Latent profile analysis of nutrition knowledge, attitudes, and practices and their influencing factors in maintenance hemodialysis patients

Abstract

To explore the current status of nutrition knowledge, attitude, and practice (KAP) among maintenance hemodialysis (MHD) patients in Anhui province in China and identify the influencing factors, providing a scientific basis for nutritional management in MHD patients. From September to October 2022 and February to March 2025, a comprehensive survey was conducted among 772 MHD patients sourced from 20 hemodialysis hospitals situated within the Anhui province in China. This survey encompassed the KAP Questionnaire, in conjunction with a general information survey. Latent profile analysis (LPA) was employed to identify potential categories of nutritional KAP among patients. Chi-square tests and multivariate logistic regression were used to analyze the distribution differences and influencing factors among different KAP categories. A total of 740 valid questionnaires were collected with a response rate of 95.9% (740/772). LPA divided the patients' nutritional KAP scores into three categories: low KAP group (40 patients, 5.41%), moderate KAP group (564 patients, 76.21%), and high KAP group (136 patients, 18.38%). Significant differences were observed in age, education level, dialysis cause, number of non-renal diseases, exercise, smoking, visiting the hospital alone, sleep duration, nursing status, albumin, hemoglobin, and sarcopenia among the different KAP categories. Multivariate logistic regression analysis indicated that independent factors affecting the nutritional KAP classification of MHD patients included education level, hemoglobin, physical exercise, and sleep duration. MHD patients exhibit distinct nutritional KAP profiles influenced by modifiable factors. Clinically, tailored interventions-such as simplified education and practice-focused support for Low and Moderate KAP Group-should address these subgroups' unique needs. This paper's limitations are its cross-sectional design, regional sampling bias in Anhui province.

Keywords: Knowledge-attitudes-practices; Latent profile analysis; Maintenance hemodialysis; Nutrition.

Fig. 1

Distribution of characteristics among the three latent profiles of nutrition KAP. The analysis of the nutrition KAP questionnaire scores for MHD patients revealed that a three-profile model (Classes 1 to 3) best fit the dimensions of knowledge, attitudes, and practices. Class 1 had 136 patients (18.38%) with high knowledge, attitude, and practice scores, termed the “High KAP Group”. Class 3 included 40 patients (5.41%) with low knowledge, attitude, and practice scores, known as the “Low KAP Group”. Class 2 comprised 564 patients (76.21%) with intermediate scores, referred to as the “Moderate KAP Group”. KAP, Knowledge-Attitude-Practice.