Current status and influencing factors of knowledge, attitude and practice of diet management in patients with enterostomy: a cross-sectional study

OBJECTIVES: The incidence of malnutrition is high in enterostomy patients, which impacts their nutritional status and requires targeted dietary management strategies to improve outcomes. This study evaluated the knowledge, attitude and practice (KAP) of dietary management among enterostomy patients, identified influencing factors and provided recommendations for comprehensive nutritional care. DESIGN: Cross-sectional study. SETTING: 43 hospitals in Hubei Province. PARTICIPANTS: A convenience sample of 643 enterostomy patients was surveyed between November 2024 and April 2025. The inclusion criteria were as follows: (1) age of 18 years or older; (2) at least 4 weeks post-enterostomy surgery with recovery at home and (3) provision of informed consent and voluntary participation in the study. The exclusion criteria included: (1) inability to eat normally due to illness or other reasons and (2) presence of consciousness, cognitive or communication disorders. PRIMARY AND SECONDARY OUTCOME MEASURES: KAP questionnaire score, social alienation scale score and general information. RESULTS: Of 621 valid responses (96.58% valid questionnaires), the average KAP score was 185, with 79.07% achieving a passing score (≥111). Moderate social isolation was observed with a mean score of 40.04±13.98. Regression analysis revealed that social isolation (β=-0.393, p<0.001), medical insurance type (employee medical insurance: β=0.233, p<0.001; resident medical insurance: β=0.315, p<0.001) and education level (β=0.096, p=0.019) significantly influenced KAP. CONCLUSIONS: Enterostomy patients showed moderate to high knowledge, positive attitudes and good practices in dietary management, but experienced moderate social isolation. A multidisciplinary nutrition team should assess patients' nutritional, physiological, psychological and social support needs. Personalised dietary plans based on education level and diverse educational methods can enhance intervention effectiveness. Encouraging self-care and leveraging the 'Internet Plus' platform for regular progress monitoring can improve self-management capabilities. Continuous monitoring of nutrition and quality of life is essential to support enterostomy patients. These findings may have implications for enterostomy care in resource-limited settings, including low-income and middle-income countries, where multidisciplinary nutrition teams and patient education resources may be limited.