Table 1_A knowledge, attitude and practice study of evidence-based nursing combined with narrative nursing mode to improve the quality of life of glioma patients.docx

BackgroundExisting nursing knowledge-attitude-practice (KAP) studies have mostly focused on a single model of evidence-based nursing (EBN) or narrative nursing (NN) rather than an integrative approach. Meanwhile factors influencing nurses’ KAP in glioma care scenarios have not been studied. These gaps hinder the translation of evidence-based and narrative nursing integration into clinical practice and limit the improvement of patient prognosis.
MethodsThe knowledge-attitude-practice online questionnaire for nurses included the EBN knowledge questionnaire and NN cognitive assessment. Structural equation modeling was used to analyze the path relationships between knowledge, attitude, and practice. Pearson correlation coefficient was employed to explore the correlations among knowledge, attitude, and practice. Multivariate logistic regression analysis was conducted to examine the impact of demographic factors on the knowledge-attitude-practice levels of nurses. The quality of life of glioma patients was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.
ResultsA total of 164 nurses and 352 glioma patients were included in the study. Significant differences in the three knowledge-attitude-practice dimensions of nurses were found based on age, length of work, education background and job title. Professional knowledge played a central role in the construction of attitudes and the transformation of behaviors in nurses. A strong positive correlation was observed between knowledge and practice (r = 0.837), while a moderate positive correlation existed between attitude and both knowledge (r = 0.481) and practice (r = 0.499). Nurses with higher job title (head nurse) performed better in terms of attitude. The impact of education level on the three knowledge-attitude-practice dimensions was relatively small. Additionally, the overall functional status of glioma patients was good (median = 86 points, Q1 = 70.93, Q3 = 95), there was a significant difference in health status (median = 66.7 points, Q1 = 50, Q3 = 83.3), while the difference in symptom severity was relatively small (median = 11.11 points, Q1 = 3.7, Q3 = 24.69).
ConclusionThe knowledge-attitude-practice levels of nurses on EBN and NN are influenced by their own background factors, with professional knowledge playing a crucial role in shaping their attitude and behavior transformation, which may help in developing targeted educational interventions and effective public health strategies for glioma patients.

**研究背景**：现有护理领域的知识-态度-行为（Knowledge-Attitude-Practice, KAP）相关研究多聚焦于循证护理（Evidence-Based Nursing, EBN）或叙事护理（Narrative Nursing, NN）单一模式，而非整合式护理路径。同时，目前尚未有研究探讨胶质瘤（glioma）护理场景中影响护士知识-态度-行为水平的相关因素。上述研究空白阻碍了循证护理与叙事护理整合模式向临床实践的转化，也限制了胶质瘤患者预后的改善。

**研究方法**：本研究采用的护士知识-态度-行为在线问卷涵盖循证护理知识问卷与叙事护理认知评估量表。研究采用结构方程模型（structural equation modeling）分析知识、态度与行为三者间的路径关系；通过Pearson相关系数（Pearson correlation coefficient）探究三者间的相关性；运用多因素logistic回归（multivariate logistic regression）分析人口学因素对护士知识-态度-行为水平的影响。胶质瘤患者的生活质量则采用欧洲癌症研究与治疗组织生活质量问卷（European Organization for Research and Treatment of Cancer Quality of Life Questionnaire）进行评估。

**研究结果**：本研究共纳入164名护士与352例胶质瘤患者。分析显示，护士的知识-态度-行为三维度得分在年龄、工作年限、学历与职称层面均存在显著差异。专业知识在护士态度塑造与行为转变过程中发挥核心作用。知识与行为间呈强正相关（r=0.837）；态度与知识（r=0.481）、态度与行为（r=0.499）均呈中等程度正相关。职称更高的护士（如护士长）在态度维度上表现更优。学历对知识-态度-行为三维度的影响相对较小。此外，胶质瘤患者的整体功能状态良好（中位数=86分，四分位距Q1=70.93，Q3=95）；健康状况存在显著差异（中位数=66.7分，Q1=50，Q3=83.3），而症状严重程度的组间差异相对较小（中位数=11.11分，Q1=3.7，Q3=24.69）。

**研究结论**：护士针对循证护理与叙事护理的知识-态度-行为水平受自身背景因素影响，其中专业知识在塑造其态度与行为转变过程中起到关键作用。本研究结果可为胶质瘤患者制定针对性护理教育干预措施与高效公共卫生策略提供参考依据。