Helsinki Metropolia University of Applied Sciences The Client-Centeredness of Nursing Students and The Support Received to it Through Education. Students´ view. Ly Kalam-Salminen PhD, RN, Principal Lecturer, Metropolia UAS, Finland Olga Ruonala, Nursing Student Metropolia UAS, Finland Leo Tuominen, Nursing Student Metropolia UAS, Finland Ilme Aro, MNSc, Lecturer, University of Tartu Pirkko Routasalo, PhD, RN, Professor, University of Tartu 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Background: Client-/patient-centeredness is a widely-applied and appreciated term. The general idea and thinking behind the term is to refocus on the client and to respond to their specific and unique individual needs and wishes. The activity and involvement of the client/patient in their care is also strongly advocated. 18/11/18 Helsinki Metropolia University of Applied Sciences

Significance of Client-centeredness: Client-centeredness has a positive connection to Client satisfaction Commitment to care Empowerment of both - Client and Caretaker Improved overall cost-efficiency Quality of nursing care 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Background Research on the current level of client-centeredness of nurses is insufficient. Patient/client-centeredness in adult intensive care, elderly care and health education – project launched to adress this issue. This presentation represents the health education partakers in the project. Participants Metropolia UAS Central Ostrobothnia UAS University of Tartu Tallinna Tervishoiu Kõrgkool (Tallinn Health Care College) Tartu Tervishoiu Kõrgkool (Tartu Health Care College) 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Aim: The aim of this presentation is to describe and compare the client-centeredness of graduating nursing students of two Finnish Universities of Applied Science and the support they received to it during their education. 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Research questions: How client-centered were the graduating nursing students? How has the provided theoretical education supported the client-centeredness of the students? How has the provided practical education(eg. work placement) supported the client-centeredness of the students? What were the differences between the two UAS in client-centeredness and support? 18/11/18 Helsinki Metropolia University of Applied Sciences

Research methods: Sample The data was collected in 2009 from the graduating nursing students (N = 195) of two Finnish Universities of Applied Sciences. All students graduated as Registered Nurses, with some specializing in Midwifery, Public Health and Emergency Care. 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Data collecting The data was collected using a structured questionnaire including 19 backround variables and 46 research variables (statements). The questionnaire was split into segments, each concerning a different aspect of client-centredness: Value Base of Client-centeredness (6 statements) Maintaining a Client-centered Atmosphere (8 statements) Personal Key Abilities and Skills (14 statements) Equality in the Patient-Caretaker Relationship (18 statements) 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Data collecting Each statement was to be assessed in three categories: Current client-centeredness Support from theoretical education Support from practical education The respondent was to choose a numerical value between 1(poor) and 5(excellent) that best reflected their assessment in each category 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Data analysis The data was statistically analyzed using the SPSS program. Frequencies, standard deviations and mean averages have been used as indicators of client-centeredness and received support. The results are depicted using bar diagrams. The correlation between client-centeredness and received support was tested using Spearman’s rho. The differences between the two UAS were tested using the Mann-Whitney U Test. 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Results: Overall Current client-centeredness of Finnish Students Students´ client-centeredness Mean SD Value Base of Client-centeredness 4,49 0,45 Maintaining a Client-centred atmosphere 4,20 Equality in the Patient-Caretaker Relationship 4,25 0,43 Personal Key Abilities and Skills 3,95 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Differences between OB UAS and Metropolia UAS in Current client-centeredness P-values 0,01 no sign. 0,02 0,00 Asymp. Sig. (2-tailed) 18/11/18 Helsinki Metropolia University of Applied Sciences

Overall Support from Theoretical Education Support provided by theoretical education Mean SD Correlation to Client-centeredness P-value Value Base of Client-centeredness 4,20 0,59 0,436 0,00 Maintaining a Client-centred atmosphere 3,76 0,64 0,522 Equality in the Patient-Caretaker Relationship 3,26 0,71 0,575 Personal Key Abilities and Skills 3,91 0,65 0,593 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Differences between OB UAS and Metropolia UAS in Support from Theoretical Education P-values 0,47 0,01 0,00 0,05 Asymp. Sig. (2-tailed) 18/11/18 Helsinki Metropolia University of Applied Sciences

Overall Support from Practical Education Support provided by practical education Mean SD Correlation to Client-centeredness P-value Value Base of Client-centeredness 4,05 0,58 0,531 0,00 Maintaining a Client-centred atmosphere 3,84 0,59 0,576 Equality in the Patient-Caretaker Relationship 3,89 0,53 0,622 Personal Key Abilities and Skills 3,97 0,511 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Differences between OB UAS and Metropolia UAS in Support from Practical Education P-values no sign. no sign. 0,07 0,22 Asymp. Sig. (2-tailed) 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Conclusions: On the whole, the students from the two Finnish UAS assessed themselves as being quite client-centered Practical education was generally considered to provide slightly better support to client-centeredness than theoretical education. Value Base of Client-centeredness was supported better by theoretical studies than practical education, but had the best support in both categories of education. Equality in the Patient-Caretaker relationship received the weakest support, through theoretical education. Students from Ostrobothnia UAS assessed themselves to be more client-centered AND that they received better support to it. 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Discussion: Educational resources should be focused on the areas in which students were found to be least client-centered More specifically, students assessed themselves to be the least client-centered concerning the following statements in the segment Personal Key Abilities and Skills: “I am able to use nursing equipment and technical appliances required in client care” (Mean 2,86) “I know how to use information technology required in client care” (Mean 2,56) “I develop my technical skills whenever I lack them” (Mean 2,83) 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Discussion: Further research is required to uncover the specific factors that produced the difference between the two UAS. The differences between the two UAS in client-centeredness and received support give indication of the advantages of co-operation and mutual sharing of the practices found to be effective. 18/11/18 Helsinki Metropolia University of Applied Sciences

Helsinki Metropolia University of Applied Sciences Thank you for your time! 18/11/18 Helsinki Metropolia University of Applied Sciences