Work

Knowledge, Attitude, and Practice in Inflammatory Bowel Disease: Associated Factors and the Mediating Role of Attitude

Year: 2026

Type: article

Abstract: 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. Keywords: inflammatory bowel disease, knowledge, attitude, practice, self-management, mediation analysis

Source: Patient Preference and Adherence

DOI: 10.2147/ppa.s643084

Authors: Wei Wang, Dan Zhou, Haoping Zhao, Liling Yang, Jiwei Wang

Institutions: Nanchang University, Second Affiliated Hospital of Nanchang University

Language: English

Topic: Inflammatory Bowel Disease

Subfield: Gastroenterology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836