Client-centeredness of Finnish and Estonian nursing students and the support from nursing education to develop it. Students' self-evaluation

Purpose: The purpose of this comparative study is to describe the differences between Finnish and Estonian students evaluations about their client-centeredness and educational support they received to develop it. Background: Client-centeredness has many positive effects on the quality and effectiveness of care. However, some deficiencies have been identified in the client-centeredness of nursing staff. Research on the subject has been limited, and we lack knowledge of graduating students' competence in client-centeredness and the support of their education to develop it. Methods: The sample consisted of 390 undergraduate nursing students, 195 from Finland and 195 from Estonia. The data were collected in 2009 using the structured five-point scale questionnaire. The questionnaire was designed to measure students' client-centeredness and the educational support they received from nursing education. The data were analyzed by the PASW Statistics 18-programme using descriptive statistics, Kolmogorov-Smirnov test and Mann-Whitney U-test. Results: Predominantly, students in both countries evaluated their level of client-centeredness high. The Estonian students generally evaluated their client-centeredness higher compared to the Finnish students. The same applied to support provided by nursing education. The greatest differences were related to education and particularly theoretical teaching. In Estonia, students' client-centeredness manifested itself more in politeness and willingness to serve clients, whereas respecting the clients' values was emphasized in Finland. Students' requisites, referred here as knowledge, skills and abilities to implement client-centered nursing, for client-centeredness had deficiencies, and the support from education was also the weakest regarding these aspects. Conclusion: In future, education on development of nursing activities, acquisition of knowledge and services provided by health care as well as legislation should be enhanced, since these areas proved the most difficult for the students. (C) 2013 Elsevier Ltd. All rights reserved.