Knowledge, attitudes, and practices of nurses regarding bowel preparation for colonoscopy: a structural equation modeling analysis

Abstract

Objective This study aimed to investigate nurses' knowledge, attitude, and practice regarding bowel preparation for colonoscopy. Methods This multicenter cross-sectional study was conducted among registered nurses from eight hospitals in Jiangsu Province, China, between December 2025 and March 2026. Data were collected using a self-administered online questionnaire covering demographic characteristics and KAP scores. Multivariable linear regression was used to identify factors associated with KAP scores, and structural equation modeling (SEM) was used to explore the relationships among knowledge, attitudes, and practices. Results A total of 382 valid questionnaires were included. The median knowledge, attitude, and practice scores were 10.00 (9.00, 14.00), 37.00 (36.00, 43.00), and 28.00 (23.00, 32.00), respectively. Lack of bowel preparation-related training was independently associated with lower knowledge (β = −4.097, 95% CI: −5.006 to −3.188), attitude (β = −1.052, 95% CI: −2.000 to −0.104), and practice scores (β = −2.297, 95% CI: −3.335 to −1.260). SEM showed significant direct associations of knowledge with attitude (β = 0.491, 95% CI: 0.407–0.584, P = 0.001) and practice (β = 0.707, 95% CI: 0.626–0.780, P = 0.002), as well as a significant indirect association between knowledge and practice through attitude (β = 0.068, 95% CI: 0.024–0.118, P = 0.002). Conclusion Nurses demonstrated insufficient knowledge, positive attitudes, and moderate practice regarding bowel preparation for colonoscopy. These findings identify potential targets for future nurse-oriented educational and organizational interventions, particularly knowledge gaps and bowel preparation-related practices.