Knowledge, attitudes, and practices of healthcare professionals regarding palliative care family meetings: a multicenter cross-sectional study

Abstract

To assess the knowledge, attitudes, and practices (KAP) of healthcare professionals (HP) regarding palliative care family meetings and to identify factors independently associated with practice level. This multicenter cross-sectional study was conducted among 401 healthcare professionals across four institutions in Fujian Province between January and February 2026. Data were collected using a validated self-designed questionnaire encompassing demographic characteristics and KAP scores. Multivariable logistic regression identified factors independently associated with practice level, and structural equation modeling (SEM) examined whether attitude mediated the knowledge-practice relationship. The mean scores were 14.35 ± 5.95 for perceived knowledge (55.2% of maximum), 42.63 ± 5.92 for attitude (85.3%), and 24.96 ± 8.93 for practice (71.3%). Multivariable analysis identified knowledge score (OR = 1.088, 95%CI: 1.046–1.132, p  < 0.001), attitude score (OR = 1.063, 95%CI: 1.023–1.104, p  = 0.002), and monthly income <5,000 RMB versus >10,000 RMB (OR = 0.448, 95%CI: 0.217–0.923, p  = 0.029) as independent associates of proactive practice. SEM indicated that attitude partially mediated the perceived knowledge-practice relationship (indirect effect β  = 0.052, p  = 0.003), with knowledge also showing a significant direct association with practice ( β  = 0.277, p  = 0.010). Healthcare professionals in Fujian Province demonstrated limited perceived knowledge but positive attitudes and proactive practices toward palliative care family meetings. Both perceived knowledge and attitude were independently associated with practice, with attitude serving as a partial mediator. Targeted training programs and institutional support are needed to translate positive attitudinal endorsement into consistent, high-quality practice.