Nursing Assistants' Knowledge, Attitudes and Training Needs Regarding Urinary Incontinence in Nursing Homes: a Mixed-methods Study

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2023 Jan 22

PMID 36683023

Authors

Lulu Liao

Hui Feng

Jingjing Jiao

Yinan Zhao

Hongting Ning

Affiliations

Soon will be listed here.

Abstract

Background: Urinary incontinence is an increasingly common problem, especially among older people in nursing homes. Nursing assistants are the leading workforce in nursing homes, and their knowledge and attitudes regarding urinary incontinence have garnered considerable attention in the context of aging in China. However, most previous studies on this issue have focused on registered nurses. This study aimed to explore nursing assistants' knowledge, attitudes and training needs with regard to urinary incontinence.

Methods: We conducted a two-part mixed-methods study. After institutional manager approval, we surveyed the knowledge and attitudes of 509 nursing assistants regarding urinary incontinence. We carried out semi-structured interviews with 40 nursing assistants to elicit detailed information on training needs.

Results: In general, knowledge about urinary incontinence was poor (14.00 ± 4.18), although attitudes were primarily positive (35.51 ± 3.19). Most nursing assistants were very willing to learn more about urinary incontinence (93.9%, 478/509), but time constraints and low educational background may be barriers to learning motivation. The three preferred training styles among nursing assistants were face-to-face guidance from a mentor, training combining theory with practice, and online video training.

Conclusions: Chinese nursing assistants had poor knowledge but positive attitudes toward urinary incontinence. Facility managers should focus on developing training and learning mechanisms regarding urinary incontinence. It is important to adopt diverse training styles according to the actual situation of nursing homes.

Citing Articles

Knowledge, attitude, and practice towards knee osteoarthritis: a regional study in Chinese patients.

Liu T, Lin C, Shi H, Ren Q, Lin X Clin Rheumatol. 2025; .

PMID: 40067574 DOI: 10.1007/s10067-025-07385-0.

Healthcare professionals' knowledge, attitude and practice towards ischemic bowel disease.

Ying M, Li Y, Chen Y, Fu M, Zhang G World J Gastrointest Surg. 2025; 17(2):96493.

PMID: 40061978 PMC: 11885997. DOI: 10.4240/wjgs.v17.i2.96493.

Knowledge, attitudes and practices of ICU nurses regarding postextubation dysphagia in tracheal intubation patients in 25 hospitals in China: A multicentre cross-sectional survey.

Zheng Y, Cui N, Sha R, Yu W, Tan Y, Guan X Nurs Crit Care. 2025; 30(2):e13280.

PMID: 40033478 PMC: 11876486. DOI: 10.1111/nicc.13280.

Knowledge, attitude, and practice of aesthetic medicine practitioners towards laser and/or light therapy for hypertrophic scars.

Yang W, Yang L, Li H, Cheng X Sci Rep. 2025; 15(1):3237.

PMID: 39863619 PMC: 11762269. DOI: 10.1038/s41598-024-85037-0.

Knowledge, attitudes and practices regarding pulmonary rehabilitation among patients with chronic respiratory diseases: a cross-sectional questionnaire-based study in a tertiary hospital in China.

Su L, Wang L, Ding J, Zhang X, Wang R, Bai X BMJ Open. 2025; 15(1):e085944.

PMID: 39842929 PMC: 11784421. DOI: 10.1136/bmjopen-2024-085944.

References

Hunter K, Dahlke S . Nurse and Health Care Aide Knowledge of Urinary Continence Promotion and Management In Hospitalized Older People. J Wound Ostomy Continence Nurs. 2021; 48(5):435-439. DOI: 10.1097/WON.0000000000000794. View

Moyle W, Venturato L, Cooke M, Hughes J, van Wyk S, Marshall J . Promoting value in dementia care: staff, resident and family experience of the capabilities model of dementia care. Aging Ment Health. 2013; 17(5):587-94. DOI: 10.1080/13607863.2012.758233. View

Vethanayagam N, Orrell A, Dahlberg L, McKee K, Orme S, Parker S . Understanding help-seeking in older people with urinary incontinence: an interview study. Health Soc Care Community. 2016; 25(3):1061-1069. DOI: 10.1111/hsc.12406. View

Joo J, Hwang S, Abu H, Gallo J . An Innovative Model of Depression Care Delivery: Peer Mentors in Collaboration with a Mental Health Professional to Relieve Depression in Older Adults. Am J Geriatr Psychiatry. 2016; 24(5):407-16. PMC: 5116434. DOI: 10.1016/j.jagp.2016.02.002. View

Huang P, Luo K, Wang C, Guo D, Wang S, Jiang Y . Urinary Incontinence Is Associated With Increased All-Cause Mortality in Older Nursing Home Residents: A Meta-Analysis. J Nurs Scholarsh. 2021; 53(5):561-567. DOI: 10.1111/jnu.12671. View

Parra-Anguita L, Garcia-Fernandez F, Del-Pino-Casado R, Pancorbo-Hidalgo P . Knowledge about the Care of People with Alzheimer's Disease of the Nursing Staff of Nursing Homes in Spain. Int J Environ Res Public Health. 2019; 16(24). PMC: 6950273. DOI: 10.3390/ijerph16244907. View

Mukhalalati B, Taylor A . Adult Learning Theories in Context: A Quick Guide for Healthcare Professional Educators. J Med Educ Curric Dev. 2019; 6:2382120519840332. PMC: 6458658. DOI: 10.1177/2382120519840332. View

Michie S, van Stralen M, West R . The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011; 6:42. PMC: 3096582. DOI: 10.1186/1748-5908-6-42. View

Park S, De Gagne J, So A, Palmer M . Knowledge, attitudes, beliefs, and practices in registered nurses and care aids about urinary incontinence in Korean nursing homes: a cross-sectional survey. J Wound Ostomy Continence Nurs. 2015; 42(2):183-9. DOI: 10.1097/WON.0000000000000095. View

10.

Ostaszkiewicz J, Tomlinson E, Hunter K . The Effects of Education About Urinary Incontinence on Nurses' and Nursing Assistants' Knowledge, Attitudes, Continence Care Practices, and Patient Outcomes: A Systematic Review. J Wound Ostomy Continence Nurs. 2020; 47(4):365-380. DOI: 10.1097/WON.0000000000000651. View

11.

Milsom I, Gyhagen M . The prevalence of urinary incontinence. Climacteric. 2018; 22(3):217-222. DOI: 10.1080/13697137.2018.1543263. View

12.

Alzghoul B, Abdullah N . Pain Management Practices by Nurses: An Application of the Knowledge, Attitude and Practices (KAP) Model. Glob J Health Sci. 2016; 8(6):154-60. PMC: 4954874. DOI: 10.5539/gjhs.v8n6p154. View

13.

Terzoni S, Montanari E, Mora C, Destrebecq A . Urinary incontinence in adults: nurses' beliefs, education and role in continence promotion. A narrative review. Arch Ital Urol Androl. 2012; 83(4):213-6. View

14.

Yuan H, Williams B . Knowledge of urinary incontinence among Chinese community nurses and community-dwelling older people. Health Soc Care Community. 2009; 18(1):82-90. DOI: 10.1111/j.1365-2524.2009.00876.x. View

15.

Cacciari L, Kouakou C, Poder T, Vale L, Morin M, Mayrand M . Group-based pelvic floor muscle training is a more cost-effective approach to treat urinary incontinence in older women: economic analysis of a randomised trial. J Physiother. 2022; 68(3):191-196. DOI: 10.1016/j.jphys.2022.06.001. View

16.

Sackley C, Rodriguez N, Van Den Berg M, Badger F, Wright C, Besemer J . A phase II exploratory cluster randomized controlled trial of a group mobility training and staff education intervention to promote urinary continence in UK care homes. Clin Rehabil. 2008; 22(8):714-21. DOI: 10.1177/0269215508089058. View

17.

Kwong P, Cumming R, Chan L, Seibel M, Naganathan V, Creasey H . Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study. Age Ageing. 2010; 39(3):349-54. DOI: 10.1093/ageing/afq025. View

18.

Burke R, Werner R . Quality measurement and nursing homes: measuring what matters. BMJ Qual Saf. 2019; 28(7):520-523. PMC: 7235636. DOI: 10.1136/bmjqs-2019-009447. View

19.

Lin S, Wang R, Lin C, Chiang H . Competence to provide urinary incontinence care in Taiwan's nursing homes: perceptions of nurses and nurse assistants. J Wound Ostomy Continence Nurs. 2012; 39(2):187-93. DOI: 10.1097/WON.0b013e3182435700. View

20.

Yan F, Xiao L, Zhou K, Li Z, Tang S . Perceptions and help-seeking behaviours among community-dwelling older people with urinary incontinence: A systematic integrative review. J Adv Nurs. 2022; 78(6):1574-1587. DOI: 10.1111/jan.15183. View