnaire completed by clients of a parish nursing agency. The responses were analyzed using descriptive statistical methods. Results 82 individuals participated; 77% were autonomous, while 23% were accompanied by a caregiver. Among those without caregivers, 24% were foreigners, significantly higher than the regional average. Most users had a high educational level and at least one chronic condition. Frequently requested services included medical appointment scheduling, vital sign monitoring, and health information. Satisfaction was high: 83% rated the service as “excellent”, and 17% as “satisfying”. Conclusion These preliminary findings indicate that parish nursing can provide accessible, person-centered, and satisfactory care to vulnerable individuals from diverse educational and socioeconomic backgrounds and suggest that parish nursing agencies could be considered a valuable component in shaping health policy recommendations.
Evidence appraisal
Main Findings
- Eighty-two clients of a parish nursing agency in Italy's Marche Region completed an anonymous questionnaire assessing socio-demographics, service use, and satisfaction.
- Most participants (77%) attended the parish nursing agency autonomously, while 23% were accompanied by a caregiver.
- Among clients without a caregiver, 24% were foreign-born, a proportion the authors describe as significantly higher than the regional average.
- Most users had a relatively high educational level and at least one chronic health condition, and the most frequently requested services were medical appointment scheduling, vital sign monitoring, and health information.
- Satisfaction was very high, with 83% of clients rating the service as "excellent" and 17% as "satisfying."
Practice transfer
Clinical Relevance
- Nurses working in community or territorial care roles can consider low-barrier services, such as appointment navigation and vital sign checks, as high-value entry points that draw in clients who might otherwise delay contact with the health system.
- The high representation of foreign-born clients in this sample suggests parish or faith-community nursing models may help reach immigrant populations who face additional barriers to accessing mainstream primary care, a consideration relevant to Canadian community and public health nursing.
- Because most users in this study had at least one chronic condition, community nurses in similar programs should be prepared to support chronic disease self-management alongside basic navigation and information services.
- High reported satisfaction supports considering parish or community nursing partnerships as a complement to, not a replacement for, standard primary care and specialist services.
- Nurse leaders and health policy planners exploring territorial or community-based care strategies may look to this preliminary Italian model as one example, while recognizing that further outcome-focused research is needed before broad implementation claims can be made.
Faculty notes
Educational Relevance
This paper reports a single-site, cross-sectional, exploratory quantitative study examining a parish nursing agency operating in Italy's Marche Region. Parish nursing, historically associated with faith-community health outreach, is framed here as an emerging territorial care strategy intended to widen access to primary care and community-based services in a region where reaching formal healthcare can be difficult for some residents. The study's purpose was descriptive: to characterize the socio-demographic profile, service utilization patterns, and satisfaction levels of people who used the agency, using an anonymous client questionnaire analyzed with descriptive statistics.
The sample consisted of 82 participants, a modest number appropriate for an exploratory pilot but insufficient to support inferential claims. Seventy-seven percent attended independently and 23% were accompanied by a caregiver. Within the unaccompanied subgroup, 24% were foreign-born, a proportion the authors note as significantly higher than the regional average, though the paper (based on the available abstract) does not specify the statistical test used to establish that comparison. This finding is worth flagging for discussion: it is suggestive of the agency reaching an underserved population, but instructors should prompt students to ask what comparison data and test were used, since the abstract states significance without detailing methodology.
Most users reported a relatively high educational level and at least one chronic condition, and the three most requested services were help scheduling medical appointments, vital-sign monitoring, and general health information. These utilization patterns point to parish nursing functioning as a low-barrier access and navigation point rather than a substitute for clinical or specialist care, complementary to, rather than competing with, primary care.
Satisfaction was uniformly high, 83% rating the service "excellent" and 17% "satisfying," with no lower ratings reported. High satisfaction in a self-selected, single-site convenience sample should be interpreted cautiously; it reflects the experience of people who chose to use and complete a survey about a free or low-barrier community service, which is a population prone to positive response bias.
Good discussion points for a research-appraisal seminar include: the cross-sectional, single-agency design limits generalizability to other parish nursing programs or regions; the descriptive-only analysis cannot establish causal links between parish nursing contact and any health outcome; the questionnaire's validity and reliability are not described in the abstract; and the absence of a comparison group (for example, similar clients not using parish nursing) means satisfaction and utilization data stand alone rather than being benchmarked. Faculty may also want to connect this study to Italy's broader Family and Community Nurse model, introduced nationally in Italian health reforms, and to Canadian equivalents such as community health centres, outreach nursing, and faith-based health ministries serving rural and immigrant populations, drawing parallels and contrasts in structure, funding, and scope of practice.
The authors' conclusion, that parish nursing may be a valuable component of health policy discussions around territorial and person-centred care, is appropriately hedged as preliminary. This paper is best used in class as a model of an early-stage, hypothesis-generating study: strong on descriptive characterization of an under-studied care model, but not yet positioned to demonstrate effectiveness, and a good vehicle for teaching students to separate what a small exploratory study can and cannot claim.
Critical appraisal
Limitations
- The study used a single-site, cross-sectional design at one parish nursing agency, which limits how far the findings can be generalized to other agencies, regions, or countries.
- With only 82 participants, the sample size is small, restricting the precision and statistical power of any comparisons, including the claim about foreign-born representation being significantly different from the regional average.
- The analysis relied on descriptive statistics only; the abstract does not report the questionnaire's validity or reliability testing, or the specific statistical method used to establish the significance of demographic comparisons.
Classroom use
Discussion Questions
- What features of the parish nursing model described in this study make it well suited to reaching people who might otherwise avoid or delay contact with the formal health system?
- Why is it important to distinguish between a study that measures client satisfaction and utilization versus a study that measures health outcomes? What can this study tell us, and what can it not tell us?
- The abstract states that 24% of unaccompanied clients were foreign-born, which was significantly higher than the regional average. What additional information would you want to see before accepting this as a meaningful finding?
- How might the small sample size (82 participants) and single-site design affect the conclusions health policymakers should draw from this study?
- What parallels exist between the parish nursing model described here and community health or outreach nursing roles in Canada, particularly in rural, remote, or underserved urban settings?
- The three most requested services were appointment scheduling, vital sign monitoring, and health information. What does this tell you about the kinds of barriers clients were facing before using the agency?
- How might response bias affect the very high satisfaction ratings (83% excellent, 17% satisfying) reported in this study?
- If you were designing a follow-up study to build on these exploratory findings, what research question and design would you propose, and why?
- What ethical or scope-of-practice considerations should nurses working in a faith-based or community setting like a parish nursing agency keep in mind?
- How could a model like parish nursing be adapted or piloted within a Canadian primary care or community health context, and what barriers might it face here that differ from Italy?
Knowledge check
Quiz
1. What type of study design was used in this research on parish nursing in the Marche Region?
- A randomized controlled trial
- A quantitative, cross-sectional explorative study
- A longitudinal cohort study
- A systematic review
Rationale: The abstract states: 'This quantitative, cross-sectional explorative study drew on original data collected through an anonymous questionnaire completed by clients of a parish nursing agency.'
2. How many participants took part in the study?
- 28
- 82
- 128
- 820
Rationale: The abstract states: 'Results 82 individuals participated.'
3. What percentage of participants attended the parish nursing agency without a caregiver?
- 23%
- 50%
- 77%
- 83%
Rationale: The abstract states: '77% were autonomous, while 23% were accompanied by a caregiver.'
4. Among clients without a caregiver, what percentage were foreign-born, according to the abstract?
- 12%
- 17%
- 24%
- 40%
Rationale: The abstract states: 'Among those without caregivers, 24% were foreigners, significantly higher than the regional average.'
5. Which characteristic was common among most parish nursing agency users, according to the study?
- No formal education and no chronic conditions
- A high educational level and at least one chronic condition
- Recent hospital discharge only
- Employment in healthcare
Rationale: The abstract states: 'Most users had a high educational level and at least one chronic condition.'
6. Which three services were most frequently requested by users of the parish nursing agency?
- Wound care, medication administration, and surgery referral
- Medical appointment scheduling, vital sign monitoring, and health information
- Mental health counseling, transportation, and housing assistance
- Immunizations, physical therapy, and nutrition counseling
Rationale: The abstract states: 'Frequently requested services included medical appointment scheduling, vital sign monitoring, and health information.'
7. What percentage of users rated the parish nursing service as "excellent"?
- 17%
- 50%
- 77%
- 83%
Rationale: The abstract states: 'Satisfaction was high: 83% rated the service as "excellent", and 17% as "satisfying".'
8. How did the authors analyze the questionnaire responses?
- Using inferential statistical modeling
- Using descriptive statistical methods
- Using qualitative thematic analysis only
- Using a randomized comparison group
Rationale: The abstract states: 'The responses were analyzed using descriptive statistical methods.'
9. According to the study's conclusion, how do the authors describe their findings?
- Definitive proof that parish nursing improves health outcomes
- Preliminary findings suggesting parish nursing can provide accessible, person-centered care
- Evidence that parish nursing should replace primary care
- Inconclusive results with no policy relevance
Rationale: The abstract states: 'These preliminary findings indicate that parish nursing can provide accessible, person-centered, and satisfactory care to vulnerable individuals from diverse educational and socioeconomic backgrounds.'
10. Why is the small sample size of this study (82 participants) an important limitation to consider?
- It means the study had no participants with chronic conditions
- It restricts generalizability and the precision of any statistical comparisons made
- It automatically invalidates all descriptive statistics
- It means the study cannot have been anonymous
Rationale: A single-site, cross-sectional study with 82 participants provides limited statistical power and generalizability beyond the one agency and region studied, a standard limitation of small exploratory samples.
Study cards
Flashcards
What is parish nursing, as described in this study's context?
A community- and often faith-based nursing model that helps connect residents to healthcare services, framed here as a territorial care strategy in Italy's Marche Region.
Where was this parish nursing study conducted?
In Italy's Marche Region.
What was the aim of the study?
To assess the socio-demographic characteristics, service utilization, and satisfaction of users attending a parish nursing agency in the Marche Region.
What type of study design was used?
A quantitative, cross-sectional, explorative study.
How was the data collected?
Through an anonymous questionnaire completed by clients of a parish nursing agency.
How were the questionnaire responses analyzed?
Using descriptive statistical methods.
How many individuals participated in the study?
82 individuals.
What percentage of participants attended the agency autonomously (without a caregiver)?
77%.
What percentage of participants were accompanied by a caregiver?
23%.
Among clients without a caregiver, what percentage were foreign-born?
24%, which the authors describe as significantly higher than the regional average.
What educational and health characteristics were common among most users?
Most users had a high educational level and at least one chronic health condition.
What were the three most frequently requested services at the parish nursing agency?
Medical appointment scheduling, vital sign monitoring, and health information.
What percentage of users rated the service as "excellent"?
83%.
What percentage of users rated the service as "satisfying"?
17%.
What overall conclusion do the authors draw about parish nursing?
That it can provide accessible, person-centered, and satisfactory care to vulnerable individuals from diverse educational and socioeconomic backgrounds.
How do the authors suggest parish nursing agencies could be used at a policy level?
As a valuable component in shaping health policy recommendations for territorial and primary care.
Why should the finding about foreign-born clients be interpreted cautiously?
Because the sample size is small (82 participants) and the abstract does not specify the statistical test used to establish significance.
What is a key limitation related to how satisfaction data was collected?
It came from a self-selected group who chose to use and respond to the survey, creating potential response and selection bias.
Why is this study described as descriptive rather than outcome-focused?
Because it measures utilization and satisfaction, not whether contact with the agency changed health outcomes over time.
How is this study relevant to Canadian nursing practice?
It offers an example of a community or faith-based nursing model that could inform strategies for reaching rural, remote, or underserved populations in Canada, while illustrating how to critically appraise an exploratory, single-site study.
Search-ready answers
Frequently asked questions
What is parish nursing?
Parish nursing is a community- and often faith-based model of nursing care in which nurses help connect local residents to healthcare services, provide basic health monitoring, and share health information. In this study, it is described as a territorial care strategy introduced in Italy's Marche Region.
What did this study find about who uses parish nursing services?
Among 82 participants, 77% attended independently and 23% with a caregiver. Most users had a high educational level and at least one chronic condition, and 24% of unaccompanied clients were foreign-born, a proportion higher than the regional average.
How satisfied were clients with the parish nursing agency?
Satisfaction was high: 83% of users rated the service as 'excellent' and 17% rated it as 'satisfying'.
What services did people most often seek from the parish nursing agency?
The most frequently requested services were medical appointment scheduling, vital sign monitoring, and health information.
How was this study designed?
It was a quantitative, cross-sectional, explorative study using an anonymous questionnaire completed by clients of one parish nursing agency, analyzed with descriptive statistics.
Can this study prove that parish nursing improves health outcomes?
No. The study describes utilization and satisfaction at a single point in time; it does not measure whether parish nursing contact changed health outcomes, so it cannot establish effectiveness or causation.
Why might parish nursing be particularly relevant for foreign-born or immigrant populations?
The study found a higher-than-average proportion of foreign-born clients among unaccompanied users, suggesting this low-barrier community model may help reach people who face extra obstacles navigating a health system, such as unfamiliarity with local services.
What are the main limitations of this study?
It is a small (82 participants), single-site, cross-sectional study with no described validity or reliability testing of the questionnaire and no comparison group, so findings should be considered preliminary and not generalized broadly.
How could this research be relevant to Canadian nursing students?
It offers a real-world example of community and faith-based nursing extending access to care, a concept relevant to rural, remote, and underserved Canadian populations, and it is a useful case study for practicing critical appraisal of exploratory research.
What do the study authors recommend based on their findings?
They suggest parish nursing agencies could be considered a valuable component in shaping health policy recommendations aimed at strengthening territorial and person-centered primary care, while noting their findings are preliminary.