Preferences trust interaction of nurses and parents as mediating variables between knowledge and shared decision making in the care of newborns in Hospitals

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Making decisions without having adequate knowledge will potentially lead to decision conflicts. This study aimed to analyze of preferences, trust, and interactions between nurses and parents as mediating between knowledge and shared decision-making in the care of newborns in hospitals. Methods The research design was cross-sectional. The population was all parents of newborns hospitalized in Regional Hospital Jember Regency, East Java, Indonesia March–June 2021. The sampling methode was selected by simple random sampling. The required participants are 92. Data collection by questionnaires compiled by researchers, and data analysis by Partial Least Square. Results: The results showed that knowledge (T-statistics=4.464; p=0.000) influenced shared decision making through preferences (T-statistics=3.600; p=0.000), trust (T-statistics=6.760; p=0.000), and nurse interactions and parents (T-statistic=9,160; p=0,000). The interaction of nurses and parents proved to have the strongest influence on shared decision-making. This study recommends that nurses increase interaction with parents. Nurses can maximize the role of parents in together decision-making on the care of newborns in the hospital. Conclusion The knowledge influenced shared decision-making of newborn care through the preferences, trust, and interactions of nurses and parents. This study recommends that nurses should increase interaction with parents. Nurses can maximize the role of parents in shared decision-making on the care of newborns in the hospital. Knowledge Preferences Trust Interaction Shared decision-making Figures Figure 1 Figure 2 1 Introduction Studies on the care of Low-Birth-Weight infants (LBW) have proven that a shared decision-making model can predict an increase in LBW care in hospitals. The trial application of the model affects the provision of breast milk (ASI), the giving of touch stimulation, and the provision of sound stimulation [ 1 ]. However, there has not been much research on decision-making in newborn care. Children need good care from birth to two years of age [ 2 ]. Various problems in newborn care are still high [ 3 ]. Mothers with low education and young age are associated with infant mortality problems in the first year [ 4 ]. As many as 60% of mothers reported not attending the kangaroo mother care. Infants received supplementary formula (47%), insufficient milk production (18%), inadequate breastfeeding (16%), the inability of mothers to breastfeed (14%), and 32% of mothers stopped breastfeeding on day 60 [ 5 , 6 , 7 ]. Problems in newborns can be minimized through the participation of parents in the care of babies in the hospital. A systematic review reported barriers to shared decision making in the neonatology area, including lack of medical information provided to parents to make decisions, inadequate communication, poor relationship with caregivers [ 8 ]. The results of another systematic review also reported barriers to shared decision making in the pediatric clinic area, including poor quality of information about conditions and/or options; lack of unacceptable options/alternatives; the emotional state of the parent/child feeling overwhelmed, anxious, in denial; insufficient time [ 9 ]. The results of the systematic review show that one of the problems in newborn care is the quality of the information in making the right care decisions. The impact of nursing plans that tend to be decided unilaterally, will trigger a conflict of decisions [ 10 ]. Shared decision-making in this study uses the theory of Elwyn (2012). Shared decision-making is designed with three conversations. 1) Choice talk, namely determining the problem and offering options; 2) Talking about options, providing information about the advantages and disadvantages of the action; and 3) Talking decisions. Nurses share ideas and support parents in making choices [ 11 ]. Studies by Haiek et al have also shown that shared decision-making has three structures: 1) discussion with parents of evidence-based information and various options; 2) help parents to recognize the sensitive nature of the decision to clarify values; and 3) provide guidance and support for making and implementing decisions [ 12 ]. A randomized controlled trial study proved that a group of postpartum mothers who made shared decision-making felt more confident, had the best understanding [ 13 ]. Parents' preferences in making decisions are defined by many factors including knowledge and trust in their child's health care doctor [ 14 ]. Knowledge is an important element in making decisions. Making decisions without having adequate knowledge will potentially lead to decision conflicts. Previous studies have found evidence that shared decision-making is influenced by parent-nurse interactions, family support, parental trust, preferences, and decision aids [ 1 ]. Based on some of the results of the studies mentioned above, it can be concluded that there is a relationship between knowledge, trust, preference for shared decision making. However, it has not been explained how this variable affects the overall care of newborns in the hospital. 2 Methods The cross-sectional study was conducted in the perinatology room of the regional hospital in the province of East Java, Indonesia in March-June 2021. The perinatology room is an inpatient room for newborns who have health problems or are at risk of having health problems. The perinatology room is divided into three rooms. The first observation room, the second isolation room, and the third stable baby room. The observation room for low birth weight, asphyxia, respiratory distress syndrome, hyaline membrane disease. The isolation room for babies born outside the hospital, and babies with congenital abnormalities. The stable baby room for babies who come from other hospitals, or babies in isolation and observation rooms who are starting to stabilize. The population was parents who had a newborn baby in the perinatology room. The criteria for parents are mother and father, have good awareness, able to read and write, and were present in the perinatology room. The estimated population that meets the inclusion criteria based on previous research is 106 [ 1 ]. Calculation of the number of samples is based on the 95% confidence level, 5% margin of error, and 50% population proportion. The sample required is 84 participants. Estimated drop-out participants are 10% (8.4). The total required participants is 84 + 8.4 = 92.4 = 92 participants. The sampling method is simple random sampling. The population was 604. 146 potential participants met the criteria from 604 participants. The results of a simple random draw resulted in 102 being included in the sample and 44 not being the sample. A total of 10 participants filled out incomplete data and were excluded from the study sample. So, number of samples size was 92 (see Fig. 1 ). Collecting data using a questionnaire. The questionnaire was prepared by Rohmah, N. Yusuf., and Hargono in 2019. The questionnaire has been used in similar research in three districts of the East Java region of Indonesia [ 1 ]. Test the content validity by calculating the content-validity coefficient. Aiken's V (1985) coefficient value of 0.70 is considered to have adequate content validity. The results of the content-validity coefficient test have an average value between 0.80–0.93, indicating that the content validity is adequate. The results of the validity of the questionnaire with the provisions of n = 24; p 0.7. The results of testing the validity of the questionnaire have a value of r > 0.3297, and the value of Cronbach's Alpha > 0.7, and the questionnaire has met the criteria of validity and reliability [ 1 ]. The latent variables studied included: knowledge (ten indicators), preferences (three indicat ors), parental trust in nurses (five indicators), nurse and parent interactions (five indicators), and shared decision-making (five indicators). Latent variables are also called unobserved variables. Variables latent are, cannot be measured directly. Variable latent measured by one or more manifest variables or also called indicators [ 15 ]. Data analysis using Partial Least Square (PLS). Analysis includes measurements of the outer model and inner model. The results of the outer model testing, on the PLS test, were carried out on all indicators in the study. Knowledge variable indicators include: 1) knowledge about how to treat breasts; 2) knowledge of how to express breast milk; 3) knowledge of how to store breast milk; 4) knowledge of how to deliver breast milk to the nursery; 5) knowledge of how to breastfeed correctly; 6) knowledge of how to increase breast milk; 7) knowledge of how to care for the kangaroo method; 8) knowledge of how to touch a baby; 9) knowledge of how to provide a sound stimulus; 10) knowledge about how to give affection. Each indicator consists of one statement on a Likert scale of 1–4. Indicators of preference variables consist of 1) autonomy; 2) cooperation; and 3) submission. Each indicator consists of one statement on a Likert scale of 1–4. The indicators of the trust variable consist of five indicators. The first, Giving the best action. The second is being able to take action in bad conditions. The third is able to provide accurate information. The fourth always provides information before taking action, and the five always is present if needed. Each indicator consists of one statement on a Likert scale of 1–4. Indicators of interaction variables between nurses and parents consist of 1) information seeking; 2) providing information; 3) information verification; 4) socio-emotional communication, and 5) problem identification. Each indicator consists of one statement on a Likert scale of 1–4. The indicators for joint decision making consist of 1) discussing goals with a single statement; 2) options talk with four statements; 3) choice talk with two statements; 4) decision talk with four statements; and 5) commitment with four statements. All statements with a Likert scale of 1–4. The results of the first measurements of the outer model have six loading factor values ​​<0.5 and a T-statistic value < 1.96 so that the indicator is declared invalid and not significant. Invalid indicators are not included in the second test. The value of outer loading on the second test, all indicators of latent variables > 0.5 so that it has met the validity test. The result of the next test is the value of composite reliability or Cronbachs alpha of all latent variable constructs. The results of testing the value of composite reliability or Cronbach's alpha of all constructs showed > 0.7, so it can be concluded that all latent variables have met the reliability test. The result of the next test is Average Variance Extracted (AVE). AVE values above 0.5 are highly recommended. AVE value for all latent variables > 0.5. Next, evaluate of discriminant validity is measured to see cross-loadings. The test results show that the indicators in each component of the construct have a higher correlation with each construct. This means that the results of the examination of convergent validity and discriminant validity show that they have been met. Next, evaluate the structural model (inner) model. 3 Results Table 1 shows that most of the respondents (65.2%) are aged 20–35 years, 35.9% have elementary school education and 30.4% have junior high school education. The minimum age of the mother is 17 years and the maximum is 47 years. Indications for giving birth at the hospital include premature rupture of membranes (28.25%), delivery > 24 hours (23.91%), hypertension in pregnancy (18.48%), delivery by cesarean section 36.96%. Most of the babies (78.3%) included low birth weight babies, and 69.6% were premature babies. Table 1 Demographic data No Characteristics f (92) % No Characteristics f (92) % 1 Mother's Age 5 Father's Age 15–19 years old 17 18,5 15–19 years old 4 4,3 20–35 years old 60 65,2 20–35 years old 58 63,0 > 35 years old 15 16,3 > 35 years old 30 32,6 2 Mother's Education 6 Father's Education No education 0 0 No education 3 3,2 Elementary school 33 35,9 Elementary school 27 29,3 Junior high school 28 30,4 Junior high school 27 29,3 Senior high school 21 22,8 Senior high school 29 31,5 Higher education 10 10,9 Higher education 6 6,5 3 Baby weight 7 Parent's Tribe < 2500 grams 72 78,3 Javanese 66 71,7 2500–4000 grams 20 21,7 Madurese 26 28,3 4 Gestational Age 8 Baby's Birthplace 42 weeks 2 2,2 Hospital 72 78,3 Table 2 Relationship between variables No. Variables Original sampel (0) T statistic P Value Description 1. Effect of knowledge on preferences 0,405 4,464 0,000 Significants 2. The effect of preference on parents' trust in nurses 0,344 3,600 0,000 Significants 3. The effect of preference on shared decision-making 0,006 0,086 0,932 No significants 4. The effect of parental trust on nurse-parent interactions. 0,546 6,760 0,000 Significants 5. The effect of nurse and parent interactions on shared decision-making in newborn care 0,663 9,160 0,000 Significants Table 2 shows the results of the hypothesis test show that knowledge has an effect (T-statistics = 4.464; p = 0.000) on shared decision-making through preference (T-statistics = 3.600; p = 0.000), trust (T-statistics = 6.760; p = 0.000), and interaction between nurses and parents (T-statistic = 9.160; p = 0.000). The interaction between nurses and parents has the direct and strongest influence on shared decision-making. Figure 2 shows knowledge variables are explained by six indicators, including how to express affection for babies, how to touch babies gently, how to increase breast milk, how to deliver breast milk to the baby room, how to breastfeed properly correct, and how to provide sound stimulation. The preference variable is explained by three indicators, including submission, cooperation, and autonomy. The trust variable is explained by five indicators, including being able to provide the right information, being able to take action in bad conditions, providing the best action, always being there when needed, and always giving information before taking action. The interaction variables were explained by five indicators, including: providing information, problem identification, information verification, socio-emotional communication, and information seeking. The shared decision-making variable is explained by five indicators, including decision talk, choices talk, goal setting, choice talk, and commitment. Based on these results, knowledge has an indirect effect on shared decision-making mediated by preferences, trust, and interactions. 4 Discussion The results of this study indicate that knowledge is related to parental preferences. A study on behavior intention also proves that brand knowledge has a significant effect on customer preference, high brand knowledge causes high customer preference [ 16 ]. Studies on knowledge and preferences of Australian society also report that Australian adults have low knowledge about the role of substitute decision-maker (SDM). The activity of discussing medical treatment preferences is also still low [ 17 ]. Another study in China reported that the quality of knowledge, has a positive effect on the adoption of health knowledge through trust [ 18 ]. Knowledge gained from follow-up directions is related to treatment preferences [ 19 ]. Higher knowledge is associated with higher preference in determining hospice care [ 20 ]. The results of this study support these findings. Mothers' knowledge of giving expressions of affection, gentle touch, and sound stimulation is good capital in meeting the psychological needs of babies. This study proves that the modality of parental knowledge has a contribution to decision-making preferences. The results of this study indicate that there is an influence between preference and trust. The results of a study in nine European Union countries stated that trust and preference significantly predict intentions. The position of family physicians in all countries is as the most trusted provider of information [ 21 ]. A study in Canada found that patients with autonomic preferences had a relatively low level of trust, while passive preferences were more likely to have blind trust. Sharing decisions requires a trusting relationship between patient and doctor [ 22 ]. A further meta-analysis revealed that, from a clinical perspective, patients reported more satisfaction with treatment when they had higher trust in their health care professionals [ 23 ]. The results of this study provide additional evidence of building trust through the role of preferences in decision-making. The results of this study prove that trust influences nurses-parents interaction. Trust is fundamental and existential, an interpersonal and essential element of all patient-nurse relationships. Trust requires mutual trust. A study conducted by Carla (2017) revealed that the values ​​that patients expect of health professionals are professional behavior, interactions between patients and professionals [ 24 ]. Characteristics of professional competence and caring attributes are an important part of the trust. On average, patients have a high sense of trust in nurses [ 25 ]. A good nurse-patient relationship improves quality and satisfaction [ 26 ]. Open and structured communication is considered important in building interpersonal relationships [ 27 ]. Literature review studies reveal that there is still poor communication between nurse-patients. This barrier is caused due to poor communication skills [ 28 ]. Some things that support facilitating nurse-patient interactions are using nonverbal language. Trust has an important role in confidence in providing care to patients [ 29 ]. The results of this study strengthen the evidence of a relationship between trust and interaction. Patients believe that nurses are competent and informative. Nurses provide information, verify information, behave in a friendly and pleasant manner during interactions. Information during the interaction process is a modality in shared decision-making. The results of this study prove that the interaction of nurses and parents affects shared decision-making. Previous studies reported that key elements in the patient-health professional relationship include: professionalism and partnership, the strength of the nurse-patient relationship also allows health decisions and disease processes to be obtained by patients independently with the advice of professionals [ 24 , 26 ]. Decision-making preferences involve the family, especially parents [ 19 ]. A qualitative study in Malaysia stated that ten patients preferred to make their own decisions, six patients indicated that doctors had to make decisions, and only one patient, expressed a preference for a collaborative role [ 30 ]. Health education interventions can improve staff and parent collaboration as well as shared decision-making in infant care [ 31 ]. A recent study by Anton et al. (2021) reported that the basic components of nurse decision-making are identifying patient needs, identifying potential risks, and building relationships with patients and families [ 32 ]. Decision making has elements of 1) communication and relationship, 2) leading to shared decision-making, 3) and action for decision-making [ 33 ]. The results of this study corroborate previous findings. Discussing decisions with a good knowledge base and supported by commitment will produce quality decisions. In a practical theory, knowledge is in an interaction between humans. Meanwhile, traditional decision-making models often place knowledge in the minds of health professionals. Shared decision-making of each role uses knowledge to generate solutions and solve problems together [ 34 ]. Studies in Canada, the United States, the Netherlands, and the UK prove that the average knowledge of shared decision making in medical students is 83.9% [ 35 ]. On the shared decision making implementation platform, it requires the intention to share knowledge from medical personnel other health [ 36 ]. Based on this discussion, it can be proven that knowledge indirectly influences shared decision-making in the care of newborns in hospitals. Some of the variables that mediate include preferences, trust, and interactions between nurses and parents. The variable that has the strongest influence on shared decision-making is the interaction of parents with nurses. 5 Conclusions In the present study, the knowledge influenced shared decision-making of newborn care through the preferences, trust, and interactions of nurses and parents. This study recommends that nurses should increase interaction with parents. Nurses can maximize the role of parents in shared decision-making on the care of newborns in the hospital. Declarations Funding This research was funded by the Institute for Research and Community Service, Universitas Muhammadiyah Jember East Java, Indonesia with grant number: 249/II.3.AU/LPPM/Riset/2021. Conflicts of interest/Competing interests Nothing to declare Data availability The data that support the findings of this study are available from Health Research Ethics Committee of the Faculty of Health Sciences, Muhammadiyah University of Jember, but restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available from the authors upon reasonable request and with the permission of Health Research Ethics Committee of the Faculty of Health Sciences, Muhammadiyah University of Jember. Code availability Not applicable Authors' contributions NR and RU contributed to conceptualization and methodology. NR, RU, and SK conducted the formal analysis and investigation. NR drafted the original manuscript. NR and RU revised it critically. All co-authors, NR, RU, and SK reviewed and approved the final manuscript. Acknowledgements The author would like to acknowledge the grant received from the Institute for Research and Community Service, Universitas Muhammadiyah Jember Ethics approval and consent to participate This research has been approved by the Health Research Ethics Commission of the Faculty of Health Sciences, the University of Muhammadiyah Jember, with the number 007/KEPK/FIKES/I/2021. The ethical principles in this study include fidelity, beneficence, autonomy, justice, non-maleficence, anonymity, and confidentiality. The application of ethical principles in this research includes: respecting human dignity (respect for persons), doing good (beneficence) and not harming (non-maleficence), and justice (justice), namely treating everyone (as an autonomous person) the same as morals right and worthy of obtaining their rights. All respondents stated that they were voluntarily involved in this research and signed a consent form after being explained. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4525148","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":323406017,"identity":"8b601633-7ab2-44af-8ba1-b6a8ba5fb14e","order_by":0,"name":"Nikmatur Rohmah","email":"data:image/png;base64,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","orcid":"","institution":"Universitas Muhammadiyah Jember","correspondingAuthor":true,"prefix":"","firstName":"Nikmatur","middleName":"","lastName":"Rohmah","suffix":""},{"id":323406018,"identity":"3b8a23d8-15c4-4f4a-b4bd-5e6e9259eed4","order_by":1,"name":"Resti Utami","email":"","orcid":"","institution":"Universitas Muhammadiyah Jember","correspondingAuthor":false,"prefix":"","firstName":"Resti","middleName":"","lastName":"Utami","suffix":""},{"id":323406019,"identity":"5a6afaa3-ad28-4d04-822c-bc9206cbd857","order_by":2,"name":"Siti Kholifah","email":"","orcid":"","institution":"Universitas Muhammadiyah Jember","correspondingAuthor":false,"prefix":"","firstName":"Siti","middleName":"","lastName":"Kholifah","suffix":""}],"badges":[],"createdAt":"2024-06-04 04:39:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4525148/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4525148/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60598615,"identity":"ee8f7f62-6353-4864-86f0-10540ca0aa65","added_by":"auto","created_at":"2024-07-18 15:54:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37516,"visible":true,"origin":"","legend":"\u003cp\u003eResearch Sampling\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4525148/v1/8ce26a881d0bd133631f5970.png"},{"id":60598614,"identity":"cd102302-aff1-48d3-88f2-5625263a0074","added_by":"auto","created_at":"2024-07-18 15:54:35","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":113925,"visible":true,"origin":"","legend":"\u003cp\u003eThe effect of knowledge on shared decision-making in caring for newborns in hospitals and the variables that mediate\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4525148/v1/1403386c0c31a6ce94697a26.png"},{"id":60600654,"identity":"a9df2420-03dc-4712-acf2-256021861d88","added_by":"auto","created_at":"2024-07-18 16:02:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":583842,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4525148/v1/f884614a-d04e-451f-bd9d-c81f68cdadd4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Preferences trust interaction of nurses and parents as mediating variables between knowledge and shared decision making in the care of newborns in Hospitals","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eStudies on the care of Low-Birth-Weight infants (LBW) have proven that a shared decision-making model can predict an increase in LBW care in hospitals. The trial application of the model affects the provision of breast milk (ASI), the giving of touch stimulation, and the provision of sound stimulation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. However, there has not been much research on decision-making in newborn care. Children need good care from birth to two years of age [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Various problems in newborn care are still high [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Mothers with low education and young age are associated with infant mortality problems in the first year [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. As many as 60% of mothers reported not attending the kangaroo mother care. Infants received supplementary formula (47%), insufficient milk production (18%), inadequate breastfeeding (16%), the inability of mothers to breastfeed (14%), and 32% of mothers stopped breastfeeding on day 60 [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Problems in newborns can be minimized through the participation of parents in the care of babies in the hospital.\u003c/p\u003e \u003cp\u003eA systematic review reported barriers to shared decision making in the neonatology area, including lack of medical information provided to parents to make decisions, inadequate communication, poor relationship with caregivers [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The results of another systematic review also reported barriers to shared decision making in the pediatric clinic area, including poor quality of information about conditions and/or options; lack of unacceptable options/alternatives; the emotional state of the parent/child feeling overwhelmed, anxious, in denial; insufficient time [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The results of the systematic review show that one of the problems in newborn care is the quality of the information in making the right care decisions. The impact of nursing plans that tend to be decided unilaterally, will trigger a conflict of decisions [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Shared decision-making in this study uses the theory of Elwyn (2012). Shared decision-making is designed with three conversations. 1) Choice talk, namely determining the problem and offering options; 2) Talking about options, providing information about the advantages and disadvantages of the action; and 3) Talking decisions. Nurses share ideas and support parents in making choices [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Studies by Haiek et al have also shown that shared decision-making has three structures: 1) discussion with parents of evidence-based information and various options; 2) help parents to recognize the sensitive nature of the decision to clarify values; and 3) provide guidance and support for making and implementing decisions [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A randomized controlled trial study proved that a group of postpartum mothers who made shared decision-making felt more confident, had the best understanding [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Parents' preferences in making decisions are defined by many factors including knowledge and trust in their child's health care doctor [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eKnowledge is an important element in making decisions. Making decisions without having adequate knowledge will potentially lead to decision conflicts. Previous studies have found evidence that shared decision-making is influenced by parent-nurse interactions, family support, parental trust, preferences, and decision aids [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Based on some of the results of the studies mentioned above, it can be concluded that there is a relationship between knowledge, trust, preference for shared decision making. However, it has not been explained how this variable affects the overall care of newborns in the hospital.\u003c/p\u003e"},{"header":"2 Methods","content":"\u003cp\u003e The cross-sectional study was conducted in the perinatology room of the regional hospital in the province of East Java, Indonesia in March-June 2021. The perinatology room is an inpatient room for newborns who have health problems or are at risk of having health problems. The perinatology room is divided into three rooms. The first observation room, the second isolation room, and the third stable baby room. The observation room for low birth weight, asphyxia, respiratory distress syndrome, hyaline membrane disease. The isolation room for babies born outside the hospital, and babies with congenital abnormalities. The stable baby room for babies who come from other hospitals, or babies in isolation and observation rooms who are starting to stabilize.\u003c/p\u003e \u003cp\u003eThe population was parents who had a newborn baby in the perinatology room. The criteria for parents are mother and father, have good awareness, able to read and write, and were present in the perinatology room. The estimated population that meets the inclusion criteria based on previous research is 106 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Calculation of the number of samples is based on the 95% confidence level, 5% margin of error, and 50% population proportion. The sample required is 84 participants. Estimated drop-out participants are 10% (8.4). The total required participants is 84\u0026thinsp;+\u0026thinsp;8.4\u0026thinsp;=\u0026thinsp;92.4\u0026thinsp;=\u0026thinsp;92 participants. The sampling method is simple random sampling. The population was 604. 146 potential participants met the criteria from 604 participants. The results of a simple random draw resulted in 102 being included in the sample and 44 not being the sample. A total of 10 participants filled out incomplete data and were excluded from the study sample. So, number of samples size was 92 (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCollecting data using a questionnaire. The questionnaire was prepared by Rohmah, N. Yusuf., and Hargono in 2019. The questionnaire has been used in similar research in three districts of the East Java region of Indonesia [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Test the content validity by calculating the content-validity coefficient. Aiken's V (1985) coefficient value of 0.70 is considered to have adequate content validity. The results of the content-validity coefficient test have an average value between 0.80\u0026ndash;0.93, indicating that the content validity is adequate. The results of the validity of the questionnaire with the provisions of n\u0026thinsp;=\u0026thinsp;24; p\u0026thinsp;\u0026lt;\u0026thinsp;=\u0026thinsp;0.05; value of r table\u0026thinsp;=\u0026thinsp;0.3297; Cronbach's Alpha value\u0026thinsp;\u0026gt;\u0026thinsp;0.7. The results of testing the validity of the questionnaire have a value of r\u0026thinsp;\u0026gt;\u0026thinsp;0.3297, and the value of Cronbach's Alpha\u0026thinsp;\u0026gt;\u0026thinsp;0.7, and the questionnaire has met the criteria of validity and reliability [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe latent variables studied included: knowledge (ten indicators), preferences (three indicat ors), parental trust in nurses (five indicators), nurse and parent interactions (five indicators), and shared decision-making (five indicators). Latent variables are also called unobserved variables. Variables latent are, cannot be measured directly. Variable latent measured by one or more manifest variables or also called indicators [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Data analysis using Partial Least Square (PLS). Analysis includes measurements of the outer model and inner model. The results of the outer model testing, on the PLS test, were carried out on all indicators in the study.\u003c/p\u003e \u003cp\u003eKnowledge variable indicators include: 1) knowledge about how to treat breasts; 2) knowledge of how to express breast milk; 3) knowledge of how to store breast milk; 4) knowledge of how to deliver breast milk to the nursery; 5) knowledge of how to breastfeed correctly; 6) knowledge of how to increase breast milk; 7) knowledge of how to care for the kangaroo method; 8) knowledge of how to touch a baby; 9) knowledge of how to provide a sound stimulus; 10) knowledge about how to give affection. Each indicator consists of one statement on a Likert scale of 1\u0026ndash;4. Indicators of preference variables consist of 1) autonomy; 2) cooperation; and 3) submission. Each indicator consists of one statement on a Likert scale of 1\u0026ndash;4. The indicators of the trust variable consist of five indicators. The first, Giving the best action. The second is being able to take action in bad conditions. The third is able to provide accurate information. The fourth always provides information before taking action, and the five always is present if needed. Each indicator consists of one statement on a Likert scale of 1\u0026ndash;4.\u003c/p\u003e \u003cp\u003eIndicators of interaction variables between nurses and parents consist of 1) information seeking; 2) providing information; 3) information verification; 4) socio-emotional communication, and 5) problem identification. Each indicator consists of one statement on a Likert scale of 1\u0026ndash;4. The indicators for joint decision making consist of 1) discussing goals with a single statement; 2) options talk with four statements; 3) choice talk with two statements; 4) decision talk with four statements; and 5) commitment with four statements.\u003c/p\u003e \u003cp\u003eAll statements with a Likert scale of 1\u0026ndash;4. The results of the first measurements of the outer model have six loading factor values ​​\u0026lt;0.5 and a T-statistic value\u0026thinsp;\u0026lt;\u0026thinsp;1.96 so that the indicator is declared invalid and not significant. Invalid indicators are not included in the second test. The value of outer loading on the second test, all indicators of latent variables\u0026thinsp;\u0026gt;\u0026thinsp;0.5 so that it has met the validity test. The result of the next test is the value of composite reliability or Cronbachs alpha of all latent variable constructs. The results of testing the value of composite reliability or Cronbach's alpha of all constructs showed\u0026thinsp;\u0026gt;\u0026thinsp;0.7, so it can be concluded that all latent variables have met the reliability test. The result of the next test is Average Variance Extracted (AVE). AVE values above 0.5 are highly recommended. AVE value for all latent variables\u0026thinsp;\u0026gt;\u0026thinsp;0.5. Next, evaluate of discriminant validity is measured to see cross-loadings. The test results show that the indicators in each component of the construct have a higher correlation with each construct. This means that the results of the examination of convergent validity and discriminant validity show that they have been met. Next, evaluate the structural model (inner) model.\u003c/p\u003e"},{"header":"3 Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows that most of the respondents (65.2%) are aged 20\u0026ndash;35 years, 35.9% have elementary school education and 30.4% have junior high school education. The minimum age of the mother is 17 years and the maximum is 47 years. Indications for giving birth at the hospital include premature rupture of membranes (28.25%), delivery\u0026thinsp;\u0026gt;\u0026thinsp;24 hours (23.91%), hypertension in pregnancy (18.48%), delivery by cesarean section 36.96%. Most of the babies (78.3%) included low birth weight babies, and 69.6% were premature babies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic data\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ef (92)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ef (92)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMother's Age\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eFather's Age\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;19 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18,5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15\u0026ndash;19 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;35 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20\u0026ndash;35 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e63,0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;35 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;35 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e32,6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMother's Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eFather's Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3,2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElementary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eElementary school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e29,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eJunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e29,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSenior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22,8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSenior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e31,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10,9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6,5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eBaby weight\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eParent's Tribe\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2500 grams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eJavanese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e71,7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2500\u0026ndash;4000 grams\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21,7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMadurese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e28,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGestational Age\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e8\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eBaby's Birthplace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;37 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMidwife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37\u0026ndash;42 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28,3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePublic health center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e17,4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;42 weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e78,3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationship between variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOriginal sampel (0)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT statistic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDescription\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffect of knowledge on preferences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0,405\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4,464\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSignificants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe effect of preference on parents' trust in nurses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0,344\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3,600\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSignificants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe effect of preference on shared decision-making\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0,006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0,086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0,932\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo significants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe effect of parental trust on nurse-parent interactions.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0,546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6,760\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSignificants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe effect of nurse and parent interactions on shared decision-making in newborn care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0,663\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9,160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSignificants\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the results of the hypothesis test show that knowledge has an effect (T-statistics\u0026thinsp;=\u0026thinsp;4.464; p\u0026thinsp;=\u0026thinsp;0.000) on shared decision-making through preference (T-statistics\u0026thinsp;=\u0026thinsp;3.600; p\u0026thinsp;=\u0026thinsp;0.000), trust (T-statistics\u0026thinsp;=\u0026thinsp;6.760; p\u0026thinsp;=\u0026thinsp;0.000), and interaction between nurses and parents (T-statistic\u0026thinsp;=\u0026thinsp;9.160; p\u0026thinsp;=\u0026thinsp;0.000). The interaction between nurses and parents has the direct and strongest influence on shared decision-making.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows knowledge variables are explained by six indicators, including how to express affection for babies, how to touch babies gently, how to increase breast milk, how to deliver breast milk to the baby room, how to breastfeed properly correct, and how to provide sound stimulation. The preference variable is explained by three indicators, including submission, cooperation, and autonomy. The trust variable is explained by five indicators, including being able to provide the right information, being able to take action in bad conditions, providing the best action, always being there when needed, and always giving information before taking action. The interaction variables were explained by five indicators, including: providing information, problem identification, information verification, socio-emotional communication, and information seeking. The shared decision-making variable is explained by five indicators, including decision talk, choices talk, goal setting, choice talk, and commitment. Based on these results, knowledge has an indirect effect on shared decision-making mediated by preferences, trust, and interactions.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThe results of this study indicate that knowledge is related to parental preferences. A study on behavior intention also proves that brand knowledge has a significant effect on customer preference, high brand knowledge causes high customer preference [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Studies on knowledge and preferences of Australian society also report that Australian adults have low knowledge about the role of substitute decision-maker (SDM). The activity of discussing medical treatment preferences is also still low [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Another study in China reported that the quality of knowledge, has a positive effect on the adoption of health knowledge through trust [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Knowledge gained from follow-up directions is related to treatment preferences [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Higher knowledge is associated with higher preference in determining hospice care [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The results of this study support these findings. Mothers' knowledge of giving expressions of affection, gentle touch, and sound stimulation is good capital in meeting the psychological needs of babies. This study proves that the modality of parental knowledge has a contribution to decision-making preferences.\u003c/p\u003e \u003cp\u003eThe results of this study indicate that there is an influence between preference and trust. The results of a study in nine European Union countries stated that trust and preference significantly predict intentions. The position of family physicians in all countries is as the most trusted provider of information [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. A study in Canada found that patients with autonomic preferences had a relatively low level of trust, while passive preferences were more likely to have blind trust. Sharing decisions requires a trusting relationship between patient and doctor [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. A further meta-analysis revealed that, from a clinical perspective, patients reported more satisfaction with treatment when they had higher trust in their health care professionals [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The results of this study provide additional evidence of building trust through the role of preferences in decision-making.\u003c/p\u003e \u003cp\u003eThe results of this study prove that trust influences nurses-parents interaction. Trust is fundamental and existential, an interpersonal and essential element of all patient-nurse relationships. Trust requires mutual trust. A study conducted by Carla (2017) revealed that the values ​​that patients expect of health professionals are professional behavior, interactions between patients and professionals [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Characteristics of professional competence and caring attributes are an important part of the trust. On average, patients have a high sense of trust in nurses [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A good nurse-patient relationship improves quality and satisfaction [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Open and structured communication is considered important in building interpersonal relationships [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Literature review studies reveal that there is still poor communication between nurse-patients. This barrier is caused due to poor communication skills [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Some things that support facilitating nurse-patient interactions are using nonverbal language. Trust has an important role in confidence in providing care to patients [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The results of this study strengthen the evidence of a relationship between trust and interaction. Patients believe that nurses are competent and informative. Nurses provide information, verify information, behave in a friendly and pleasant manner during interactions. Information during the interaction process is a modality in shared decision-making.\u003c/p\u003e \u003cp\u003eThe results of this study prove that the interaction of nurses and parents affects shared decision-making. Previous studies reported that key elements in the patient-health professional relationship include: professionalism and partnership, the strength of the nurse-patient relationship also allows health decisions and disease processes to be obtained by patients independently with the advice of professionals [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Decision-making preferences involve the family, especially parents [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. A qualitative study in Malaysia stated that ten patients preferred to make their own decisions, six patients indicated that doctors had to make decisions, and only one patient, expressed a preference for a collaborative role [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Health education interventions can improve staff and parent collaboration as well as shared decision-making in infant care [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. A recent study by Anton et al. (2021) reported that the basic components of nurse decision-making are identifying patient needs, identifying potential risks, and building relationships with patients and families [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Decision making has elements of 1) communication and relationship, 2) leading to shared decision-making, 3) and action for decision-making [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The results of this study corroborate previous findings. Discussing decisions with a good knowledge base and supported by commitment will produce quality decisions. In a practical theory, knowledge is in an interaction between humans. Meanwhile, traditional decision-making models often place knowledge in the minds of health professionals. Shared decision-making of each role uses knowledge to generate solutions and solve problems together [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Studies in Canada, the United States, the Netherlands, and the UK prove that the average knowledge of shared decision making in medical students is 83.9% [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. On the shared decision making implementation platform, it requires the intention to share knowledge from medical personnel other health [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBased on this discussion, it can be proven that knowledge indirectly influences shared decision-making in the care of newborns in hospitals. Some of the variables that mediate include preferences, trust, and interactions between nurses and parents. The variable that has the strongest influence on shared decision-making is the interaction of parents with nurses.\u003c/p\u003e"},{"header":"5 Conclusions","content":"\u003cp\u003eIn the present study, the knowledge influenced shared decision-making of newborn care through the preferences, trust, and interactions of nurses and parents. This study recommends that nurses should increase interaction with parents. Nurses can maximize the role of parents in shared decision-making on the care of newborns in the hospital.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded by the Institute for Research and Community Service, Universitas Muhammadiyah Jember East Java, Indonesia with grant number: 249/II.3.AU/LPPM/Riset/2021.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest/Competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNothing to declare\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from Health Research Ethics Committee of the Faculty of Health Sciences, Muhammadiyah University of Jember, but restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available from the authors upon reasonable request and with the permission of Health Research Ethics Committee of the Faculty of Health Sciences, Muhammadiyah University of Jember.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNR and RU contributed to conceptualization and methodology. NR, RU, and SK conducted the formal analysis and investigation. NR drafted the original manuscript. NR and RU revised it critically. All co-authors, NR, RU, and SK reviewed and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author would like to acknowledge the grant received from the Institute for Research and Community Service, Universitas Muhammadiyah Jember\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003col start=\"1\" style=\"list-style-type: lower-alpha;\"\u003e\n \u003cli\u003eThis research has been approved by the Health Research Ethics Commission of the Faculty of Health Sciences, the University of Muhammadiyah Jember, with the number 007/KEPK/FIKES/I/2021. The ethical principles in this study include fidelity, beneficence, autonomy, justice, non-maleficence, anonymity, and confidentiality. The application of ethical principles in this research includes: respecting human dignity (respect for persons), doing good (beneficence) and not harming (non-maleficence), and justice (justice), namely treating everyone (as an autonomous person) the same as morals right and worthy of obtaining their rights. All respondents stated that they were voluntarily involved in this research and signed a consent form after being explained.\u003c/li\u003e\n \u003cli\u003eThe study was performed in accordance with the guidelines of the World Health Organization (WHO) 2011 and Council for International Organizations of Medical Sciences (CIOMS) 2016.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eRohmah N, Yusuf A, Hargono R. Pengembangan Model Pengambilan Keputusan Bersama Perawat Dan Orang Tua Dalam Merawat Bayi Berat Lahir Rendah Di Rumah Sakit [Internet]. Universitas Airlangga Surabaya Indonesia; 2019. 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Int J Nurs Pr. 2015;21(2):125\u0026ndash;31.\u003c/li\u003e\n \u003cli\u003eToivonen M, Lehtonen L, L\u0026ouml;yttyniemi E, Ahlqvist-Bj\u0026ouml;rkroth S, Axelin A. Close Collaboration with Parents intervention improves family-centered care in different neonatal unit contexts: a pre\u0026ndash;post study. Pediatr Res. 2020;88(3):421\u0026ndash;8.\u003c/li\u003e\n \u003cli\u003eAnton N, Hornbeck T, Modlin S, Haque MM, Crites M, Yu D. Identifying factors that nurses consider in the decision-making process related to patient care during the COVID-19 pandemic. PLoS One. 2021;16(7 July):1\u0026ndash;15.\u003c/li\u003e\n \u003cli\u003eTruglio-Londrigan M, Slyer JT. Shared Decision-Making for Nursing Practice: An Integrative Review. Open Nurs J. 2018;12(1):1\u0026ndash;14.\u003c/li\u003e\n \u003cli\u003eLoughlin M, Buetow S, Cournoyea M, Copeland SM, Chin-Yee B, Fulford KWM. Interactions between persons\u0026mdash;Knowledge, decision making, and the co-production of practice. J Eval Clin Pract. 2019;25(6):911\u0026ndash;20.\u003c/li\u003e\n \u003cli\u003eYen RW, Barr PJ, Cochran N, Aarts JW, L\u0026eacute;gar\u0026eacute; F, Reed M, et al. Medical Students\u0026rsquo; Knowledge and Attitudes Toward Shared Decision Making: Results From a Multinational, Cross-Sectional Survey. MDM Policy Pract. 2019;4(2):1\u0026ndash;11.\u003c/li\u003e\n \u003cli\u003eHsieh P-J. Determinants of Knowledge-Sharing Intentions for Shared Decision-Making Platforms. J Comput Inf Syst. 2021;19(November):1\u0026ndash;12.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Knowledge, Preferences, Trust, Interaction, Shared decision-making","lastPublishedDoi":"10.21203/rs.3.rs-4525148/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4525148/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e Knowledge is an important element in making decisions. Making decisions without having adequate knowledge will potentially lead to decision conflicts. This study aimed to analyze of preferences, trust, and interactions between nurses and parents as mediating between knowledge and shared decision-making in the care of newborns in hospitals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods \u003c/strong\u003eThe research design was cross-sectional. The population was all parents of newborns hospitalized in Regional Hospital Jember Regency, East Java, Indonesia March–June 2021. The sampling methode was selected by simple random sampling. The required participants are 92. Data collection by questionnaires compiled by researchers, and data analysis by Partial Least Square.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results showed that knowledge (T-statistics=4.464; p=0.000) influenced shared decision making through preferences (T-statistics=3.600; p=0.000), trust (T-statistics=6.760; p=0.000), and nurse interactions and parents (T-statistic=9,160; p=0,000). The interaction of nurses and parents proved to have the strongest influence on shared decision-making. This study recommends that nurses increase interaction with parents. Nurses can maximize the role of parents in together decision-making on the care of newborns in the hospital.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e The knowledge influenced shared decision-making of newborn care through the preferences, trust, and interactions of nurses and parents. This study recommends that nurses should increase interaction with parents. Nurses can maximize the role of parents in shared decision-making on the care of newborns in the hospital.\u003c/p\u003e","manuscriptTitle":"Preferences trust interaction of nurses and parents as mediating variables between knowledge and shared decision making in the care of newborns in Hospitals","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 15:54:22","doi":"10.21203/rs.3.rs-4525148/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-16T07:22:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-12T02:51:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"208119772542929106213065965448376280001","date":"2024-08-12T00:12:24+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-09T11:34:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"205856019743864323121135309954391892675","date":"2024-08-05T22:41:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"137628614795416185023864808483107959503","date":"2024-08-02T11:53:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"309185679257708680982665663762866714455","date":"2024-07-23T15:05:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-07-13T23:44:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"41637027843431638883906630900735976823","date":"2024-07-06T01:41:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-04T06:08:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-19T13:48:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-19T13:43:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Social Science and Health","date":"2024-06-04T04:38:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-social-science-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"diss","sideBox":"Learn more about [Discover Social Science and Health](https://www.springer.com/journal/44155)","snPcode":"","submissionUrl":"","title":"Discover Social Science and Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"80d60960-a7dc-40cc-bea8-459eaaa14bd9","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-04-16T13:53:37+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 15:54:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4525148","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4525148","identity":"rs-4525148","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}