[Pregnancies and deliveries in Finland and Estonia in 1997 to 2011]. / Raskaudet ja synnytykset Suomessa ja Virossa 1997-2011.

BACKGROUND AND METHODS: Treatment practices of pregnancies and deliveries and newborn health have differed from each other between Finland and Estonia. We examined changes in the differences from 1997 to 2011 from national birth registers and official statistics. RESULTS: Deliveries, abortions and overall fertility remained similar in Finland. In Estonia, the number of deliveries increased and abortions decreased. Problems in the perinatal period continued to be more common in Estonia. CONCLUSIONS: Estonian reproductive health and treatment practices of deliveries have approached the situation in Finland.

Finnish nurses' perceptions of care of older patients.

The aim of the study was to explore how far the perceptions of care of nurses in Finland take into account the preferences of the older patient and the patient's family members and to evaluate related background factors. The data were collected by questionnaire with nurses (n=167) working in a geriatric hospital. The questionnaire contained items about shared decision-making, attitudes to nursing patients, assessment of patients' functional ability and need for care, goal-setting, evaluation of outcomes and discharge planning. This study showed that taking into account the preferences of the patient and the patient's family members regarding the patient's care was challenging for the nurses in practice. About one-third of the nurses reported making the decisions on a patient's care themselves and not respecting patient autonomy in situations where patients are not able to assess their own situation. In addition, the nurses reported asking for the views of patients less frequently than those of family members when assessing and setting patient care goals. In practice, nurses need to be aware of this, during the transition from routine-centred care to patient-centred care.

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.

Patient-centeredness in long-term care of older patients - a structured interview.

AIM: The aim of this study was to describe assessments of older people about patient-centeredness in the long-term care of Estonian hospitals, and to determine correlations between patients' assessments and their socio-demographic characters. BACKGROUND: Patient-centeredness increases patients' satisfaction and enhances their recovery. Still, patients' opinions are not always taken into account. METHOD: A cross-sectional study included 111 older people in long-term care of 14 Estonian hospitals. Data were collected in 2008 by means of structured interviews. RESULTS: What patients agreed most was that they were given enough opportunity to carry out activities they were capable of performing themselves. Two thirds of participants had not been sufficiently consulted on who would be providing their care. Half of the participants were not given sufficient opportunity to decide what kind of care was needed and how they would receive it. The more assistance patients needed in daily living activities, the less they considered the care as patient-centred. CONCLUSIONS: From the perspective of older people, the patient-centeredness in Estonian long-term care is above average. Providing patient-centred long-term care in Estonian hospitals deserves more attention. RELEVANCE TO CLINICAL PRACTICE: Older people should be more involved in decision-making, especially those who need more assistance in daily living activities.