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下肢肿胀和疼痛患者及其家属对深静脉血栓形成的认知、态度和行为:中国一家三级医院的横断面调查

Knowledge, attitudes and practices regarding deep vein thrombosis among patients presenting with lower limb swelling and pain and their families: a cross-sectional survey at a tertiary hospital in China.

作者信息

Zhang Hong, Ding Tingting, Lu Tiehua, Du Yanru, Cong Yanhui

机构信息

Department of Nuclear Medicine, Zhongshan Hospital Xiamen University, Xiamen, Fujian, China.

Department of Nuclear Medicine, Zhongshan Hospital Xiamen University, Xiamen, China.

出版信息

BMJ Open. 2025 Sep 1;15(9):e097304. doi: 10.1136/bmjopen-2024-097304.

Abstract

OBJECTIVES

To investigate the knowledge, attitudes and practices (KAP) regarding deep vein thrombosis (DVT) among patients presenting with lower limb swelling and pain and their accompanying family members. A secondary objective was to compare KAP levels between these two groups and identify predictors of higher KAP.

DESIGN

A cross-sectional survey study.

SETTING

The study was conducted in various hospital wards and outpatient clinics at a single tertiary academic hospital (Zhongshan Hospital, Xiamen University) in Xiamen, China, from October 2023 to May 2024.

PARTICIPANTS

A total of 725 participants were recruited using convenience sampling, comprising 358 patients presenting with lower limb swelling and pain and 367 accompanying family members. Key inclusion criteria were age of ≥18 years and the ability to provide informed consent.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary outcomes were KAP scores measured by a validated, self-designed questionnaire. Scores ≥70% of the maximum possible score for each domain were defined as adequate knowledge (≥16.8/24), a positive attitude (≥19) and proactive practice (≥30.4). Secondary outcomes included the comparison of KAP scores between patients and family members and the identification of factors associated with higher overall KAP levels using multivariate logistic regression analysis.

RESULTS

Of 725 participants, both patients and family members demonstrated inadequate mean knowledge scores (10.62±4.71 and 11.88±4.95, respectively, below the adequacy threshold of 16.8), though mean attitude and practice scores were above the positive/proactive thresholds. Family members had significantly higher scores than patients across all domains: knowledge (mean difference: 1.26, p<0.001), attitude (mean difference: 0.55, p=0.031) and practice (mean difference: 1.45, p<0.001). KAP were all positively correlated (all p<0.001). In multivariate analysis of the family member group, a higher education level (OR=3.06, 95% CI: 1.70 to 5.49) and being medical personnel (OR=5.21, 95% CI: 2.36 to 11.48) were significant predictors of higher overall KAP scores.

CONCLUSIONS

Patients presenting with lower limb symptoms and their families possess inadequate knowledge about DVT, despite generally positive attitudes and proactive practices. Family members represent a key resource with significantly better KAP than patients. Targeted educational interventions, focusing on individuals with lower educational levels and non-medical backgrounds, are crucial to improve DVT awareness and facilitate timely medical consultation.

摘要

目的

调查下肢肿胀和疼痛患者及其陪同家属对深静脉血栓形成(DVT)的知识、态度和行为(KAP)。次要目的是比较这两组的KAP水平,并确定KAP较高的预测因素。

设计

横断面调查研究。

背景

该研究于2023年10月至2024年5月在中国厦门的一家三级学术医院(厦门大学附属中山医院)的各个医院病房和门诊进行。

参与者

采用便利抽样法共招募了725名参与者,包括358名出现下肢肿胀和疼痛的患者以及367名陪同家属。主要纳入标准为年龄≥18岁且能够提供知情同意书。

主要和次要观察指标

主要观察指标是通过经过验证的自行设计问卷测量的KAP得分。每个领域得分≥最高可能得分的70%被定义为具备足够知识(≥16.8/24)、积极态度(≥19)和积极行为(≥30.4)。次要观察指标包括患者和家属之间KAP得分的比较,以及使用多因素逻辑回归分析确定与总体KAP水平较高相关的因素。

结果

在725名参与者中,患者和家属的平均知识得分均不足(分别为10.62±4.71和11.88±4.95,低于充足阈值16.8),尽管平均态度和行为得分高于积极/主动阈值。在所有领域,家属的得分均显著高于患者:知识(平均差异:1.26,p<0.001)、态度(平均差异:0.55,p=0.031)和行为(平均差异:1.45,p<0.001)。KAP均呈正相关(均p<0.001)。在对家属组的多因素分析中,较高的教育水平(OR=3.06,95%CI:1.70至5.49)和医务人员身份(OR=5.21,95%CI:2.36至11.48)是总体KAP得分较高的显著预测因素。

结论

出现下肢症状的患者及其家属对DVT的知识不足,尽管态度普遍积极且行为主动。家属是一个关键资源,其KAP明显优于患者。针对教育水平较低和非医学背景的个体进行有针对性的教育干预,对于提高DVT意识和促进及时就医至关重要。

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