Factors related to the use of community nursing services in The Netherlands.

This study aims to identify factors important in explaining the nature of community nursing care received by patients in their homes because little is known about the relation between individual characteristics of patients receiving nursing care and the nature of care delivered by community nurses. During a period of 2 weeks a representative sample of 137 community nurses and 49 community nurses' auxiliaries at 47 different locations paid a total number of 12,847 home visits to provide care to 3,315 patients. For each home visit, patient's characteristics, the nature of care delivered by the nurse and the length of the home visit was recorded. The results suggested that three groups of patients could be identified in terms of the nature of nursing care received at home. First, patients who were older, who were also receiving informal care and did not suffer from psychosocial problems, were most likely to receive assistance in their activities of daily living. Second, patients suffering from multiple disorders, whose situation was assessed as unstable, and those who did not suffer from psychosocial problems were most likely to receive technical nursing care. These patients were visited most often. Finally, male patients suffering from multiple disorders, whose situation was assessed as unstable, especially when new mental or social problems emerged, were most likely to receive psychosocial support and education from the community nurse. These visits appeared to be the most time-consuming.