Table 1 The formal version of the RSDM-N scale

1

Knowledge

q1. When patients face situations where there is no best or unique treatment/care plan and available options have pros and cons, SDM is the ideal medical decision-making model.

q2. Both SDM and evidence-based medicine emphasize patient involvement and respect for patients’ values and preferences.

q3. The goal of SDM is to explicitly reach a consensus on health decisions between clinicians and/or nurses and patients and/or family members.

q4. Before implementing SDM, it is necessary to assess whether the patient has the willingness and ability to participate in decision-making.

q5. During the SDM process, high-quality information about different options should be provided to patients based on the best evidence from evidence-based practice.

q6. During the SDM process, I should be objectively and neutrally assisted in fully weighing the pros and cons of different options.

q7. During the SDM process, patients’ understanding of the information should be explored by having them repeat the specific content of the relevant information.

q8. During the SDM process, patients should be encouraged to provide their own thoughts and feelings about the disease and decision-making to healthcare professionals.

q9. Decision aids are evidence-based tools that can assist in the implementation of SDM by providing information about choices and corresponding outcomes related to the patient’s health condition, helping patients make informed choices.

q10. The construction of decision aids should follow the International Patient Decision Aid Standards (IPDAS) or other recognized methods.

2

Attitude

q11. I believe that patient or family involvement in SDM is beneficial to themselves.

q12. I believe that SDM helps improve the doctor-patient relationship and reduce doctor-patient conflicts.

q13. I believe that SDM will enrich my professional knowledge and promote my professional development.

q14. I believe that patients’ values and decision-making preferences should be an important part of the decision-making process.

q15. I believe that SDM has broad application prospects in our country.

q16. I am willing to actively participate in the SDM process.

q17. I am willing to actively consult relevant books, literature, etc., to understand the latest progress of SDM.

q18. I am willing to actively participate in SDM-related training courses.

q19. I believe that I will play a key role as a bridge and link between doctors and patients in the SDM process in various roles.

3

Ability

q20. I can explain to patients the importance of their participation in the decision-making process.

q21. Before implementing SDM, I can determine whether the patient is suitable for SDM and in what way SDM should be implemented.

q22. Before implementing SDM, I can accurately understand the patient’s willingness to participate in decision-making.

q23. I can provide patients with scientific and reliable information about different options based on the best evidence from evidence-based practice.

q24. I can help patients fully weigh the pros and cons of different options in a neutral and objective manner.

q25. I can explore patients’ understanding of the information by having them repeat the specific content of the relevant information.

q26. I can encourage patients to express their true thoughts and feelings about the disease and decision-making, such as expectations and concerns.

q27. I can guide patients to consider their own values and preferences, helping them balance the pros and cons accordingly.

q28. I can choose the way to provide information according to the situation to help patients understand and make decisions (for example, using cards, manuals, websites, videos, and other decision aids).

q29. I can provide clear opportunities for patients to ask questions during the decision-making process.

q30. I can actively assist and guide patients to discuss their condition and make decisions together with them step by step.

q31. I can help patients understand information in a way that is easy to understand.

q32. I can share important patient information with multidisciplinary team members.

q33. I can guide and coordinate the ideas and expectations of both doctors and patients.

q34. I can respect and understand patients’ values and preferences.

4

Change team

q35. Leaders are good at actively exploring and improving clinical work.

q36. Leaders have good influence, and we are willing to follow her/his suggestions or orders

q37. Leaders can reasonably allocate human resources according to clinical work.

q38. Leaders have good communication and coordination skills.

q39. Leaders can widely listen to our opinions and views.

q40. I have good execution ability for tasks assigned by superiors.

q41. My ward has a cultural atmosphere and workflow of multidisciplinary collaboration.

q42. Doctors and other members of the multidisciplinary team can fully recognize the role that nurses can play in SDM.

q43. Team members can cooperate with each other and work together to achieve specific goals.

q44. The team has practice change facilitators with rich professional knowledge and clinical experience.

q45. The team has practice change facilitators who can develop feasible evidence-based practice plans.

5

Contextual support

q46. Senior leadership (hospital/nursing department) supports the development of evidence-based practice changes.

q47. There are incentive policies that encourage participation in evidence-based practice (such as job prospects, learning opportunities, collective honors, rewards, etc.).

q48. There are various forms of training courses related to SDM (such as lectures, video lessons, seminars, simulation exercises).

q49. Evidence related to SDM has been transformed into forms that are easy to disseminate and conducive to understanding and application, such as forming a complete SDM workflow, SDM practice manual, SDM program promotion posters, etc.

q50. There are decision aids available to provide decision support to patients (such as online decision support websites, video and audio materials that provide decision-related information).

q51. There is a feedback system that can optimize practice plans based on feedback from clinical nursing staff and patients.

q52. There is sufficient time to participate in SDM.

q53. There are information technology resources required for evidence-based practice (medical data, software development technology, technical staff support, etc.).

q54. There is a harmonious doctor-patient relationship based on mutual trust.

q55. There is active and appropriate SDM-related hospital publicity or media guidance to make SDM a social norm.