Gong Pengfeng, Shen Jie, Yang Yu, Xue Dong, Lu Hao, Zhuang Qianfeng, Wang Xiaogang, Tian Zinong, Chen Yiming, Chen Cheng, Cao Yunjie
Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, 213000, People's Republic of China.
Department of Hepato-Pancreato-Biliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, People's Republic of China.
Int J Gen Med. 2024 Aug 7;17:3423-3432. doi: 10.2147/IJGM.S471004. eCollection 2024.
To explore patients' knowledge, attitude, and practice (KAP) toward varicocele in China and the relationship between treatment selection and KAP.
This cross-sectional study enrolled varicocele patients at the Third Affiliated Hospital of Soochow University (September to October 2023). Structural equation modeling (SEM) was used to explore the relationship between clinical factors and KAP. A score >mean score for each dimension was defined as adequate knowledge, positive attitude, and proactive practice. The patients were grouped according to varicocelectomy vs no surgery. Univariable and multivariable logistic regression analyses were used to identify the factors independently associated with KAP. A structural equation modeling (SEM) analysis was performed to examine how the KAP dimensions influenced each other.
Among 502 patients, 44.02%, 35.86%, and 20.12% were ≤30, 31-40, and >40 years old, respectively. Those who underwent varicocelectomy (n=407) had significantly higher knowledge (20 (15-22) vs 0 (0-6), P<0.001), attitude (26 (24-26) vs 14 (10-18), P<0.001), and practice (20 (17-24) vs 8 (6-16), P<0.001) than those who did not. A higher proportion of patients with varicocelectomy were <40 years old, more educated, had higher income, and were unmarried compared with those without surgery (all P<0.001). High school or higher education level and varicocelectomy (irrespective of type) were independently associated with adequate knowledge (all P<0.001). Knowledge, college/bachelor's degree education, and varicocelectomy type (irrespective of type) were associated with positive attitudes (all P<0.05). In the SEM, knowledge directly influenced attitude, knowledge directly influenced practice, and attitude directly influenced practice (all P<0.001). Having knowledge of the subject may direct varicocele patients to varicocelectomy.
Chinese patients who underwent varicocelectomy exhibit appropriate KAP regarding varicocele, while non-surgery patients have poorer KAP. These results suggest that patients who did not undergo surgery should nevertheless be properly informed about their disease.
探讨中国患者对精索静脉曲张的知识、态度和行为（KAP），以及治疗选择与KAP之间的关系。
这项横断面研究于2023年9月至10月在苏州大学附属第三医院招募精索静脉曲张患者。采用结构方程模型（SEM）探讨临床因素与KAP之间的关系。每个维度得分高于平均分被定义为具备充分知识、积极态度和主动行为。患者根据是否接受精索静脉结扎术分为两组。采用单因素和多因素逻辑回归分析确定与KAP独立相关的因素。进行结构方程模型（SEM）分析以检验KAP各维度之间的相互影响。
在502例患者中，年龄≤30岁、31 - 40岁和>40岁的患者分别占44.02%、35.86%和20.12%。接受精索静脉结扎术的患者（n = 407）在知识（20（15 - 22）对0（0 - 6），P < 0.001）、态度（26（24 - 26）对14（10 - 18），P < 0.001）和行为（20（17 - 24）对8（6 - 16），P < 0.001）方面显著高于未接受手术的患者。与未接受手术的患者相比，接受精索静脉结扎术的患者中年龄<40岁、受教育程度更高、收入更高且未婚的比例更高（均P < 0.001）。高中及以上教育水平和精索静脉结扎术（无论何种类型）与具备充分知识独立相关（均P < 0.001）。知识、大专/本科学历教育和精索静脉结扎术类型（无论何种类型）与积极态度相关（均P < 0.05）。在SEM中，知识直接影响态度，知识直接影响行为，态度直接影响行为（均P < 0.001）。了解该疾病可能会引导精索静脉曲张患者选择精索静脉结扎术。
接受精索静脉结扎术的中国患者对精索静脉曲张表现出适当的KAP，而未接受手术的患者KAP较差。这些结果表明，未接受手术的患者仍应得到关于其疾病的适当告知。
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