Abstract

Objective: Art therapy has been proposed as a complementary approach to support psychosocial well-being in chronic disease management, but patients’ understanding and perceived acceptability of art therapy in type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to describe item-level knowledge, attitudes, and art-related behaviors regarding art therapy among patients with T2DM in Nanjing, China, and to explore factors associated with willingness to try art therapy. Methods: A cross-sectional questionnaire survey was conducted from January to April 2025 among patients with T2DM receiving care at the Department of Endocrinology, Taikang Xianlin Drum Tower Hospital, Nanjing, China. Demographic characteristics and KAP related to art therapy for diabetes were collected. Univariable and multivariable logistic regression analyses were performed to explore factors associated with willingness to try art therapy. Results: A total of 982 patients with T2DM were included in the final analysis (mean age 50.61 ± 13.25 years; 662 (67.41%) male). Of these, 427 patients (43.48%) believed that art therapy is effective for diabetes, whereas 839 (85.44%) reported a willingness to try art therapy. In exploratory item-level analyses, patients who perceived art therapy as effective differed from those who did not across multiple knowledge, attitude, and behavior-related items. In multivariable logistic regression, lower willingness to try art therapy was associated with female sex (versus male, aOR = 3.914, 95%CI = 2.309–6.634), older age (aOR = 1.025 per year, 95%CI = 1.002–1.048), being a farmer or manual worker (versus teacher/cadre/medical staff, aOR = 2.129, 95%CI = 1.125–4.031), being unmarried/divorced (versus married, aOR = 9.961, 95% CI = 4.478–22.155), having out-of-province household registration (versus within province, aOR = 2.542, 95%CI = 1.333–4.850), being covered by employee/basic medical insurance (versus public expense or the new rural cooperative medical scheme, aOR = 1.961, 95%CI = 1.126–3.415), having chronic diseases (versus without chronic diseases, aOR = 2.495, 95% CI = 1.451–4.288), and frequent smoking (versus never smoking, aOR = 11.896, 95% CI = 5.555–25.477). Conclusion: Despite heterogeneous understanding of art therapy, most patients with T2DM reported willingness to try it, indicating generally favorable perceived acceptability. Future studies should examine how this stated willingness can be translated into informed participation in appropriately designed programs and evaluate their feasibility, uptake, and potential benefits.

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