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Knowledge, Attitude, and Practice in Inflammatory Bowel Disease: Associated Factors and the Mediating Role of
Wei Wang1, Dan Zhou1, Haoping Zhao2
1Department of Ultrasound, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, People's Republic of China.
Purpose:
Inflammatory bowel disease (IBD) requires long-term self-management, yet evidence on patients' knowledge, attitude, and practice (KAP) remains limited. This study assessed KAP levels in patients with IBD, identified factors associated with overall KAP levels and explored whether attitude mediates the relationship between knowledge and practice.
Patients And Methods:
A cross-sectional survey was conducted among patients with IBD attending the Second Affiliated Hospital of Nanchang University from June to December 2025. Data were collected using a study-specific questionnaire covering sociodemographic characteristics and KAP dimensions. Spearman correlation analysis, multivariable linear regression, and structural equation modeling with bootstrap resampling were performed.
Results:
A total of 520 patients were included. The mean knowledge, attitude, and practice scores were 3.97 ± 1.98 (range: 0-10), 24.43 ± 3.58 (range: 8-40), and 28.82 ± 4.41 (range: 8-40), respectively. Knowledge item correct response rates ranged from 29.4% to 48.3%, indicating limited disease-related knowledge. Knowledge was positively correlated with attitude (r = 0.190, P < 0.01) and practice (r = 0.223, P < 0.001), while attitude was positively correlated with practice (r = 0.346, P < 0.001). In multivariable analysis, female sex was associated with lower total KAP scores, whereas higher monthly family income was associated with higher scores. Former and current smoking and drinking were associated with lower total KAP scores, while having 2-3 comorbidities was associated with higher scores. Attitude did not significantly mediate the knowledge-practice relationship.
Conclusions:
Patients with IBD showed limited knowledge, relatively unfavorable attitude, and moderately proactive practice. Knowledge and attitude were both positively associated with practice, but attitude did not significantly mediate the association between knowledge and practice. The potential benefits of educational, behavioral, and psychosocial interventions require evaluation in prospective or interventional studies.
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