Knowledge, Attitude, Practice, and Awareness Regarding Disease Management Among Patients with Chronic Lower Limb Ischemia: A Cross-Sectional Study

Fei Wang, Xue Chen, Yafei Jiang, Yueqin Liu, Yi Li, Xiaofeng Yang, Hui Zhang, Xiuni Gan Vascular & Hernia & Abdorminal Wall Surgery Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Xiuni Gan, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China, Tel +8613883309318, Email 300650@cqmu.edu.cnPurpose: This study aims to investigate knowledge, attitude, practice (KAP), and disease awareness among patients with chronic lower limb ischemia.Patients and Methods: This cross-sectional study was conducted between November 2024 and January 2025 at the Second Affiliated Hospital of Chongqing Medical University. A self-administered questionnaire, with good internal consistency (Cronbach’s α = 0.917), was used to assess knowledge, attitude, and practice, while the Brief Illness Perception Questionnaire measured awareness.Results: Among 491 participants (73.7% male), most were aged 70– 79 years (38.7%), and 41.5% had a primary school education or below. Nearly half (48.1%) had ischemia for 2– 3 years. The mean knowledge, attitude, practice, and awareness scores were 8.71 ± 5.42, 31.55 ± 2.92, 31.47 ± 4.88, and 31.68 ± 5.03, respectively. Significant correlations were observed between knowledge and attitude (r = 0.513, P < 0.001), practice (r = 0.448, P < 0.001), and awareness (r = 0.175, P < 0.001). Attitude also correlated with practice (r = 0.331, P < 0.001) and awareness (r = 0.227, P < 0.001). Path analysis indicated that knowledge directly affected attitude (β = 0.522, P < 0.001), awareness (β = 0.164, P < 0.001), and practice (β = 0.356, P < 0.001), while attitude directly affected practice (β = 0.159, P < 0.001), knowledge also indirectly affected practice through attitude (β = 0.083, P = 0.001).Conclusion: Patients with chronic lower limb ischemia showed limited knowledge but generally maintained positive attitudes, proactive practices, and moderate awareness toward disease management. Enhancing awareness alongside knowledge may help improve overall self-management and clinical outcomes.Keywords: chronic limb-threatening ischemia, disease management, knowledge, attitude, practice, endovascular treatment, patient education, cross-sectional study