This study aims to develop and evaluate an online shared decision-making (SDM) educational program for nurses and patients with chronic diseases. Shared decision-making is a process in which healthcare professionals and patients make health-related decisions together based on the best available evidence and the patient's values and preferences. The study includes an evaluation phase. In the evaluation phase, the program will be tested among nurses working in general hospitals and adults with chronic diseases living in the community. Outcomes related to shared decision-making will be assessed at baseline, immediately after the 4-week program, and 1 month later. The study is expected to improve shared decision-making competence, experience, and preparedness among both nurses and patients.
Registered nurses currently providing direct patient care in participating general hospitals
Able to understand the purpose and procedures of the study and provide informed consent
Able to use a computer, tablet, or smartphone to access the online program
Not currently engaged in direct patient care
Unable to clearly express willingness to participate
Unable to complete the educational program or questionnaires because of technical or language limitations
Adults aged 19 years or older living in the community
Parallel
Online Shared Decision-Making Educational Program for Nurses
BehavioralThe nurse program is a 4-week web-based shared decision-making educational program for nurses working in general hospitals. It is designed to enhance nurses' knowledge and skills in shared decision-making, decision support, and patient communication through self-directed online learning.
Online Shared Decision-Making Educational Program for Patients With Chronic Diseases
BehavioralThe patient program is a 4-week web-based shared decision-making educational program for adults with chronic diseases. It is designed to support patients in participating in shared decision-making by helping them prepare for decisions, explore options, and clarify their values and preferences.
General Communication Education for Nurses
BehavioralThe control condition consists of access to publicly available communication-related educational materials, such as those provided by the Nursing Human Resources Employment Education Center.
General Health Information for Patients With Chronic Diseases
BehavioralThe control condition consists of access to publicly available health management information, such as that provided by the National Health Information Portal.
Change in nurses' shared decision-making competence
Nurses' shared decision-making competence will be assessed using a shared decision-making competence scale for nurses. The scale consists of 26 items with total scores ranging from 26 to 130. Higher scores indicate greater shared decision-making competence. Changes in scores from baseline to each follow-up assessment will be compared between the intervention and control groups.
Change in patients' shared decision-making experience
Patients' shared decision-making experience will be assessed using the Shared Decision-Making Questionnaire-9 items(SDM-Q-9). The SDM-Q-9 consists of 9 items, with total raw scores ranging from 0 to 45. Higher scores indicate a greater level of patient-perceived shared decision-making. Changes in scores from baseline to each follow-up assessment will be compared between the intervention and control groups.
Change in nurses' shared decision-making experience
Nurses' perceived shared decision-making practice will be assessed using the Shared Decision-Making Questionnaire-Physician version(SDM-Q-Doc). The SDM-Q-Doc consists of 9 items, with total raw scores ranging from 0 to 45. Higher scores indicate a greater level of clinician-perceived shared decision-making. Changes in scores across assessment points will be compared between the intervention and control groups.
Change in patients' decisional conflict
Patients' decisional conflict will be assessed using the Decision Conflict Scale(DCS) Korean version. Scores range from 0 to 100, with higher scores indicating greater decisional conflict. Therefore, lower scores indicate a better outcome. Changes in scores across assessment points will be compared between the intervention and control groups.
Change in shared decision-making knowledge
Shared decision-making knowledge and understanding of the educational content will be assessed using pre- and post-program quizzes developed for each study population. For nurses, the quiz consists of 24 items, and the number of correct answers will range from 0 to 24. For patients, the quiz consists of 10 items, and the number of correct answers will range from 0 to 10. A higher number of correct answers indicates greater knowledge and understanding of the educational content. Changes in the number of correct answers from baseline to post-intervention will be compared between the intervention and control groups.
Preparation for decision making after the intervention
Preparation for decision making will be assessed using the Preparation for Decision Making(PrepDM), including the practitioner version for nurses and the participant version for patients, as applicable. Scores range from 0 to 100, with higher scores indicating a higher perceived level of preparation for decision making. Scores will be compared between the intervention and control groups after the intervention and at follow-up.
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