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Knowledge, attitude, and practice toward pulmonary nodules among patients in Northern China

A multicenter cross-sectional study

Bibliographic Data

ID22089949
AuthorsLina Wang (0009-0002-3877-4928, Fourth People’s Hospital of Jinan), Xuehui Li (0000-0002-9644-2422, Chinese PLA General Hospital), Xiaoling Ji (Fourth People’s Hospital of Jinan), Ying Liu (0000-0001-5584-7805, Tianjin Nankai Hospital), Yongping Chen (Cixian People's Hospital), Jian Liu (0000-0002-1447-0973, Fourth People’s Hospital of Jinan), Yunna Zhou (Fourth People’s Hospital of Jinan), Xianghong Yu (Shandong Provincial Hospital), Honglu Shi (0000-0001-9437-0309, Shandong Provincial Hospital, corresponding author), Xueliang Wang (0000-0003-2834-9370, Department of Respiratory Medicine, The Fifth People's Hospital of Jinan)
Year2026
Volume14
Pages1735755-1735755
Publication date2026-02-18
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1735755
PMID41788518
OpenAlexW7130406297
LanguageEN
References cited33

Introduction Northern China, characterized by higher rates of lung cancer incidence and pulmonary nodule detection due to elevated air pollution levels and smoking prevalence, necessitates focused assessments. This study aimed to evaluate knowledge, attitudes, and practices (KAP) among pulmonary nodule patients in Northern China. Methods This multicenter cross-sectional study was conducted across four hospitals in Northern China between August and December 2024. Results A total of 500 patients (95.6% response rate) completed questionnaires. The knowledge, attitudes and practices were 13.82 ± 2.72 (0–18), 31.90 ± 3.44 (9–45), and 34.35 ± 7.22 (13–65), respectively. Spearman analysis revealed significant positive correlations between knowledge-attitude ( r = 0.271, p < 0.001), knowledge-practice ( r = 0.270, p < 0.001), and attitude-practice ( r = 0.112, p = 0.013). Structural equation modeling (SEM) showed that knowledge was significantly associated with attitudes ( β = 0.553, p < 0.001), and attitudes were strongly associated with practices ( β = 0.865, p < 0.001). In addition, a significant indirect association between knowledge and practices through attitudes was observed ( β = 0.479, p < 0.001). Conclusion Patients in Northern China exhibit moderate knowledge, neutral attitudes, and suboptimal practices toward pulmonary nodules, with attitudes mediating the knowledge-practice relationship. Targeted interventions should prioritize regional education programs and enhanced clinician-patient communication to improve risk perception and follow-up adherence

China · Cross-sectional study · Lung cancer · Multicenter study · Psychological intervention · Structural equation modeling · Global Cancer Incidence and Screening · Lung Cancer Diagnosis and Treatment · Radiation Dose and Imaging

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