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Knowledge, attitude, and behavior regarding the implementation of shared decision-making among advanced practice
Nai-Chen Lu1,2, Su-Ying Fang3,4
1Department of Nursing, College of Medicine, National Cheng Kung University, No. 1, Daxue Rd, Tainan, 70101, Taiwan.
BMC Nursing
|May 28, 2026
Summary
Advanced Practice Nurses’ (APNs) positive attitudes strongly predict their shared decision-making (SDM) behaviors. Enhancing APNs’ SDM skills requires targeted training in risk communication and practical experience.
Area of Science:
- Nursing
- Healthcare Management
- Patient Engagement
Background:
- Shared decision-making (SDM) research primarily involves physicians and patients, with limited focus on Advanced Practice Nurses (APNs).
- Understanding APNs' roles in SDM is crucial for improving patient outcomes, particularly in regions with lower patient involvement in medical decisions.
- This study addresses the need to explore SDM knowledge, attitudes, and behaviors among APNs in Taiwan.
Purpose of the Study:
- To investigate the factors influencing and the relationships among SDM knowledge, attitudes, and behaviors of APNs in Taiwan.
- To identify how these factors impact the implementation of SDM in clinical practice.
- To inform strategies for enhancing APNs' engagement in shared decision-making.
Main Methods:
- Cross-sectional survey design involving 112 APNs in Taiwan.
- Online questionnaire assessing SDM knowledge, attitudes, and behaviors.
- Descriptive statistics and univariate linear regression for data analysis.
Main Results:
- APN attitude was the strongest predictor of SDM behavior, positively correlating with implementation effort and quality.
- Practical experience in SDM significantly increased APNs' effort in the decision-making process.
- Gaps were identified in APNs' risk communication knowledge, specifically regarding relative risk and natural frequency formats.
Conclusions:
- SDM training for APNs should integrate risk communication, reflective learning, and simulations.
- Structured feedback and practical experience are essential for consistent clinical application of SDM principles.
- Enhanced training can improve APNs' understanding and implementation of core SDM concepts.
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