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

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.