Parental Knowledge, Attitudes, and Practices Regarding Low-Temperature Plasma Adenotonsillectomy for Pediatric Obstructive Sleep Apnea Syndrome: A Structural Equation Modeling Analysis

Background: To investigate parental knowledge, attitudes, and practices (KAP) regarding low-temperature plasma adenotonsillectomy for children with obstructive sleep apnea syndrome (OSAS). Methods: This cross-sectional study employed a self-administered KAP questionnaire for data collection from parents of children with OSAS at the Second Affiliated Hospital of Wenzhou Medical University, spanning August, 2023, to August, 2024. Results: A total of 415 parents were included, with 83.86% were female and 84.34% being primary caregivers. The knowledge, attitude, and practice scores were 14.91 ± 2.40 (total score: 18 points), 31.87 ± 3.12 (total score: 35 points), and 32.01 ± 3.15 (total score: 35 points), respectively. Knowledge positively correlated with attitude (r = 0.365, P < 0.001), and practices (r = 0.336, P < 0.001). Attitude correlated with practice (r = 0.745, P < 0.001). Structural equation modelling revealed that knowledge influenced attitude (β = 0.490, P < 0.001), and attitude strongly impacted practice (β = 0.729, P < 0.001). Conclusion: Parents demonstrated adequate knowledge, positive attitudes, and proactive practices regarding low-temperature plasma surgery. This underscores the clinical value of incorporating structured parental education and counseling into perioperative care to support adherence and improve recovery in children with OSAS. These findings warrant continued, targeted health education focused on knowledge gaps to further enhance treatment compliance and optimize postoperative outcomes for children with OSAS. Keywords: obstructive sleep apnea syndrome, tonsillectomy, adenoidectomy, knowledge, attitudes, practice, cross-sectional study