Abstract
The objective of this study was to assess the knowledge, attitudes, and practices (KAP) related to the functional status of arteriovenous fistulas (AVF) among patients undergoing hemodialysis. This cross-sectional study was conducted from April to May 2025 at the First Affiliated Hospital of Nanchang University, employing a self-developed questionnaire for data collection. Among 536 respondents (62.1% male), the mean scores for knowledge, attitude, and practice were 14.74 ± 4.89 (possible range: 0-20), 42.84 ± 4.87 (possible range: 10-50), and 40.75 ± 7.89 (possible range: 10-50), respectively. Statistically significant positive correlations were identified between knowledge and attitude (r = 0.682, P < 0.001), knowledge and practice (r = 0.711, P < 0.001), and attitude and practice (r = 0.622, P = 0.001). Structural equation modeling analysis revealed that knowledge directly influenced both attitude (β = 0.752, P < 0.001) and practice (β = 0.388, P < 0.001), while attitude also had a direct effect on practice (β = 0.449, P < 0.001). Furthermore, knowledge exerted an indirect effect on practice through attitude (β = 0.337, P < 0.001). These findings underscore the necessity for structured and continuous patient education interventions to enhance AVF maintenance and improve long-term dialysis outcomes.