{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:35:53Z","timestamp":1791657353209,"version":"4.3.4"},"reference-count":31,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"unspecified","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,10,4]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the knowledge, attitude and practice (KAP) towards chemotherapy-related neutropenia and febrile neutropenia (FN) among breast cancer patients. The major hypothesis was that demographic characteristics influence patients\u2019 KAP regarding chemotherapy-related neutropenia and FN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A multi-centre cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Conducted in four secondary care hospitals between April and June 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The study enrolled 246 breast cancer patients undergoing chemotherapy. Participants were aged 18 years or older, currently on chemotherapy and willing to complete the questionnaire. Exclusion criteria included significant cognitive impairments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcome measures were KAP scores regarding chemotherapy-related neutropenia and FN. Secondary outcomes included factors associated with adequate knowledge and positive attitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 246 patients completed the questionnaire. The mean knowledge score was 12.46\u00b16.21 (range: 0\u201326), and the mean attitude score was 30.00\u00b12.58 (range: 7\u201335). Less than half of the patients (45.95%) knew whether their chemotherapy protocol was high risk for FN, while 79.67% were aware of the need for prophylactic administration of leukocyte-raising agents. Multivariate logistic regression analysis revealed that having a junior college education or higher was significantly associated with knowledge scores (OR=4.69, 95%\u2009CI 2.23 to 9.89, p&lt;0.001). Living in urban areas was associated with attitude scores (OR=0.58, 95%\u2009CI 0.34 to 0.97, p=0.037). Structural equation modelling analysis indicated that experience with chemotherapy-related neutropenia or FN influenced knowledge to some degree (\u03b2=1.77, p=0.029).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study found inadequate knowledge, a positive attitude and suboptimal practice towards chemotherapy-related neutropenia and FN among breast cancer patients undergoing chemotherapy. Tailored education programmes are needed to improve KAP in this patient population. Further research should explore additional demographic and psychosocial factors influencing KAP to develop comprehensive educational interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089738","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:35:01Z","timestamp":1730288101000},"page":"e089738","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Knowledge, attitude and practice towards chemotherapy-related neutropenia and febrile neutropenia among breast cancer patients"],"prefix":"10.1136","volume":"14","author":[{"given":"Yilin","family":"Chen","sequence":"first","affiliation":[{"name":"The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6405-6335","authenticated-orcid":false,"given":"Huanhao","family":"Zhou","sequence":"additional","affiliation":[{"name":"The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junzhen","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"2025121513564039000_14.10.e089738.1","doi-asserted-by":"crossref","first-page":"4287","DOI":"10.3390\/cancers13174287","article-title":"Breast Cancer\u2014Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies\u2014An Updated Review","volume":"13","author":"\u0141ukasiewicz","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2025121513564039000_14.10.e089738.2","doi-asserted-by":"crossref","first-page":"867","DOI":"10.31557\/APJCP.2020.21.4.867","article-title":"A Review of the Epidemiology of Breast Cancer in Asia: Focus on Risk Factors","volume":"21","author":"Youn","year":"2020","journal-title":"Asian Pac J Cancer Prev"},{"key":"2025121513564039000_14.10.e089738.3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0132853","article-title":"Impact of Adjuvant Chemotherapy on Breast Cancer Survival: A Real-World Population","volume":"10","author":"Rossi","year":"2015","journal-title":"PLoS One"},{"key":"2025121513564039000_14.10.e089738.4","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1016\/j.breast.2015.07.035","article-title":"Long term side effects of adjuvant chemotherapy in patients with early breast cancer","volume":"24","author":"Tao","year":"2015","journal-title":"Breast"},{"key":"2025121513564039000_14.10.e089738.5","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-71927-6","article-title":"Machine learning improves the prediction of febrile neutropenia in Korean inpatients undergoing chemotherapy for breast cancer","volume":"10","author":"Cho","year":"2020","journal-title":"Sci Rep"},{"key":"2025121513564039000_14.10.e089738.6","doi-asserted-by":"crossref","DOI":"10.3332\/ecancer.2021.1188","article-title":"Chemotherapy induced neutropenia and febrile neutropenia among breast cancer patients in a tertiary hospital in Nigeria","volume":"15","author":"Salako","year":"2021","journal-title":"Ecancermedicalscience"},{"key":"2025121513564039000_14.10.e089738.7","doi-asserted-by":"crossref","first-page":"2714","DOI":"10.3390\/cancers14112714","article-title":"Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results","volume":"14","author":"Ong","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2025121513564039000_14.10.e089738.8","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1159\/000366466","article-title":"Management of breast cancer patients with chemotherapy-induced neutropenia or febrile neutropenia","volume":"9","author":"Fontanella","year":"2014","journal-title":"Breast Care (Basel)"},{"key":"2025121513564039000_14.10.e089738.9","first-page":"2413","article-title":"Patient factors and their impact on neutropenic events: a systematic review and meta-analysis","volume":"27","author":"Chambers","year":"2019","journal-title":"Supp Care Cancer"},{"key":"2025121513564039000_14.10.e089738.10","first-page":"4509","article-title":"An internet-based survey exploring the awareness of febrile neutropenia in patients with malignant lymphoma","volume":"28","author":"Takamatsu","year":"2020","journal-title":"Supp Care Cancer"},{"key":"2025121513564039000_14.10.e089738.11","doi-asserted-by":"crossref","first-page":"100765","DOI":"10.1016\/j.cegh.2021.100765","article-title":"Study on knowledge of chemotherapy\u2019s adverse effects and their self-care ability to manage - 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