# Knowledge, attitudes, and proactive practices regarding PICC in gastrointestinal cancer: a mediation analysis of a patient empowerment attempt

## TL;DR

This study explores how gastrointestinal cancer patients understand and manage PICC lines, finding that education and self-care training can improve outcomes.

## Contribution

The study introduces a mediation analysis of KAP factors to guide patient empowerment in PICC self-care.

## Key findings

- Patients showed good knowledge, attitudes, and proactive practices regarding PICC management.
- Duration of illness and self-care ability negatively influenced knowledge, while higher education improved attitudes.
- Targeted education and self-care training are recommended to enhance PICC outcomes.

## Abstract

To examine the knowledge, attitudes, and practices (KAP) related to the use and self-care of peripherally inserted central catheters (PICC) among gastrointestinal cancer patients.

This cross-sectional study was conducted between January and July 2024 at Inner Mongolia Hospital and Peking University Cancer Hospital. A questionnaire was used to collect self-reported KAP data. Achieving scores above 70% of the maximum in each section indicated adequate knowledge, positive attitudes, and proactive practices. A mediation analysis was performed to examine the relationships among KAP dimensions.

A total of 444 valid cases were included. Of these, 305 (68.69%) were male, and 338 (76.13%) had undergone a single PICC placement. The knowledge, attitude, and practice scores were 11.27 ± 3.69 (possible range: 0–14; 80.50%), 30.48 ± 3.22 (possible range: 8–40; 76.20%), and 31.32 ± 5.38 (possible range: 8–40; 78.30%), respectively, indicating good KAP. Path analysis revealed that duration of illness (β = -1.04, P = 0.001) and self-care ability (β = -1.08, P = 0.01) had a direct negative influence on knowledge. Knowledge (β = 0.27, P < 0.001) and higher education (β = 0.36, P = 0.021) had a positive influence on attitude, while type of tumor (β = -0.31, P = 0.041) had a direct negative influence.

Patients demonstrated sufficient knowledge, generally positive attitudes, and proactive practices regarding PICC. Based on the KAP theoretical framework, targeted educational interventions to improve patients’ knowledge and self-care abilities and positively shape their attitudes may further enhance PICC management and optimize patient outcomes by promoting patient empowerment. These findings highlight the importance of integrating self-care training into patient discharge protocols.