Perceived knowledge, attitudes, and practices regarding nutritional management among gastric cancer patients: an exploratory path analysis.

OBJECTIVES: This cross-sectional study aimed to evaluate the perceived knowledge, attitudes, and practices (KAP) regarding nutritional management among patients with gastric cancer (GC). METHODS: The study was conducted among patients with histopathologically confirmed GC at Shanxi Provincial Cancer Hospital between April 2025 and September 2025. Participants completed a self-administered questionnaire capturing socio-demographic characteristics and KAP scores. Exploratory path analysis was employed to examine interrelationships among the KAP domains. RESULTS: A total of 828 valid questionnaires were analyzed, yielding an effective response rate of 98.8%. Mean scores for perceived knowledge, attitudes, and practices were 16.48 ± 3.96 (range: 0-26), 44.19 ± 2.06 (range: 10-50), and 23.58 ± 1.86 (range: 6-30), respectively. KAP scores varied significantly across subgroups defined by education level, area of residence, and prior receipt of nutritional education (all P < 0.001). Knowledge was positively correlated with attitudes (r = 0.284, P < 0.001) and practices (r = 0.163, P < 0.001), and attitudes were positively correlated with practices (r = 0.230, P < 0.001). Path analysis revealed that perceived knowledge was directly associated with attitudes (β = 0.417, 95% CI: 0.311-0.490, P = 0.019) and demonstrated a significant total association with practices (β = 0.160, 95% CI: 0.076-0.241, P = 0.033). Attitudes were directly associated with practices (β = 0.311, P = 0.007) and served as a potential mediator in the relationship between perceived knowledge and practices (indirect β = 0.130, P = 0.004). CONCLUSION: Despite generally positive attitudes, substantial gaps remain in GC patients' nutritional knowledge and implementation of healthy practices. Structured, skill-based nutritional education, integrated within a multidisciplinary care framework, may enhance adherence.