Instrument

The questionnaire consisted of three parts. In the first part, there were seven items regarding participant characteristics. The second part was the questionnaire used to measure the frequency of cooperative activity and to verify the specific relationships between nurses and physicians in truth disclosure. We used the Nurse–Physician Collaboration Scale (NPCS) developed by Ushiro (2009) [24]. It was translated into Chinese by Jing Chen and adapted to expressions and semantics to reflect the Chinese culture [25]. The Chinese version of the NPCS was validated and proved to have a relatively high reliability and validity when used to evaluate the status of nurse–physician collaboration in the Chinese medical environment [25]. It had 21 items in total and could be divided into three dimensions: sharing of patient information, joint participation in the cure/care decision-making process, and cooperativeness. In this study, we changed the words “care or decision-making process” to “truth disclosure” to lead the participants to complete the questionnaire from the perspective of truth disclosure. However, these modifications did not change the essence of the questions. All items were rated on a 5-point Likert scale from “never” to “always,” scoring from “1” to “5”. A higher score indicates better cooperation between nurses and physicians in truth telling. To categorize the response, we defined a mean answer of > 3 on the questionnaire items as a positive response [26]. Cronbach’s α coefficient was 0.970 in the present study, indicating sound reliability. In the third part, a multiple-choice question was provided to assess participants’ perceived difficulties in truth telling.