Knowledge, attitudes, and practices regarding the functional status of arteriovenous fistulas among hemodialysis patients

The objective of this study was to assess the knowledge, attitudes, and practices (KAP) related to the functional status of arteriovenous fistulas (AVF) among patients undergoing hemodialysis. This cross-sectional study was conducted from April to May 2025 at the First Affiliated Hospital of Nanchang University, employing a self-developed questionnaire for data collection. Among 536 respondents (62.1% male), the mean scores for knowledge, attitude, and practice were 14.74 ± 4.89 (possible range: 0-20), 42.84 ± 4.87 (possible range: 10-50), and 40.75 ± 7.89 (possible range: 10-50), respectively. Statistically significant positive correlations were identified between knowledge and attitude (r = 0.682, P < 0.001), knowledge and practice (r = 0.711, P < 0.001), and attitude and practice (r = 0.622, P = 0.001). Structural equation modeling analysis revealed that knowledge directly influenced both attitude (β = 0.752, P < 0.001) and practice (β = 0.388, P < 0.001), while attitude also had a direct effect on practice (β = 0.449, P < 0.001). Furthermore, knowledge exerted an indirect effect on practice through attitude (β = 0.337, P < 0.001). These findings underscore the necessity for structured and continuous patient education interventions to enhance AVF maintenance and improve long-term dialysis outcomes.