Purpose: The purpose of this study was to investigate and analyze the level of actual participation and perceived importance of shared decision-making on treatment and care of lung cancer patients, to compare their differences and to explore factors that in uence them.Methods: A total of 290 lung cancer patients were collected from the department of oncology and thoracic surgery of a comprehensive medical center in Qingdao from October 2018 to December 2019. Participants completed a cross-sectional questionnaire to assess their actual participation and perceived importance in shared decision-making on treatment and care.Descriptive analysis and non-parametric tests were carried out to assess the status quo of patients' shared decision-making on treatment and care. Binary logistic regression analysis with a stepwise back-wards was applied to predict the factors that affected patients' participation in shared decision-making.Results: The results showed that patients with lung cancer had a low degree of participation in shared decision-making. There were signi cant differences between actual participation and perceived importance of shared decision-making on treatment and care. Education level, younger, gender, income, marital status, personality, the course of the disease (>6 months), and the Pathological TNM staging ( ) affected the patient's level of participation in shared decision-making.Conclusion: Actual participation in shared decision-making for the treatment and care of lung cancer patients was low and considered unimportant. We could train oncology nurses to use patient decision aids to help patients and families participate in shared decision-making based patients' value, preferences and needs.

AimThe present study aimed to develop the Risk Perception Scale of Disease Aggravation for older patients with non‐communicable diseases and evaluate its psychometric properties.DesignInstrument development and cross‐sectional validation study were conducted.MethodsThis study contained four phases. In phase I, a systematic literature review was conducted to identify the conception of disease aggravation and risk perception. In phase II, a draft scale was formulated from face‐to‐face semi‐structured in‐depth interviews by Colaizzi's seven‐step qualitative analysis method and group discussions among the researchers. In phase III, domains and items of the scale were revised in accordance with the suggestions from Delphi consultation and patient feedback. In phase IV, psychometric properties were evaluated.FindingsExploratory and confirmatory factor analyses determined four structural factors. Convergent and discriminant validities were acceptable because the average variance extracted coefficients ranged from .622 to .725, and the square roots of the average variance extracted coefficients for the four domains were larger than those of bivariate correlations between domains. The scale also exhibited excellent internal consistency and test–retest reliability (Cronbach's alpha coefficient = .973, intraclass correlation coefficient = .840).ConclusionsRisk Perception Scale of Disease Aggravation is a new instrument that measures the risk perception of disease aggravation for older patients with non‐communicable diseases, including possible reason, serious outcome, behaviour control and affection experience. The scale contains 40 items that are scored on a 5‐point Likert scale, and it has acceptable validity and reliability.ImpactThe scale is applied to identify different levels of risk perception of disease aggravation for older patients with non‐communicable diseases. Clinical nurses can provide targeted interventions to improve older patients' risk perception of disease aggravation based on levels of risk perception during hospitalization and the period before discharge.Patient or Public ContributionExperts provided suggestions for revising the scale dimensions and items. Older patients participated in the scale revision process to improve the wording of the scale.