2026 Volume 46 Pages 1-11
Purpose: To develop an e-learning-based shared decision-making (SDM) education program and evaluate its impacts on the behavioral intentions of those practicing SDM.
Methods: A single-group pre–post comparison study was conducted with 49 mid-career nurses from healthcare institutions across Japan. The nurses were provided with a self-directed e-learning program and were subsequently assessed for their behavioral intentions regarding SDM practice by using a CPD-reaction questionnaire at three time points: pre-intervention (T0), immediately post-intervention (T1), and 1 month post-intervention (T2).
Results: Behavioral intention scores improved significantly immediately after the intervention (T1) (p = 0.001) but showed no significant difference from baseline at the 1-month follow-up (T2). Multiple regression analysis revealed that “belief in capabilities” (β = 0.445) and “moral norms” (β = 0.386) were positively associated with behavioral intentions immediately post-intervention (T1). However, only the moral norm scores showed sustained improvement at the 1-month follow-up (T2).
Conclusions: The e-learning SDM education program developed in this study enhanced the behavioral intentions of mid-career nurses in the short term. However, the sustainability of this impact must be addressed in future studies. This study suggests that the enhancement of both belief in capabilities and moral norms is important for promoting SDM practice among nurses.
