Knowledge, attitudes, and practice regarding rehabilitation among postoperative patients with spinal degenerative diseases: a cross-sectional study

Abstract

Background This study aimed to investigate postoperative patients’ knowledge, attitudes, and practice (KAP) regarding spinal degenerative diseases and rehabilitation training. Methods This single-center cross-sectional study was conducted from July 1, 2025, to September 30, 2025, at Beijing Jishuitan Hospital, Capital Medical University. The questionnaire was developed through two rounds of Delphi consultation with seven experts, pilot-tested in 35 patients, and evaluated using confirmatory factor analysis (CFA). Results Among 382 included patients (median age, 59 years [P25, P75: 49, 66]; 54.5% male), the median (P25, P75) knowledge, attitude, and practice scores were 21 (14, 28) (possible range: 0–39), 43 (40, 49) (10–50), and 33 (26, 40) (10–50), respectively. CFA supported the three-factor structure (CMIN/DF = 2.607, IFI = 0.915, TLI = 0.905, CFI = 0.915, and RMSEA = 0.065). SEM showed positive path coefficients from knowledge to attitude (β = 0.707, p = 0.011), knowledge to practice (β = 0.493, p = 0.014), and attitude to practice (β = 0.269, p = 0.008). A positive indirect association between knowledge and practice through attitude was also observed (β = 0.190, p = 0.006). Conclusion Participants demonstrated moderate knowledge, positive attitudes, and moderate practice behaviors. The findings identify an attitude–practice gap and support evaluating structured follow-up and practical barrier-focused strategies to help patients sustain rehabilitation behaviors.