Table 1_Knowledge, attitudes, and practices regarding melasma among female patients.docx

Structural equation modeling showed that knowledge was directly associated with attitude (β = 0.153, p = 0.002) and practice (β = 0.492, p < 0.001), attitude was directly associated with practice (β = 0.357, p < 0.001), and knowledge was indirectly associated with practice through attitude (β = 0.054, p = 0.002). Multivariate logistic regression identified rural/suburban residence (OR = 0.546, 95%CI 0.363–0.820) and never using sun protection (OR = 0.384, 95%CI 0.176–0.837) as independent predictors of lower knowledge, whereas prior treatment-seeking predicted higher knowledge (OR = 2.079, 95%CI 1.230–3.515).

Each one-point increase in knowledge score (OR = 1.150, 95% CI 1.081–1.223, p < 0.001) and each one-point increase in attitude score (OR = 1.071, 95% CI 1.024–1.120, p < 0.001) were strong independent predictors of good practice. All three dimension scores were positively correlated (r = 0.145–0.390, all p ≤ 0.001).</p>Conclusion<p>Participants demonstrated knowledge scores below the scale midpoint, attitude scores in the lower half of the possible range, and practices indicating infrequent routine monitoring and active information seeking.

Feasible improvements may include structured, photoprotection-centered education with brief standardized counseling and digital follow-up, prioritizing groups with low sun-protection use and rural/suburban residence to improve long-term self-management behaviors.</p>