Copyright
©The Author(s) 2023.
World J Gastrointest Surg. Aug 27, 2023; 15(8): 1751-1760
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1751
Published online Aug 27, 2023. doi: 10.4240/wjgs.v15.i8.1751
Table 1 Participant’ demographics and knowledge, attitude, and practice scores regarding gastric cancer recurrence after endoscopic submucosal dissection
Characteristic | Number of participants | Knowledge score | Attitude score | Practice score | |||
mean ± SD | P | mean ± SD | P | mean ± SD | P | ||
Total | 400 | 3.34 ± 1.42 | 23.76 ± 2.81 | 5.75 ± 2.35 | |||
Sex | 0.266 | 0.517 | 0.537 | ||||
Male | 192 | 3.26 ± 1.46 | 23.86 ± 3.04 | 5.83 ± 2.46 | |||
Female | 208 | 3.42 ± 1.38 | 23.68 ± 2.58 | 5.68 ± 2.25 | |||
Age in yr | 0.063 | 0.930 | 0.689 | ||||
≤ 40 | 35 | 3.57 ± 1.12 | 23.83 ± 2.47 | 5.31 ± 1.94 | |||
41-50 | 56 | 3.57 ± 1.28 | 23.88 ± 2.34 | 5.73 ± 2.39 | |||
51-60 | 117 | 3.49 ± 1.36 | 23.62 ± 2.72 | 5.75 ± 2.45 | |||
> 60 | 192 | 3.15 ± 1.52 | 23.81 ± 3.05 | 5.84 ± 2.35 | |||
Residency | 0.001 | 0.425 | 0.510 | ||||
Rural areas | 333 | 3.25 ± 1.46 | 23.71 ± 2.88 | 5.72 ± 2.34 | |||
Urban areas | 67 | 3.79 ± 1.10 | 24.01 ± 2.40 | 5.93 ± 2.40 | |||
Education | 0.001 | 0.418 | 0.737 | ||||
Junior middle school or lower | 297 | 3.20 ± 1.48 | 23.66 ± 2.90 | 5.72 ± 2.33 | |||
Senior middle school/technical secondary school | 55 | 3.71 ± 1.13 | 24.04 ± 2.50 | 5.69 ± 2.27 | |||
Junior college/college or higher | 48 | 3.81 ± 1.10 | 24.13 ± 2.59 | 6.00 ± 2.59 | |||
Occupation | 0.000 | 0.512 | 0.407 | ||||
General staff or relevant personnel | 77 | 3.70 ± 1.15 | 23.95 ± 2.45 | 5.92 ± 2.45 | |||
Professional and technical staff | 10 | 4.50 ± 0.53 | 24.60 ± 2.95 | 6.80 ± 2.97 | |||
Others | 313 | 3.22 ± 1.47 | 23.69 ± 2.89 | 5.68 ± 2.30 | |||
Medical insurance | 0.125 | 0.128 | 0.013 | ||||
Yes | 384 | 3.32 ± 1.43 | 23.72 ± 2.69 | 5.69 ± 2.35 | |||
No | 16 | 3.88 ± 1.03 | 24.81 ± 5.01 | 7.19 ± 2.07 | |||
Family income in Yuan | 0.002 | 0.116 | 0.977 | ||||
< 2000 | 51 | 2.92 ± 1.59 | 23.12 ± 2.30 | 5.69 ± 2.08 | |||
2000-5000 | 247 | 3.29 ± 1.47 | 23.89 ± 2.91 | 5.77 ± 2.37 | |||
> 5000 | 102 | 3.69 ± 1.09 | 23.79 ± 2.79 | 5.75 ± 2.45 | |||
The time since last ESD in mo | 0.001 | 0.000 | 0.000 | ||||
≤ 12 | 193 | 3.10 ± 1.41 | 23.17 ± 2.86 | 4.92 ± 1.92 | |||
13-24 | 121 | 3.40 ± 1.44 | 24.24 ± 2.72 | 6.13 ± 2.53 | |||
≥ 25 | 86 | 3.80 ± 1.28 | 24.44 ± 2.56 | 7.09 ± 2.24 | |||
Family history | 0.215 | 0.479 | 0.639 | ||||
Yes | 19 | 3.74 ± 1.05 | 24.21 ± 2.72 | 6.00 ± 1.97 | |||
No | 381 | 3.32 ± 1.43 | 23.74 ± 2.82 | 5.74 ± 2.37 | |||
Infection with Helicobacter pylori in the past or present | 0.984 | 0.295 | 0.886 | ||||
Yes | 59 | 3.34 ± 1.17 | 24.12 ± 2.34 | 5.71 ± 2.11 | |||
No/unclear | 341 | 3.34 ± 1.46 | 23.70 ± 2.89 | 5.76 ± 2.39 | |||
Smoking history | 0.000 | 0.181 | 0.053 | ||||
Yes | 53 | 2.53 ± 1.67 | 23.28 ± 2.57 | 5.17 ± 2.35 | |||
No | 347 | 3.47 ± 1.34 | 23.84 ± 2.84 | 5.84 ± 2.34 | |||
Drinking alcohol | 0.000 | 0.001 | 0.000 | ||||
Yes | 70 | 2.57 ± 1.53 | 22.71 ± 3.04 | 4.71 ± 2.16 | |||
No | 330 | 3.51 ± 1.34 | 23.99 ± 2.71 | 5.97 ± 2.33 | |||
Pathological confirmation of early tumors after ESD | 0.033 | 0.611 | 0.031 | ||||
Yes | 357 | 3.39 ± 1.40 | 23.79 ± 2.82 | 5.84 ± 2.33 | |||
No/not detected | 43 | 2.91 ± 1.49 | 23.56 ± 2.80 | 5.02 ± 2.41 |
Table 2 Questions and answers of attitude assessments, n (%)
Questions | Strongly agree | Agree | Fair | Disagree | Strongly disagree |
1. I am afraid of gastric cancer | 0 | 0 | 28 (7.0) | 219 (54.8) | 153 (38.3) |
2. I am satisfied with the endoscopic submucosal dissection | 0 | 0 | 27 (6.8) | 213 (53.3) | 160 (40.0) |
3. Despite receiving endoscopic submucosal dissection, I am still terrified of gastric cancer | 0 | 0 | 27 (6.8) | 220 (55.0) | 153 (38.3) |
4. I am terrified of gastric cancer recurrence | 0 | 0 | 27 (6.8) | 217 (54.3) | 156 (39.0) |
5. I do not believe reexamination is necessary after endoscopic submucosal dissection | 19 (4.8) | 265 (66.3) | 69 (17.3) | 47 (11.8) | 0 |
6. I am willing to undergo regular reexaminations and follow-ups according to the doctor’s advice | 0 | 0 | 98 (24.5) | 185 (46.3) | 117 (29.3) |
Table 3 Questions and answers of practice assessments, n (%)
Questions | No | Yes |
1. Do you have regular follow-up appointments in the Gastroenterology Outpatient Department after surgery? | 161 (40.3) | 239 (59.8) |
2. Do you follow a low-salt diet after surgery? | 66 (16.5) | 334 (83.5) |
3. Did you stop drinking alcohol after surgery? | 63 (15.8) | 337 (84.3) |
4. Did you have Helicobacter pylori reexamination after surgery, such as a C-urea breath test? | 309 (77.3) | 91 (22.8) |
5. Do you undergo regular gastroscopy reexaminations after surgery (3 mo, 6 mo, 9 mo, and 12 mo after surgery, then one gastroscopy every year afterward)? | 234 (58.5) | 166 (41.5) |
6. Do you undergo yearly reexaminations by abdominal and chest CT scans after surgery? | 286 (71.5) | 114 (28.5) |
7. Do you undergo yearly reexaminations of blood tumor biomarkers after surgery? | 275 (68.8) | 125 (31.3) |
8. Do you regularly exercise after surgery? | 328 (82.0) | 72 (18.0) |
9. Did you have significant body weight changes after surgery (more than 5 kilograms increased or decreased)? | 14 (3.5) | 386 (96.5) |
10. Has your sleep status improved since the surgery? | 296 (74.0) | 104 (26.0) |
11. Do you use dietary supplements or Traditional Chinese Medicine after surgery? | 67 (16.8) | 333 (83.3) |
Table 4 Pearson correlation analysis between knowledge, attitude, and practice of monitoring gastric cancer after endoscopic submucosal dissection
Knowledge | Attitude | Practice | |
Knowledge | 1.000 | - | - |
Attitude | 0.405 (P < 0.001) | 1.000 | - |
Practice | 0.511 (P < 0.001) | 0.458 (P < 0.001) | 1 |
Table 5 Influencing factors of proactive practice
Factors | Univariate logistic regression | Multivariate logistic regression | ||
OR (95%CI) | P | OR (95%CI) | P | |
Knowledge score | 2.528 (1.893-3.375) | < 0.001 | 1.916 (1.424-2.578) | < 0.001 |
Attitude score | 1.395 (1.260-1.545) | < 0.001 | 1.253 (1.124-1.396) | < 0.001 |
Sex | ||||
M | Reference | - | ||
F | 0.943 (0.606-1.466) | 0.794 | ||
Age in yr | ||||
≤ 40 | Reference | - | ||
41-50 | 2.289 (0.807-6.495) | 0.119 | ||
51-60 | 1.820 (0.691-4.793) | 0.226 | ||
> 60 | 1.795 (0.705-4.752) | 0.220 | ||
Registered residence | ||||
Rural area | Reference | - | ||
Urban area | 1.085 (0.605-1.946) | 0.784 | ||
Educational level | ||||
Junior middle school or lower | Reference | - | ||
Senior middle school/technical secondary school | 0.840 (0.428-1.645) | 0.611 | ||
Junior college/college or higher | 1.233 (0.636-2.390) | 0.535 | ||
Occupation | ||||
General staff or relevant personnel | Reference | - | ||
Professional and technical staff | 1.472 (0.380-5.701) | 0.576 | ||
Others | 0.758 (0.440-1.308) | 0.320 | ||
Medical insurance | ||||
Yes | Reference | - | ||
No | 1.659 (0.588-4.680) | 0.339 | ||
Family income in Yuan | ||||
< 2000 | Reference | - | ||
2000-5000 | 1.066 (0.535-2.125) | 0.856 | ||
> 5000 | 1.161 (0.542-2.490) | 0.701 | ||
The time since last ESD in mo | ||||
≤ 12 | Reference | - | Reference | - |
13-24 | 3.788 (2.130-6.736) | < 0.001 | 3.296(1.761-6.172) | < 0.001 |
≥ 25 | 7.743 (4.220-14.208) | < 0.001 | 5.768(2.963-11.226) | < 0.001 |
Family history | ||||
Yes | Reference | - | ||
No | 1.370 (0.365-2.952) | 0.945 | ||
Infection with Helicobacter pylori in the past or present | ||||
Yes | 0.652 (0.331-1.282) | 0.215 | ||
No/unclear | Reference | - | ||
Smoking history | ||||
Yes | Reference | - | ||
No | 1.952 (0.918-4.148) | 0.082 | ||
Alcohol drinking | ||||
Yes | Reference | - | Reference | - |
No | 2.534 (1.246-5.154) | 0.010 | 1.160 (0.500-2.691) | 0.729 |
Pathological confirmation of early tumors after ESD | ||||
Yes | Reference | - | ||
No/not detected | 0.493 (0.212-1.144) | 0.099 |
- Citation: Yang XY, Wang C, Hong YP, Zhu TT, Qian LJ, Hu YB, Teng LH, Ding J. Knowledge, attitude, and practice of monitoring early gastric cancer after endoscopic submucosal dissection. World J Gastrointest Surg 2023; 15(8): 1751-1760
- URL: https://www.wjgnet.com/1948-9366/full/v15/i8/1751.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v15.i8.1751