Community nursing in Belgium, Germany and The Netherlands

This paper contains a comparative study on community nursing in the Netherlands, Belgium and Germany, carried out in the region around Maastricht, where the borders of the three countries meet. The well-known problem of comparative studies (the incomparability of concepts and data) has been solved by using the same measuring instruments in the three countries. The comparison between the countries was on three aspects: the level of care dependency of the patients, the type and number of services provided and the nurses' job interpretation and job satisfaction. During 1 week in June or September 1991, 89 community nurses made records of all their home visits and nursing activities. In total the community nurses paid 5165 home visits to provide care to 1796 patients. The results indicate that both the level of care dependency of the patients as well as the type of care provided differs between the three countries. Belgian community nurses have the highest number of patients with a high level of care dependency. Curative services like technical nursing care and domestic care are most frequently provided by the German and Belgian community nurses. Informing, educating and supporting care is most frequently provided by the Dutch community nurses. The German community nurses spend less time on administration activities. With respect to job interpretation and job satisfaction the following results were found. The Dutch community nurses mentioned in their job interpretation many more preventive tasks, whereas the German community nurses more often mentioned domestic tasks. Concerning the hygienic and technical tasks, no significant differences were found between the three countries. Finally, job satisfaction is lowest in the Netherlands. Dutch community nurses are less satisfied with the work organization and the possibilities of autonomy and professionalization than the German and Belgian community nurses.