Abstract: Objective: To investigate the current status and influencing factors of clinical nurses' Knowledge, Attitude, and Practice (KAP) regarding Shared Decision-Making (SDM) and to provide a basis for the development of SDM implementation strategies. Methods: A convergent mixed-methods design was adopted. Using convenience sampling, a total of 898 nurses from 13 hospitals in Ningxia Hui Autonomous Region were surveyed in July 2024 with a general information questionnaire and the SDM Questionnaire. Simultaneously, a descriptive qualitative study was conducted, in which 10 nurses were selected through purposive sampling for semi-structured interviews. Results: The score of nurses' SDM-KAP was 97.00 (96.00, 117.00), with a scoring rate of 80.8%. Generalized linear model analysis showed that nurses' age, professional position, hospital level, city of hospital location, and awareness of patient decision aids were significant factors influencing SDM-KAP levels (all P<0.05). Qualitative analysis yielded two themes and six subthemes regarding the cognitive and implementation attitudes of clinical nurses towards shared decision-making, as well as the constraints on nurses' participation in shared decision-making. Conclusion: The overall level of SDM-KAP among clinical nurses in this region was moderately high, and was influenced by multiple factors, including individual characteristics, environmental conditions, and tool support.

Key words: Shared Decision-Making; Knowledge, Attitude and Practice; clinical nurse; influencing factor