{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:43:22Z","timestamp":1789494202399,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"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":"\n Introduction<\/jats:title>\n To assess the knowledge, attitude, and practice (KAP) levels among patients with osteomyelitis, analyze their associated factors, and explore the pathways between knowledge, attitude, and practice.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A cross-sectional study was conducted in a large tertiary hospital from April 1st to June 1st, 2025, enrolling 405 patients with osteomyelitis. A self-administered questionnaire collected demographic and disease-related information and assessed KAP. Cronbach\u2019s\n \u03b1<\/jats:italic>\n tested questionnaire reliability, and confirmatory factor analysis examined construct validity. Univariate analysis, multivariate binary logistic regression with a two-tailed\n p<\/jats:italic>\n \u202f&lt;\u202f0.05 as the statistical significance cut-off, and structural equation modeling (SEM) were used to explore factors associated with KAP and their interrelationship mechanisms.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Mean scores for knowledge, attitude, and practice were 28.56\u202f\u00b1\u202f10.28, 29.08\u202f\u00b1\u202f11.36, and 28.58\u202f\u00b1\u202f11.62, respectively; achievement rates were 32.1, 35.6, and 30.9%. The overall Cronbach\u2019s\n \u03b1<\/jats:italic>\n was 0.962, the KMO value was 0.971, and model fit was good (CMIN\/DF\u202f=\u202f1.32, RMSEA\u202f=\u202f0.028, CFI\u202f=\u202f0.984). Multivariate analysis showed that age (\n p<\/jats:italic>\n \u202f=\u202f0.013), income (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), education (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), history of diabetes mellitus (\n p<\/jats:italic>\n \u202f=\u202f0.009), and number of hospitalizations (\n p<\/jats:italic>\n \u202f=\u202f0.020) were independently associated with knowledge. Knowledge level (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), age (\n p<\/jats:italic>\n \u202f=\u202f0.034), income (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and education (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) were associated with attitude. Attitude level (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), knowledge level (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), income (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and education (\n p<\/jats:italic>\n \u202f=\u202f0.019) were associated with practice. SEM revealed that knowledge had a direct theoretical association with attitude (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.694,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and practice (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.303,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001); attitude had a direct theoretical association with practice (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.465,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). The indirect theoretical association of knowledge with practice via attitude was significant (\n \u03b2<\/jats:italic>\n \u202f=\u202f0.357,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), accounting for 54.1% of the total effect.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Patients with osteomyelitis showed insufficient knowledge, attitude, and practice. Older age, lower education, and lower income were associated with poorer outcomes. Attitude mediated the knowledge-practice association. Future interventions should focus on attitude change in vulnerable populations, and prospective studies are warranted.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1838790","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:38:31Z","timestamp":1783661911000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Knowledge, attitude, and practice of patients with osteomyelitis: a cross-sectional study using structural equation modeling"],"prefix":"10.3389","volume":"14","author":[{"given":"Lin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaze","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinglin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuyin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianpeng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuxu","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Affiliated Hospital of Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1038\/s41579-022-00686-0","article-title":"Skeletal infections: microbial 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