Measuring readiness for nurse-led shared decision making in clinical practice: development and first testing of the RSDM-N scale

Abstract

Object: To develop a scale to measure the organizational readiness for change (ORC) in nurse-led shared decision-making (SDM) in clinical practice of China, test its reliability and validity, and conduct an analysis of the current status of nurse-led SDM readiness. Methods: This study follows the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology guidance and has two phases. The first phase, based on ORC theory, an item pool was formed through literature review, qualitative interviews and group discussions. Two rounds of Delphi consultations were conducted to optimize items, developed an initial scale. Cognitive interviews were then conducted to understand the target population’s comprehension of each item, addressing differences during the development process, resulting in the first scale version. In the second phase, the scale underwent reliability and validity testing, and the results were analyzed to assess the current status of nurse-led SDM readiness. Results: The final scale consists of 55 items across five dimensions.The overall Cronbach’s α coefficient is 0.987, with a split-half reliability of 0.911, a test-retest reliability of 0.904, and an average content validity index of 0.989, indicating good reliability and validity. A field test was conducted among 496 nurses, revealing that the total score of nurses’ SDM readiness ranged from 118 to 270, with an average of 209.79 ± 35.82. Conclusion: The RSDM-N scale exhibits sufficient measurement qualities for assessing nurse-led SDM readiness in China, guiding the implementation of nurse-led SDM.