Knowledge, attitudes, and practices of primary caregivers regarding postoperative nutritional management after pancreaticoduodenectomy: a cross-sectional study

Abstract This study investigated the knowledge, attitudes, and practices (KAP) of 501 primary caregivers for postoperative nutrition after pancreaticoduodenectomy. A cross-sectional survey was conducted in our hospital using a questionnaire. A total of 501 primary caregivers were included. The mean knowledge score was 14.38 ± 5.21 (possible range: 0–22), the mean attitude score was 39.35 ± 5.35 (possible range: 10–50), and the mean practice score was 47.57 ± 8.17 (possible range: 10–60). Multivariate analysis demonstrated that higher knowledge (β = 0.241, P < 0.001) and more positive attitudes (β = 0.722, P < 0.001) were independently associated with better practice. Structural equation modeling confirmed significant direct associations of knowledge with attitude (β = 0.317) and practice (β = 0.157), as well as a strong direct association of attitude with practice (β = 0.790), along with a significant indirect association between knowledge and practice via attitude (β = 0.250; all P < 0.001). Caregivers demonstrated adequate knowledge, generally positive attitudes, but suboptimal nutritional practices after pancreaticoduodenectomy. Overall, attitudes emerged as the key mechanism linking knowledge to actual practices. Incorporating a structured, stage-specific caregiver support package into clinical follow-up may improve implementation fidelity and sustain nutritional management behaviors in home-based care.