Introduction: Kidney transplantation is the preferred treatment for End-Stage Renal Disease, and it is also the parenchymal organ transplantation with the earliest clinical development, the largest number of transplantation cases and the most mature technology¹. However, many reasons may lead to a decline in the nutritional status of kidney transplant recipients in the middle and later stages after transplantation², and good dietary behavior is an important basis for ensuring the nutritional status of patients after kidney transplantation³, and plays a crucial role in the recovery of patients' kidney function⁴. Based on the knowledge, belief and practice model, knowledge and attitude can affect the behavior of patients. This study focuses on the mediating role of dietary attitude between dietary knowledge and dietary behavior in kidney transplant recipients.
Methods: 289 kidney transplant recipients from four general hospitals were selected by convenient sampling method to conduct a questionnaire survey. The research tools mainly included self-designed general data questionnaire and Dietary Self-management Ability Scale. SPSS25.0 was used for statistical analysis, and model 4 in SPSS PROCESS was selected for mediating effect analysis, and P<0.05 was considered statistically significant.
Results:
(1) The median score of dietary knowledge dimension was 15 (P25=13, P75= 19), the median score of dietary attitude dimension was 37 (P25=35, P75=43) and the median score of dietary behavior dimension was 39 (P25=34.5, P75= 42).
(2) Dietary knowledge was positively correlated with dietary behavior (rs=0.362, P<0.001), dietary attitude was positively correlated with dietary behavior (rs=0.407, P<0.001), and dietary knowledge was positively correlated with dietary attitude (rs=0.385, P<0.001).
(3) The dietary attitude of renal transplant recipients not only positively predicted dietary behavior (β=0.319, P<0.001), but also played a partial mediating role between dietary knowledge and dietary behavior (β=0.110, P<0.001), with the mediating effect accounting for 29.33% of the total effect.
Conclusion: The dietary knowledge level of kidney transplant recipients is low, and the scores of dietary behavior and attitude are at a good level. Dietary attitude plays a partial mediating role between dietary knowledge and dietary behavior of kidney transplant recipients, suggesting that nurses can take appropriate measures to improve dietary attitude and knowledge level of kidney transplant recipients, so as to improve their dietary behavior and promote the recovery of renal function.

Keywords: kidney transplant; dietary behavior; dietary knowledge; dietary attitude; mediating effect
References:
[1] Global observatory on donation and transplantation[EB/OL]. http://www.transplant-observatory.org/summary/，2024-3-18.
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[4] Oste M, Gomes-Neto A W, Corpeleijn E, et al. Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients[J]. Am J Transplant, 2018,18(10):2523-2533.
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