Li Houxi, Su Qingqing, Qin Lei, Li Qi, Li Yake, Wang Chunyan, Zhu Houxia, Li Haiyan
Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Joint Surgery, Affiliated Hospital of Qingdao University, Qingdao, China.
PeerJ. 2025 Jun 4;13:e19511. doi: 10.7717/peerj.19511. eCollection 2025.
To investigate the knowledge, attitude, and practice (KAP) in patients with knee osteoarthritis (OA) towards perioperative functional exercise after total knee arthroplasty (TKA).
The cross-sectional survey enrolled knee OA patients in two tertiary public hospitals at Shandong Province between September 2023 and January 2024. Demographic characteristics, KAP scores, and Tampa Scale for Kinesiophobia (TSK) scores were gathered a self-made questionnaires.
A total of 583 valid questionnaires were collected, 65.01% were females and 48.89% over 65. The average scores of knowledge, attitude, practice and TSK were 11.17 ± 4.31 (possible range: 0-16), 21.78 ± 2.57 (possible range: 6-30), 35.44 ± 5.80 (possible range: 9-45), and 39.21 ± 10.75 (possible range: 17-68), respectively. Spearman correlation analysis showed positive correlation between knowledge and attitude (r = 0.3406, < 0.001), attitude and practice (r = 0.3464, < 0.001), attitude and practice (r = 0.6390, < 0.001), negative correlation between TSK and knowledge (r = -0.3663, < 0.001), attitude (r = -0.2937, < 0.001), and practice (r = -0.3970, < 0.001), respectively. Path analysis found that attitude, underlying diseases, occupation, total knee arthroplasty had direct effects on practice. Knowledge, age, education level, residence, diagnosis time, marital status had indirect effects on practice. Total knee arthroplasty had direct and indirect effects on practice (all < 0.05).
While most patients held a positive attitude and practice, concerns and misconceptions regarding perioperative exercises emerged as urgent issues. It is imperative to implement targeted interventions to enhance adherence by addressing factors influencing KAP.
调查膝骨关节炎（OA）患者对全膝关节置换术（TKA）围手术期功能锻炼的知识、态度和实践（KAP）情况。
这项横断面调查于2023年9月至2024年1月在山东省两家三级公立医院纳入膝骨关节炎患者。通过自制问卷收集人口统计学特征、KAP评分和坦帕运动恐惧量表（TSK）评分。
共收集到583份有效问卷，女性占65.01%，65岁以上者占48.89%。知识、态度、实践和TSK的平均得分分别为11.17±4.31（可能范围：0 - 16）、21.78±2.57（可能范围：6 - 30）、35.44±5.80（可能范围：9 - 45）和39.21±10.75（可能范围：17 - 68）。Spearman相关性分析显示，知识与态度之间呈正相关（r = 0.3406，P < 0.001），态度与实践之间呈正相关（r = 0.3464，P < 0.001），态度与实践之间呈正相关（r = 0.6390，P < 0.001），TSK与知识之间呈负相关（r = -0.3663，P < 0.001），与态度之间呈负相关（r = -0.2937，P < 0.001），与实践之间呈负相关（r = -0.3970，P < 0.001）。路径分析发现，态度、基础疾病、职业、全膝关节置换术对实践有直接影响。知识、年龄、教育程度、居住地、诊断时间、婚姻状况对实践有间接影响。全膝关节置换术对实践有直接和间接影响（均P < 0.05）。
虽然大多数患者态度和实践积极，但对围手术期锻炼的担忧和误解成为紧迫问题。必须实施有针对性的干预措施，通过解决影响KAP的因素来提高依从性。
