Measurement of patient knowledge, attitude, and practices regarding allergic conjunctivitis

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Chinese researchers led by first author Ke Song, MD, found that patients diagnosed with allergic conjunctivitis possess very little knowledge about the disease and that providing them with targeted educational interventions can improve their attitude toward and management of their disease.¹ The team of investigators were from the Ophthalmology Department, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing.

“Allergic diseases significantly impair quality of life and can lead to severe symptoms, necessitating a better understanding of disease management from the patient’s perspective. This understanding is essential for guiding clinical practices to improve treatment methods and educational strategies. For those with allergic conjunctivitis, where daily life and vision can be severely affected, there is a distinct need for personalized and effective treatment strategies to enhance compliance and quality of life,” the investigators emphasized.

They conducted this first-of-a-kind cross-sectional study at the outpatient clinic of the Eye Hospital of China Academy of Chinese Medical Sciences from March to June 2024. Patients completed an online self-designed questionnaire to gather demographic data and establish their scores for their knowledge, attitude, and practices regarding allergic conjunctivitis.

The basis for the study, ie, the knowledge, attitude, and practice (KAP) model, “posits that knowledge forms the foundation for behavior change, with attitudes and beliefs serving as the driving forces behind this transformation.² According to the KAP theory, the process of human behavior change unfolds in three sequential steps: the acquisition of knowledge, the formation of attitudes/beliefs, and the establishment of practices/behaviors.³ While acquiring knowledge is crucial, it alone does not guarantee behavior change. Instead, it should precipitate a shift in perception, which in turn influences behavior,⁴ they explained.

The scores were determined as followed: the knowledge section included 12 questions and a scoring system by which “very knowledgeable” received 2 points, “heard of it” 1 point, and “unclear” 0 points, with the total possible score ranging from 0 to 24; the attitudes section contained 8 questions, using a five-point Likert scale ranging from “strongly agree” (5 points) to “strongly disagree” (1 point), and a total score range of 8 to 40; and the practices section included 10 questions, using a five-point Likert scale, with scoring from “always” (5 points) to “never” (1 point), and a total score range of 10 to 50. Scores over 70% of the maximum possible in each section indicated adequate knowledge, a positive attitude, and proactive practice.⁵

KAP model results

The researchers collected data from 482 valid questionnaires. Most patients were women (n = 329, 68.26%).

The authors reported that the mean knowledge, attitude and practice scores were, respectively, 11.48 ± 6.90, 29.70 ± 4.33, and 31.09 ± 8.71. The investigators reported identifying significant positive correlations were found between knowledge and attitude (r = 0.214, P < 0.001), knowledge and practice (r = 0.352, P < 0.001), and attitude and practice (r = 0.303, P < 0.001). The standard error of the mean indicated that knowledge directly influenced attitude and, in turn, influenced practice.

The investigators concluded, “The study highlights a knowledge gap about allergic conjunctivitis, indicating a need for targeted educational interventions to improve attitudes and practices. The patients demonstrated inadequate knowledge, positive attitudes, and insufficiently proactive practices in managing allergic conjunctivitis. Enhancing patient education programs on allergic conjunctivitis could significantly improve both attitudes and practices, potentially leading to better management and outcomes for sufferers.”

References:

1. Song K, Ye S, Song J, Kang Z. Knowledge attitude and practice of patients with allergic conjunctivitis towards their disease.Sci Rep. 2025;15:6238. https://doi.org/10.1038/s41598-025-87518-2

2. Gao L, Su S, Du N, et al. Medical and non-medical students’ knowledge, attitude and willingness towards the COVID-19 vaccine in China: A cross-sectional online survey.Hum Vaccin Immunother. 2022;18:2073757.

3. Twinamasiko N, Olum R, Gwokyalya AM, et al. Assessing knowledge, attitudes and practices towards COVID-19 public health preventive measures among patients at Mulago National Referral Hospital.Risk Manag Healthc Policy 2021;14:221–230.

4. Wang J, Chen L, Yu M, He J. Impact of knowledge, attitude, and practice (KAP)-based rehabilitation education on the KAP of patients with intervertebral disc herniation. Ann Palliat Med. 2020;9:388–393.

5. Lee F, Suryohusodo AA. Knowledge, attitude, and practice assessment toward COVID-19 among communities in East Nusa Tenggara, Indonesia: A cross-sectional study.Front Public Health. 2022;10:957630.