KAP survey on integrated traditional Chinese and western medicine for ischemic stroke among healthcare workers in Zhengzhou City: A cross-sectional study based on multi-tiered healthcare institutions

This cross-sectional study (n = 517) assessed healthcare workers' knowledge, attitudes, and practices (KAP) regarding integrated traditional Chinese and Western medicine (TCM-WM) for acute ischemic stroke (AIS) across 12 multi-tiered institutions in Zhengzhou. Using validated questionnaires and multivariate logistic regression, we identified tertiary hospital staff, integrated TCM-WM practitioners, and senior professionals as KAP strongholds (odds ratio (OR) ≥ 2.7, P < .001). Community hospitals and nursing staff exhibited knowledge deficits but strong operational competence. Knowledge-practice correlation was robust (R = 0.612), mediated by professional title and experience. Findings underscore the need for tiered training systems, role-specific competency frameworks, and evidence-based protocols to standardize TCM-WM integration in regional stroke networks. In the treatment of AIS, challenges such as the limitation of the thrombolytic time window and insufficient neurological functional recovery persist. The integrated traditional Chinese and Western medicine model demonstrates potential through multi-target interventions, yet there are disparities in healthcare professionals' understanding and practice of this approach, along with a lack of regional empirical evidence. This study aims to evaluate the KAP of healthcare professionals in Zhengzhou regarding the integrated traditional Chinese and Western medicine treatment for AIS, identify influencing factors, and provide evidence-based support for optimizing the regional stroke prevention and treatment network. A cross-sectional survey was conducted from January to March 2024. Using a multi-stage, stratified sampling method, 586 healthcare professionals from 12 medical institutions in Zhengzhou (including tertiary, secondary, and community hospitals) were enrolled in this study. The questionnaire covered basic information, AIS knowledge assessment (33 items), treatment attitudes (12 items), and practice behaviors (10 items). SPSS 26.0 was used for descriptive statistics, correlation analysis (Pearson), and multiple logistic regression analysis. Of the 586 questionnaires distributed, 517 were validly returned, yielding an overall valid response rate of 88.23% (517/586). Stratified analysis by demographic characteristics was performed on the KAP scores of the 517 medical staff. Tertiary hospitals exhibited significantly better KAP scores than community hospitals (Knowledge OR = 2.74, Practice OR = 2.38, P < .05). Integrated TCM-WM practitioners demonstrated the highest KAP scores (Knowledge OR = 3.25, P < .05), while nursing staff had the lowest knowledge scores (23.13 ± 3.67) but outstanding practical competency (40.13 ± 5.57). Senior professional titles were associated with higher knowledge (OR = 3.95), and staff with >15 years of experience showed 2.89 times higher practice initiative than those with <5 years (P < .05). Among physicians, TCM majors showed significant KAP advantages (Practice OR = 5.22 vs Clinical medicine, P < .05), and male physicians exhibited higher practice initiative (OR = 1.88, P = .017). Among other medical staff (nurses/technicians), females demonstrated stronger practice initiative (OR = 2.05, P = .008), and intermediate titles were associated with more positive attitudes (OR = 2.10, P = .028). The study revealed that healthcare professionals in Zhengzhou generally possess a sound understanding of integrated traditional Chinese and Western medicine for AIS treatment. However, disparities were observed across healthcare institution tiers and professional specialties. It is recommended to establish a tiered training system, enhancing knowledge dissemination among community hospitals and junior staff. Treatment protocols should leverage the specialized strengths of integrated medicine to design comprehensive plans, while the practical competencies of nursing staff can be utilized to develop knowledge translation tools. Future research should validate the effectiveness of these tiered strategies through intervention trials and explore the neurocognitive mechanisms underlying a direct "knowledge-to-practice" pathway.