Knowledge, attitude and practice toward postoperative upper limb exercise among patients undergoing axillary lymph...

This study examines the knowledge, attitude, and practice (KAP) toward postoperative upper limb exercise among patients undergoing axillary lymph node dissection for breast cancer.

A cross-sectional study was carried out at Guangdong Medical University Affiliated Hospital from July 1, 2023, to May 1, 2024. Demographic information and KAP scores regarding postoperative upper limb exercises were collected using questionnaires.

A total of 479 valid questionnaires were included. Among the respondents, 178 (37.2%) were aged 41-50 years, and 372 (77.7%) learned about postoperative rehabilitation from doctors and nurses. The average knowledge, attitude, and practice scores were 10 [8.00, 10.00] (range 0-10), 24 [24.00, 28.00] (range 6-30), and 36 [32.00, 39.00] (range 9-45), respectively. Multivariate logistic regression showed that having medical insurance (OR = 3.059, 95% CI: [1.063, 8.804], P = 0.038) and having hyperlipidemia (OR = 0.191, 95% CI: [0.039, 0.939], P = 0.042) were independently associated with good knowledge. Additionally, the attitude score (OR = 1.740, 95% CI: [1.275, 2.376], P < 0.001) was independently associated with proactive practice. The structural equation model showed that knowledge directly affected attitude (β = 0.279, P < 0.001), and both knowledge (β = 0.300, P < 0.001) and attitude (β = 0.494, P < 0.001) directly affected practice. Knowledge also indirectly affected practice through attitude (β = 0.138, P < 0.001).

The study indicates that breast cancer patients who have undergone axillary lymph node dissection generally possess sufficient knowledge, maintain a positive attitude, and engage in proactive practices regarding postoperative upper limb exercises. It is recommended that healthcare providers continuously enhance patient education programs, particularly emphasizing the importance of medical insurance and managing conditions like hyperlipidemia, to further improve knowledge and practice outcomes in postoperative care.