Duan Qiong, Sun Mingyu, Kong Desheng, Liu Jun, Liu Bo, Li Kelin
Department of Plastic Surgery, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, 450003, People's Republic of China.
Department of Breast Surgery, Xuzhou Central Hospital. The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, 221009, People's Republic of China.
J Multidiscip Healthc. 2025 Sep 11;18:5701-5712. doi: 10.2147/JMDH.S534905. eCollection 2025.
This study evaluated the knowledge, attitude, and practice (KAP) of breast surgery healthcare professionals in China towards breast reconstruction.
This multicenter cross-sectional study was performed between July and September 2024, recruiting breast surgery healthcare professionals across China. Data were collected using a self-administered questionnaire with high reliability (Cronbach's α = 0.915) to capture demographic and KAP information. Multivariate logistic analyses identified factors independently associated with the KAP.
A total of 371 participants were enrolled. The mean knowledge, attitude, and practice scores were 8.25±3.67, 43.77±6.25, and 25.56±4.77. Working at a teaching hospital (OR=7.019, 95% CI: 2.519-19.562, P<0.001) and performing or participating in breast reconstruction surgery for patients (OR=4.128, 95% CI: 2.170-7.853, P<0.001) were independently associated with adequate knowledge. The knowledge scores (OR=1.093, 95% CI: 1.019-1.173, P=0.013), female gender (OR=3.774, 95% CI: 1.959-7.279, P<0.001), master's degree or above education (OR=5.597, 95% CI: 2.050-15.284, P=0.001), non-public tertiary hospitals (OR=8.196, 95% CI: 2.368-28.363, P=0.001), >20 years of experience (OR=11.249, 95% CI: 1.554-81.443, P=0.017), teaching hospital (OR=3.367, 95% CI: 1.262-8.980, P=0.015), and performed or participated in breast reconstruction surgery for patients (OR=2.228, 95% CI: 1.041-4.769, P=0.039) were independently associated with the positive attitude. The knowledge scores (OR=1.176, 95% CI: 1.095-1.262, P<0.001), doctor (OR=3.502, 95% CI: 1.025-11.971, P=0.046), master's degree or above education (OR=0.116, 95% CI: 0.043-0.313, P<0.001), junior title (OR=0.194, 95% CI: 0.052-0.730, P=0.015), non-public tertiary hospitals (OR=0.225, 95% CI: 0.078-0.650, P=0.006), and 10-20 years of experience (OR=0.318, 95% CI: 0.109-0.924, P=0.035) were independently associated with the proactive practice. Structural equation modeling showed that knowledge significantly influenced both attitudes (β=-1.753, P<0.001) and practices (β=1.981, P<0.001).
While attitudes and practices were generally positive, significant gaps remain in routine recommendation and education practices. Targeted educational programs may enhance their knowledge and improve clinical practices.
本研究评估了中国乳腺外科医疗保健专业人员对乳房重建的知识、态度和实践（KAP）。
本多中心横断面研究于2024年7月至9月进行，招募了中国各地的乳腺外科医疗保健专业人员。使用具有高可靠性（Cronbach's α = 0.915）的自填式问卷收集数据，以获取人口统计学和KAP信息。多变量逻辑分析确定了与KAP独立相关的因素。
共纳入371名参与者。知识、态度和实践的平均得分分别为8.25±3.67、43.77±6.25和25.56±4.77。在教学医院工作（OR = 7.019，95% CI：2.519 - 19.562，P < 0.001）以及为患者进行或参与乳房重建手术（OR = 4.128，95% CI：2.170 - 7.853，P < 0.001）与足够的知识独立相关。知识得分（OR = 1.093，95% CI：1.019 - 1.173，P = 0.013）、女性性别（OR = 3.774，95% CI：1.959 - 7.279，P < 0.001）、硕士及以上学历（OR = 5.597，95% CI：2.050 - 15.284，P = 0.001）、非公立三级医院（OR = 8.196，95% CI：2.368 - 28.363，P = 0.001）、超过20年经验（OR = 11.249，95% CI：1.554 - 81.443，P = 0.017）、教学医院（OR = 3.367，95% CI：1.262 - 8.980，P = 0.015）以及为患者进行或参与乳房重建手术（OR = 2.228，95% CI：1.041 - 4.769，P = 0.039）与积极态度独立相关。知识得分（OR = 1.176，95% CI：1.095 - 1.262，P < 0.001）、医生（OR = 3.502，95% CI：1.025 - 11.971，P = 0.046）、硕士及以上学历（OR = 0.116，95% CI：0.043 - 0.313，P < 0.001）、初级职称（OR = 0.194，95% CI：0.052 - 0.730，P = 0.015）、非公立三级医院（OR = 0.225，95% CI：0.078 - 0.650，P = 0.006）以及10 - 20年经验（OR = 0.318，95% CI：0.109 - 0.924，P = 0.035）与积极实践独立相关。结构方程模型显示，知识对态度（β = -1.753，P < 0.00）和实践（β = 1.981，P < 0.001）均有显著影响。
虽然态度和实践总体上是积极的，但在常规推荐和教育实践方面仍存在显著差距。有针对性的教育项目可能会增强他们的知识并改善临床实践。
