Beyond Clinical Skills: Gaps in Patient-Centered Nursing Competence in a Mountainous Area of Vietnam

Background: Nurses often face high workloads, limited supervision, and challenging conditions. This study was conducted to assess the competence of clinical nurses and explore driving forces for nursing competence in a mountainous area of Vietnam. Method: A cross-sectional survey was conducted among 356 clinical nurses working at nine district health centers, using a structured self-administered questionnaire. Logistic regression was used to examine factors associated with higher competence. Results: Of the nurses, 67.4% reported good overall competence. The highest rated domains were comprehensive care practice and collaboration with colleagues in patient care. However, notable gaps were noted in patient-centered competencies, especially patient communication and education (62.4%), prioritization of care based on patient needs (70.2%), and medication guidance communication (71.9%). Nurses who reported higher job motivation (odds ratio = 7.9, p < .001) and recent training (odds ratio = 3.6, p < .001) showed notably better competence. Conclusion: These findings highlight critical areas for improvement, particularly in patient-centered communication skills. Targeted training initiatives and strategies to enhance professional motivation are essential interventions to address these competence gaps, thereby improving health care quality and workforce retention in underserved mountainous areas.