Knowledge, attitudes and practices regarding deep vein thrombosis among patients presenting with lower limb swelling and pain and their families: a cross-sectional survey at a tertiary hospital in China

BMJ Open. 2025 Sep 1;15(9):e097304. doi: 10.1136/bmjopen-2024-097304.

Abstract

Objectives: To investigate the knowledge, attitudes and practices (KAP) regarding deep vein thrombosis (DVT) among patients presenting with lower limb swelling and pain and their accompanying family members. A secondary objective was to compare KAP levels between these two groups and identify predictors of higher KAP.

Design: A cross-sectional survey study.

Setting: The study was conducted in various hospital wards and outpatient clinics at a single tertiary academic hospital (Zhongshan Hospital, Xiamen University) in Xiamen, China, from October 2023 to May 2024.

Participants: A total of 725 participants were recruited using convenience sampling, comprising 358 patients presenting with lower limb swelling and pain and 367 accompanying family members. Key inclusion criteria were age of ≥18 years and the ability to provide informed consent.

Primary and secondary outcome measures: Primary outcomes were KAP scores measured by a validated, self-designed questionnaire. Scores ≥70% of the maximum possible score for each domain were defined as adequate knowledge (≥16.8/24), a positive attitude (≥19) and proactive practice (≥30.4). Secondary outcomes included the comparison of KAP scores between patients and family members and the identification of factors associated with higher overall KAP levels using multivariate logistic regression analysis.

Results: Of 725 participants, both patients and family members demonstrated inadequate mean knowledge scores (10.62±4.71 and 11.88±4.95, respectively, below the adequacy threshold of 16.8), though mean attitude and practice scores were above the positive/proactive thresholds. Family members had significantly higher scores than patients across all domains: knowledge (mean difference: 1.26, p<0.001), attitude (mean difference: 0.55, p=0.031) and practice (mean difference: 1.45, p<0.001). KAP were all positively correlated (all p<0.001). In multivariate analysis of the family member group, a higher education level (OR=3.06, 95% CI: 1.70 to 5.49) and being medical personnel (OR=5.21, 95% CI: 2.36 to 11.48) were significant predictors of higher overall KAP scores.

Conclusions: Patients presenting with lower limb symptoms and their families possess inadequate knowledge about DVT, despite generally positive attitudes and proactive practices. Family members represent a key resource with significantly better KAP than patients. Targeted educational interventions, focusing on individuals with lower educational levels and non-medical backgrounds, are crucial to improve DVT awareness and facilitate timely medical consultation.

Keywords: Attitude; GENERAL MEDICINE (see Internal Medicine); Knowledge.

MeSH terms

  • Adult
  • Aged
  • China
  • Cross-Sectional Studies
  • Edema* / etiology
  • Family* / psychology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Logistic Models
  • Lower Extremity*
  • Male
  • Middle Aged
  • Pain* / etiology
  • Surveys and Questionnaires
  • Tertiary Care Centers
  • Venous Thrombosis* / complications
  • Venous Thrombosis* / psychology