Development and Evaluation of an Online Shared Decision-Making Educational Program for Nurses and Patients With Chronic Diseases

Overview

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.

Detailed description

Shared decision-making is a key component of patient-centered care and is particularly important in chronic disease management, where patients often face repeated decisions about treatment options, symptom management, lifestyle modification, and long-term care. Effective shared decision-making requires healthcare professionals and patients to exchange information, consider available options, and make decisions that reflect both clinical evidence and patient values and preferences. Nurses play an important role in chronic disease care by providing education, coordinating communication, and supporting patient participation in health-related decision-making. Patients with chronic diseases also need support to understand their options, clarify their values, and participate actively in decisions about their care. However, structured educational opportunities to strengthen shared decision-making competence are limited for both nurses and patients. This study will develop an online shared decision-making educational program for nurses and patients with chronic diseases and will evaluate its effectiveness in two parallel sub-studies. For nurses, the study will be conducted as a cluster-randomized pretest-posttest controlled trial in general hospitals in Daejeon and Chungcheong-do, Republic of Korea. Hospitals will serve as clusters, and one hospital will be assigned to the intervention group and the other to the control group by coin toss conducted by a third researcher who is not involved in study implementation or data analysis. For patients with chronic diseases, the study will be conducted as a cluster-randomized pretest-posttest controlled trial in community health and welfare institutions. Institutions will serve as clusters and will be assigned in a 1:1 ratio to intervention or control conditions using a computer-generated random allocation sequence prepared by a third researcher not involved in study implementation or data analysis. The intervention will consist of a 4-week online SDM educational program delivered through a web-based platform. Nurses in the intervention group will receive an online program consisting of 12 educational videos. Patients in the intervention group will receive an online program consisting of 5 educational videos. Control participants will receive comparison materials according to the study protocol. Outcome measures will be collected at baseline, immediately after the 4-week intervention, and 1 month after the first post-intervention assessment. The study will evaluate whether the program improves shared decision-making-related competence, experience, knowledge, decisional preparedness, and related outcomes in the two target populations.

Interventions

• Behavioral Online Shared Decision-Making Educational Program for Nurses
  The 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.
• Behavioral Online Shared Decision-Making Educational Program for Patients With Chronic Diseases
  The 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.
• Behavioral General Communication Education for Nurses
  The control condition consists of access to publicly available communication-related educational materials, such as those provided by the Nursing Human Resources Employment Education Center.
• Behavioral General Health Information for Patients With Chronic Diseases
  The control condition consists of access to publicly available health management information, such as that provided by the National Health Information Portal.

Primary outcome measures

• Change in nurses' shared decision-making competence [Time frame: Baseline, immediately after the 4-week intervention, and 1 month after the first post-intervention assessment]
• Change in patients' shared decision-making experience [Time frame: Baseline, immediately after the 4-week intervention, and 1 month after the first post-intervention assessment]

Secondary outcome measures (4)

• Change in nurses' shared decision-making experience [Time frame: Baseline, immediately after the 4-week intervention, and 1 month after the first post-intervention assessment]
• Change in patients' decisional conflict [Time frame: Baseline, immediately after the 4-week intervention, and 1 month after the first post-intervention assessment]
• Change in shared decision-making knowledge [Time frame: Baseline and immediately after the 4-week intervention]
• Preparation for decision making after the intervention [Time frame: Immediately after the 4-week intervention and 1 month after the first post-intervention assessment]

Eligibility criteria

Inclusion Criteria for Nurse:

• 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

Exclusion Criteria for Nurse:

• 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

Inclusion Criteria for Patients:

• Adults aged 19 years or older living in the community
• Diagnosed with one or more chronic diseases requiring ongoing management, including but not limited to hypertension, diabetes mellitus, dyslipidemia, arthritis, chronic respiratory disease, or cardiovascular disease, with at least 3 months elapsed since diagnosis
• Able to understand the purpose and procedures of the study and provide informed consent
• Able to read and respond to survey questions
• Able to use a computer, tablet, or smartphone to access the online program

Exclusion Criteria for Patients:

• Cognitive impairment or communication problems that make participation difficult
• Unable to complete the educational program or questionnaires because of technical or language limitations

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Supportive care

Study locations

South Korea · 1 center

• Chungnam National University — Daejeon

Identifiers

NCT: NCT07589673 · 202511-SB-236-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗