# The knowledge, attitudes and practice of nasal irrigation among patients with rhinosinusitis: a cross-sectional study

## TL;DR

This study explores how well patients with nasal inflammation understand and use nasal irrigation, finding significant knowledge gaps despite high adherence.

## Contribution

The study identifies specific knowledge gaps and factors influencing nasal irrigation practices in rhinosinusitis patients.

## Key findings

- Participants showed significant knowledge gaps in solvent/solute selection, concentration, and device use.
- Younger participants had better understanding of temperature, frequency, and pediatric applicability.
- Hospitals were the primary information source, but online resources were used more by younger, educated patients.

## Abstract

Nasal inflammatory diseases significantly impair patients' quality of life, with global prevalence varying regionally. Nasal irrigation, endorsed by international guidelines as adjunctive therapy, lacks standardized protocols and patient education, potentially compromising efficacy. This study evaluated the knowledge, attitudes, and practice regarding nasal irrigation in patients with rhinosinusitis and identified factors influencing adherence, with the objective of informing evidence-based strategies to improve patient education and clinical management.

A cross-sectional survey was conducted at a tertiary hospital via a 40-item questionnaire assessing the knowledge, attitudes, practice and information sources related to nasal irrigation among 233 patients with nasal inflammatory diseases.

The participants exhibited significant knowledge gaps in solvent/solute selection, concentration, temperature, irrigation devices, shelf life, and clinical indications of nasal irrigation (correct answer rate <60%). Younger participants (<50 years) demonstrated a better understanding of temperature, frequency, device differences and pediatric applicability. The attitudes were favorable: 88.7% perceived nasal irrigation as safe, and 92.6% acknowledged its importance; however, only 58.4% believed it could independently treat rhinosinusitis. Practice rates were high (80.4%), with 94.1% performing self-administered irrigation. Hospitals were the primary information source (75.5%), whereas younger, educated patients more frequently utilized online platforms and science/professional literature.

Despite high adherence and positive perceptions, critical knowledge gaps persist in solution parameters, device use, and clinical applications. Age- and education-stratified communication, which integrate multimedia resources and hospital-led guidance, are essential for addressing disparities and enhancing treatment efficacy, particularly among older, less educated and read populations.