Knowledge, attitudes, and practices related to health management among patients receiving intravesical instillation

This study aimed to investigate the knowledge, attitudes, and practices (KAP) related to health management among patients receiving intravesical instillation.

This cross-sectional survey was conducted between July 1, 2025 and December 1, 2025. Patients receiving intravesical instillation were recruited using convenience sampling and completed an online, self-designed Chinese questionnaire distributed via Wenjuanxing and WeChat. The questionnaire collected sociodemographic characteristics and assessed three KAP domains.

A total of 422 valid questionnaires were included. Most participants were male (71.8%), with age groups of <60 years(27.3%), 60-69 years(39.8%), and ≥70 years (32.9%). Mean (SD) scores were 10.26(2.40) for knowledge(possible range: 0-15), 39.42 (6.90) for attitude (possible range: 12-60), and 39.39 (6.15) for practice (possible range: 10-50). SEM was conducted using a saturated path model with χ² = 0 and df = 0; therefore, the global fit indices were not interpreted as evidence of model adequacy. The SEM results showed significant direct effects of knowledge on practice (β=0.272, P<0.001) and attitude on practice (β=0.252, P<0.001), while the knowledge-attitude pathway was not significant (β=0.049, P = 0.317). Multivariate analysis showed that higher knowledge (OR = 1.291, 95%CI 1.170-1.424, P<0.001) and more positive attitudes (OR = 1.070, 95%CI 1.033-1.106, P<0.001) independently predicted better practice. Knowledge and attitude were both positively correlated with practice (r=0.306 and r=0.238, respectively; both P<0.001).

Participants demonstrated suboptimal knowledge, neutral attitudes, and positive practices regarding health management during intravesical instillation. Improved practice was mainly driven by knowledge and attitudes rather than by a sequential knowledge-to-attitude effect. Proposed item-informed interventions, including clarification of regimen-related misconceptions, support for fear of recurrence and side-effect concerns, and training in simple coping behaviors, may help strengthen patient self-management and adherence, but their feasibility, acceptability, and effectiveness should be further evaluated in future implementation studies.