Perception and Practices Regarding Muscle Loss Protection in Childhood Cancer Patients: A National Survey of Chinese...

To investigate perception and practices regarding muscle loss protection (MLP) among Chinese pediatric oncologists in a nationwide survey.

A nationwide online survey was conducted among pediatric oncologists using a self-designed structured questionnaire assessing predominant roles, barriers, practices, attitudes, and knowledge. Behavior and attitude were measured using a 5-point Likert scale. Barrier scores were based on classification: denial scores 3, uncertainty 2, and confirmation 1. Knowledge scores were calculated based on the number of correct responses (one point per correct answer). Binary logistic regression, ordinal logistic regression, and multiple linear regression models were applied to identify factors associated with knowledge, attitudes, behaviors, and composite scores related to MLP, and spatial analysis (Moran's I) was used to evaluate geographic clustering.

Among 253 respondents, physicians, surgeons, physiatrists, and nutritionists were most trusted to lead MLP. Physicians, particularly hematologists, received the most support as the predominant specialists. While the absence of relevant guidelines and consensus was a significant barrier, the primary barrier was illness severity. Although the general attitude was positive, behavior and knowledge were far from satisfactory. Doctors in centers with ML assessment resources had significantly higher practice scores. Spatial analysis indicated regional variation in scores, with localized patterns of relatively higher and lower performance across provinces.

Chinese pediatric oncologists demonstrate positive attitudes but concerning deficiencies in MLP practices and knowledge, with notable disparities primarily associated with institutional resources and regional context. The development of evidence-based national guidelines is strongly recommended to standardize care and address these gaps.