Knowledge, attitudes, and proactive practices regarding PICC in gastrointestinal cancer: a mediation analysis of a patient empowerment attempt

Objective To examine the knowledge, attitudes, and practices (KAP) related to the use and self-care of peripherally inserted central catheters (PICC) among gastrointestinal cancer patients. Methods This cross-sectional study was conducted between January and July 2024 at Inner Mongolia Hospital and Peking University Cancer Hospital. A questionnaire was used to collect self-reported KAP data. Achieving scores above 70% of the maximum in each section indicated adequate knowledge, positive attitudes, and proactive practices. A mediation analysis was performed to examine the relationships among KAP dimensions. Results A total of 444 valid cases were included. Of these, 305 (68.69%) were male, and 338 (76.13%) had undergone a single PICC placement. The knowledge, attitude, and practice scores were 11.27 ± 3.69 (possible range: 0–14; 80.50%), 30.48 ± 3.22 (possible range: 8–40; 76.20%), and 31.32 ± 5.38 (possible range: 8–40; 78.30%), respectively, indicating good KAP. Path analysis revealed that duration of illness (β = -1.04, P = 0.001) and self-care ability (β = -1.08, P = 0.01) had a direct negative influence on knowledge. Knowledge (β = 0.27, P < 0.001) and higher education (β = 0.36, P = 0.021) had a positive influence on attitude, while type of tumor (β = -0.31, P = 0.041) had a direct negative influence. Conclusions Patients demonstrated sufficient knowledge, generally positive attitudes, and proactive practices regarding PICC. Based on the KAP theoretical framework, targeted educational interventions to improve patients’ knowledge and self-care abilities and positively shape their attitudes may further enhance PICC management and optimize patient outcomes by promoting patient empowerment. These findings highlight the importance of integrating self-care training into patient discharge protocols.