{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:38:28Z","timestamp":1773041908479,"version":"3.50.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to assess the knowledge, attitude, and practice (KAP) of older adults patients with rheumatoid arthritis (RA) regarding disease management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter cross-sectional study enrolled older adults patients with RA between November and December 2024 in Sichuan Province, China. Self-administered questionnaires were utilized to collect demographic information and evaluate KAP scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 488 participants were included in the study, with 72.54% aged 60\u201369\u202fyears and 70.29% female. The mean KAP scores were 10.72\u202f\u00b1\u202f4.68 (possible range: 0\u201320), 20.11\u202f\u00b1\u202f2.31 (possible range: 6\u201330), and 25.05\u202f\u00b1\u202f6.10 (possible range: 7\u201335), respectively. Spearman correlation analysis revealed that knowledge positively correlated with both attitude (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.1293,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.0042) and practice (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.5037,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), while attitude positively correlated with practice (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.2066,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). The structural equation model showed that knowledge directly affected attitude (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f\u22120.56,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001) and practice (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f0.61,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001), while also indirectly affected practice through attitude mediation (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f0.52,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001). Furthermore, attitude demonstrated a direct effect on practice (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f\u22120.93,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found that older adults patients with RA generally exhibited insufficient knowledge and predominantly negative attitudes toward disease management, although many reported relatively proactive behaviors in managing their condition. Targeted educational interventions are necessary to improve knowledge and attitudes, which may further enhance disease management practices among older adults RA patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1763566","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:47:54Z","timestamp":1773038874000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge attitude and practice of older adults rheumatoid arthritis patients regarding disease management in a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yue","family":"Gou","sequence":"first","affiliation":[{"name":"Department of Outpatient, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuedan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Outpatient, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Medical Affairs Department of Medical Affairs Division, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Outpatient, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"He","sequence":"additional","affiliation":[{"name":"The Second People's Hospital of Yibin","place":["Yibin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Outpatient, West China Hospital, Sichuan University\/West China School of Nursing, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qibing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1016\/s0140-6736(10)60826-4","article-title":"Rheumatoid arthritis","volume":"376","author":"Scott","year":"2010","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1093\/rheumatology\/kep252","article-title":"Trends in cardiovascular mortality in patients with rheumatoid arthritis over 50 years: a systematic review and meta-analysis of cohort studies","volume":"48","author":"Meune","year":"2009","journal-title":"Rheumatology (Oxford)"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1920","DOI":"10.1136\/ard.2009.122226","article-title":"Explaining the cardiovascular risk associated with rheumatoid arthritis: traditional risk factors versus markers of rheumatoid arthritis severity","volume":"69","author":"Solomon","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1016\/j.kint.2017.11.025","article-title":"Treatment of rheumatoid arthritis with biologic agents lowers the risk of incident chronic kidney disease","volume":"93","author":"Sumida","year":"2018","journal-title":"Kidney Int"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e594","DOI":"10.1016\/s2665-9913(23)00211-4","article-title":"Global, regional, and national burden of rheumatoid arthritis, 1990-2020, and projections to 2050: a systematic analysis of the global burden of disease study 2021","volume":"5","author":"Black","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/1759720x17740075","article-title":"An autumn tale: geriatric rheumatoid arthritis","volume":"10","author":"Kobak","year":"2018","journal-title":"Ther Adv Musculoskelet Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1080\/14397595.2019.1682776","article-title":"Epidemiological characteristics of rheumatoid arthritis in Japan: prevalence estimates using a nationwide population-based questionnaire survey","volume":"30","author":"Kojima","year":"2020","journal-title":"Mod Rheumatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1136\/annrheumdis-2019-215920","article-title":"Global, regional and national burden of rheumatoid arthritis 1990-2017: a systematic analysis of the global burden of disease study 2017","volume":"78","author":"Safiri","year":"2019","journal-title":"Ann Rheum Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"R17","DOI":"10.1186\/ar2368","article-title":"Rheumatic diseases in China","volume":"10","author":"Zeng","year":"2008","journal-title":"Arthritis Res Ther"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1186\/s13075-017-1457-z","article-title":"Chinese registry of rheumatoid arthritis (CREDIT): II. Prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis","volume":"19","author":"Jin","year":"2017","journal-title":"Arthritis Res Ther"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1186\/s13018-020-01883-4","article-title":"The prevalence of rheumatoid arthritis in middle-aged and older adults people living in Naqu City, Tibet, autonomous region of China","volume":"15","author":"Zhang","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/s0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1002\/art.41752","article-title":"2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis","volume":"73","author":"Fraenkel","year":"2021","journal-title":"Arthritis Rheumatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/annrheumdis-2015-207524","article-title":"Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force","volume":"75","author":"Smolen","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/maj.0000000000000376","article-title":"Assessment of rheumatoid arthritis patients' adherence to treatment","volume":"349","author":"Gadallah","year":"2015","journal-title":"Am J Med Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1097\/NOR.0b013e3181e5c2c9","article-title":"Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a narrative review of the literature","volume":"29","author":"Salt","year":"2010","journal-title":"Orthop Nurs"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.2147\/ijgm.S351315","article-title":"Knowledge, attitude, and practice of bee venom acupuncture therapy on rheumatoid arthritis among patients in Saudi Arabia","volume":"15","author":"Sharaf","year":"2022","journal-title":"Int J Gen Med"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17103469","article-title":"Tailoring Tofacitinib oral therapy in rheumatoid arthritis: the TuTORApp-A usability study","volume":"17","author":"Sciascia","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1177\/2047487315597209","article-title":"Determinants of adherence to evidence-based therapy after acute myocardial infarction","volume":"23","author":"Hamood","year":"2016","journal-title":"Eur J Prev Cardiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update","volume":"76","author":"Smolen","year":"2017","journal-title":"Ann Rheum Dis"},{"key":"ref21","first-page":"1256","article-title":"Expert guidelines for chronic disease management of rheumatoid arthritis","volume":"62","year":"2023","journal-title":"Chin J Internal Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"957630","DOI":"10.3389\/fpubh.2022.957630","article-title":"Knowledge, attitude, and practice assessment toward COVID-19 among communities in East Nusa Tenggara, Indonesia: a cross-sectional study","volume":"10","author":"Lee","year":"2022","journal-title":"Front Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"121","DOI":"10.4103\/0253-7176.116232","article-title":"How to calculate sample size for different study designs in medical research?","volume":"35","author":"Charan","year":"2013","journal-title":"Indian J Psychol Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3390\/ijerph18052247","article-title":"Enablers of patient knowledge empowerment for self-Management of Chronic Disease: an integrative review","volume":"18","author":"Vainauskien\u0117","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1159\/000517696","article-title":"Physical activity and health in chronic kidney disease","volume":"199","author":"Wilund","year":"2021","journal-title":"Contrib Nephrol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1490189","DOI":"10.3389\/fpubh.2024.1490189","article-title":"Knowledge, attitudes, and practices of dietary management among patients with rheumatoid arthritis in China","volume":"12","author":"Li","year":"2024","journal-title":"Front Public Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.cger.2020.08.007","article-title":"Evaluation and treatment of constipation in the geriatric population","volume":"37","author":"Lucak","year":"2021","journal-title":"Clin Geriatr Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1189574","DOI":"10.3389\/fendo.2023.1189574","article-title":"Association between remnant cholesterol and chronic kidney disease in Chinese hypertensive patients","volume":"14","author":"Yuan","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.2147\/copd.S313841","article-title":"The relationship between anxiety, depression and treatment adherence in chronic obstructive pulmonary disease: a systematic review","volume":"16","author":"Volpato","year":"2021","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s12909-023-04008-7","article-title":"Comparison of attitudes toward the medical student-led community health education service to support chronic disease self-management among students, faculty and patients","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Med Educ"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"313","DOI":"10.17245\/jdapm.2019.19.6.313","article-title":"General anesthesia in the management of early childhood caries: an overview","volume":"19","author":"Oubenyahya","year":"2019","journal-title":"J Dent Anesth Pain Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e0287337","DOI":"10.1371\/journal.pone.0287337","article-title":"Rates, patterns, and predictors of complementary medicine use among patients with musculoskeletal diseases","volume":"18","author":"Alnaimat","year":"2023","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"3233","DOI":"10.1007\/s00520-021-06722-8","article-title":"Relationship between prescribed opioids, pain management satisfaction, and pain intensity in oncology outpatients","volume":"30","author":"Wang","year":"2022","journal-title":"Support Care Cancer"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"19","DOI":"10.3390\/ijerph19169994","article-title":"Physical and functional clinical profile of older adults in specialized geriatric rehabilitation Care Services in Saguenay-Qu\u00e9bec: a retrospective study at La Baie hospital","volume":"19","author":"de Lima","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3390\/nu13103376","article-title":"Targeting probiotics in rheumatoid arthritis","volume":"13","author":"Bungau","year":"2021","journal-title":"Nutrients"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"2267","DOI":"10.1007\/s10067-023-06654-0","article-title":"What are the core recommendations for rheumatoid arthritis care? Systematic review of clinical practice guidelines","volume":"42","author":"Conley","year":"2023","journal-title":"Clin Rheumatol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1186\/1471-2458-10-695","article-title":"Utilization of delivery care among rural women in China: does the health insurance make a difference? A cross-sectional study","volume":"10","author":"Xiao","year":"2010","journal-title":"BMC Public Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"627169","DOI":"10.3389\/fpubh.2022.627169","article-title":"The reimbursement rate of new rural cooperative medical scheme and self-rated health among rural middle-aged and older adults","volume":"10","author":"Xie","year":"2022","journal-title":"Front Public Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12955-018-0868-0","article-title":"Comparing the effects of China\u2019s three basic health insurance schemes on the equity of health-related quality of life: using the method of coarsened exact matching","volume":"16","author":"Su","year":"2018","journal-title":"Health Qual Life Outcomes"},{"key":"ref40","doi-asserted-by":"crossref","DOI":"10.1002\/9781118619179","volume-title":"Structural equations with latent variables","author":"Bollen","year":"1989"},{"key":"ref41","volume-title":"Principles and practice of structural equation modeling","author":"Kline","year":"2023"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1080\/17437199.2021.1878050","article-title":"The common sense model of illness self-regulation: a conceptual review and proposed extended model","volume":"16","author":"Hagger","year":"2022","journal-title":"Health Psychol Rev"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s10865-016-9782-2","article-title":"The common-sense model of self-regulation (CSM): a dynamic framework for understanding illness self-management","volume":"39","author":"Leventhal","year":"2016","journal-title":"J Behav Med"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"2355","DOI":"10.1093\/rheumatology\/keaa615","article-title":"Changes in the illness perceptions of patients with rheumatoid arthritis over the first year of methotrexate therapy","volume":"60","author":"Gwinnutt","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/s0022-3999(98)00073-7","article-title":"Depression, illness perception and coping in rheumatoid arthritis","volume":"46","author":"Murphy","year":"1999","journal-title":"J Psychosom Res"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1002\/acr.22249","article-title":"Impact of psychological factors on subjective disease activity assessments in patients with severe rheumatoid arthritis","volume":"66","author":"Cordingley","year":"2014","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1529100620920576","article-title":"Education and cognitive functioning across the life span","volume":"21","author":"L\u00f6vd\u00e9n","year":"2020","journal-title":"Psychol Sci Public Interest"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1038\/s41584-020-00541-7","article-title":"Persistent inflammatory and non-inflammatory mechanisms in refractory rheumatoid arthritis","volume":"17","author":"Buch","year":"2021","journal-title":"Nat Rev Rheumatol"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"101482","DOI":"10.1016\/j.berh.2019.101482","article-title":"Nonpharmacological treatment in established rheumatoid arthritis","volume":"33","author":"K\u00fc\u00e7\u00fckdeveci","year":"2019","journal-title":"Best Pract Res Clin Rheumatol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1763566\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:47:56Z","timestamp":1773038876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1763566\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":49,"alternative-id":["10.3389\/fpubh.2026.1763566"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1763566","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"article-number":"1763566"}}