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Knowledge; attitude; and practice of patients with osteomyelitis: a cross-sectional study using structural equation modeling
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DOI：10.3389/fpubh.2026.1838790.png)
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Abstract
En 中文
IntroductionTo assess the knowledge; attitude; and practice (KAP) levels among patients with osteomyelitis; analyze their associated factors; and explore the pathways between knowledge; attitude; and practice.MethodsA cross-sectional study was conducted in a large tertiary hospital from April 1st to June 1st; 2025; enrolling 405 patients with osteomyelitis. A self-administered questionnaire collected demographic and disease-related information and assessed KAP. Cronbach’s α tested questionnaire reliability; and confirmatory factor analysis examined construct validity. Univariate analysis; multivariate binary logistic regression with a two-tailed p < 0.05 as the statistical significance cut-off; and structural equation modeling (SEM) were used to explore factors associated with KAP and their interrelationship mechanisms.ResultsMean scores for knowledge; attitude; and practice were 28.56 ± 10.28; 29.08 ± 11.36; and 28.58 ± 11.62; respectively; achievement rates were 32.1; 35.6; and 30.9%. The overall Cronbach’s α was 0.962; the KMO value was 0.971; and model fit was good (CMIN/DF = 1.32; RMSEA = 0.028; CFI = 0.984). Multivariate analysis showed that age (p = 0.013); income (p < 0.001); education (p < 0.001); history of diabetes mellitus (p = 0.009); and number of hospitalizations (p = 0.020) were independently associated with knowledge. Knowledge level (p < 0.001); age (p = 0.034); income (p < 0.001); and education (p < 0.001) were associated with attitude. Attitude level (p < 0.001); knowledge level (p < 0.001); income (p < 0.001); and education (p = 0.019) were associated with practice. SEM revealed that knowledge had a direct theoretical association with attitude (β = 0.694; p < 0.001) and practice (β = 0.303; p < 0.001); attitude had a direct theoretical association with practice (β = 0.465; p < 0.001). The indirect theoretical association of knowledge with practice via attitude was significant (β = 0.357; p < 0.001); accounting for 54.1% of the total effect.ConclusionPatients with osteomyelitis showed insufficient knowledge; attitude; and practice. Older age; lower education; and lower income were associated with poorer outcomes. Attitude mediated the knowledge-practice association. Future interventions should focus on attitude change in vulnerable populations; and prospective studies are warranted.
Keywords:
knowledge
osteomyelitis
structural equation modeling
practice
attitude
cross-sectional study
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