Knowledge, attitudes, and practices regarding childhood epilepsy among parents of children with epilepsy: a questionnaire-based study

This study examined the knowledge, attitudes, and practices (KAP) among caregivers of children with epilepsy. A cross-sectional survey was conducted from September 2024 to February 2025 in two hospitals in Zibo, China. Structural equation modeling (SEM) was applied to explore the relationships among the KAP components. A total of 385 caregivers participated; most were female (59.5%) and urban residents (44.7%). Regarding education, 39.5% held an associate degree or higher, and 49.1% were employed. Most children were aged 7-12 years (45.7%). Mean scores for knowledge, attitudes, and practices were 19.76 ± 2.68, 23.43 ± 3.18, and 23.57 ± 2.52, respectively. Although overall knowledge levels met the threshold for adequacy, important gaps remained, such as uncertainty regarding vaccination safety. Attitudes were often negative, with 70.9% of caregivers believing epilepsy would adversely affect career and marriage prospects and 35.6% expecting social prejudice. In addition, some caregivers reported potentially unsafe practices, such as inserting objects into the mouth during seizures. SEM results indicated that knowledge was positively associated with attitude (β = 0.303, P < 0.001) and practice (β = 0.204, P = 0.001), while attitude showed a strong association with practice (β = 0.708, P < 0.001). Knowledge also demonstrated an indirect association with practice through attitude (β = 0.215, P < 0.001), although the magnitude of this effect was modest. In conclusion, caregivers of children with epilepsy demonstrated knowledge levels that met the adequacy threshold but exhibited persistent misconceptions, negative attitudes, and suboptimal caregiving practices. These findings suggest that improving caregiving behavior may require multifaceted interventions that address not only knowledge but also attitudinal and contextual factors.