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已发表论文
老年糖尿病患者及其家属对合并非酒精性脂肪肝疾病的知识、态度和行为：结构方程模型分析
Authors Wang Q, Zhang Y, Guo X, Zhao L
Received 20 May 2025
Accepted for publication 19 September 2025
Published 15 October 2025 Volume 2025:18 Pages 3833—3844
DOI https://doi.org/10.2147/DMSO.S541709
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Jae Woong Sull
Qian Wang,* Yingze Zhang,* Xinmiao Guo, Lin Zhao
Department of Endocrinology, Guang’anmen Hospital (Baoding) China Academy of Chinese Medical Sciences, Baoding, Hebei, 071000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qian Wang, Email wq12272024@163.com
Background: To explore the knowledge, attitudes, and practices (KAP) concerning non-alcoholic fatty liver disease (NAFLD) among elderly diabetic patients and their families.
Methods: A cross-sectional survey was conducted in the outpatient and inpatient units of the Endocrinology Department at Baoding First Hospital of Traditional Chinese Medicine between September, 2023, and March, 2024. Data and KAP scores were collected using a self-designed questionnaires.
Results: The survey yielded 511 valid responses. Of these respondents, 361 (70.65%) were patients, and 177 (34.64%) were diagnosed with NAFLD. The mean scores for knowledge, attitudes, and practices among patients were 5.20 ± 3.37, 37.98 ± 3.96, and 41.85 ± 5.92, respectively, while the scores among patients’ family members were 6.42 ± 4.22, 37.72 ± 4.46, and 41.31 ± 7.02, respectively. Structural equation modeling (SEM) demonstrated significant direct and indirect influences on knowledge, attitude, and practice. Education level (β = 0.71, P < 0.001) were direct determinants of knowledge. Directly, knowledge (β = 0.42, P < 0.001), use of antidiabetic medications (β = − 1.8, P < 0.001), and body mass index (BMI) (β = 0.11, P = 0.011) influenced attitude, while knowledge (β = 0.33, P < 0.001), attitude (β = 0.64, P < 0.001), and NAFLD (β = − 1.2, P < 0.001) affected practice. Indirectly, education level (β = 0.30, P < 0.001) influenced attitude; education level (β = 0.43, P < 0.001), BMI (β = 0.07, P = 0.013), and use of antidiabetic medications (β = − 1.1, P = 0.001) impacted practice.
Conclusion: Despite elderly diabetic patients and their families showing a general lack of in-depth knowledge about NAFLD, they exhibit positive attitudes and proactive practices toward managing the condition. Healthcare providers should focus on enhancing educational interventions targeted at this demographic to improve knowledge, which is crucial for sustaining positive attitudes and effective practices in NAFLD management.
Keywords: knowledge, attitude, practice, non-alcoholic fatty liver disease, diabetes, cross-sectional study
Department of Endocrinology, Guang’anmen Hospital (Baoding) China Academy of Chinese Medical Sciences, Baoding, Hebei, 071000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qian Wang, Email wq12272024@163.com
Background: To explore the knowledge, attitudes, and practices (KAP) concerning non-alcoholic fatty liver disease (NAFLD) among elderly diabetic patients and their families.
Methods: A cross-sectional survey was conducted in the outpatient and inpatient units of the Endocrinology Department at Baoding First Hospital of Traditional Chinese Medicine between September, 2023, and March, 2024. Data and KAP scores were collected using a self-designed questionnaires.
Results: The survey yielded 511 valid responses. Of these respondents, 361 (70.65%) were patients, and 177 (34.64%) were diagnosed with NAFLD. The mean scores for knowledge, attitudes, and practices among patients were 5.20 ± 3.37, 37.98 ± 3.96, and 41.85 ± 5.92, respectively, while the scores among patients’ family members were 6.42 ± 4.22, 37.72 ± 4.46, and 41.31 ± 7.02, respectively. Structural equation modeling (SEM) demonstrated significant direct and indirect influences on knowledge, attitude, and practice. Education level (β = 0.71, P < 0.001) were direct determinants of knowledge. Directly, knowledge (β = 0.42, P < 0.001), use of antidiabetic medications (β = − 1.8, P < 0.001), and body mass index (BMI) (β = 0.11, P = 0.011) influenced attitude, while knowledge (β = 0.33, P < 0.001), attitude (β = 0.64, P < 0.001), and NAFLD (β = − 1.2, P < 0.001) affected practice. Indirectly, education level (β = 0.30, P < 0.001) influenced attitude; education level (β = 0.43, P < 0.001), BMI (β = 0.07, P = 0.013), and use of antidiabetic medications (β = − 1.1, P = 0.001) impacted practice.
Conclusion: Despite elderly diabetic patients and their families showing a general lack of in-depth knowledge about NAFLD, they exhibit positive attitudes and proactive practices toward managing the condition. Healthcare providers should focus on enhancing educational interventions targeted at this demographic to improve knowledge, which is crucial for sustaining positive attitudes and effective practices in NAFLD management.
Keywords: knowledge, attitude, practice, non-alcoholic fatty liver disease, diabetes, cross-sectional study