Caregivers' knowledge, attitudes, and practices regarding postpartum depression: a cross-sectional study

Postpartum depression (PPD) is a prevalent psychiatric condition with significant implications for maternal and infant health. However, the role of caregivers in its management remains underexplored, particularly regarding their specific knowledge, attitudes, and practices (KAP). To address this gap, this study aimed to quantify KAP levels regarding PPD among caregivers. This cross-sectional study collected 503 surveys from primary caregivers of postpartum women in Henan, China, using a validated questionnaire between November 2024 and February 2025. Multivariable logistic regression was performed to identify factors associated with KAP outcomes, while structural equation modeling (SEM) was applied to explore the interrelationships among KAP dimensions. The results showed that mean knowledge, attitude, and practice scores were 10.63 ± 3.36 (possible range: 0-26), 38.31 ± 4.80 (possible range: 9-45), and 30.28 ± 6.49 (possible range: 8-40), respectively. Multivariable logistic regression showed that lack of access to professional psychological counseling was associated with poorer knowledge, while higher knowledge and more positive attitudes were significantly associated with proactive caregiving practices (all P < 0.001). SEM demonstrated that knowledge had significant direct effects on attitude (β = 0.300, P < 0.001) and practice (β = 0.217, P < 0.001), while attitude had a strong direct effect on practice (β = 0.703, P < 0.001). In conclusion, caregivers demonstrated limited knowledge but relatively positive attitudes and practices regarding PPD. Targeted educational interventions and improved access to psychological support may help enhance caregiver knowledge and support for postpartum mental health.