Knowledge, attitudes, and proactive practices regarding PICC in gastrointestinal cancer: a mediation analysis of a patient empowerment attempt

关于胃肠道癌症患者PICC置管的知识、态度和积极行为:一项患者赋权尝试的中介分析

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Abstract

OBJECTIVE: To examine the knowledge, attitudes, and practices (KAP) related to the use and self-care of peripherally inserted central catheters (PICC) among gastrointestinal cancer patients. METHODS: This cross-sectional study was conducted between January and July 2024 at Inner Mongolia Hospital and Peking University Cancer Hospital. A questionnaire was used to collect self-reported KAP data. Achieving scores above 70% of the maximum in each section indicated adequate knowledge, positive attitudes, and proactive practices. A mediation analysis was performed to examine the relationships among KAP dimensions. RESULTS: A total of 444 valid cases were included. Of these, 305 (68.69%) were male, and 338 (76.13%) had undergone a single PICC placement. The knowledge, attitude, and practice scores were 11.27 ± 3.69 (possible range: 0-14; 80.50%), 30.48 ± 3.22 (possible range: 8-40; 76.20%), and 31.32 ± 5.38 (possible range: 8-40; 78.30%), respectively, indicating good KAP. Path analysis revealed that duration of illness (β = -1.04, P = 0.001) and self-care ability (β = -1.08, P = 0.01) had a direct negative influence on knowledge. Knowledge (β = 0.27, P < 0.001) and higher education (β = 0.36, P = 0.021) had a positive influence on attitude, while type of tumor (β = -0.31, P = 0.041) had a direct negative influence. CONCLUSIONS: Patients demonstrated sufficient knowledge, generally positive attitudes, and proactive practices regarding PICC. Based on the KAP theoretical framework, targeted educational interventions to improve patients' knowledge and self-care abilities and positively shape their attitudes may further enhance PICC management and optimize patient outcomes by promoting patient empowerment. These findings highlight the importance of integrating self-care training into patient discharge protocols.

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