Knowledge, attitudes, and practices toward bowel preparation for sedation-assisted colonoscopy among patients with digestive disorders: a structural equation modeling analysis

BACKGROUND: This study aims to assess the knowledge, attitudes, and practices (KAP) regarding bowel preparation prior to sedation-assisted colonoscopy among patients with digestive disorders. METHODS: A cross-sectional survey was conducted at Peking University People's Hospital between June and August 2025. Data were collected through structured questionnaires. RESULTS: A total of 459 participants had undergone sedation-assisted colonoscopy. The majority of these patients were female (58.8%), most respondents were undergoing the procedure for the first time (66.9%), primarily due to gastrointestinal symptoms (47.3%). Their knowledge, attitudes, and practices scores were 9.61 ± 6.60 (possible range: 0-18), 30.72 ± 4.29 (possible range: 8-40), and 35.09 ± 5.99 (possible range: 8-40), respectively. SEM analysis showed that knowledge was significantly associated with attitude (β = 0.424, P = 0.006) and practice (β = 0.555, P = 0.025). CONCLUSION: Patients with digestive disorders demonstrated limited knowledge and suboptimal attitudes despite generally favorable bowel preparation practices, with knowledge being most strongly associated with both attitudinal and behavioral outcomes. To enhance overall bowel preparation effectiveness, future interventions should prioritize structured, evidence-based educational strategies that target knowledge deficits and cognitive barriers, particularly among first-time or lower-literacy patients.