Study On "Knowledge-Attitude-Practice" Pertaining To Traditional Chinese Medicine And Their Pathway Among Urban And Rural Residents In Liaoning Province

Objective:The importance of traditional Chinese medicine(TCM)in the area of medical and health care in China cannot be ignored.However,the insufficient utilization of TCM health services in China is still a problem at present,and TCM health service utilization practice of residents(hereinafter referred to as "TCM practice")is influenced by many factors.The knowledge attitude practice(K-A-P)model is one of the important theories of health behavior change.Based on this model,the study is designed to investigate the current situation and influencing factors of TCM knowledge,TCM attitude and TCM practice among urban and rural residents in Liaoning Province,as well as whether TCM attitude plays a mediating role in the relationship between TCM knowledge and TCM practice.The K-A-P pathway of TCM was clarified among residents in Liaoning Province.The urban-rural differences of TCM knowledge,TCM attitude and TCM practice in residents of Liaoning Province were explored and the TCM K-A-P pathways were clarified among urban residents and rural residents respectively.This study provides an effective reference for how to improve the TCM health service utilization practice of residents,and propose some countermeasures and suggestions.Methods:A cross-sectional design was used to investigate the current situation of K-AP of TCM among urban and rural residents in Liaoning Province by means of a questionnaire survey.A stratified random sampling method was adopted in the sampling.According to the proportion of urban and rural population in Liaoning Province,3 districts from 59 municipal districts in the province,1 county from 41 counties,2 streets/towns in each district/county,and 1 resident committee/village committee in each street/town were selected.The questionnaires included the basic situation of residents,the knowledge of TCM,the attitude of TCM,and the practice of TCM.1681 questionnaires were distributed and 1664 valid questionnaires were collected,with a valid response rate of 98.99%.SPSS26.0 was applied for analysis.Chi-square test,Mann-Whitney U test,Kruskal-Wallis H test,Spearman rank correlation analysis,single factor logistic regression analysis,and hierarchical logistic regression analysis were used to determine influencing factors and urban-rural differences of TCM knowledge,TCM attitude and TCM practice for residents and to explore the mediating effect of TCM attitude between TCM knowledge and TCM practice.Finally,Process macro(4.1)for SPSS was applied to test the mediating effect of TCM attitude between TCM knowledge and TCM practice and clarify the TCM K-A-P pathways.Results:Among residents of Liaoning Province,the level of TCM knowledge was 5.00(3.00,7.75),the level of TCM attitude was 9.50(9.00,12.00),and the percentage of existing TCM practice was 50.3%.Urban and rural areas,age,marital status,education level,health status,and chronic disease illness were related to residents’ TCM knowledge.Urban and rural areas,education level,medical insurance status,income status,and health status were related to residents’ TCM attitude.Urban and rural areas,age,education level,work status,health status,and chronic disease illness were related to residents’ TCM practice.There was a positive correlation between residents’ TCM knowledge and TCM attitude(P<0.01).Both TCM knowledge and TCM attitude had a positive effect on TCM practice(P<0.001).The residents’ TCM attitude played a mediating role between TCM knowledge and TCM practice(direct effect coeff=0.2552,indirect effect coeff=0.0914).There were significant differences between urban residents and rural residents in this study in TCM knowledge,TCM attitudes and TCM practice.The urban residents’ TCM attitude played a mediating role between TCM knowledge and TCM practice(direct effect coeff=0.3696,indirect effect coeff=0.0815).The rural residents’ TCM attitude didn’t play a mediating role between TCM knowledge and TCM practice.Conclusion:TCM knowledge and TCM attitude of residents in Liaoning Province are important influencing factors of TCM health service utilization practice,and TCM attitude plays a mediating role in the relationship between TCM knowledge and TCM health service utilization practice.There are differences between urban residents and rural residents in Liaoning Province in TCM knowledge,TCM attitudes and TCM health service utilization practice.TCM attitude of urban residents plays a mediating role in the relationship between TCM knowledge and TCM health service utilization practice,but TCM attitude of rural residents doesn’t play a mediating role in the relationship between TCM knowledge and TCM health service utilization practice.