# Understanding patients' self-management after enterostomy: knowledge, attitudes, and practices in a cross-sectional study

## TL;DR

This study explores how knowledge, attitudes, and practices affect self-management in patients who have had an enterostomy, emphasizing the role of attitudes in improving long-term outcomes.

## Contribution

The study introduces new evidence that attitudes mediate the relationship between knowledge and self-management practices in post-enterostomy patients.

## Key findings

- Median KAP scores were 12.00 for knowledge, 41.00 for attitudes, and 70.00 for practices.
- Knowledge improves attitudes, which in turn promote better self-management practices.
- A significant indirect effect of knowledge on practice through attitudes was confirmed (β = 0.262).

## Abstract

Few studies have explored the knowledge, attitudes, and practices (KAP) related to self-management among post-enterostomy patients, particularly in China. Such understanding is crucial for developing targeted interventions that improve long-term recovery, quality of life, and healthcare resource utilization. This study aimed to fill this gap by examining KAP levels and their interrelationships in this population.

A cross-sectional survey was conducted at the China-Japan Friendship Hospital between March 15 and May 15, 2024, using a structured questionnaire with confirmed reliability (Cronbach's α = 0.825, 0.748, and 0.770, respectively) and validity.

A total of 497 valid responses were analyzed. The median scores for KAP were 12.00 (IQR: 11.00–13.00), 41.00 (IQR: 35.00–47.00), and 70.00 (IQR: 63.00–77.00), respectively. Path analysis revealed that knowledge improved attitudes, which subsequently promoted better self-management practices. Bootstrapping analysis confirmed a significant indirect effect of knowledge on practice through the mediating role of attitudes (β = 0.262, 95% CI [0.089, 0.451]).

This study provides new evidence that attitudes mediate the relationship between knowledge and self-management practices among post-enterostomy patients. It highlights the scientific value of applying the KAP framework to this population and underscores the need for attitude-focused education, structured follow-up, and psychosocial support. Future research should explore longitudinal interventions to sustain long-term self-managemente improvements.