Knowledge, Attitude, and Practice of Thrombolysis in Family Members of Cerebral Infarction Patients: Structural Equation Modeling Analysis

Fan Huang,1,2 Ling Zhou,1,2 Ping Zhao,1,2 Meiping Guo,1,2 Wujia Chen1,2 1Intensive Care Unit, Wujin Hospital Affiliated with Jiangsu University, Changzhou, 213000, People’s Republic of China; 2The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213000, People’s Republic of ChinaCorrespondence: Wujia Chen, Email [email protected]: Ischemic stroke, a leading cause of death globally, is often treated with thrombolytic therapy. However, low thrombolysis rates persist due to knowledge gaps among patients and families. This study assessed the knowledge, attitudes, and practices (KAP) of family members of cerebral infarction patients regarding thrombolysis.Methods: A cross-sectional study was conducted at Wujin People’s Hospital (August 2023–July 2024) using an online questionnaire. Demographic data and KAP scores were collected from 505 family members of cerebral infarction patients, including 188 (37.23%) whose relatives underwent thrombolysis.Results: A total of 505 valid questionnaires were analyzed. Among the participants, 256 (50.69%) were male, and 188 (37.23%) were family members of patients who had undergone thrombolysis during the survey period. The mean scores for knowledge, attitude, and practice were 6.50 ± 2.44 (range: 0 to 10), 21.59 ± 6.33 (range: 6 to 30), and 16.26 ± 5.36 (range: 5 to 25), respectively. Structural equation modeling (SEM) indicated that, within the total population, knowledge had a significant influence on attitude (β = − 0.511, P < 0.001) and practice (β = 0.660, P < 0.001), while attitude also significantly affected practice (β = 0.896, P < 0.001). Among participants whose relatives had received thrombolysis, knowledge significantly impacted attitude (β = − 0.513, P = 0.008) and practice (β = 0.343, P = 0.041), with attitude further influencing practice (β = 0.856, P < 0.001). For participants whose relatives had not undergone thrombolysis, knowledge significantly affected attitude (β = − 0.433, P = 0.048) and practice (β = 0.934, P < 0.001), with attitude continuing to influence practice.Conclusion: Family members exhibited inadequate thrombolysis knowledge but positive attitudes. Poor practice engagement underscores the need for targeted education to improve decision-making and stroke management participation.Keywords: cerebral infarction, thrombolysis, knowledge, attitude, and practice, family members, structural equation modeling, stroke management