Cancer-related lymphedema educational needs disparities and optimization strategies.

AIM: Identify distinct knowledge, attitude and practice (KAP) profiles and teaching preferences among healthcare workers (HCWs) and explore barriers to implementing cancer-related lymphedema (CRL) management services.

BACKGROUND

HCWs play a crucial role in the early prevention and management of CRL. However, existing research on their KAP has largely relied on scale-based total score approaches, which overlook individual heterogeneity. Meanwhile, on the practical side, there is a lack of a systematic environment conducive to supporting HCWs in lymphedema services.

DESIGN

Cross-sectional design.

METHOD: This study surveyed 1130 healthcare workers from 21 Chinese hospitals between December 2024 and January 2025. Latent profile analysis profiled KAP-based subgroups, whose predictive factors and learning method preferences were analyzed using generalized linear mixed models and DCAT. Barriers to service implementation were explored via latent Dirichlet allocation.

RESULTS

Three latent class profiles were identified: low-level, medium-level and high-level KAP. Education, experience in CRL management, professional title and department significantly influenced the KAP categories. Preferences for instructional strategies varied across profiles: Groups 1 and 2 favored structured instruction, whereas Group 3 preferred methods enriched with interactive elements. Thematic analysis identified several key barriers to lymphedema service implementation by HCWs, including resource investment, public awareness, medical security coverage, etc.

CONCLUSIONS

Our findings reveal heterogeneous KAP profiles and distinct learning method preferences among HCWs. This heterogeneity suggests a potential direction for developing stratified training tailored to specific needs or competency levels. Future optimization of the lymphedema care environment requires multifaceted interventions at the policy, regulatory, staffing and patient levels.