Zhou Lin, Qi Xinmeng, Xu Liuliu, Duanmu Xinrong, Wang Ke, Liu Kai, Zhang Yue
Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Hospital Reform and Development Research Institute, Nanjing University, Nanjing, China.
Front Public Health. 2025 Jun 25;13:1572046. doi: 10.3389/fpubh.2025.1572046. eCollection 2025.
This research aims to explore the levels of knowledge, attitudes, and willingness (KAW) of patients with bipolar disorder (BD) regarding electroconvulsive therapy (ECT).
A cross-sectional survey was conducted in Nanjing from April 10 to November 3, 2024, using a validated questionnaire [Cronbach's α = 0.936, Kaiser-Meyer-Olkin (KMO) = 0.917]. Participants completed structured items assessing knowledge, attitudes, and willingness toward ECT. Data analysis involved descriptive statistics, non-parametric tests, Spearman correlation, multivariate logistic regression, and structural equation modeling (SEM).
The study successfully enrolled 479 participants. Of these, 282 participants (58.87%) were female. One hundred and sixty seven respondents (34.86%) had previously undergone ECT. The mean knowledge, attitude, and willingness scores were 5.57 ± 4.84 (possible range: 0-16), 29.08 ± 6.21 (possible range: 9-45), and 21.49 ± 5.14 (possible range: 6-30), respectively. SEM analysis showed that electroconvulsive therapy (β = -0.377, = 0.014), years of BD (β = 0.196, = 0.014) had direct effects on knowledge. Knowledge (β = 0.526, = 0.023) directly affected attitude. Meanwhile, electroconvulsive therapy (β = -0.198, = 0.013) and years of BD (β = 0.103, = 0.016) indirectly affected attitude. Knowledge (β = 0.107, = 0.018), attitude (β = 0.674, = 0.009), and gender (β = 0.104, = 0.020) directly affected willingness. Knowledge (β = 0.355, = 0.011), electroconvulsive therapy (β = -0.174, = 0.015), and years of BD (β = 0.090, = 0.020) indirectly affected willingness.
The study found that bipolar disorder patients generally lack knowledge and hold negative attitudes but demonstrate a relatively high willingness to accept ECT treatment. Targeted educational programs are recommended to improve understanding, shift attitudes, and enhance acceptance of this treatment in clinical willingness.
本研究旨在探讨双相情感障碍（BD）患者对电休克治疗（ECT）的知识、态度和意愿水平。
于2024年4月10日至11月3日在南京进行了一项横断面调查，使用经过验证的问卷[克朗巴哈α系数 = 0.936，Kaiser-Meyer-Olkin（KMO）值 = 0.917]。参与者完成了评估对ECT的知识、态度和意愿的结构化项目。数据分析包括描述性统计、非参数检验、Spearman相关性分析、多因素逻辑回归分析和结构方程模型（SEM）分析。
该研究成功招募了479名参与者。其中，282名参与者（58.87%）为女性。167名受访者（34.86%）曾接受过ECT治疗。知识、态度和意愿的平均得分分别为5.57±4.84（可能范围：0 - 16）、29.08±6.21（可能范围：9 - 45）和21.49±5.14（可能范围：6 - 30）。SEM分析表明，电休克治疗（β = -0.377，P = 0.014）、双相情感障碍病程（β = 0.196，P = 0.014）对知识有直接影响。知识（β = 0.526，P = 0.023）直接影响态度。同时，电休克治疗（β = -0.198，P = 0.013）和双相情感障碍病程（β = 0.103，P = 0.016）间接影响态度。知识（β = 0.107，P = 0.018）、态度（β = 0.674，P = 0.009）和性别（β = 0.104，P = 0.020）直接影响意愿。知识（β = 0.355，P = 0.011）、电休克治疗（β = -0.174，P = 0.015）和双相情感障碍病程（β = 0.090，P = 0.020）间接影响意愿。
该研究发现双相情感障碍患者普遍缺乏相关知识且持负面态度，但接受ECT治疗的意愿相对较高。建议开展针对性的教育项目，以提高临床对该治疗的理解、转变态度并增强接受度。
