Cent Eur J Nurs Midw 2025;16(4):2297–2305 
doi: 10.15452/CEJNM.2025.16.0024 
 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2297 
ORIGINAL PAPER 
Administration of patient education in nursing: perspective of nurse 
administrators in Finland 
Elina Linnavuori1 , Milka Virmajoki1, Heli Virtanen1,2 , Helena Leino-Kilpi1,2  
1Department of Nursing Science, University of Turku, Finland 
2Turku University Hospital, Wellbeing services county of Southwest Finland, Finland 
Received February 15, 2025; Accepted October 16, 2025. Copyright: This is an open access article under the CC BY-NC-4.0 license. 
Abstract 
Aim: To analyze administration of patient education in nursing from the perspective of nurse administrators to provide new 
information and support for evidence-based practice and development. Design: A descriptive study. Methods: Data were 
collected through individual semi-structured interviews. The informants were nurse administrators (n = 6) working in primary 
health care in two large Finnish cities. The data were analyzed using inductive qualitative content analysis. Results: Two main 
categories were identified: administration of patient education and areas for improvement in the administration of patient 
education. Each category was further divided into four subcategories. Administration of patient education involves recognizing 
it as a distinct nursing action, ensuring nurses’ competence, supporting processes and resources, and fostering a value-based 
approach to patient education. Areas for improvement concern the identification, planning, implementation, and evaluation 
of patient education. Conclusion: At present, the administration of patient education in nursing appears to be unstructured 
and unsystematic. Moving forward, systematic administration and improvement of patient education will require a clear 
identification and delineation of the entire patient education process. 
Keywords: administration, interview, nurse administrator, nursing, patient education. 
 
Introduction 
Patient education is a core component of both health 
care (Forbes et al., 2021; World Health Organization 
[WHO], 2023) and nursing, as emphasized 
in European Directive 2013/55/EU, which defines 
the minimum educational requirements for nurses 
responsible for general care (European Union, 2013). 
Patient education is understood as an interaction 
between a healthcare professional and a patient, 
aimed at increasing health-related knowledge 
and skills and supporting patients’ empowerment 
in maintaining and promoting their health (Health 
Care Education Association [HCEA], 2021). 
Patient education is important in the various 
healthcare settings in primary or secondary 
healthcare (WHO, 2023; Organization for Economic 
Co-operation and Development [OECD], 2017) 
and has been shown to positively impact patient 
outcomes (Brunner et al., 2023; Feng et al., 2021). 
Primary health care is a society-wide approach 
to strengthening national health systems and bringing  
 
Corresponding author: Elina Linnavuori, Department of Nursing 
Science, University of Turku, Kiinamyllynkatu 10, 20520 Turku, 
Finland; email: melinn@utu.fi 
services closer to communities. It includes 
integrating health services for all stages of life, 
addressing broader health determinants through 
multisectoral action, and empowering individuals 
and communities to manage their health 
(WHO, 2018). Primary healthcare services are 
typically delivered in outpatient settings (Rajan et al., 
2024).  
The importance of patient education in health care 
and nursing is growing as long-term conditions 
become more prevalent and hospital stays shorter, 
which increases patients’ responsibility for managing 
their health (WHO, 2023) while simultaneously 
reducing the time available for patient education 
in hospitals. As the largest group of health 
professionals, nurses have an important role 
in patient education, since they work in diverse 
settings, often serving as the primary contact 
for patients from all backgrounds (National 
Academies of Sciences, 2021). However, previous 
studies indicate that patient education is among 
the most frequently omitted nursing care activities, 
and it is informal and ancillary to other work 
(Bergh et al., 2012, 2015a, 2015b; Hätönen et al., 
2010; See et al., 2020; Seyedin et al., 2015). 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2298 
Other organizational factors hindering the delivery 
of patient education include lack of time 
and organizational support (Spann et al., 2024; Wang 
et al., 2024).  
Integrating patient education into practice has 
recently been emphasized in guidebooks 
for policymakers, highlighting administrators’ roles 
in implementing health promotion measures 
to address public health challenges (OECD, 2022; 
WHO, 2023). In nursing, the role of nurse 
administrators in patient education has also been 
recognized (Ho et al., 2023; Paulse et al., 2020). 
However, research on the administration of patient 
education in nursing is limited, and most studies 
describe it in terms of its absence (Bergh et al., 2012, 
2015a, 2015b; Fereidouni et al., 2019; Hätönen et al., 
2010; Latter et al., 1992; Paulse et al., 2020; See 
et al., 2020; Seyedin et al., 2015). Nurse 
administrators’ actions related to patient education 
have been identified, including strengthening 
commitment to patient education, ensuring 
the availability of necessary resources, and enhancing 
patient education policies (Linnavuori et al., 2024). 
However, some findings indicate that administrators 
do not always recognize their responsibility 
for patient education (Bergh et al., 2015a, 2015b).  
Based on this evidence, examining the administration 
of patient education and the role of nurse 
administrators is warranted. This study focuses 
on patient education administration within 
the context of primary health care, where education 
and guidance play a central role in population 
services. In this study, a nurse administrator 
is defined as an individual working at various 
organizational levels, from unit to strategic level, 
with responsibility for administering nursing. Titles 
for these administrators may include nurse manager, 
nurse leader, nurse director, or head nurse, among 
others. 
Aim  
The aim of this study was to analyze 
the administration of patient education in nursing 
from the perspective of nurse administrators, in order 
to provide new insights and support evidence-based 
practice and development. The study addresses 
the following research questions: (1) How is patient 
education administered? and (2) What areas, if any, 
require improvement in the administration of patient 
education? 
 
 
Methods 
Design 
An explorative descriptive qualitative approach was 
adopted to address the research aim and questions. 
This methodological approach was chosen because 
it is well-suited for exploring under-researched areas 
of healthcare practice (Hunter et al., 2019). It was 
employed in this study to explore and describe nurse 
administrators’ perspectives on (1) the administration 
of patient education and (2) areas for improvement  
in its administration. For data collection,  
semi-structured individual interviews were used. 
The findings are reported following the consolidated 
criteria for reporting qualitative research (COREQ) 
checklist (Tong et al., 2007). 
Sample 
A sample of nurse administrators working at different 
organizational levels was recruited from purposively 
selected primary healthcare organizations in two 
large cities in Finland. In Finland, nurse 
administrators are typically registered nurses 
who hold a master’s degree in health sciences 
(from either a university or a university of applied 
sciences), and some also hold a PhD. The inclusion 
criteria for participants were that (1) they worked 
in primary health care as nursing administrators 
and (2) they administered nursing staff delivering 
patient education in an outpatient context. Primary 
healthcare organizations were selected to encompass 
large populations with diverse health issues. 
The outpatient context was chosen because 
it typically involves a wide range of educational 
activities. 
Participants were recruited from selected 
organizations via contact persons, who distributed 
the interview invitation, information letter, 
and informed consent form to all nurse administrators 
within their organization. Nursing administrators 
interested in participating contacted the researcher 
by email. Recruitment continued until data saturation 
was reached, at which point the interviews no longer 
yielded significant new insights. 
Data collection 
Semi-structured individual interviews were 
conducted from September 2021 to February 2022 
via the Zoom video conferencing platform and were 
audio-recorded. The interviews were carried out 
by one of the researchers, who has a nursing 
background. The interview questions were designed 
to address the two research questions and were 
developed based on the researchers’ experience 
and relevant literature on the topic. The duration 
of the interview ranged between 32–49 minutes 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2299 
(average 40 minutes).  A total of six participants 
(n = 6) were interviewed until the data became 
saturated, which was defined as the point at which no 
additional information was identified. 
Data analysis 
The statistical analysis was conducted using 
The data were analyzed using a qualitative inductive 
approach (Graneheim et al., 2017). First, all 
interviews were audio-recorded and transcribed 
verbatim. Next, expressions such as words 
and sentences relevant to the research questions were 
identified, and meaning units were extracted 
from the text. A total of 129 meaning units were 
identified for the first, and 29 for the second research 
question. Third, these meaning units were condensed 
and then coded focusing on the manifest content 
(Graneheim & Lundman, 2004). After that, codes 
were first grouped into subcategories and then 
into categories based on correspondence content 
(Table 1). All authors discussed and reviewed 
the codes and categories several times in their joint 
meetings until a consensus was reached. 
 
Table 1 Example of coding and categorizing 
Meaning unit in original data Condensed 
meaning unit 
Code Subcategory 
H4: “What I like to invest in and where I feel that things 
get on to a good start is education –  so that they have the 
opportunity to ask and learn and take their time to adopt 
it, and that’s where it starts, the foundation for good 
client education as well” 
Patient education 
is included 
in the orientation 
programs. 
Continuing 
education 
in patient 
education. 
Ensuring 
the competence 
of nurses in patient 
education. 
 
Results 
Two categories were identified based  
on the responses to the research questions (Figure 1): 
administration of patient education, and areas  
for improvement in its administration. Each category 
was further divided into subcategories. 
The following sections describe these categories 
in detail. 
 
Figure 1 Administration of patient education and areas requiring improvement: categories and subcategories 
 
Administration of patient education   
Administration of patient education encompasses all 
actions related to patient education that nurse 
administrators described in their interviews as part 
of their professional responsibilities. It consists 
of four subcategories: (1) recognizing patient 
education as a distinct nursing action, (2) ensuring 
nurses’ competence in patient education, (3) 
supporting processes and resources for patient 
education, and (4) fostering a value-based approach 
to patient education. These subcategories are 
described in detail below. First, experiences shared 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2300 
by most interviewees are presented, followed 
by specific examples and direct quotes to illustrate 
individual perspectives. 
Recognizing patient education as a distinct nursing 
action is reflected in how it is administered 
and integrated into administrative roles. Nurse 
administrators’ responses indicated that patient 
education is currently acknowledged to varying 
degrees across units. Some participants noted 
that it was only addressed when problems arose. 
Patient education and its administration were often 
perceived as occurring alongside other tasks rather 
than as a standalone activity. For example, one 
administrator stated: “Well, maybe there isn’t 
so much that is clearly visible, so it’s perhaps sort 
of embedded, but maybe that’s what makes it a bit 
hard for me to grasp it” (H1). 
Ensuring the competence of nurses in patient 
education involves both maintaining sufficient 
nursing competence and providing ongoing 
education. Nurse administrators’ responses indicated 
that the level of competence required for patient 
education varied and was often not clearly defined 
within healthcare units. Some administrators noted 
that basic nursing education was considered 
adequate, although certain roles, such as diabetes 
education, were expected to require additional 
expertise. Administrators emphasized that the most 
important competencies for delivering patient 
education included interpersonal skills 
and the ability to assess patients’ knowledge needs. 
They acknowledged their responsibility for ensuring 
that nurses’ knowledge remained up to date 
and grounded in evidence-based practice: 
“We manage to keep people’s skills and knowledge 
up to date, from the employer’s perspective as well, 
that’s important” (H4). 
Continuing education also contributes to supporting 
nurses’ competence in patient education. However, 
administrators’ responses revealed that opportunities 
for ongoing training varied significantly between 
units. Currently, the responsibility for identifying 
training needs often falls to the nurses themselves. 
To improve consistency, administrators suggested 
that patient education be more systematically 
integrated into training plans, orientation programs, 
and continuing education opportunities. They 
also acknowledged their responsibility in supporting 
this process: “If a nurse comes to ask for advice 
we consider the matter together with the client, 
so there are like three of us involved in it, so that’s 
where the superior’s viewpoint is needed” (H5).  
Supporting processes and resources for patient 
education involves resource allocation, managing 
structural conditions, and monitoring and developing 
patient education. The allocation of resources 
includes factors enabling nurses to deliver patient 
education in their daily work. These were aspects 
that administrators felt they could influence, 
depending on their organizational level. One nurse 
administrator described these factors as including, 
for example, time, space, and resources: 
“As a whole, the work is arranged so that there are 
possibilities for it, so that there is an allocated space 
and arrangements and time resources are in place” 
(H4). 
Administering structural conditions for patient 
education within an organization involves ensuring 
effective communication and consistent practices 
to facilitate proper information flow between nursing 
administrators and nurses. This includes 
the responsibility of acting as a link between 
strategic-level management and staff. Administrators 
recognized their own responsibility for example, 
providing information, and implementing new 
knowledge in practice: “Forwarding them [the new 
guidelines] and on the other hand, going through 
them at nurses’ meetings, well that is of course also 
kind of reflected in getting the correct information 
to patients and clients” (H1). 
Ensuring consistent practices involves promoting 
adherence to policies and best practices, providing 
a standardized approach to the systematic 
administration and quality of patient education. 
For example, one nurse administrator emphasized 
the importance of clearly defined roles 
and responsibilities: “As to what the nurse’s role 
is and how the nurse can promote it within 
the teamwork, and, like, act and educate the patient” 
(H3). 
Monitoring and developing patient education 
involves overseeing daily care practices using 
various methods and data sources, as well 
as improving practices to enhance patient education. 
Interviewees mentioned monitoring nurses’ daily 
work, collecting patient feedback, and reviewing 
incident reports as part of their practice. One 
participant explained: “It is also the superior’s task 
to monitor it or follow the so-called quality, 
or the education and patient care” (H2). 
Fostering a value-based working method in patient 
education involves promoting a culture that 
emphasizes patient-centeredness, continuous 
learning, and the importance of a positive working 
environment. Administrators set an example through 
their own actions and serve as guides. Interviewees 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2301 
noted, for instance, that patient education should 
be considered during the recruitment of nurses 
and developed with input from both employees 
and patients: “It is patient-driven, so you must, like, 
think that you don’t go into the organization 
to provide education by using bureaucratic jargon; 
instead, you must think about it from the patient’s 
point of view, as it were” (H5). 
“It’s pretty important that you are able to get people 
engaged, so maybe you must try to be inspiring 
and positive towards education” (H3). 
Areas for improvement in the administration 
of patient education 
Areas for improvement in the administration 
of patient education encompass all elements 
identified by nursing administrators during 
interviews when asked about potential 
enhancements. These were divided into four 
subcategories: (1) identifying the administration 
of patient education, (2) planning the administration 
of patient education, (3) executing the administration 
of patient education, and (4) evaluating 
the administration of patient education. 
The following sections describe these subcategories 
in detail. First, experiences shared by most 
interviewees are presented, followed by specific 
examples and direct quotes illustrating individual 
perspectives. 
Identifying the administration of patient education 
involves defining patient education and establishing 
a shared understanding of its content across 
the organization. Such a common understanding 
is essential for recognizing patient education 
as a distinct nursing action. Participants emphasized 
the importance of viewing patient education 
as a whole and considering their work from this 
perspective. For example, one participant stated: 
“You need to be, like, really aware of what 
is the dimension in relation to patient education 
in leadership and supervision work” (H4). 
Planning the administration of patient education 
involves proactivity, as well as defining 
and harmonizing consistent practices. Establishing 
consistent practices was viewed as a key area 
for improvement from both patient education 
and administrative perspectives. Interviewees 
emphasized that improvements should be 
implemented before issues manifested as negative 
patient feedback or adverse events in care. 
Developing these practices was considered part 
of their responsibility, as one administrator noted: 
“We are there in the unit, so naturally we have 
the power and means to develop this practice 
and make it possible” (H2). 
Executing the administration of patient education 
can be viewed from two perspectives: project-based 
development and continuous development. These 
perspectives are not mutually exclusive and can 
overlap and complement each other. In continuous 
development, implementing new knowledge 
into practice was described as a concrete action. One 
administrator illustrated this by saying: 
“And naturally there are the instructions for further 
care as well as availability, well those are everyday 
challenges for us. We think about them and try 
to impact them on a broad spectrum, from, like, 
the head nurse’s perspective, so yes, we do this work 
all the time” (H5). 
Continuous evaluation, monitoring, and critical 
examination of current practices are essential 
for administering patient education effectively. 
Participants emphasized that improving 
administration requires identifying areas that may 
compromise the quality of patient education. 
For example, one administrator stated: “As a rule, 
high-quality work starts right there, so you need 
to be able to look at those activities, and you must 
look at them and question them at times” (H3). 
Discussion 
This study aimed to explore how patient education is 
administered in nursing by using nurse 
administrators as informants and addressing two 
research questions. By exploring the current 
practices of administrators and identifying areas 
for improvement, the research offers new insights 
into the field of patient education. This study 
focused on primary health care in an outpatient 
setting, an area that seems to have been less explored 
in previous research (Linnavuori et al., 2024). 
As a result, various administrative actions were 
identified, often occurring alongside other work 
areas. Nursing administrators also recognized 
the need to improve the administration of patient 
education. Such improvement encompasses 
identifying, planning, executing, and 
evaluatingpatient education administration. 
Together, these findings indicate that, at present, 
systematic administration of patient education is 
lacking. This is an important finding, as the role 
of administrators has been highlighted as crucial for 
ensuring best practices in the future (OECD, 2022). 
Based on the exploration of current practices, 
the administration of patient education appears to be 
unstructured and partly unconscious, a finding 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2302 
that aligns with previous studies (Bergh et al., 2012, 
2015a; 2015b; Fereidouni et al., 2019; Hätönen 
et al., 2010; Latter et al., 1992; Paulse et al., 2020; 
See et al., 2020; Seyedin et al., 2015). However, 
it should be noted that regulations regarding patient 
education vary from country to country and this may 
lead to differences in nursing administrators’ 
perceptions of the administration of patient 
education. For instance, in Finland patient education 
is mandated by law, which states that patients have 
the right to receive information about their care, 
whereas in other countries the approach may be less 
formal. Nevertheless, in this study, administrators 
demonstrated limited familiarity with the process 
of patient education administration when asked 
about written guidelines or policies related to it. 
The topic of administration of patient education was 
mostly new for the interviewees and they had not 
considered it before.  For example, they did 
not mention Finnish legislation on patients’ rights 
to information (Act on the Status and Rights 
of Patients, 785/1992; Ministry of Social Affairs 
and Health, 1992), the promotion of this right 
through management (Inkeroinen et al., 2023), 
or ethical guidelines for nursing. Future empirical 
research with a larger sample is needed 
at the individual, unit, and organizational levels 
to identify, structure, and evaluate the administration 
of patient education and to develop relevant policies 
and practices. Although the results of this study 
pertain to primary care, future studies should extend 
across the entire healthcare system. 
This study revealed that interviewees had varied 
approaches to nursing and patient education. Some 
participants focused more on patients’ ability 
to receive and understand information, rather 
than on fostering two-way interaction between 
nurses and patients. This variation is also evident 
in other contexts, in which sociocultural factors play 
a role. In diverse patient populations, language 
barriers, differences in health literacy, and cultural 
beliefs about illness and health care can make 
implementing a uniform education strategy 
challenging. Looking ahead, patient empowerment 
and self-management will continue to be highly 
emphasized across clinical fields and organizations 
internationally (European Parliament, 2024; WHO, 
2023), which also presents ongoing challenges 
for nurse administrators. A positive finding is that 
some participants highlighted the importance 
of nurses’ interpersonal skills and the individuality 
and knowledge needs of patients. However, 
the interviews revealed that administrators’ roles 
in promoting nurse–patient interaction or supporting 
these interpersonal skills were not clearly articulated. 
Similar challenges have been identified in other 
studies, in which nursing administrators struggled 
to support the less visible, fundamental elements 
of nursing care (Mudd et al., 2023; Poikkeus et al., 
2014). Recent research suggests that recognizing 
and addressing nurse burnout, for example, may 
positively influence empathic behavior in nursing 
practice (Dong et al., 2025). Accordingly, in patient 
education, administrators can play a key role 
in fostering an ethical culture within work units 
and promoting high-quality patient education. Future 
research would benefit from examining 
the administration of patient education from this 
perspective. 
There were areas in patient education administration 
that required improvement, consistent with previous 
research findings (Bergh et al., 2012, 2015a, 2015b; 
Fereidouni et al., 2019; See et al., 2020). These areas 
were identified directly by administrators 
themselves, without supporting evidence or formal 
evaluation. Notably, similar findings were first 
reported ten years ago (Bergh et al., 2012), 
highlighting the need for systematic development 
in these areas. The first step in administering patient 
education is therefore to define it clearly. Without 
such a definition, essential elements of patient 
education risk being overlooked or misunderstood. 
For instance, identifying the process of educational 
diagnosis aids in assessing patients’ knowledge 
needs (Ait-Taleb Lahsen et al., 2023; Gorina et al., 
2019). This should be followed by reflection 
on current practices and consideration of ways 
to enhance the implementation and quality of patient 
education. While administrative actions related 
to patient education already exist, raising awareness 
of them and making them visible requires 
knowledge, insight, and persistence. 
This study has limitations regarding 
the transferability and credibility of its findings 
(Graneheim & Lundman, 2004). First, data were 
collected from a relatively small sample 
of participants from primary healthcare 
organizations in two cities in Finland. Therefore, 
the results should be interpreted with caution, 
and the study underscores the need for further 
research in this field. Additionally, limited 
knowledge or experience in administrative actions 
related to patient education among participants may 
have constrained the data, preventing the categories 
from being developed into broader themes. 
The findings may also have been influenced 
by the interviewees’ perceptions of patient 
education, their views on nursing, and their 
understanding of the nurse’s role. Nevertheless, data 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2303 
saturation was achieved, and the findings are 
presented alongside participants’ original 
expressions to enhance transferability. In the future, 
at least part of these results could be used to develop 
a structured instrument in this field. 
Practice implications for nursing administration 
This study can be considered a starting point for this 
understudied topic, highlighting the need for further 
research. Future studies should investigate nurse 
administrators’ perceptions and practices related 
to patient education, evaluate the impact of patient 
education approaches, and identify evidence-based 
strategies, training programs, and organizational 
tools to strengthen the administration of patient 
education across healthcare settings. 
At the organizational level, the results can inform 
strategies that foster a common understanding 
of patient education and its administration, clarify 
responsibilities, and establish consistent practices. 
At the individual level, the findings can help nurse 
administrators define their responsibilities 
and identify specific actions integral to their role. 
These actions include recognizing patient education 
as a core nursing activity, ensuring nursing staff 
are competent in delivering education, supporting 
processes and necessary resources, and fostering 
a value-based working approach. 
Additionally, the results can encourage 
administrators to reflect on their role from a new 
perspective. Administering patient education should 
not be viewed merely as a task performed alongside 
other work; rather, it is a strategic responsibility 
that influences nurses’ professional development, 
patient outcomes, and the overall quality of care. 
Conclusion 
The results of this study highlight the importance 
of recognizing patient education as a distinct nursing 
action for its systematic administration. At present, 
the administration of patient education appears to be 
inconsistent or sporadic. Administrative actions 
already undertaken by nurse administrators include 
recognizing patient education as a distinct nursing 
action, ensuring nurses’ competence, supporting 
processes and resources, and fostering a value-based 
working approach. However, this study suggests 
that these actions are often performed unconsciously 
alongside other duties rather than deliberately 
for patient education. There remains a need to raise 
awareness of patient education as a distinct nursing 
responsibility, as its administration is still largely 
unstructured. Future research is needed to improve 
the administration of patient education. This study 
identified key areas related to identifying, planning, 
executing, and systematically evaluating 
the administration of patient education, but further 
research is required to enhance patient education 
and its administration across healthcare settings. 
Ethical aspects and conflict of interest 
Ethical approval for the study was obtained  
on June 7, 2021, from the Healthcare Division  
of the Ethics Committee for Human Sciences  
at the University of Turku. In addition, research 
permissions were obtained from the two  
participating healthcare organizations (9704-2021-3; 
637/07.01.04.01.03/2022). All participants provided 
written informed consent prior to the interviews 
and took part voluntarily. 
The authors declare that they have no competing 
interests or personal relationships that could have 
influenced the work reported in this paper. 
Funding 
This work was supported by the Wellbeing Services 
County of Southwest Finland, with governmental 
funding for research in health sciences [Project 
13762]. 
Author contributions  
Conception and design (MV, HV, HLK), data 
collection (MV), data analysis and interpretation 
(EL, MV), manuscript draft (EL), critical revision 
of the manuscript (HV, HLK), final approval 
of the manuscript (EL, MV, HV, HLK). 
References 
Ait-Taleb Lahsen, H., Ragala, M. E. A., El Abed, H., Hajjaj, 
S., El Makhtari, R., Benani, S., El Hilaly, J., Zarrouq, B., 
& Halim, K. (2023). Educational needs of type 1 diabetes 
mellitus T1DM children and adolescents in Morocco: 
a qualitative study. Journal of Education and Health 
Promotion, 12(1), 114. 
https://doi.org/10.4103/jehp.jehp_54_23 
Bergh, A. L., Friberg, F., Persson, E., & Dahlborg-Lyckhage, 
E. (2015a). Perpetuating “New Public Management” 
at the expense of nurses’ patient education: a discourse 
analysis. Nursing Inquiry, 22(3), 190–201. 
https://doi.org/10.1111/nin.12085  
Bergh, A. L., Friberg, F., Persson, E., & Dahlbogr-Lyckhage, 
E. (2015b). Registered nurses’ patient education 
in everyday primary care practice: managers’ discourses. 
Global Qualitative Nursing Research, 2. 
https://doi.org/10.1177/2333393615599168 
Bergh, A. L., Karlsson, J., Persson, E., & Friberg, F. (2012). 
Registered nurses’ perceptions of conditions for patient 
education – focusing on organisational, environmental 
and professional cooperation aspects. Journal of Nursing 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2304 
Management, 20(6), 758–770. 
https://doi.org/10.1111/j.1365-2834.2012.01460.x 
Brunner, C., Theiler, M., Znoj, H., Holzer, S., & Seliner, B. 
(2023). The characteristics and efficacy of educational 
nurse-led interventions in the management of children 
with atopic dermatitis – an integrative review. Patient 
Education and Counseling, 116, 107936.  
Dong, M., Zhang, X., Wu, L., & Cao, F. (2025). Exploring 
the bidirectional relationship between job burnout 
and empathy in nurses: a longitudinal study. Patient 
Education and Counseling, 130, 108445. 
https://doi.org/10.1016/j.pec.2024.108445 
European Parliament: Directorate-General for Parliamentary 
Research Services, & Mahieu, V. (2024). Future-proofing 
the EU’s global health strategy: strategic autonomy 360°. 
European Parliament. 
https://data.europa.eu/doi/10.2861/579625 
European Union. (2013). Directive 2013/55/EU 
of the European Parliament and of the Council of 20 
November 2013 amending Directive 2005/36/EC 
on the recognition of professional qualifications 
and Regulation (EU) No 1024/2012 on administrative 
cooperation through the Internal Market Information 
System (IMI). Official Journal of the European Union, 
L354/132. https://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=celex%3A32013L0055 
Feng, Y. Y., Chaves, G. S. S., Shi, W., Pakosh, M., Zhang, L., 
Gallagher, R., Oh, P., & Ghisi, G. L. M. (2021). Education 
interventions in Chinese cardiac patients on health 
behaviours, disease-related knowledge, and health 
outcomes: a systematic review and meta-analysis. Patient 
Education and Counselling, 104(5), 1018–1029. 
https://doi.org/10.1016/j.pec.2020.12.001 
Fereidouni, Z., Sabet Sarvestani, R., Hariri, G., Kuhpaye, S. 
A., Amirkhani, M., & Kalyani, M. N. (2019). Moving 
into action: the master key to patient education. Journal 
of Nursing Research, 27(1), 1–8. 
https://doi.org/10.1097/jnr.0000000000000280 
Forbes, R., Clasper, B., Ilango, A., Kan, H., Peng, J., 
& Mandrusiak, A. (2021). Effectiveness of patient 
education training on health professional student 
performance: a systematic review. Patient Education 
and Counselling, 104(10), 2453–2466. 
https://doi.org/10.1016/j.pec.2021.02.039 
Gorina, M., Limonero, J. T., & Álvarez, M. (2019). 
Educational diagnosis of self-management behaviours 
in patients with diabetes mellitus, hypertension 
and hypercholesterolaemia based on the PRECEDE model: 
qualitative study. Journal of Clinical Nursing, 28(9–10), 
1745–1759. https://doi.org/10.1111/jocn.14794 
Graneheim, U. H., Lindgren, B. M., & Lundman, B. (2017). 
Methodological challenges in qualitative content analysis: 
a discussion paper. Nurse Education Today, 56, 29–34. 
https://doi.org/10.1016/j.nedt.2017.06.002 
Graneheim, U. H., & Lundman, B. (2004). Qualitative content 
analysis in nursing research: concepts, procedures 
and measures to achieve trustworthiness. Nurse Education 
Today, 24(2), 105–112. 
https://doi.org/10.1016/j.nedt.2003.10.001 
Hätönen, H., Kuosmanen, L., Koivunen, M., & Välimäki, M. 
(2010). Patient education practices in psychiatric hospital 
wards: a national survey in Finland. Nordic Journal 
of Psychiatry, 64(5), 334–339. 
https://doi.org/10.3109/08039481003675076 
Health Care Education Association. (2021). Patient education 
practice guidelines for health care professionals. HCEA. 
https://www.hcea-
info.org/assets/hcea%20guidelines%20color%201-25-
2021.pdf 
Ho, J. T., See, M. T. A., Tan, A. J. Q., Levett-Jones, T., Lau, 
T. C., Zhou, W., & Liaw, S. Y. (2023). Healthcare 
professionals’ experiences of interprofessional collaboration 
in patient education: a systematic review. Patient Education 
and Counselling, 116, 107965. 
https://doi.org/10.1016/j.pec.2023.107965 
Hunter, D., J. McCallum, & Howes, D. (2019). Defining 
Exploratory-Descriptive Qualitative (EDQ) research 
and considering its application to healthcare. Journal 
of Nursing and Health Care, 4(1). 
https://eprints.gla.ac.uk/180272/. 
Inkeroinen, S., Virtanen, H., Stolt, M., & Leino-Kilpi, H. 
(2023). Patients’ right to know: a scoping review. Journal 
of Clinical Nursing, 32(15–16), 4311–4324. 
https://doi.org/10.1111/jocn.16603 
Latter, S., Clark, J. M., Wilson-Barnett, J., & Maben Clark, J. 
(1992). Health education in nursing: perceptions of practice 
in acute settings. Journal of Advanced Nursing, 17(2),  
164–172.  
Linnavuori, E., Inkeroinen, S., Kostylev, A., Seel, M., 
Virmajoki, M., Virtanen, H., & Leino-Kilpi, H. (2024). 
Delivering patient education in healthcare organizations: 
an integrative review of the nursing administrative actions. 
Journal of Nursing Management, 2014, 1296011. 
https://doi.org/10.1155/2024/1296011 
Ministry of Social Affairs and Health, Finland. (1992). Act 
on the status and rights of patients (785/1992). Finlex Data 
Bank. 
https://www.finlex.fi/en/laki/kaannokset/1992/en19920785.
pdf 
Mudd, A., Feo, R., Voldbjerg, S. L., Laugesen, B., Kitson, A., 
& Conroy, T. (2023). Nurse managers’ support 
of fundamental care in the hospital setting. An interpretive 
description of nurse managers’ experiences across Australia, 
Denmark, and New Zealand. Journal of Advanced Nursing, 
79(3), 1056–1068. https://doi.org/10.1111/jan.15139 
National Academies of Sciences, Engineering, and Medicine; 
National Academy of Medicine, Committee on the Future 
of Nursing 2020–2030, Flaubert, J. L., Le Menestrel, S., 
Williams, D. R., & Wakefield, M. K. (Eds.). (2021). 
The Future of Nursing 2020–2030: Charting a path 
to achieve health equity. National Academies Press (US). 
https://doi.org/10.17226/25982 
Organisation for Economic Co-operation and Development. 
(2017). Caring for quality in health: lessons learnt from 15 
reviews of health care quality. OECD Publishing. 
https://doi.org/10.1787/9789264267787-en 
Organisation for Economic Co-operation and Development. 
(2022). Guidebook on best practices in public health. 
OECD Publishing. https://doi.org/10.1787/4f4913dd-en 
Paulse, P., Jooste, K., & Majee, M. (2020). Closing the gap: 
exploring nurse managers’ support to midwives 
in implementing HIV/AIDS testing and counselling within 
protocol. Africa Journal of Nursing & Midwifery, 22(2),  
1–19. https://doi.org/10.25159/2520-5293/4882 
Poikkeus, T., Numminen, O., Suhonen, R., & Leino-Kilpi, H. 
(2014). A mixed-method systematic review: support 
for ethical competence of nurses. Journal of Advanced 
Nursing, 70(2), 256–271. https://doi.org/10.1111/jan.12213 
Linnavuori, E., et al.                                                                                                                               Cent Eur J Nurs Midw 2025;16(4):2297–2305 
 
 
© 2025 Central European Journal of Nursing and Midwifery 2305 
Rajan, D., Rouleau, K., Winkelmann, J., Kringos, D., Jakab, 
M., Khalid, F. (Eds.). (2024). Implementing the primary 
health care approach: a primer. World Health 
Organization.  
See, M., Chee, S., Rajaram, R., Kowitlawakul, Y., & Liaw, S. 
(2020). Missed nursing care in patient education: 
a qualitative study of different levels of nurses’ 
perspectives. Journal of Nursing Management, 28(8),  
1960–1967, https://doi.org/10.1111/jonm.12983 
Seyedin, H., Goharinezhad, S., Vatankhah, S., & Azmal, M. 
(2015). Patient education process in teaching hospitals 
of Tehran University of Medical Sciences. Medical Journal 
of the Islamic Republic of Iran, 29, 220. 
Spann, A., Steininger, A., Jukic-Puntigam, M., & Grandy, S. 
(2024). Nurses’ experiences with ad-hoc patient education 
in an Austrian acute care setting – a qualitative multicentric 
study. Patient Education and Counseling, 130, 108401. 
https://doi.org/10.1016/j.pec.2024.108401 
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated 
criteria for reporting qualitative research (COREQ):  
a 32-item checklist for interviews and focus 
groups. International Journal for Quality in Health Care, 
19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042 
Wang, S., Liu, K., Tang, S., Wang, G., Qi, Y., & Chen, Q. 
(2024). Barriers and facilitators to patient education 
provided by nurses: a mixed-method systematic 
review. Journal of Clinical Nursing, 33(7), 2427–2437. 
https://doi.org/10.1111/jocn.17111 
World Health Organization. (2018). Declaration of Astana. 
WHO. https://www.who.int/publications/i/item/WHO-HIS-
SDS-2018.61 
World Health Organization Regional Office for Europe. 
(2023). Therapeutic patient education: an introductory 
guide. WHO.