Development And Application Of Shared Decision Making Questionnaire Among Oncology Nurses Based On The Theory Of Knowledge-attitude-practice

ObjectivesTo compile a shared decision making questionnaire for oncology nurses in the medical background of our country,and to test its reliability and validity using the theory of knowledge attitude practice(KAP).This questionnaire was used to investigate the oncology nurses from tertiary hospitals and oncology specialty hospitals in Zhengzhou City,Henan Province,and to analyze the influencing factors.So as to provide a valid assessment tool for nursing managers to further measure the current status of oncology nurses’knowledge,attitude and practice of shared decision making,and to provide a reliable basis for optimizing training strategies for shared decision making.MethodsPart Ⅰ:Development and evaluation of the questionnaireBased on the KAP(knowledge,attitude and practice)theory,combined with literature review and reference to previous scales,and by qualitative interviews to develop the first draft of the questionnaire.It was designed on the basis of consulting15 experts from different regions who have made great achievements in shared decision-making,including clinical nursing,nursing management and oncologists in oncology.Then,two rounds of Delphi experts consultation and a small sample(36cases)pre-experiment were conducted to form the preliminary test draft of the questionnaire.The formal survey was divided into three phases:280 and 40questionnaires were distributed in the first and second stages respectively,Exploratory factor analysis and retest reliability analysis were conducted respectively with IBM SPSS 22.0 version to form the official questionnaire.378 were distributed in the third stage and the confirmatory factor analysis was performed using AMOS.Part Ⅱ:A cross-sectional studyWith the tools of general information questionnaire and tool of shared decision making questionnaire among oncology nurses based on the theory of knowledge attitude practice,descriptive statistics,one-way ANOVA and multiple stepwise regression analysis were carried out on the data collected in the third stage by using IBM SPSS 22.0,so to describe the level of oncology nurses’knowledge,attitude and practice towards shared decision making and analyze the influencing factors.ResultsThe first part:the shared decision making questionnaire among oncology nurses based on the theory of knowledge attitude practice consisted of 24 items in 3dimensions.Three factors were generated by exploratory factor analysis,and the contribution rate of cumulative variance was 57.657%.The overall Cronbach’sαcoefficient of the questionnaire was 0.941,the overall retest reliability was 0.894,the scale validity index(S-CVI)of was 0.929.The result of confirmatory factor analysis showed that:the factor loading of all the items were above 0.4,and the value of x~2/df was 2.945,RMSEA was 0.075,GFI、AGFI、NFI、IFI and CFI was0.862、0.819、0.924、0.948 and 0.948,respectively,all are within acceptable limits.The AVE values of each dimension are 0.619～0.715,CR values were all greater than 0.8,and the correlation coefficients between each dimension are less than the square root of the corresponding AVE.The second part:The scores of knowledge,attitudes,and practice were respectively 34.76±6.99、21.48±4.00、19.83±5.02.Univariate analysis showed that oncology nurses with different age,oncology experience,title,post,oncology nurse specialist,and monthly income had significant differences in shared decision-making knowledge,attitude and practice scores(P<0.05).The results from multiple stepwise regression analysis showed that,oncology specialist nurses were important factors influencing knowledge,attitude and behavior scores,and nurses’age and position were important factors influencing their shared decision-making attitude and behavior scores,respectivelyConclusionsThe shared decision making questionnaire among oncology nurses based on the theory of knowledge attitude practice includes 24 items in 3 dimensions and has been validated to have good reliability and validity as a tool to evaluate the current situation and factors influencing the shared decision making of oncology nurses.The results show that the level of shared decision making knowledge of oncology nurses was not high and its application in clinical practice was limited.But on the whole,they had a positive attitude toward shared decision making.Age,position,and the identity of oncology nurse specialist are the main influencing factors on oncology nurses’knowledge,attitude and practice scores for shared decisions making scores.