Measuring Knowledge, Attitude, and Response (A-KAR) regarding chemotherapy among cancer patients: a cross-sectional study.

Chemotherapeutic agents serve as a fundamental treatment approach for numerous cancer types. Providing patients with comprehensive information about chemotherapy's purposes, advantages, disadvantages, and management strategies is crucial for decreasing anxiety, boosting treatment compliance, and improving general well-being. This study aims to measure the knowledge, attitude, and response (KAR) scores among cancer patients, in addition to identifying the potential associated factors for high scores. This observational cross-sectional study was conducted at the Oncology Center, Mansoura University, a tertiary care center, between September 2025 and October 2025. The study enrolled 669 cancer patients aged 18 years and above. Data were collected via a structured, Arabic-translated questionnaire developed from previous literature to assess KAR toward chemotherapy. Content validity was confirmed by three oncologists. Reliability and construct validity were evaluated using Cronbach's alpha and exploratory factor analysis. Associated factors of total A-KAR scores were identified using univariate and multiple linear regression. A total of 669 patients participated with a mean age of 51.5 ± 13.2 years, predominantly female (68.2%). The mean knowledge score was 5.4 ± 2.3 out of 10, the mean attitude score was 10.8 ± 2.1 out of 15, and the mean response score was 2.7 ± 0.6 out of 3, with an overall total A-KAR score of 18.9 ± 3.9 (range: 5-28). Females exhibited significantly higher knowledge, attitude, and total A-KAR scores than males (p < 0.001). In the multiple regression model, higher A-KAR scores were independently predicted by female gender (β = - 0.329, p < 0.001), urban residency (β = 0.175, p = 0.037), absence of a family history of malignancy (β = - 0.164, p = 0.027), and receiving chemotherapy (β = - 0.478, p = 0.012). Duration since chemotherapy initiation was a strong independent associated factor, with significantly lower scores among those treated for less than one year compared with those treated for one to three years (all p < 0.001). Cancer patients demonstrated moderate overall knowledge and attitudes toward chemotherapy, with generally positive response behaviors. Several sociodemographic and clinical factors were significant independent associated factors of A-KAR scores. These findings highlight the need for targeted educational interventions that address knowledge gaps and support patients throughout their treatment journey.