Community nursing in Finland: the division of fields of activity and patterns of care--comprehensive or specialized care?

The aim of this study was, first, to describe the changes taking place in the division of fields of activity in Finnish community nursing during a national project on primary health care; second, to describe and analyze patterns of care by categorizing different points of view in nurses' personal experiences. Data on the division of fields of activity in all project areas were collected in a survey and in annual registrations of public health nurses' tasks (n = 87-113). Care patterns were discerned in focused interviews with public health nurses (n = 18). Three types of division of fields of activity were identified: the comprehensive, semi-comprehensive and specialized model. The comprehensive and semi-comprehensive models became more common during the project and the specialized one less common. Patterns of care were classified into four main categories: structural, individualistic, family-centred and community-centred. The division of fields of activity was not always compatible with the care patterns. The study identified several issues that should be considered in the definition and implementation of comprehensive and specialized care.