Investigation of the knowledge, attitude and practice regarding nutrition in older adults with tuberculosis and diabetes: a cross-sectional study in Eastern China

Objectives Older adults with tuberculosis and diabetes have special needs regarding dietary nutrition. This study aimed to investigate the knowledge, attitude and practice (KAP) regarding dietary nutrition among older adults with those two conditions. Design Cross-sectional study. Setting Three tertiary medical centres in China. Participants Adults over 60 year old diagnosed with tuberculosis and diabetes. Interventions Between July 2023 and October 2023. Primary and secondary outcome measures Demographic characteristics and KAP scores collected by self-designed questionnaire. Results A total of 456 valid questionnaires were analysed, with 261 (57.24%) participants being over 70 years old. The mean scores were 6.84 +/- 3.16 (possible range: 0-24) for knowledge, 23.23 +/- 2.23 (possible range: 8-40) for attitude and 22.73 +/- 3.14 (possible range: 8-40) for practice, respectively. Correlation analysis revealed significant positive correlations between knowledge and attitude (r=0.287, p<0.001), knowledge and practice (r=0.189, p<0.001) and attitude and practice (r=0.176, p<0.001). Structural equation modelling demonstrated that knowledge significantly influenced attitude (beta=0.343, 95% CI (0.257 to 0.422), p<0.001) and practice (beta=0.245, 95% CI (0.101 to 0.405), p<0.001) and attitude significantly influenced practice (beta=0.274, 95% CI (0.146 to 0.405), p<0.001). Conclusions The study highlights a need for improvements in dietary nutrition practices for older adults with tuberculosis and diabetes. Findings emphasise the urgency of enhancing dietary education among this population in China. Implementation of targeted educational programmes is warranted to improve knowledge, foster positive attitudes and encourage healthier dietary practices, ultimately leading to improved patient outcomes and well-being.