Knowledge, attitude, and practice toward post-stroke depression among stroke caregivers: a cross-sectional study and path analysis

Post-stroke depression (PSD) significantly affects stroke recovery, and caregivers play a crucial role in managing this condition. However, little is known about caregivers’ knowledge, attitude, and practice (KAP) regarding PSD in China. This study aims to evaluate the KAP of caregivers of stroke patients concerning PSD and identify factors influencing these dimensions. A cross-sectional study was conducted at the China Rehabilitation Research Center, Beijing. A total of 497 valid questionnaires, covering demographic information, knowledge, attitude, and practice related to PSD, were collected from caregivers of stroke patients. Statistical analysis included descriptive statistics, logistic regression, and structural equation modeling (SEM). The mean age of caregivers was 42.65 ± 13.97 years, with the majority being women (62.98%) and married (81.49%). The average knowledge score was 18.37 ± 9.77 (57.4% of the maximum score), indicating insufficient knowledge. The scores of attitude and practice were 33.17 ± 3.89 (82.92%) and 22.51 ± 3.13 (90.04%), respectively, indicating a positive attitude and favorable practice. Significant differences were found in knowledge based on gender, education, income, stroke duration, and whether patients had undergone depression screening. Knowledge was positively associated with attitude (OR = 1.11, 95% CI: 1.08–1.15, p < 0.001) and practice (OR = 1.07, 95% CI: 1.02–1.12, p = 0.006). SEM analysis revealed positive associations between knowledge, attitude, and practice (all p < 0.001), with knowledge and attitude influencing practice. Caregivers exhibited insufficient knowledge about PSD, particularly regarding the recognition of PSD symptoms, its potential severity (e.g., association with self-harm or suicidal tendencies), and appropriate management strategies, but displayed positive attitudes and practices. Factors like stroke duration, depression screening, and caregiver education significantly influenced these dimensions. These knowledge gaps may limit caregivers’ ability to identify and respond appropriately to PSD, despite their generally positive attitudes and practices. The findings suggest the need for targeted and structured educational interventions to improve caregivers’ ability to recognize and manage PSD, which may ultimately enhance patient outcomes and caregiving quality.