Knowledge and attitudes of family members of cancer patients towards immunotherapy toxicity and health management

Family members play a critical role in the care and decision-making processes of cancer patients. This study aimed to examine the knowledge and attitudes of cancer patients' family members regarding the toxicity and health management of immunotherapy. A cross-sectional study was conducted at People's Hospital of Quzhou City in Zhejiang Province, from January to March 2024. Questionnaires were administered to collect demographic data, as well as knowledge and attitude scores, from family members of cancer patients.: The study enrolled 382 participants. Among them, 132 (34.6%) were aged between 41 and 50 years, 192 (50.3%) were male, 211 (55.2%) were retired, and 158 (41.4%) were spouses of the patients. Correlation analysis showed that there was significant positive correlation between knowledge and attitude (r = 0.259, P < .001). Multivariate logistic regression showed that with junior high school education (OR = 0.194, 95% CI:[0.073, 0.514], P = .001) and with high school/vocational school education (OR = 0.250, 95% CI:[0.099, 0.632], P = .003) were independently associated with poor knowledge. Concurrently, aged 41-50 years old (OR = 10.147, 95% CI: [1.912, 53.844], P = .007) and retired (OR = 0.026, 95% CI: [0.005, 0.144], P < .001) were independently associated with attitude. Structural equation modeling (SEM) indicated a positive association between knowledge and attitude. Overall, educational attainment was a strong predictor of knowledge, whereas attitudes were more strongly shaped by age and occupational status. Family members demonstrated insufficient knowledge and mixed attitudes regarding immunotherapy toxicity. Educational level was strongly associated with knowledge, whereas attitudes appeared to be influenced by age and occupational status, as well as emotional and socioeconomic factors. These findings highlight the potential value of stratified family education, standardized caregiver support, and targeted assistance for vulnerable groups.