ArticleFrontiers in public health2026
Knowledge, attitude, and practice regarding cancer pain management in Southwest China: a two-center cross-sectional study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Cancer pain management depends partly on patients' knowledge, attitudes, and practices (KAP), but evidence from Southwest China remains limited. This study assessed cancer pain-related KAP, identified factors associated with Practice, and explored whether Attitude statistically accounted for the association between Knowledge and Practice. Methods: A two-center cross-sectional study was conducted among 523 patients with cancer-related pain at two tertiary hospitals in Southwest China. Data were collected using a self-developed KAP questionnaire, and domain scores were standardized to a 0-100 scale. Preliminary psychometric properties were assessed using internal consistency, item-level analyses, and confirmatory factor analysis. Factors associated with Practice were examined using multivariable linear regression. Exploratory indirect-effect analyses were performed using the PROCESS macro. Results: The mean standardized scores were 61.3 ± 32.6 for Knowledge, 62.0 ± 21.1 for Attitude, and 53.3 ± 28.9 for Practice; 51.6% of participants had poor Practice scores. Higher Knowledge score and peri-urban or urban residence were associated with higher Practice scores, whereas greater current pain intensity, age ≥60 years, and female sex were associated with lower Practice scores. Stage IV disease was positively associated with Practice after adjustment and remained generally consistent in the education-adjusted sensitivity model, although unadjusted analyses showed the opposite direction. Neither unadjusted nor covariate-adjusted exploratory indirect-effect analysis supported a statistically significant indirect association through Attitude. Conclusion: Among tertiary-hospital patients with cancer pain in Southwest China, Practice was comparatively lower than Knowledge and Attitude. Improving cancer pain-management practice may require attention to knowledge-to-action translation, symptom burden, and care-context factors rather than knowledge or attitudes alone. Future prospective, multicenter, and community-based studies are needed to validate the questionnaire and clarify temporal relationships among KAP domains.
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