Knowledge, Attitudes, and Practices Toward Nutritional Management Among Patients with Gastrointestinal Cancer: A Cross-Sectional Study

This study aimed to evaluate the knowledge, attitudes, and practices (KAP) regarding nutritional management among patients with gastrointestinal cancer. A descriptive cross-sectional study was conducted from December 2023 to May 2024 across hospitals in Jiangsu, Henan, Shanghai, and Tianjin, China. Participants completed questionnaires that collected demographic data and assessed their KAP toward nutritional management. A total of 1239 valid questionnaires were analyzed. Among the participants, 769 (62.1%) were male, and 452 (36.5%) had been diagnosed with gastrointestinal cancer for less than six months. The proportion of participants demonstrating adequate knowledge, positive attitudes, and proactive practices were 1018 (82.1%), 328 (26.4%), and 403 (32.5%), respectively. Multivariate logistic regression identified several factors independently associated with proactive practices, including adequate knowledge, lack of insurance, a gastrointestinal tumor duration of 2-3 years or more, no doubts about nutritional management, absence of nutritional screening, and having others as primary caregivers. Structural equation modeling revealed direct effects of knowledge on both attitude (β ​= ​0.308, P ​< ​0.001) and practice (β ​= ​0.475, P ​< ​0.001), as well as of attitude on practice (β ​= ​0.286, P ​< ​0.001). Additionally, knowledge indirectly influenced practice through attitude (β ​= ​0.088, P ​< ​0.001). While most gastrointestinal cancer patients demonstrated adequate knowledge regarding nutritional management, their attitudes were predominantly negative, and their practices were largely inactive. These findings highlight a critical need for targeted educational interventions to bridge knowledge gaps and encourage more active engagement with nutritional guidelines.