Structural Equation Modeling of Healthcare Professionals’ Knowledge, Attitudes, and Practices on Electroacupuncture for Post-Stroke Hemiplegia

Mingming Song, Lidan Deng, Yunfei Zhu, Hongting Du, Suqin GuoDepartment of Rehabilitation Medicine, Wuxi No.2 Chinese Medicine Hospital, Wuxi, 214000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Mingming Song, Email [email protected]: Stroke remains a leading cause of disability worldwide, and hemiplegia is a common sequela that greatly affects patients’ quality of life. Electroacupuncture, which combines traditional acupuncture with modern electrotherapy, has been applied in stroke rehabilitation, but its use among healthcare professionals is uneven. This study aimed to assess healthcare professionals’ knowledge, attitudes, and practices (KAP) regarding electroacupuncture in post-stroke hemiplegia management.Methods: A cross-sectional survey was conducted at Wuxi Secondary Chinese Medicine Hospital during 2023– 2024 using a validated questionnaire covering demographics and KAP domains.Results: Of 311 valid responses, 200 participants (64.31%) were physicians, and 188 (60.45%) had prior electroacupuncture experience. Mean knowledge, attitude, and practice scores were 17.77± 7.21, 41.05± 4.63, and 33.03± 11.39, respectively, indicating insufficient knowledge, favorable attitudes, and moderate practice. Structural equation modeling (SEM) analysis revealed that knowledge was positively associated with practice both directly and indirectly through attitude. Notably, the direct associations of knowledge with attitude (β = 0.37 vs β = 0.26) and practice (β = 0.58 vs β = 0.55) were stronger among participants with prior electroacupuncture experience compared to the inexperienced group.Conclusion: Healthcare professionals demonstrated insufficient knowledge yet generally favorable attitudes towards electroacupuncture. While knowledge significantly improved attitudes and practices, these relationships were markedly stronger among participants with prior clinical experience. Targeted, competency-based educational interventions combining theory with clinical mentorship must be prioritized to promote evidence-based integration in stroke rehabilitation.Keywords: electroacupuncture, stroke, hemiplegia, healthcare professionals, knowledge, attitude, practice, rehabilitation, cross-sectional study