Wu Guiping, Che Xiaowen, Wu Jiabei, Niu Jianqiang, Zhou Yun
Department of Cardiology, The Fifth Hospital of Shanxi Medical University (Shanxi Provincial People's Hospital), Taiyuan, 030012, Shanxi, China.
Department of Public Health, Taiyuan Center for Disease Control and Prevention, Taiyuan, 030012, Shanxi, China.
Sci Rep. 2025 Jul 1;15(1):20748. doi: 10.1038/s41598-025-07522-4.
Primary aldosteronism (PA), though affecting approximately 10% of hypertensive patients, remains significantly underdiagnosed globally, especially in resource-limited healthcare settings. Despite its clinical importance, there is a notable gap in research assessing healthcare professionals' preparedness in diagnosing and managing this condition. This study, the first of its kind in China, aimed to comprehensively evaluate the knowledge, attitudes, and practices (KAP) of healthcare workers regarding PA in Shanxi Province and to identify factors associated with proactive clinical practices, with the goal of identifying specific educational and training needs. From August 1 to 7, 2024, a multi-center cross-sectional study enrolled 337 doctors from cardiology, endocrinology, and urology departments. The cohort comprised 51.63% females, with 61.42% having managed patients with primary aldosteronism. Mean KAP scores were 4.42 ± 1.56 (knowledge), 26.46 ± 2.65 (attitude), and 29.27 ± 7.42 (practice), based on respective scoring ranges. Spearman correlation analysis revealed significant positive correlations among knowledge, attitude, and practice (r = 0.279, P < 0.001; r = 0.347, P < 0.001; r = 0.507, P < 0.001). Mediation analysis indicated that knowledge directly influenced both attitude (β = 0.450, P = 0.012) and practice (β = 0.461, P = 0.006), with an indirect effect on practice (β = 0.095, P = 0.030). This study uniquely demonstrates that knowledge levels directly influence clinical practices both directly and indirectly through attitudinal changes, highlighting the critical importance of targeted educational interventions. Overall, healthcare workers exhibited insufficient knowledge but maintained moderate attitudes and practices regarding primary aldosteronism. Targeted educational programs are essential to enhance their knowledge, consequently improving attitudes and practices, particularly within higher-tier healthcare settings. Our findings provide novel insights into the specific knowledge gaps and practice limitations that may contribute to PA underdiagnosis in China, offering targeted recommendations for improving clinical outcomes through enhanced professional education.
原发性醛固酮增多症（PA）虽然影响着约10%的高血压患者，但在全球范围内仍存在严重的诊断不足问题，尤其是在医疗资源有限的环境中。尽管其具有临床重要性，但在评估医疗专业人员对该疾病的诊断和管理准备情况的研究方面仍存在显著差距。本研究是中国首例此类研究，旨在全面评估山西省医护人员对PA的知识、态度和实践（KAP），并确定与积极临床实践相关的因素，以确定具体的教育和培训需求。2024年8月1日至7日，一项多中心横断面研究招募了来自心内科、内分泌科和泌尿外科的337名医生。该队列中女性占51.63%，其中61.42%曾治疗过原发性醛固酮增多症患者。根据各自的评分范围，平均KAP分数分别为4.42±1.56（知识）、26.46±2.65（态度）和29.27±7.42（实践）。Spearman相关性分析显示，知识、态度和实践之间存在显著正相关（r = 0.279，P < 0.001；r = 0.347，P < 0.001；r = 0.507，P < 0.001）。中介分析表明，知识直接影响态度（β = 0.450，P = 0.012）和实践（β = 0.461，P = 0.006），对实践有间接影响（β = 0.095，P = 0.030）。本研究独特地表明，知识水平直接并通过态度变化间接影响临床实践，突出了针对性教育干预的至关重要性。总体而言，医护人员对原发性醛固酮增多症的知识不足，但态度和实践处于中等水平。针对性的教育项目对于提高他们的知识水平至关重要，从而改善态度和实践，特别是在高级医疗环境中。我们的研究结果为可能导致中国PA诊断不足的具体知识差距和实践局限性提供了新的见解，为通过加强专业教育改善临床结果提供了针对性建议。
