Patient's knowledge, attitudes and behaviours towards pulmonary nodule management: a cross-sectional study in Wenzhou, China.

Objectives: The prevalence of pulmonary nodules (PNs) has been rising in China, but PN patients' perceptions towards the management remain underexplored. This study aimed to investigate the knowledge, attitudes and behaviours (KAB) regarding PN management among Chinese patients.

Design: A cross-sectional study was conducted to evaluate the KAB scores using a self-designed questionnaire.

Participants: The study included 519 PN patients (275 males, aged 41.07±19.47) diagnosed at Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medicine University between November 2022 and January 2023. Participants completed a self-designed questionnaire assessing their KAB regarding PN management.

Primary and secondary outcome measures: The primary outcomes included mean scores for KAB, with secondary outcomes examining correlations and associations with demographic factors.

Results: The mean KAB scores were 4.24±2.93 (range: 0-10), 17.97±4.88 (range: 0-32) and 31.30±11.98 (range: 0-52). Pearson's correlation analysis revealed a weakly positive correlation between knowledge and behaviour (r=0.248, p<0.001). Medical insurance (OR=3.62, 95% CI 1.18 to 11.15, p=0.025) and family history of lung cancer (OR=1.85, 95% CI 1.10 to 3.12, p=0.020) were positively associated with knowledge, while self-employment showed a negative association (OR=0.35, 95% CI 0.15 to 0.78, p=0.011). Female gender (OR=1.79, 95% CI 1.10 to 2.91, p=0.019), moderate income (OR=2.80, 95% CI 1.09 to 7.16, p=0.032) and longer diagnosis duration (OR=5.27, 95% CI 2.63 to 10.54, p<0.001) were positively associated with attitude, but divorced/widowed status (OR=0.31, 95% CI 0.14 to 0.66, p=0.003), comorbidities (OR=0.35, 95% CI 0.22 to 0.56, p<0.001) and family history of lung cancer (OR=0.24, 95% CI 0.13 to 0.45, p<0.001) were the opposite. Moreover, positive associations were noted of knowledge (OR=1.10, 95% CI 1.03 to 1.18, p=0.008), attitudes (OR=1.06, 95% CI 1.01 to 1.10, p=0.018) and postgraduate education (OR=4.91, 95% CI 1.47 to 16.36, p=0.010) with practice.

Conclusions: PN patients demonstrate insufficient knowledge and moderate attitudes and behaviours regarding PN management. These findings highlight the need for targeted educational interventions to improve understanding among PN patients.