Abstract
OBJECTIVES: To assess the knowledge, attitude and practice (KAP) of patients with type A aortic dissection (AD) or their relatives regarding postoperative management. DESIGN: Cross-sectional study. SETTING: The participants were recruited from three hospitals between October 2022 and February 2023. PARTICIPANTS: Patients diagnosed with type A AD or their relatives. INTERVENTIONS: No interventions were administered. A structured questionnaire was used to gather the demographic and KAP data from the participants. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures included the levels of KAP regarding postoperative management. RESULTS: A total of 483 participants were included. They exhibited poor knowledge (15.52±7.67, possible score: 0-32), positive attitude (31.10±5.86, possible score: 9-45) and poor practice (21.96±4.83, possible score: 8-40) towards postoperative management. The multivariable logistic analysis showed that knowledge scores (OR=1.09, 95% CI 1.05 to 1.12, p<0.001), attitude scores (OR=1.22, 95% CI 1.16 to 1.29, p<0.001) and diagnosis for ≤5 years (OR=1.97, 95% CI 1.23 to 3.15, p=0.005) were independently associated with good practice. The structured equation modelling analysis showed that knowledge directly influenced attitudes (β=0.22, p<0.001) and practice (β=0.15, p<0.001), while attitude directly impacted practice (β=0.52, p<0.001) and mediated the relationship between knowledge and practice (β=0.11, p<0.001). CONCLUSIONS: Patients with type A AD and their relatives have poor knowledge, positive attitudes and poor practice towards postoperative management. Knowledge might be the prerequisite for practice, and attitudes have a mediating effect.