{"paper_id":"4e50c21d-2a33-40f7-96c8-162ba2baefaf","body_text":"Development and Validation of a Knowledge, Attitude and Practice Questionnaire for Venous Thromboembolism Prevention in Perinatal Women | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development and Validation of a Knowledge, Attitude and Practice Questionnaire for Venous Thromboembolism Prevention in Perinatal Women Chenxi Zhang, Rong Li, Feifei Qian, Xuan Zhang, Na Zhou This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5768046/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Venous thromboembolism (VTE) is a significant complication among perinatal women. However, current tools for assessing VTE prevention are not suitable for pregnant women. In this study, we aim to develop and validate a VTE prevention knowledge, attitude and practice (VTE-KAP) questionnaire tailored to this population. Methods This study was conducted in two phases. Phase 1 involved creating a preliminary item pool through a literature review and group discussions, followed by expert consultations and a pre-survey. Phase 2 involved validating the questionnaire, which began by screening the items using correlation and factor analyses. Reliability was assessed using Cronbach’s alpha coefficient and retest reliability. Furthermore, structural validity was evaluated through exploratory and confirmatory factor analyses. Results The finalised VTE-KAP questionnaire consists of 37 items. The Kaiser–Meyer–Olkin measure of sampling adequacy was 0.751 for the knowledge dimension and 0.901 for the practice dimension. Bartlett’s test for sphericity confirmed statistical significance ( p < 0.001). The Cronbach’s alpha coefficient was 0.913. Test-retest reliability for the overall questionnaire showed high stability, with coefficients for all dimensions exceeding 0.9 (0.993, 0.991, 0.988 and 0.994). Confirmatory factor analysis demonstrated the robust structural validity of the scale. Conclusion The VTE-KAP questionnaire is effective and reliable in psychometrics. It can scientifically evaluate the KAP related to VTE prevention in pregnant women. Perinatal Maternity Venous Thromboembolism Reliability Validity Questionnaire Figures Figure 1 1. Introduction Venous thromboembolism (VTE) is a condition characterised by abnormal blood clotting in the lumen of a vein, leading to the formation of an embolus that obstructs the vein and impairs circulation [ 1 ] . Pregnant women are at a high risk of VTE due to the physiological changes associated with pregnancy [ 2 ] . Research has shown that the risk of VTE is 4–5 times higher in pregnant women than in non-pregnant women [ 3 – 5 ] . The highest risk period for VTE is the first postpartum week [ 6 – 7 ] . Adequate knowledge, positive attitudes and appropriate preventive practices among perinatal women are crucial for reducing the 0incidence of VTE. Pregnant women are usually hospitalised close to delivery, making it challenging for healthcare workers to manage and prevent maternal VTE during the antenatal period [ 8 , 9 ] . However, there is a lack of scientific tools to assess the knowledge, attitudes and practices (KAP) related to VTE prevention among pregnant women, making it difficult to effectively gauge their awareness. Existing VTE assessment tools for pregnant women focus on identifying high-risk populations [ 10 , 11 ] , offering the advantage of rapidly screening for high-risk pregnancies. However, these tools overlook the need for pregnant women to actively prevent VTE on their own. Given the unique physiological characteristics of this population, the current tools used for other groups do not fully capture the reality of VTE prevention in perinatal women. There is an urgent need to develop a tailored VTE prevention knowledge, attitude and practice (VTE-KAP) questionnaire for perinatal women. The Knowledge, Attitude and Practice (KAP) theory explores the relationship between knowledge, attitude and practice [ 12 ] . It helps assess the current status of postpartum women’s KAP regarding VTE prevention. Additionally, it helps identify gaps in perceptions related to VTE prevention in pregnant women. While previous research questionnaires for investigating disease cognition are mostly based on the KAP theory, a limitation is their overemphasis on the role of knowledge in the three interconnected stages [ 13 ] . In practice, individuals may become stagnant after gaining knowledge, or partial behavioural changes may arise due to specific needs or circumstances. The Health Belief Model (HBM) is a theoretical model that explains the adoption of health behaviours from a psychological perspective, providing robust predictive and explanatory insights into behaviour [ 14 ] . This theory facilitates the structured design of surveys targeting patient attitudes. The questionnaire was developed using the KAP theory combined with the HBM. It has been established as a validated tool for assessing perinatal maternal KAP related to VTE prevention. This questionnaire offers valuable health guidance for maternal VTE prevention and is a more scientific assessment tool for medical professionals. 2. Methods 2.1 Phase 1: Questionnaire development 2.1.1 Literature review A literature review was conducted to gather information on maternal VTE prevention, both nationally and internationally. Subject terms such as ‘puerperae’, ‘postpartum’, ‘pregnancy’, ‘puerperal period’, ‘puerperium’, ‘venous thromboembolism’, ‘VTE’, ‘prevent’ and ‘knowledge attitude practice’ were used in databases including CNKI, PubMed, Web of Science, ScienceDirect and Cochrane Library. The literature search was conducted on current maternal VTE prevention studies published from the inception of each database through November 2023. The item pool for the questionnaire was initially compiled based on the literature review and clinical experience, followed by a discussion within the research group. The study process is shown in Scheme 1 . 2.1.2 Expert consultation Relevant experts were invited to review the structure of the questionnaire, the importance of the items and the semantic expression. The questionnaire items were then modified based on their feedback. Fifteen Chinese experts from Yunnan, Shandong, Beijing and Shanghai were invited to participate in this study. Inclusion criteria for experts were as follows: participants must have over 10 years of experience in fields related to obstetrics and gynaecology, surgery, rehabilitation or nursing education; possess substantial practical experience and a strong theoretical foundation in maternal VTE prevention or scale development; hold intermediate or higher professional titles; and demonstrate active and serious engagement in this study. The questionnaire items were modified and adjusted based on the experts’ feedback. Irrelevant or unclear items were removed, and the content of some items was optimised to ensure that the scale was more scientific and rational. Following the revision, experts were invited to re-evaluate the updated questionnaire. The resulting preliminary draft comprises 38 items, divided into the KAP dimensions. 2.1.3 Pre-survey To further refine the expression of the items, a pre-survey was conducted with 20 randomly selected pregnant women who were enrolled in and attended the hospital before the formal survey. Explanations were adjusted based on suggestions from these women. The inclusion criteria for study subjects were as follows: (a) perinatal women (from 28 weeks of gestation to 1 week postpartum); (b) aged 18–45 years; (c) capable of understanding and willing to participate in the study; and (d) having clear consciousness, no communication barriers and the ability to cooperate in completing the questionnaire. The exclusion criteria were as follows: (a) pregnant women currently diagnosed with VTE and (b) those with mental health conditions or communication barriers that prevented survey participation. Each pregnant woman who participated in the pre-survey was asked whether they could understand each item in the questionnaire. Some participants expressed uncertainties about how many options to select for the multiple-choice questions in the knowledge dimension. Three pregnant women indicated being unaware of the terms ‘graduated compression stockings’ and ‘intermittent pneumatic compression’. No objections were raised regarding the remaining items, and the participants expressed their understanding of the content. The research team revised the questionnaire items based on feedback from the pregnant women, with no change in the number of questionnaire items. 2.2 Phase 2: Questionnaire validation The questionnaire comprised three main dimensions (KAP) related to maternal VTE prevention. The knowledge dimension included 9 items on VTE manifestations and risk factors. The attitude dimension contained 20 items on perceived susceptibility to disease, perceived severity of disease, perceived benefits of practice, perceived barriers to practice, self-efficacy and cues for action. The practice dimension comprised 9 items on mechanical and pharmacological prophylaxis. In the knowledge dimension, ‘yes’ was scored as 1 and ‘no’ as 0. Scores were calculated using a 5-point Likert questionnaire for the attitude and practice dimensions. 2.2.1 Participants In this study, pregnant women from a hospital in Yunnan Province, China, were selected between March 2024 and August 2024. All participants provided informed consent. The purpose and significance of the study were explained to the perinatal women who agreed to participate, and they subsequently filled out the questionnaire. The initial questionnaire contained 38 items, and the sample size was 5 to 10 times the number of questionnaire items [ 15 ] . Since confirmatory factor analysis (CFA) was used to test the structural validity of the questionnaire, the sample size should be at least 200 cases based on CFA sample size requirements [ 16 ] . Thirty pregnant women who participated in the survey were re-assessed 2 weeks later, and the retest reliability of the questionnaire was evaluated using the results from both surveys. 2.2.2 Statistical methods The collected data were entered into an Excel spreadsheet and then reviewed by two researchers. SPSS 26.0 and Amos 26.0 were used for the statistical analysis. The correlation coefficient and Cronbach’s alpha coefficient were used to test the quality and reliability of the items, providing a basis for selecting or modifying individual items. Exploratory factor analysis (EFA), CFA and content validity were used for validity evaluation. The Kaiser–Meyer–Olkin measure of sampling adequacy (KMO) and Bartlett’s test of sphericity were performed to evaluate the suitability of the designed variable set for factor analysis. Principal component analysis was applied to extract factors with eigenvalues greater than 1 using the maximum variance rotation method. Internal consistency and retest reliability were also evaluated to test reliability. 3. Results 3.1 Characteristics of study participants A total of 212 questionnaires were distributed, of which 206 were valid, resulting in a 77.2% recovery rate. As shown in Table 1 , 51.5% of participants were 26–30 years old, 40.8% held a bachelor’s degree, 63.1% lived in urban areas, 63.1% were first-time pregnant, 76.2% had planned their pregnancy, 68% had not contacted or participated in the ‘mother class’ or related pregnancy health lectures and 85.9% had pregnancy-related comorbidities or complications. Table 1 Socio-demographic characteristics of participants Variables Frequency Percentage(%) Age 18–25 30 14.6 26–30 106 51.5 31–35 50 24.3 36–40 20 9.7 41–45 0 0 Ethnicity Han Chinese 171 83 Minority 35 17 Level of education Junior high school 28 13.6 Secondary school 38 18.4 Junior college 47 22.8 Bachelor’s degree 84 40.8 Master’s degree/ above 9 4.4 Place of Residence Rural 59 28.6 County 17 8.3 City 130 63.1 Number of births First child 130 63.1 Second child 59 28.6 Third child 12 5.8 Over three births 5 2.4 Production methods/expected production methods Normal delivery 142 68.9 Cesarean section 64 31.1 Planned pregnancy or not No 49 23.8 Yes 157 76.2 Current month of pregnancy or postpartum time 28-32w 44 21.4 33-37w 33 16 38-42w 27 13.1 Within 1 week postpartum 102 49.5 Occupation Unemployed 44 21.4 Self-employed 29 14.1 Institution/enterprise employee 71 34.5 Freelance 33 16 Finance/sales/business/service worker 26 12.6 Others 3 1.5 Monthly household income (per capita) < 1500 7 3.4 1501 ~ 3000 38 18.4 3001 ~ 5000 82 39.8 > 5000 79 38.3 Payment of medical expenses Out-of-pocket expenses 37 18 New rural cooperative medical insurance 51 24.8 Basic medical insurance for urban workers 90 43.7 Basic medical insurance for urban residents 27 13.1 Other 1 0.5 Family members who are medical workers Yes 56 27.2 No 150 72.8 Main source of knowledge about VTE Doctor 81 39.3 Nurse 24 11.7 Friends, relatives or other patients 20 9.7 Internet/TV 77 37.4 Pamphlets/posters 4 1.9 Had contact with or participated in “Mom’s Class” or related pregnancy health seminars No 140 68 Yes 66 32 Pregnancy-related comorbidities or complications No 177 85.9 Yes 29 14.1 3.2 Item selection 3.2.1 Discrimination analysis In this study, the sample questionnaire scores were calculated and then ranked from highest to lowest. Taking 27% of the effective investigation number as the critical value (206 × 27% = 55.62). The top 56 respondents in terms of total score were considered the high group, and the bottom 56 respondents were considered the low group. Two independent samples t -tests were conducted to analyse the specific item scores of both groups. The results showed that the critical ratio for 32 items (84.21% of the 38 items in total) in the first draft of the questionnaire had t > 3.000 and p < 0.05, indicating good discrimination for most items. However, for items A1.1, A1.2, A1.4, A2.1 and B4.3, the critical ratio was t < 3.000 but p < 0.05. As a result, these items were retained for further statistical analysis. Item A2.3, with a critical ratio of t < 3.000 and p > 0.05, was deleted [ 17 , 18 ] . 3.2.2 Related analysis The Pearson correlation coefficient was calculated for each item in relation to the total questionnaire score. A higher correlation coefficient indicates that the item better represents the overall questionnaire [ 19 – 21 ] . The Pearson correlation coefficients in the first draft of the questionnaire ranged from 0.185 to 0.691, indicating positive correlations. Although the correlation coefficients for items A1.1, A1.2, A1.3, A1.4, A2.1, B4.3 and B4.4 were below 0.300, all items were statistically significant ( p < 0.05). Therefore, 37 items from the first draft of the questionnaire were retained for further testing in the subsequent factor analysis. 3.3 Exploratory factor analysis In this study, the KMO test and Bartlett’s test of sphericity were used to assess the suitability of the designed variable set for factor analysis [ 22 ] . Items meeting the following criteria were retained: (a) eigenvalues > 1, (b) cumulative variance contribution > 50% and (c) absolute loadings > 0.50. Based on the sample data, EFA was first conducted on the knowledge and practice dimensions. The attitude dimension was constructed based on HBM theory, which divides an individual’s health attitudes into the following six aspects: (1) perceived susceptibility to disease, (2) perceived severity of disease, (3) perceived benefits of health behaviours, (4) perceived barriers to health behaviours, (5) self-efficacy and (6) cues to action [ 14 ] . Since secondary indicators are clearly defined, EFA was not conducted for the attitude dimension. Instead, CFA was conducted on the attitude dimension using Amos 26.0 software. This analysis evaluated the fit of the attitude dimension questionnaire against the actual measurement data to test its correctness. 3.3.1 Knowledge dimension The KMO value for the knowledge dimension was 0.751, which is greater than 0.7. Bartlett’s test of sphericity yielded a value of 429.211, with 28 degrees of freedom and p = 0.000, indicating a significant difference and confirming that the data was suitable for EFA. Using PCA with maximum variance rotation, factors with eigenvalues > 1 were extracted. The cumulative variance contribution was 54.402%, meeting the requirement of a cumulative variance contribution rate > 50.00% [ 18 ] . This result indicates that the data are suitable for factor analysis. As shown in Table 2 , the factor analysis results align with the scale dimensions defined by the research design. Furthermore, the absolute values of the factor loadings for each item were all greater than 0.5, indicating that the scale has high validity and is effective [ 23 ] . Table 2 Rotated factor loading matrix and commonality for exploratory factor analysis of the knowledge dimension Subject Factor loadings Factor 1 Factor 2 A1.1 0.619 A1.2 0.809 A1.3 0.528 A1.4 0.777 A2.1 0.828 A2.2 0.855 A2.3 0.659 A2.4 0.564 There were two initial secondary indicators for the knowledge dimension of the questionnaire in this study. After conducting EFA, these two indicators were renamed based on specialised knowledge. Factor 1 includes four items (A1.5, A1.6, A2.1 and A2.2), while Factor 2 includes four items (A1.1, A1.2, A1.3 and A1.4). The items were re-numbered, and the final knowledge section of the questionnaire consists of two dimensions and eight items. 3.3.2 Practice dimension The KMO value for the behavioural dimension was 0.901, which is greater than 0.7. Bartlett’s test of sphericity yielded a value of 1235.238, with 36 degrees of freedom and p = 0.000, indicating a significant difference and confirming the suitability of the data for EFA. PCA and maximum variance rotation were used to extract factors with eigenvalues > 1 from the scale. The cumulative variance contribution rate was 73.512%, meeting the requirement of a cumulative variance contribution rate > 50.00% in PCA [ 16 ] . As shown in Table 3 , the factor analysis results align with the scales and dimensions defined in the research design. The absolute values of the factor loadings for each item were all greater than 0.5, indicating the high validity and reliability of the questionnaire [ 23 ] . Table 3 Rotated factor loading matrix and commonality for exploratory factor analysis of the practice dimension Subject Factor loadings Factor 1 Factor 2 C1.1 0.76 C1.2 0.797 C1.3 0.829 C1.4 0.838 C1.5 0.767 C1.6 0.777 C2.1 0.813 C2.2 0.882 C2.3 0.789 3.4 Reliability analysis 3.4.1 Internal consistency reliability In this study, questionnaires were used to measure key factors. Verifying the data quality of measurement is essential for meaningful subsequent analysis. The internal consistency of each dimension was first analysed using Cronbach’s coefficient reliability. The overall reliability of the questionnaire and the reliability coefficients for the first-level dimensions are 0.736, 0.888, 0.917 and 0.913, respectively, all in the range of 0.7–1. This indicates that the questionnaires used in this study have good internal consistency and reliability [ 24 , 25 ] . In summary, the study results passed the confidence test. 3.4.2 Test-retest reliability In this study, 30 pregnant women who participated in the initial survey were selected for a retest 7 to 10 days later. The results showed a test-retest reliability of approximately 0.994 for the total questionnaire. The test-retest reliability for all dimensions was > 0.70, with statistical significance ( p < 0.01) observed in each case. This indicates good stability of the questionnaire [ 26 ] . 3.5 Validity 3.5.1 Content validity A 5-point Likert scale was used, ranging from very unimportant (1 point) to very important (5 points). Content validity was assessed using the importance scores from an expert inquiry questionnaire: 1 point = very unimportant, 2 points = unimportant, 3 points = uncertain, 4 points = important and 5 points = very important. The I-CVI ranged from 0.87 to 1.00, and the S-CVI was 0.96, indicating good content validity of the questionnaire [ 27 ] . 3.5.2 Structural validity Amos 26.0 statistical software was used to construct a model using the maximum likelihood estimation method. CFA was conducted on each of the three dimensions of the questionnaire to test its structural validity. The results of the model fitting by the CFA of the knowledge dimensions are shown in Fig. 1 (a) , with χ 2 /df = 1.011, less than 3, GFI = 0.978, AGFI = 0.958, RMSEA = 0.007, less than 0.050, NFI = 0.956, IFI = 0.998, CFI = 0.998. The results demonstrated good structural validity of the knowledge dimension of VTE prevention [ 16 , 23 ] . The results of the initial fitted model for the CFA of attitude dimensions are shown in Fig. 1 (b) ,χ 2 /df = 1.811, GFI = 0.88, AGFI = 0.837, RMSEA = 0.063, NFI = 0.881, IFI = 0.943, CFI = 0.942, the ideal standard, the overall model fit is good [ 16 , 23 ] . Suggesting that the VTE prevention attitude dimension based on HBM has good construct validity. The results of the initial fitting model for the CFA of the practice dimensions are shown in Fig. 1 (c) , χ 2 /df = 3.972, GFI = 0.94, AGFI = 0.895, RMSEA = 0.082, NFI = 0.951, IFI = 0.971, CFI = 0.971, all within the ideal range, the overall fit of the model was better [ 16 , 23 ] .The results showed better structural validity of the practice dimension of VTE prevention. This study validated the questionnaire structure through reliability and validity testing. The final questionnaire contains 3 primary indicators, 10 secondary indicators, and a total of 37 items. Please refer to the supplementary materials for the questionnaire. 4. Discussion Special physiological and anatomical changes occur during pregnancy and puerperium, making perinatal pregnant women a high-risk group for VTE. In addition, once the thrombus falls off and develops into pulmonary embolism, it can endanger fetal growth and development, and even lead to maternal and fetal death [ 28 ] . However, most assessment tools for VTE prevention behaviors in high-risk populations are in the surgical field [ 29 – 31 ] , and relatively few VTE-KAP questionnaires are applicable to maternity. Regarding the study of the VTE-KAP questionnaire, the questionnaire designed by Korean researcher Kim ES [ 32 ] has 66 items. The Cronbach’s alpha coefficients in this study were all greater than 0.800, indicating good reliability. However, subsequent research found that the questionnaire had too many items, which could easily cause the respondents to lose patience during the questionnaire filling process and result in data bias. In a survey study of VTE cognition in the Yemeni region, the overall Cronbach’α value was 0.766, there was a lack of awareness of VTE and its prevention [ 33 ] . Korean researchers HJ Yang et al. [ 34 ] independently designed a questionnaire for patients undergoing lower limb surgery in orthopedics. The questionnaire has 15 items in the knowledge dimension and 25 items in the attitude dimension. The Cronbach’s alpha value is 0.67. The practice dimensions were scored as a VAS score on a 10-cm parallel line. The respondent’s choice of cm value is recorded as the score. The higher the score, the better the behavior of preventing venous thromboembolism. However, the practice dimension of the scale was not designed with specific survey questions. The use of VAS scoring is easily influenced by individual subjective feelings, resulting in data bias. The VTE prevention survey questionnaire developed by Chinese researcher Cai Yanting [ 35 ] is mainly divided into three dimensions: knowledge (12 items), attitude (8 items), and practice (10 items). The Cronbach’s alpha coefficients of this study are all greater than 0.800, with a split half reliability of 0.754–0.823, indicating good reliability. The I-CVI is 0.867-1.000 and S-CVI is 0.927, indicating high content validity. However, the scale only includes three items for risk factors: long-term bed rest, trauma, and surgery. The risk factors for VTE in pregnant women, such as assisted reproductive technology, have not been addressed. The aforementioned survey questionnaires are mainly divided into three dimensions: knowledge, attitude and practice. However, most are designed for orthopedic patients or other populations, and they do not detail the process of questionnaire development and validation. They are also not suitable for directly assessing the VTE prevention status in pregnant and postpartum women. In contrast, the questionnaire compiled in this study contains 3 primary dimensions and 10 secondary dimensions, totaling 37 items. The scope involved is relatively comprehensive. The Cronbach’s alpha coefficients of this study were all between 0.7-1, indicating good reliability of the questionnaire. Meanwhile,the I-CVI is 0.87-1.00 and S-CVI is 0.96, indicating good content validity of the questionnaire. In addition, the factor distribution basically conforms to the theoretical framework in the design of the scale. On this basis, the confirmatory factor analysis was conducted. The results showed that the model fits well, indicating that the structural validity of the study scale was good. The final result is the KAP-VTE questionnaire, which consists of 3 primary indicators, 10 secondary indicators and 37 items was finally formed. The questionnaire included basic knowledge of VTE, clinical manifestations, risk factors, preventive measures, disease perception, and self-efficacy. It is more suitable for perinatal maternal population than the assessment tools of previous studies. This study is based on the KAP theory and combined with the HBM model to design a questionnaire. This questionnaire is a scientific supplement to existing VTE prevention assessment tools for pregnant women. It focuses on evaluating the beliefs of pregnant women in preventing VTE. Compared to the previous division of various dimensions, it is more scientific and detailed. It is more suitable for the investigation of the current status of VTE prevention in perinatal pregnant women. In addition, this questionnaire can also help medical personnel quickly assess the knowledge, attitude, and practical level of VTE in pregnant women. Through demographic analysis of the surveyed population, it is helpful for medical personnel to develop more targeted health education. Researchers can use this questionnaire to understand the prevention of VTE among pregnant women from different regions, cultural backgrounds, and gestational weeks. Provide basic data for subsequent research. Therefore, this study has significant clinical implications. 4.1 Limitations of the studytions The pregnant women in this study all came from a tertiary hospital in Kunming, China, and the sample was relatively limited. Lack of sample surveys from other regions or countries. If further research is to be conducted, multi center large sample data will be required. 5. Conclusion Special physiological and anatomical changes occur during pregnancy and puerperium, making perinatal women a high-risk group for VTE. Additionally, if a thrombus detaches and develops into a pulmonary embolism, it can endanger fetal growth and development and even lead to maternal and foetal mortality [ 28 ] . Most VTE prevention assessment tools for high-risk populations are concentrated in the surgical field [ 29 – 31 ] , with relatively few VTE-KAP questionnaires designed for maternity. Regarding the development of the VTE-KAP questionnaire, a questionnaire designed by Korean researcher Kim ES [ 32 ] has 66 items,with Cronbach’s alpha coefficients > 0.800, indicating good reliability. However, subsequent research revealed that the questionnaire contained too many items, which could lead to respondent fatigue and data bias. In a survey of VTE cognition in the Yemeni region, the overall Cronbach’s alpha value was 0.766, highlighting a lack of awareness regarding VTE and its prevention [36] . Korean researchers Yang et al. [37] designed a questionnaire for patients undergoing lower limb surgery in orthopaedics. The questionnaire includes 15 items in the knowledge dimension and 25 items in the attitude dimension. The Cronbach’s alpha value is 0.67. For the practice dimensions, scores were recorded using a VAS score on a 10-cm parallel line. The respondent’s choice of cm value is recorded as the score, with higher scores indicating better VTE prevention behaviours. However, the practice dimension lacks specific survey questions, and the use of VAS scoring is prone to individual subjective influences, resulting in potential data bias. The VTE prevention survey questionnaire developed by Chinese researcher Cai Yanting [38] comprises three dimensions – knowledge (12 items), attitude (8 items) and practice (10 items) – with Cronbach’s alpha coefficients > 0.800 and a split-half reliability of 0.754–0.823, indicating good reliability. The I-CVI ranges from 0.867 to 1.000, while the S-CVI is 0.927, indicating high content validity. However, the scale includes only three items for risk factors: long-term bed rest, trauma and surgery. It does not address other risk factors for VTE in pregnant women, such as assisted reproductive technology. The aforementioned survey questionnaires are mainly divided into the KAP dimensions. However, most are designed for orthopaedic patients or other populations, lacking a detailed development and validation process. They are also not suitable for directly assessing VTE prevention in pregnant and postpartum women. Conversely, the questionnaire developed in this study contains three primary dimensions, 10 secondary dimensions and a total of 37 items. The scope involved is relatively comprehensive. The Cronbach’s alpha coefficients for this study ranged from 0.7 to 1, indicating good reliability. Meanwhile, the I-CVI ranges from 0.87 to 1.00, and the S-CVI is 0.96, indicating good content validity. Moreover, the factor distribution conforms to the theoretical framework used in the scale design. Therefore, CFA was conducted. The results showed that the model fits well, indicating that the structural validity of the study scale is strong. The final KAP-VTE questionnaire consists of three primary indicators, 10 secondary indicators and 37 items. The questionnaire encompasses basic knowledge of VTE, clinical manifestations, risk factors, preventive measures, disease perception and self-efficacy. This makes it more suitable for the perinatal women population than the assessment tools in previous studies. This study is based on the KAP theory, which was combined with the HBM to design a questionnaire. This questionnaire serves as a scientific supplement to existing VTE prevention assessment tools for pregnant women, focusing on evaluating their beliefs regarding VTE prevention. Compared to the previous division of various dimensions, it is more scientific and detailed. It is more suitable for investigating the current status of VTE prevention in perinatal women. Furthermore, this questionnaire enables medical professionals to quickly assess the KAP level of VTE in pregnant women. Through demographic analysis of the surveyed population, medical professionals can develop more targeted health education strategies. Researchers can use this questionnaire to examine VTE prevention among pregnant women from diverse regions, cultural backgrounds and gestational stages, providing essential data for future research. Therefore, this study has significant clinical implications. 4.1 Limitations of the study The participants in this study were all from a tertiary hospital in Kunming, China, resulting in a relatively limited sample size. Additionally, there was a lack of sample data from other regions or countries. For future research, a multi-centre study with a large sample size will be necessary. 6. Conclusion This study is based on the KAP theory, combined with the HBM theory, to develop the VTE-KAP questionnaire, which has been verified to have good reliability and validity. This questionnaire scientifically reflects the KAP regarding VTE prevention among pregnant women during the perinatal period. It also provides a scientific basis for developing targeted health education programmes for clinical practice. Declarations Authors’ contributions CXZ contributed to the writing of the original draft, reviewed and edited the manuscript, conceptualised the study, curated the data, and validated the research findings. FFQ assisted in literature collection, and thesis revision. XZ was responsible for project investigation, and data curation. NZ contributed to the manuscript by reviewing and editing, provided supervision, supplied resources, administered the project, acquired funding, and helped conceptualise the study. All authors read and wrote the manuscript as well as approved the manuscript submission. Competing interest The authors declare no competing interests. Ethics approval and consent to participate The study was approved by the Ethics Review Committee of the Third People’s Hospital of Yunnan Province (No. 2023KY219). All participants have completed an informed consent form to conduct the study and all scales have been completed anonymously. A statement to confrm that all methods were carried out in accordance with relevant guidelines and regulations - Declaration of Helsinki. The study did not involve minors. Acknowledgements We would like to thank all of the participants involved in this research for their time and contributions. Availability of data and materials Data and other materials are available upon request from the corresponding authors. References Obstetrics and Gynecology Section of the Chinese Medical Association, Huixia Y, Zilian W, et al. Expert consensus on prevention and treatment of venous thromboembolism in pregnancy and puerperium[J]. Chin J Obstet Gynecol. 2021;56(4):236–43. Gu WR, Li XT. Strategies for prevention and treatment of pregnancy-related venous thromboembolism and practice in China[J]. Chin J Practical Gynecol Obstet. 2017;33(06):578–84. 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BMC Prim Care. 2024;25(1):110. Yang JH, Pan XY, Zhong D, et al. Health behavior intervention model and theory for hypertensive population[J]. Chin J Hypertens. 2020;28(04):385–8. Chen MZ, Fang J. The current application of the Health Belief Model in hypertension health education[J]. Sci Technol Inform. 2020;18(27):196–197200. Zong Q. Investigation and Study on the Knowledge, Attitude, and Practice of Perioperative Nursing Staff in Qingdao City for Preventing Deep Vein Thrombosis[D]. Shandong: Qingdao University; 2019. Sun ZQ, Xu YY. Medical Statistics[M]. Beijing: People’s Medical Publishing House; 2018. Shrestha N. Detecting multicollinearity in regression analysis[J]. Am J Appl Math Stat. 2020;8(2):39–42. Haitovsky Y. Multicollinearity in regression analysis: Comment[J]. Rev Econ Stat, 1969: 486–9. Gulliksen H. The relation of item difficulty and inter-item correlation to test variance and reliability. Psychometrika. 1945;10(2):79–91. Piedmont RL, Hyland ME. Inter-item correlation frequency distribution analysis: a method for evaluating scale dimensionality. Educ Psychol Meas. 1993;53(2):369–78. Diamantopoulos A, Sarstedt M, Fuchs C, et al. Guidelines for choosing between multi-item and single-item scales for construct measurement: a predictive validity perspective[J]. J Acad Mark Sci. 2012;40:434–49. Demirtaş A, Akbayrak N. Development of an assessment scale for treatment compliance in type 2 diabetes Mellitus in Turkish population: psychometric evaluation. Int J Nurs Sci. 2017;4(3):244–51. Zhang WD. Study on the Dimensional Structure of the Coping Scale (COPE)[J]. Acta Physiol Sinica, 2001(01): 55–62. Juhola J, Arokoski JPA, Ervasti J, et al. Internal consistency and factor structure of Jenkins Sleep Scale: cross-sectional cohort study among 80 000 adults[J]. BMJ open. 2021;11(1):e043276. Liu QX, Wang W, Sun YH. Investigation and Analysis of the Current Status of Perioperative Nurses' Knowledge, Attitudes, and Practices in Preventing Venous Thromboembolism in the Operating Room[J]. Chin J Mod Nurs. 2021;27(28):3809–15. Wu BJ, Lan TH, Hu TM, et al. Validation of a five-factor model of a Chinese Mandarin version of the Positive and Negative Syndrome Scale (CMV-PANSS) in a sample of 813 schizophrenia patients[J]. Schizophr Res. 2015;169(1–3):489–90. Zhang C, Zhou YX. Analysis of the misapplication of content validity index in the literature of nursing measurement tools in China[J]. J Nurs 2020,35(04):86–8. Kalaitzopoulos DR, Panagopoulos A, Samant S, et al. Management of venous thromboembolism in pregnancy[J]. Thromb Res. 2022;211:106–13. Zhang ZC, Li QL, Zhou PH. Prevention of perioperative venous thromboembolism in endoscopic diagnosis and treatment [J]. Chin J Dig Endoscopy. 2023;40(1):34–8. Shi YQ, Li N, Yan L et al. Development and reliability test of venous thromboembolism risk assessment scale for adult burn patients[J]. J Army Med Univ 2023,45(12):1328–36. Xu H, Xu SF, Yuan XY, et al. Analysis of the incidence of perioperative venous thromboembolism in urological patients[J]. Chin J Urol. 2023;44(3):195–9. Kim ES, Kim HY. Knowledge, awareness and risk of occurrence of venous thromboembolism of perinatal women[J]. Korean J Women Health Nurs. 2019;25(2):154–68. Halboup AM, Alzoubi KH, Mohamed Ibrahim MI, Syed Sulaiman SA, Almahbashi Y, Al-Arifi S, Mohammed S, Othman G. Awareness and Perception of Hospitalized Patients on Thromboembolism and Thromboprophylaxis: A Cross-Sectional Study in Sana’a-Yemen. Patient Prefer Adherence. 2022;16:1649–61. Yang HJ, Kang HY. Knowledge, health belief, and preventive behavioral intention related to venous thromboembolism (VTE) of the patients with lower limb musculoskeletal system disorders[J]. J Korean Acad Soc Nurs Educ. 2013;19(4):531–41. Cai YT. Investigation on Knowledge, Willingness and Behavior of Venous Thromboembolism Prevention in Orthopedic Inpatients[D]. Nanchang University; 2018. Scheme Scheme 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files Scheme1Flowchartofthestudy.tif Scheme 1: Flowchart of the study Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-5768046\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":398232920,\"identity\":\"99bbd667-ab09-40da-a618-02872f90e857\",\"order_by\":0,\"name\":\"Chenxi Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Dali University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Chenxi\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":398232921,\"identity\":\"d48766f5-217c-4934-95bd-51bedfc16a1c\",\"order_by\":1,\"name\":\"Rong Li\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Dali University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Rong\",\"middleName\":\"\",\"lastName\":\"Li\",\"suffix\":\"\"},{\"id\":398232922,\"identity\":\"26d38ed4-082f-454f-9d8b-d5631557a7f2\",\"order_by\":2,\"name\":\"Feifei Qian\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"The Third People’s Hospital Of Yunnan Province\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Feifei\",\"middleName\":\"\",\"lastName\":\"Qian\",\"suffix\":\"\"},{\"id\":398232923,\"identity\":\"2031947f-8270-4245-a510-2f6899d8c506\",\"order_by\":3,\"name\":\"Xuan Zhang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Dali University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Xuan\",\"middleName\":\"\",\"lastName\":\"Zhang\",\"suffix\":\"\"},{\"id\":398232924,\"identity\":\"fb78b9ff-90ca-47e9-ba3f-ea10ee253a34\",\"order_by\":4,\"name\":\"Na Zhou\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAv0lEQVRIiWNgGAWjYBAC+xkwFntj48MPxGhhhGvhOdxsLEGaFon0NgEeYrQwSzcfky6oYZA3uPmwjUGCwU5Ot4GAFjaZY2nSM44xGM6cndj2oIAh2djsAAEtPBI5ZtI8bAwJ/NKJ7QYSDAcStxHSIgHW8o8hgU3yYJsEDzFaDEBaeNuAtkgwEq0lLdmatw/ol55EYCAbEOEX+xnJB2/zfAOG2PHjDx9+qLCTI6gFCv7DLCVO+SgYBaNgFIwCAgAAjTg4VF+eaJYAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"The Third People’s Hospital Of Yunnan Province\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Na\",\"middleName\":\"\",\"lastName\":\"Zhou\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2025-01-05 13:38:15\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-5768046/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-5768046/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":73308959,\"identity\":\"23afc5a5-4c81-4f47-b5a1-dc4d9399884e\",\"added_by\":\"auto\",\"created_at\":\"2025-01-08 17:45:24\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":60151,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eConfrmatory factor analysis of the scale\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"OnlineFigure1.Confrmatoryfactoranalysisofthescale.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5768046/v1/d2ec9d7d177e8bd75c4f76c0.png\"},{\"id\":73310055,\"identity\":\"6a8973b7-6d38-4bf1-b460-e3c88ef2a8dc\",\"added_by\":\"auto\",\"created_at\":\"2025-01-08 18:01:27\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":937440,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5768046/v1/4b514627-2bf8-4106-bb2f-0b38dbdbfc87.pdf\"},{\"id\":73308963,\"identity\":\"1311cc10-b0e8-4d17-9b01-e60153690664\",\"added_by\":\"auto\",\"created_at\":\"2025-01-08 17:45:25\",\"extension\":\"tif\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":176092,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003e\\u003cstrong\\u003eScheme 1\\u003c/strong\\u003e: Flowchart of the study\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"Scheme1Flowchartofthestudy.tif\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-5768046/v1/dd913f458314571672d1235c.tif\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Development and Validation of a Knowledge, Attitude and Practice Questionnaire for Venous Thromboembolism Prevention in Perinatal Women\",\"fulltext\":[{\"header\":\"1. Introduction\",\"content\":\"\\u003cp\\u003eVenous thromboembolism (VTE) is a condition characterised by abnormal blood clotting in the lumen of a vein, leading to the formation of an embolus that obstructs the vein and impairs circulation\\u003csup\\u003e[\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]\\u003c/sup\\u003e. Pregnant women are at a high risk of VTE due to the physiological changes associated with pregnancy\\u003csup\\u003e[\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e]\\u003c/sup\\u003e. Research has shown that the risk of VTE is 4\\u0026ndash;5 times higher in pregnant women than in non-pregnant women\\u003csup\\u003e[\\u003cspan additionalcitationids=\\\"CR4\\\" citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]\\u003c/sup\\u003e. The highest risk period for VTE is the first postpartum week\\u003csup\\u003e[\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eAdequate knowledge, positive attitudes and appropriate preventive practices among perinatal women are crucial for reducing the 0incidence of VTE. Pregnant women are usually hospitalised close to delivery, making it challenging for healthcare workers to manage and prevent maternal VTE during the antenatal period\\u003csup\\u003e[\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]\\u003c/sup\\u003e. However, there is a lack of scientific tools to assess the knowledge, attitudes and practices (KAP) related to VTE prevention among pregnant women, making it difficult to effectively gauge their awareness. Existing VTE assessment tools for pregnant women focus on identifying high-risk populations\\u003csup\\u003e[\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]\\u003c/sup\\u003e, offering the advantage of rapidly screening for high-risk pregnancies. However, these tools overlook the need for pregnant women to actively prevent VTE on their own. Given the unique physiological characteristics of this population, the current tools used for other groups do not fully capture the reality of VTE prevention in perinatal women. There is an urgent need to develop a tailored VTE prevention knowledge, attitude and practice (VTE-KAP) questionnaire for perinatal women.\\u003c/p\\u003e \\u003cp\\u003eThe \\u003cem\\u003eKnowledge, Attitude and Practice\\u003c/em\\u003e (KAP) theory explores the relationship between knowledge, attitude and practice\\u003csup\\u003e[\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]\\u003c/sup\\u003e. It helps assess the current status of postpartum women\\u0026rsquo;s KAP regarding VTE prevention. Additionally, it helps identify gaps in perceptions related to VTE prevention in pregnant women. While previous research questionnaires for investigating disease cognition are mostly based on the KAP theory, a limitation is their overemphasis on the role of knowledge in the three interconnected stages\\u003csup\\u003e[\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]\\u003c/sup\\u003e. In practice, individuals may become stagnant after gaining knowledge, or partial behavioural changes may arise due to specific needs or circumstances. The \\u003cem\\u003eHealth Belief Model\\u003c/em\\u003e (HBM) is a theoretical model that explains the adoption of health behaviours from a psychological perspective, providing robust predictive and explanatory insights into behaviour\\u003csup\\u003e[\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]\\u003c/sup\\u003e. This theory facilitates the structured design of surveys targeting patient attitudes. The questionnaire was developed using the KAP theory combined with the HBM. It has been established as a validated tool for assessing perinatal maternal KAP related to VTE prevention. This questionnaire offers valuable health guidance for maternal VTE prevention and is a more scientific assessment tool for medical professionals.\\u003c/p\\u003e\"},{\"header\":\"2. Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.1 Phase 1: Questionnaire development\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.1.1 Literature review\\u003c/h2\\u003e \\u003cp\\u003e A literature review was conducted to gather information on maternal VTE prevention, both nationally and internationally. Subject terms such as \\u0026lsquo;puerperae\\u0026rsquo;, \\u0026lsquo;postpartum\\u0026rsquo;, \\u0026lsquo;pregnancy\\u0026rsquo;, \\u0026lsquo;puerperal period\\u0026rsquo;, \\u0026lsquo;puerperium\\u0026rsquo;, \\u0026lsquo;venous thromboembolism\\u0026rsquo;, \\u0026lsquo;VTE\\u0026rsquo;, \\u0026lsquo;prevent\\u0026rsquo; and \\u0026lsquo;knowledge attitude practice\\u0026rsquo; were used in databases including CNKI, PubMed, Web of Science, ScienceDirect and Cochrane Library. The literature search was conducted on current maternal VTE prevention studies published from the inception of each database through November 2023. The item pool for the questionnaire was initially compiled based on the literature review and clinical experience, followed by a discussion within the research group. The study process is shown in Scheme \\u003cspan refid=\\\"Sch1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.1.2 Expert consultation\\u003c/h2\\u003e \\u003cp\\u003eRelevant experts were invited to review the structure of the questionnaire, the importance of the items and the semantic expression. The questionnaire items were then modified based on their feedback. Fifteen Chinese experts from Yunnan, Shandong, Beijing and Shanghai were invited to participate in this study. Inclusion criteria for experts were as follows: participants must have over 10 years of experience in fields related to obstetrics and gynaecology, surgery, rehabilitation or nursing education; possess substantial practical experience and a strong theoretical foundation in maternal VTE prevention or scale development; hold intermediate or higher professional titles; and demonstrate active and serious engagement in this study. The questionnaire items were modified and adjusted based on the experts\\u0026rsquo; feedback. Irrelevant or unclear items were removed, and the content of some items was optimised to ensure that the scale was more scientific and rational. Following the revision, experts were invited to re-evaluate the updated questionnaire. The resulting preliminary draft comprises 38 items, divided into the KAP dimensions.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.1.3 Pre-survey\\u003c/h2\\u003e \\u003cp\\u003eTo further refine the expression of the items, a pre-survey was conducted with 20 randomly selected pregnant women who were enrolled in and attended the hospital before the formal survey. Explanations were adjusted based on suggestions from these women. The inclusion criteria for study subjects were as follows: (a) perinatal women (from 28 weeks of gestation to 1 week postpartum); (b) aged 18\\u0026ndash;45 years; (c) capable of understanding and willing to participate in the study; and (d) having clear consciousness, no communication barriers and the ability to cooperate in completing the questionnaire. The exclusion criteria were as follows: (a) pregnant women currently diagnosed with VTE and (b) those with mental health conditions or communication barriers that prevented survey participation.\\u003c/p\\u003e \\u003cp\\u003eEach pregnant woman who participated in the pre-survey was asked whether they could understand each item in the questionnaire. Some participants expressed uncertainties about how many options to select for the multiple-choice questions in the knowledge dimension. Three pregnant women indicated being unaware of the terms \\u0026lsquo;graduated compression stockings\\u0026rsquo; and \\u0026lsquo;intermittent pneumatic compression\\u0026rsquo;. No objections were raised regarding the remaining items, and the participants expressed their understanding of the content. The research team revised the questionnaire items based on feedback from the pregnant women, with no change in the number of questionnaire items.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e2.2 Phase 2: Questionnaire validation\\u003c/h2\\u003e \\u003cp\\u003eThe questionnaire comprised three main dimensions (KAP) related to maternal VTE prevention. The knowledge dimension included 9 items on VTE manifestations and risk factors. The attitude dimension contained 20 items on perceived susceptibility to disease, perceived severity of disease, perceived benefits of practice, perceived barriers to practice, self-efficacy and cues for action. The practice dimension comprised 9 items on mechanical and pharmacological prophylaxis. In the knowledge dimension, \\u0026lsquo;yes\\u0026rsquo; was scored as 1 and \\u0026lsquo;no\\u0026rsquo; as 0. Scores were calculated using a 5-point Likert questionnaire for the attitude and practice dimensions.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.2.1 Participants\\u003c/h2\\u003e \\u003cp\\u003eIn this study, pregnant women from a hospital in Yunnan Province, China, were selected between March 2024 and August 2024. All participants provided informed consent. The purpose and significance of the study were explained to the perinatal women who agreed to participate, and they subsequently filled out the questionnaire. The initial questionnaire contained 38 items, and the sample size was 5 to 10 times the number of questionnaire items\\u003csup\\u003e[\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]\\u003c/sup\\u003e. Since confirmatory factor analysis (CFA) was used to test the structural validity of the questionnaire, the sample size should be at least 200 cases based on CFA sample size requirements\\u003csup\\u003e[\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]\\u003c/sup\\u003e. Thirty pregnant women who participated in the survey were re-assessed 2 weeks later, and the retest reliability of the questionnaire was evaluated using the results from both surveys.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec9\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e2.2.2 Statistical methods\\u003c/h2\\u003e \\u003cp\\u003eThe collected data were entered into an Excel spreadsheet and then reviewed by two researchers. SPSS 26.0 and Amos 26.0 were used for the statistical analysis. The correlation coefficient and Cronbach\\u0026rsquo;s alpha coefficient were used to test the quality and reliability of the items, providing a basis for selecting or modifying individual items. Exploratory factor analysis (EFA), CFA and content validity were used for validity evaluation. The Kaiser\\u0026ndash;Meyer\\u0026ndash;Olkin measure of sampling adequacy (KMO) and Bartlett\\u0026rsquo;s test of sphericity were performed to evaluate the suitability of the designed variable set for factor analysis. Principal component analysis was applied to extract factors with eigenvalues greater than 1 using the maximum variance rotation method. Internal consistency and retest reliability were also evaluated to test reliability.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e\"},{\"header\":\"3. Results\",\"content\":\"\\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.1 Characteristics of study participants\\u003c/h2\\u003e \\u003cp\\u003eA total of 212 questionnaires were distributed, of which 206 were valid, resulting in a 77.2% recovery rate. As shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e, 51.5% of participants were 26\\u0026ndash;30 years old, 40.8% held a bachelor\\u0026rsquo;s degree, 63.1% lived in urban areas, 63.1% were first-time pregnant, 76.2% had planned their pregnancy, 68% had not contacted or participated in the \\u0026lsquo;mother class\\u0026rsquo; or related pregnancy health lectures and 85.9% had pregnancy-related comorbidities or complications.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSocio-demographic characteristics of participants\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eVariables\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFrequency\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003ePercentage(%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e18\\u0026ndash;25\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e26\\u0026ndash;30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e106\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e51.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e31\\u0026ndash;35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e36\\u0026ndash;40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e41\\u0026ndash;45\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eEthnicity\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHan Chinese\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e171\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e83\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMinority\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e17\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eLevel of education\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eJunior high school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e28\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSecondary school\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e38\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eJunior college\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e47\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e22.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e84\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e40.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree/ above\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePlace of Residence\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRural\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCounty\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e17\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCity\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e130\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e63.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eNumber of births\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFirst child\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e130\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e63.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSecond child\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e28.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eThird child\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOver three births\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eProduction methods/expected production methods\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal delivery\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e142\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e68.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCesarean section\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e64\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e31.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePlanned pregnancy or not\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e49\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e157\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e76.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eCurrent month of pregnancy or postpartum time\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e28-32w\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e33-37w\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e16\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e38-42w\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eWithin 1 week postpartum\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e102\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e49.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eOccupation\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUnemployed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSelf-employed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e29\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInstitution/enterprise employee\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e71\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFreelance\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e16\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFinance/sales/business/service worker\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e26\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOthers\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eMonthly household income (per capita)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;1500\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1501\\u0026thinsp;~\\u0026thinsp;3000\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e38\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3001\\u0026thinsp;~\\u0026thinsp;5000\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e82\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026gt;\\u0026thinsp;5000\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e79\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e38.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePayment of medical expenses\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOut-of-pocket expenses\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e37\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNew rural cooperative medical insurance\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e51\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBasic medical insurance for urban workers\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e90\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e43.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBasic medical insurance for urban residents\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOther\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eFamily members who are medical workers\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e56\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e27.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e150\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e72.8\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eMain source of knowledge about VTE\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDoctor\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e81\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFriends, relatives or other patients\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.7\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInternet/TV\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e77\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e37.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePamphlets/posters\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eHad contact with or participated in \\u0026ldquo;Mom\\u0026rsquo;s Class\\u0026rdquo; or related pregnancy health seminars\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e140\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e68\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e66\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e32\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003ePregnancy-related comorbidities or complications\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNo\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e177\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e85.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e29\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.2 Item selection\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec13\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.2.1 Discrimination analysis\\u003c/h2\\u003e \\u003cp\\u003eIn this study, the sample questionnaire scores were calculated and then ranked from highest to lowest. Taking 27% of the effective investigation number as the critical value (206 \\u0026times; 27% = 55.62). The top 56 respondents in terms of total score were considered the high group, and the bottom 56 respondents were considered the low group.\\u003c/p\\u003e \\u003cp\\u003eTwo independent samples \\u003cem\\u003et\\u003c/em\\u003e-tests were conducted to analyse the specific item scores of both groups. The results showed that the critical ratio for 32 items (84.21% of the 38 items in total) in the first draft of the questionnaire had \\u003cem\\u003et\\u003c/em\\u003e\\u0026thinsp;\\u0026gt;\\u0026thinsp;3.000 and \\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05, indicating good discrimination for most items. However, for items A1.1, A1.2, A1.4, A2.1 and B4.3, the critical ratio was \\u003cem\\u003et\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;3.000 but \\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05. As a result, these items were retained for further statistical analysis. Item A2.3, with a critical ratio of \\u003cem\\u003et\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;3.000 and \\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05, was deleted\\u003csup\\u003e[\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec14\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.2.2 Related analysis\\u003c/h2\\u003e \\u003cp\\u003eThe Pearson correlation coefficient was calculated for each item in relation to the total questionnaire score. A higher correlation coefficient indicates that the item better represents the overall questionnaire\\u003csup\\u003e[\\u003cspan additionalcitationids=\\\"CR20\\\" citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]\\u003c/sup\\u003e. The Pearson correlation coefficients in the first draft of the questionnaire ranged from 0.185 to 0.691, indicating positive correlations. Although the correlation coefficients for items A1.1, A1.2, A1.3, A1.4, A2.1, B4.3 and B4.4 were below 0.300, all items were statistically significant (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05). Therefore, 37 items from the first draft of the questionnaire were retained for further testing in the subsequent factor analysis.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.3 Exploratory factor analysis\\u003c/h2\\u003e \\u003cp\\u003eIn this study, the KMO test and Bartlett\\u0026rsquo;s test of sphericity were used to assess the suitability of the designed variable set for factor analysis\\u003csup\\u003e[\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e]\\u003c/sup\\u003e. Items meeting the following criteria were retained: (a) eigenvalues\\u0026thinsp;\\u0026gt;\\u0026thinsp;1, (b) cumulative variance contribution\\u0026thinsp;\\u0026gt;\\u0026thinsp;50% and (c) absolute loadings\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.50.\\u003c/p\\u003e \\u003cp\\u003eBased on the sample data, EFA was first conducted on the knowledge and practice dimensions. The attitude dimension was constructed based on HBM theory, which divides an individual\\u0026rsquo;s health attitudes into the following six aspects: (1) perceived susceptibility to disease, (2) perceived severity of disease, (3) perceived benefits of health behaviours, (4) perceived barriers to health behaviours, (5) self-efficacy and (6) cues to action\\u003csup\\u003e[\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]\\u003c/sup\\u003e. Since secondary indicators are clearly defined, EFA was not conducted for the attitude dimension. Instead, CFA was conducted on the attitude dimension using Amos 26.0 software. This analysis evaluated the fit of the attitude dimension questionnaire against the actual measurement data to test its correctness.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec16\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.3.1 Knowledge dimension\\u003c/h2\\u003e \\u003cp\\u003eThe KMO value for the knowledge dimension was 0.751, which is greater than 0.7. Bartlett\\u0026rsquo;s test of sphericity yielded a value of 429.211, with 28 degrees of freedom and \\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.000, indicating a significant difference and confirming that the data was suitable for EFA. Using PCA with maximum variance rotation, factors with eigenvalues\\u0026thinsp;\\u0026gt;\\u0026thinsp;1 were extracted. The cumulative variance contribution was 54.402%, meeting the requirement of a cumulative variance contribution rate\\u0026thinsp;\\u0026gt;\\u0026thinsp;50.00%\\u003csup\\u003e[\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]\\u003c/sup\\u003e. This result indicates that the data are suitable for factor analysis.\\u003c/p\\u003e \\u003cp\\u003eAs shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e, the factor analysis results align with the scale dimensions defined by the research design. Furthermore, the absolute values of the factor loadings for each item were all greater than 0.5, indicating that the scale has high validity and is effective\\u003csup\\u003e[\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eRotated factor loading matrix and commonality for exploratory factor analysis of the knowledge dimension\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eSubject\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c3\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor loadings\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor 1\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFactor 2\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.619\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA1.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.809\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA1.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.528\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA1.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.777\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA2.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.828\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA2.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.855\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA2.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.659\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eA2.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.564\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eThere were two initial secondary indicators for the knowledge dimension of the questionnaire in this study. After conducting EFA, these two indicators were renamed based on specialised knowledge. Factor 1 includes four items (A1.5, A1.6, A2.1 and A2.2), while Factor 2 includes four items (A1.1, A1.2, A1.3 and A1.4). The items were re-numbered, and the final knowledge section of the questionnaire consists of two dimensions and eight items.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.3.2 Practice dimension\\u003c/h2\\u003e \\u003cp\\u003eThe KMO value for the behavioural dimension was 0.901, which is greater than 0.7. Bartlett\\u0026rsquo;s test of sphericity yielded a value of 1235.238, with 36 degrees of freedom and \\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;=\\u0026thinsp;0.000, indicating a significant difference and confirming the suitability of the data for EFA. PCA and maximum variance rotation were used to extract factors with eigenvalues\\u0026thinsp;\\u0026gt;\\u0026thinsp;1 from the scale. The cumulative variance contribution rate was 73.512%, meeting the requirement of a cumulative variance contribution rate\\u0026thinsp;\\u0026gt;\\u0026thinsp;50.00% in PCA\\u003csup\\u003e[\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eAs shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e, the factor analysis results align with the scales and dimensions defined in the research design. The absolute values of the factor loadings for each item were all greater than 0.5, indicating the high validity and reliability of the questionnaire\\u003csup\\u003e[\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eRotated factor loading matrix and commonality for exploratory factor analysis of the practice dimension\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eSubject\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c3\\\" namest=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor loadings\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFactor 1\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFactor 2\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.76\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.797\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.829\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.838\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.767\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC1.6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.777\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC2.1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.813\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC2.2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.882\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eC2.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.789\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.4 Reliability analysis\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec19\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.4.1 Internal consistency reliability\\u003c/h2\\u003e \\u003cp\\u003eIn this study, questionnaires were used to measure key factors. Verifying the data quality of measurement is essential for meaningful subsequent analysis. The internal consistency of each dimension was first analysed using Cronbach\\u0026rsquo;s coefficient reliability. The overall reliability of the questionnaire and the reliability coefficients for the first-level dimensions are 0.736, 0.888, 0.917 and 0.913, respectively, all in the range of 0.7\\u0026ndash;1. This indicates that the questionnaires used in this study have good internal consistency and reliability\\u003csup\\u003e[\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e]\\u003c/sup\\u003e. In summary, the study results passed the confidence test.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec20\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.4.2 Test-retest reliability\\u003c/h2\\u003e \\u003cp\\u003eIn this study, 30 pregnant women who participated in the initial survey were selected for a retest 7 to 10 days later. The results showed a test-retest reliability of approximately 0.994 for the total questionnaire. The test-retest reliability for all dimensions was \\u0026gt;\\u0026thinsp;0.70, with statistical significance (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.01) observed in each case. This indicates good stability of the questionnaire\\u003csup\\u003e[\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec21\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e3.5 Validity\\u003c/h2\\u003e \\u003cdiv id=\\\"Sec22\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.5.1 Content validity\\u003c/h2\\u003e \\u003cp\\u003eA 5-point Likert scale was used, ranging from very unimportant (1 point) to very important (5 points). Content validity was assessed using the importance scores from an expert inquiry questionnaire: 1 point\\u0026thinsp;=\\u0026thinsp;very unimportant, 2 points\\u0026thinsp;=\\u0026thinsp;unimportant, 3 points\\u0026thinsp;=\\u0026thinsp;uncertain, 4 points\\u0026thinsp;=\\u0026thinsp;important and 5 points\\u0026thinsp;=\\u0026thinsp;very important. The I-CVI ranged from 0.87 to 1.00, and the S-CVI was 0.96, indicating good content validity of the questionnaire\\u003csup\\u003e[\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec23\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003e3.5.2 Structural validity\\u003c/h2\\u003e \\u003cp\\u003eAmos 26.0 statistical software was used to construct a model using the maximum likelihood estimation method. CFA was conducted on each of the three dimensions of the questionnaire to test its structural validity.\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe results of the model fitting by the CFA of the knowledge dimensions are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e \\u003cb\\u003e(a)\\u003c/b\\u003e, with χ\\u003csup\\u003e2\\u003c/sup\\u003e/df\\u0026thinsp;=\\u0026thinsp;1.011, less than 3, GFI\\u0026thinsp;=\\u0026thinsp;0.978, AGFI\\u0026thinsp;=\\u0026thinsp;0.958, RMSEA\\u0026thinsp;=\\u0026thinsp;0.007, less than 0.050, NFI\\u0026thinsp;=\\u0026thinsp;0.956, IFI\\u0026thinsp;=\\u0026thinsp;0.998, CFI\\u0026thinsp;=\\u0026thinsp;0.998. The results demonstrated good structural validity of the knowledge dimension of VTE prevention\\u003csup\\u003e[\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]\\u003c/sup\\u003e.\\u003c/p\\u003e \\u003cp\\u003eThe results of the initial fitted model for the CFA of attitude dimensions are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e \\u003cb\\u003e(b)\\u003c/b\\u003e,χ\\u003csup\\u003e2\\u003c/sup\\u003e/df\\u0026thinsp;=\\u0026thinsp;1.811, GFI\\u0026thinsp;=\\u0026thinsp;0.88, AGFI\\u0026thinsp;=\\u0026thinsp;0.837, RMSEA\\u0026thinsp;=\\u0026thinsp;0.063, NFI\\u0026thinsp;=\\u0026thinsp;0.881, IFI\\u0026thinsp;=\\u0026thinsp;0.943, CFI\\u0026thinsp;=\\u0026thinsp;0.942, the ideal standard, the overall model fit is good\\u003csup\\u003e[\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]\\u003c/sup\\u003e. Suggesting that the VTE prevention attitude dimension based on HBM has good construct validity.\\u003c/p\\u003e \\u003cp\\u003eThe results of the initial fitting model for the CFA of the practice dimensions are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e \\u003cb\\u003e(c)\\u003c/b\\u003e, χ\\u003csup\\u003e2\\u003c/sup\\u003e/df\\u0026thinsp;=\\u0026thinsp;3.972, GFI\\u0026thinsp;=\\u0026thinsp;0.94, AGFI\\u0026thinsp;=\\u0026thinsp;0.895, RMSEA\\u0026thinsp;=\\u0026thinsp;0.082, NFI\\u0026thinsp;=\\u0026thinsp;0.951, IFI\\u0026thinsp;=\\u0026thinsp;0.971, CFI\\u0026thinsp;=\\u0026thinsp;0.971, all within the ideal range, the overall fit of the model was better\\u003csup\\u003e[\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e]\\u003c/sup\\u003e.The results showed better structural validity of the practice dimension of VTE prevention.\\u003c/p\\u003e \\u003cp\\u003eThis study validated the questionnaire structure through reliability and validity testing. The final questionnaire contains 3 primary indicators, 10 secondary indicators, and a total of 37 items. Please refer to the supplementary materials for the questionnaire.\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e\"},{\"header\":\"4. Discussion\",\"content\":\"\\u003cp\\u003eSpecial physiological and anatomical changes occur during pregnancy and puerperium, making perinatal pregnant women a high-risk group for VTE. In addition, once the thrombus falls off and develops into pulmonary embolism, it can endanger fetal growth and development, and even lead to maternal and fetal death\\u003csup\\u003e[\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e]\\u003c/sup\\u003e. However, most assessment tools for VTE prevention behaviors in high-risk populations are in the surgical field\\u003csup\\u003e[\\u003cspan additionalcitationids=\\\"CR30\\\" citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e]\\u003c/sup\\u003e, and relatively few VTE-KAP questionnaires are applicable to maternity.\\u003c/p\\u003e \\u003cp\\u003eRegarding the study of the VTE-KAP questionnaire, the questionnaire designed by Korean researcher Kim ES\\u003csup\\u003e[\\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e]\\u003c/sup\\u003e has 66 items. The Cronbach\\u0026rsquo;s alpha coefficients in this study were all greater than 0.800, indicating good reliability. However, subsequent research found that the questionnaire had too many items, which could easily cause the respondents to lose patience during the questionnaire filling process and result in data bias. In a survey study of VTE cognition in the Yemeni region, the overall Cronbach\\u0026rsquo;α value was 0.766, there was a lack of awareness of VTE and its prevention\\u003csup\\u003e[\\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e]\\u003c/sup\\u003e. Korean researchers HJ Yang et al.\\u003csup\\u003e[\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e]\\u003c/sup\\u003e independently designed a questionnaire for patients undergoing lower limb surgery in orthopedics. The questionnaire has 15 items in the knowledge dimension and 25 items in the attitude dimension. The Cronbach\\u0026rsquo;s alpha value is 0.67. The practice dimensions were scored as a VAS score on a 10-cm parallel line. The respondent\\u0026rsquo;s choice of cm value is recorded as the score. The higher the score, the better the behavior of preventing venous thromboembolism. However, the practice dimension of the scale was not designed with specific survey questions. The use of VAS scoring is easily influenced by individual subjective feelings, resulting in data bias. The VTE prevention survey questionnaire developed by Chinese researcher Cai Yanting\\u003csup\\u003e[\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e]\\u003c/sup\\u003e is mainly divided into three dimensions: knowledge (12 items), attitude (8 items), and practice (10 items). The Cronbach\\u0026rsquo;s alpha coefficients of this study are all greater than 0.800, with a split half reliability of 0.754\\u0026ndash;0.823, indicating good reliability. The I-CVI is 0.867-1.000 and S-CVI is 0.927, indicating high content validity. However, the scale only includes three items for risk factors: long-term bed rest, trauma, and surgery. The risk factors for VTE in pregnant women, such as assisted reproductive technology, have not been addressed.\\u003c/p\\u003e \\u003cp\\u003eThe aforementioned survey questionnaires are mainly divided into three dimensions: knowledge, attitude and practice. However, most are designed for orthopedic patients or other populations, and they do not detail the process of questionnaire development and validation. They are also not suitable for directly assessing the VTE prevention status in pregnant and postpartum women. In contrast, the questionnaire compiled in this study contains 3 primary dimensions and 10 secondary dimensions, totaling 37 items. The scope involved is relatively comprehensive. The Cronbach\\u0026rsquo;s alpha coefficients of this study were all between 0.7-1, indicating good reliability of the questionnaire. Meanwhile,the I-CVI is 0.87-1.00 and S-CVI is 0.96, indicating good content validity of the questionnaire. In addition, the factor distribution basically conforms to the theoretical framework in the design of the scale. On this basis, the confirmatory factor analysis was conducted. The results showed that the model fits well, indicating that the structural validity of the study scale was good. The final result is the KAP-VTE questionnaire, which consists of 3 primary indicators, 10 secondary indicators and 37 items was finally formed. The questionnaire included basic knowledge of VTE, clinical manifestations, risk factors, preventive measures, disease perception, and self-efficacy. It is more suitable for perinatal maternal population than the assessment tools of previous studies.\\u003c/p\\u003e \\u003cp\\u003eThis study is based on the KAP theory and combined with the HBM model to design a questionnaire. This questionnaire is a scientific supplement to existing VTE prevention assessment tools for pregnant women. It focuses on evaluating the beliefs of pregnant women in preventing VTE. Compared to the previous division of various dimensions, it is more scientific and detailed. It is more suitable for the investigation of the current status of VTE prevention in perinatal pregnant women. In addition, this questionnaire can also help medical personnel quickly assess the knowledge, attitude, and practical level of VTE in pregnant women. Through demographic analysis of the surveyed population, it is helpful for medical personnel to develop more targeted health education. Researchers can use this questionnaire to understand the prevention of VTE among pregnant women from different regions, cultural backgrounds, and gestational weeks. Provide basic data for subsequent research. Therefore, this study has significant clinical implications.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec25\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e4.1 Limitations of the studytions\\u003c/h2\\u003e \\u003cp\\u003eThe pregnant women in this study all came from a tertiary hospital in Kunming, China, and the sample was relatively limited. Lack of sample surveys from other regions or countries. If further research is to be conducted, multi center large sample data will be required.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"5. Conclusion\",\"content\":\"\\u003cp\\u003eSpecial physiological and anatomical changes occur during pregnancy and puerperium, making perinatal women a high-risk group for VTE. Additionally, if a thrombus detaches and develops into a pulmonary embolism, it can endanger fetal growth and development and even lead to maternal and foetal mortality\\u003csup\\u003e[\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e]\\u003c/sup\\u003e. Most VTE prevention assessment tools for high-risk populations are concentrated in the surgical field\\u003csup\\u003e[\\u003cspan additionalcitationids=\\\"CR30\\\" citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e]\\u003c/sup\\u003e, with relatively few VTE-KAP questionnaires designed for maternity.\\u003c/p\\u003e \\u003cp\\u003eRegarding the development of the VTE-KAP questionnaire, a questionnaire designed by Korean researcher Kim ES\\u003csup\\u003e[\\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e]\\u003c/sup\\u003e has 66 items,with Cronbach\\u0026rsquo;s alpha coefficients\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.800, indicating good reliability. However, subsequent research revealed that the questionnaire contained too many items, which could lead to respondent fatigue and data bias. In a survey of VTE cognition in the Yemeni region, the overall Cronbach\\u0026rsquo;s alpha value was 0.766, highlighting a lack of awareness regarding VTE and its prevention\\u003csup\\u003e[36]\\u003c/sup\\u003e. Korean researchers Yang et al.\\u003csup\\u003e[37]\\u003c/sup\\u003e designed a questionnaire for patients undergoing lower limb surgery in orthopaedics. The questionnaire includes 15 items in the knowledge dimension and 25 items in the attitude dimension. The Cronbach\\u0026rsquo;s alpha value is 0.67. For the practice dimensions, scores were recorded using a VAS score on a 10-cm parallel line. The respondent\\u0026rsquo;s choice of cm value is recorded as the score, with higher scores indicating better VTE prevention behaviours. However, the practice dimension lacks specific survey questions, and the use of VAS scoring is prone to individual subjective influences, resulting in potential data bias. The VTE prevention survey questionnaire developed by Chinese researcher Cai Yanting\\u003csup\\u003e[38]\\u003c/sup\\u003e comprises three dimensions \\u0026ndash; knowledge (12 items), attitude (8 items) and practice (10 items) \\u0026ndash; with Cronbach\\u0026rsquo;s alpha coefficients\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.800 and a split-half reliability of 0.754\\u0026ndash;0.823, indicating good reliability. The I-CVI ranges from 0.867 to 1.000, while the S-CVI is 0.927, indicating high content validity. However, the scale includes only three items for risk factors: long-term bed rest, trauma and surgery. It does not address other risk factors for VTE in pregnant women, such as assisted reproductive technology.\\u003c/p\\u003e \\u003cp\\u003eThe aforementioned survey questionnaires are mainly divided into the KAP dimensions. However, most are designed for orthopaedic patients or other populations, lacking a detailed development and validation process. They are also not suitable for directly assessing VTE prevention in pregnant and postpartum women. Conversely, the questionnaire developed in this study contains three primary dimensions, 10 secondary dimensions and a total of 37 items. The scope involved is relatively comprehensive. The Cronbach\\u0026rsquo;s alpha coefficients for this study ranged from 0.7 to 1, indicating good reliability. Meanwhile, the I-CVI ranges from 0.87 to 1.00, and the S-CVI is 0.96, indicating good content validity. Moreover, the factor distribution conforms to the theoretical framework used in the scale design. Therefore, CFA was conducted. The results showed that the model fits well, indicating that the structural validity of the study scale is strong. The final KAP-VTE questionnaire consists of three primary indicators, 10 secondary indicators and 37 items. The questionnaire encompasses basic knowledge of VTE, clinical manifestations, risk factors, preventive measures, disease perception and self-efficacy. This makes it more suitable for the perinatal women population than the assessment tools in previous studies.\\u003c/p\\u003e \\u003cp\\u003eThis study is based on the KAP theory, which was combined with the HBM to design a questionnaire. This questionnaire serves as a scientific supplement to existing VTE prevention assessment tools for pregnant women, focusing on evaluating their beliefs regarding VTE prevention. Compared to the previous division of various dimensions, it is more scientific and detailed. It is more suitable for investigating the current status of VTE prevention in perinatal women. Furthermore, this questionnaire enables medical professionals to quickly assess the KAP level of VTE in pregnant women. Through demographic analysis of the surveyed population, medical professionals can develop more targeted health education strategies. Researchers can use this questionnaire to examine VTE prevention among pregnant women from diverse regions, cultural backgrounds and gestational stages, providing essential data for future research. Therefore, this study has significant clinical implications.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec27\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003e4.1 Limitations of the study\\u003c/h2\\u003e \\u003cp\\u003eThe participants in this study were all from a tertiary hospital in Kunming, China, resulting in a relatively limited sample size. Additionally, there was a lack of sample data from other regions or countries. For future research, a multi-centre study with a large sample size will be necessary.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"6. Conclusion\",\"content\":\"\\u003cp\\u003eThis study is based on the KAP theory, combined with the HBM theory, to develop the VTE-KAP questionnaire, which has been verified to have good reliability and validity. This questionnaire scientifically reflects the KAP regarding VTE prevention among pregnant women during the perinatal period. It also provides a scientific basis for developing targeted health education programmes for clinical practice.\\u003c/p\\u003e \"},{\"header\":\"Declarations\",\"content\":\"\\u003ch2\\u003eAuthors\\u0026rsquo; contributions\\u003c/h2\\u003e\\n\\u003cp\\u003eCXZ contributed to the writing of the original draft, reviewed and edited the manuscript, conceptualised the study, curated the data, and validated the research findings. FFQ assisted in literature collection, and thesis revision. XZ was responsible for project investigation, and data curation. NZ contributed to the manuscript by reviewing and editing, provided supervision, supplied resources, administered the project, acquired funding, and helped conceptualise the study. All authors read and wrote the manuscript as well as approved the manuscript submission.\\u003c/p\\u003e\\n\\u003ch2\\u003eCompeting interest\\u003c/h2\\u003e\\n\\u003cp\\u003eThe authors declare no competing interests.\\u003c/p\\u003e\\n\\u003ch2\\u003eEthics approval and consent to participate\\u003c/h2\\u003e\\n\\u003cp\\u003eThe study was approved by the Ethics Review Committee of the Third People\\u0026rsquo;s Hospital of Yunnan Province (No. 2023KY219). All participants have completed an informed consent form to conduct the study and all scales have been completed anonymously. A statement to confrm that all methods were carried out in accordance with relevant guidelines and regulations - Declaration of Helsinki. The study did not involve minors.\\u003c/p\\u003e\\n\\u003ch2\\u003eAcknowledgements\\u003c/h2\\u003e\\n\\u003cp\\u003eWe would like to thank all of the participants involved in this research for their time and contributions.\\u003c/p\\u003e\\n\\u003ch2\\u003eAvailability of data and materials\\u003c/h2\\u003e\\n\\u003cp\\u003eData and other materials are available upon request from the corresponding authors.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eObstetrics and Gynecology Section of the Chinese Medical Association, Huixia Y, Zilian W, et al. Expert consensus on prevention and treatment of venous thromboembolism in pregnancy and puerperium[J]. Chin J Obstet Gynecol. 2021;56(4):236\\u0026ndash;43.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGu WR, Li XT. Strategies for prevention and treatment of pregnancy-related venous thromboembolism and practice in China[J]. 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Educ Psychol Meas. 1993;53(2):369\\u0026ndash;78.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDiamantopoulos A, Sarstedt M, Fuchs C, et al. Guidelines for choosing between multi-item and single-item scales for construct measurement: a predictive validity perspective[J]. J Acad Mark Sci. 2012;40:434\\u0026ndash;49.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDemirtaş A, Akbayrak N. Development of an assessment scale for treatment compliance in type 2 diabetes Mellitus in Turkish population: psychometric evaluation. Int J Nurs Sci. 2017;4(3):244\\u0026ndash;51.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhang WD. Study on the Dimensional Structure of the Coping Scale (COPE)[J]. Acta Physiol Sinica, 2001(01): 55\\u0026ndash;62.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJuhola J, Arokoski JPA, Ervasti J, et al. Internal consistency and factor structure of Jenkins Sleep Scale: cross-sectional cohort study among 80 000 adults[J]. BMJ open. 2021;11(1):e043276.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLiu QX, Wang W, Sun YH. Investigation and Analysis of the Current Status of Perioperative Nurses' Knowledge, Attitudes, and Practices in Preventing Venous Thromboembolism in the Operating Room[J]. Chin J Mod Nurs. 2021;27(28):3809\\u0026ndash;15.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWu BJ, Lan TH, Hu TM, et al. Validation of a five-factor model of a Chinese Mandarin version of the Positive and Negative Syndrome Scale (CMV-PANSS) in a sample of 813 schizophrenia patients[J]. Schizophr Res. 2015;169(1\\u0026ndash;3):489\\u0026ndash;90.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhang C, Zhou YX. Analysis of the misapplication of content validity index in the literature of nursing measurement tools in China[J]. J Nurs 2020,35(04):86\\u0026ndash;8.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKalaitzopoulos DR, Panagopoulos A, Samant S, et al. Management of venous thromboembolism in pregnancy[J]. Thromb Res. 2022;211:106\\u0026ndash;13.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eZhang ZC, Li QL, Zhou PH. Prevention of perioperative venous thromboembolism in endoscopic diagnosis and treatment [J]. Chin J Dig Endoscopy. 2023;40(1):34\\u0026ndash;8.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eShi YQ, Li N, Yan L et al. Development and reliability test of venous thromboembolism risk assessment scale for adult burn patients[J]. J Army Med Univ 2023,45(12):1328\\u0026ndash;36.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eXu H, Xu SF, Yuan XY, et al. Analysis of the incidence of perioperative venous thromboembolism in urological patients[J]. Chin J Urol. 2023;44(3):195\\u0026ndash;9.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKim ES, Kim HY. Knowledge, awareness and risk of occurrence of venous thromboembolism of perinatal women[J]. Korean J Women Health Nurs. 2019;25(2):154\\u0026ndash;68.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHalboup AM, Alzoubi KH, Mohamed Ibrahim MI, Syed Sulaiman SA, Almahbashi Y, Al-Arifi S, Mohammed S, Othman G. Awareness and Perception of Hospitalized Patients on Thromboembolism and Thromboprophylaxis: A Cross-Sectional Study in Sana\\u0026rsquo;a-Yemen. Patient Prefer Adherence. 2022;16:1649\\u0026ndash;61.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYang HJ, Kang HY. Knowledge, health belief, and preventive behavioral intention related to venous thromboembolism (VTE) of the patients with lower limb musculoskeletal system disorders[J]. J Korean Acad Soc Nurs Educ. 2013;19(4):531\\u0026ndash;41.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCai YT. Investigation on Knowledge, Willingness and Behavior of Venous Thromboembolism Prevention in Orthopedic Inpatients[D]. Nanchang University; 2018.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"},{\"header\":\"Scheme\",\"content\":\"\\u003cp\\u003eScheme 1 is available in the Supplementary Files section.\\u003c/p\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Perinatal Maternity, Venous Thromboembolism, Reliability, Validity, Questionnaire\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-5768046/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-5768046/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eVenous thromboembolism (VTE) is a significant complication among perinatal women. However, current tools for assessing VTE prevention are not suitable for pregnant women. In this study, we aim to develop and validate a VTE prevention knowledge, attitude and practice (VTE-KAP) questionnaire tailored to this population.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eThis study was conducted in two phases. Phase 1 involved creating a preliminary item pool through a literature review and group discussions, followed by expert consultations and a pre-survey. Phase 2 involved validating the questionnaire, which began by screening the items using correlation and factor analyses. Reliability was assessed using Cronbach\\u0026rsquo;s alpha coefficient and retest reliability. Furthermore, structural validity was evaluated through exploratory and confirmatory factor analyses.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eThe finalised VTE-KAP questionnaire consists of 37 items. The Kaiser\\u0026ndash;Meyer\\u0026ndash;Olkin measure of sampling adequacy was 0.751 for the knowledge dimension and 0.901 for the practice dimension. Bartlett\\u0026rsquo;s test for sphericity confirmed statistical significance (\\u003cem\\u003ep\\u003c/em\\u003e\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). The Cronbach\\u0026rsquo;s alpha coefficient was 0.913. Test-retest reliability for the overall questionnaire showed high stability, with coefficients for all dimensions exceeding 0.9 (0.993, 0.991, 0.988 and 0.994). Confirmatory factor analysis demonstrated the robust structural validity of the scale.\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e \\u003cp\\u003eThe VTE-KAP questionnaire is effective and reliable in psychometrics. It can scientifically evaluate the KAP related to VTE prevention in pregnant women.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Development and Validation of a Knowledge, Attitude and Practice Questionnaire for Venous Thromboembolism Prevention in Perinatal Women\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-01-08 17:45:20\",\"doi\":\"10.21203/rs.3.rs-5768046/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"8fade051-279d-4def-a7cb-f3ee13e067e4\",\"owner\":[],\"postedDate\":\"January 8th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2025-01-08T17:45:22+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2025-01-08 17:45:20\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-5768046\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-5768046\",\"identity\":\"rs-5768046\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}