Knowledge, attitude, and practice towards postoperative nausea and vomiting among orthopedic surgery patients

Abstract This study aimed to investigate the knowledge, attitude, and practice (KAP) of orthopedic surgery patients toward postoperative nausea and vomiting (PONV). A cross-sectional study was conducted at a single hospital from August to September 2025. Orthopedic surgery patients completed a demographic and KAP questionnaire. Multivariable analyses and structural equation modeling (SEM) were used to assess influencing factors. Among 430 participants, median scores indicated moderate knowledge (5.00/10), positive attitude (33.00/40), but suboptimal practice (24.00/30). KAP domains were positively correlated ( P < 0.001). SEM confirmed knowledge was positively associated with attitude (β = 1.331, P < 0.001), which in turn was positively associated with practice (β = 0.871, P < 0.001). Multivariable analyses identified socioeconomic and clinical factors (e.g., income, employment, BMI, surgery type) independently associated with KAP scores. Orthopedic surgery patients demonstrate positive attitude but insufficient knowledge and suboptimal practice regarding PONV. Given that attitude is identified as a potential mediator in the knowledge-practice relationship, effective clinical interventions should not only provide education but also actively foster positive attitude to encourage preventive behaviors.