ArticlePloS one2025
Clinical nurses' knowledge, attitudes and practices regarding incontinence-associated dermatitis: A cross-sectional study from China.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To explore the current status of knowledge, attitudes, and practices (KAP) regarding incontinence-associated dermatitis (IAD) among clinical nurses in China and identify factors influencing these three aspects, this study adopted a cross-sectional design and was conducted in a tertiary hospital in Fujian Province, China, with 1,153 nurses completing the questionnaire. Primary outcome measures included nurses' IAD-related knowledge, attitude, and practice scores, with scoring rates of 70.6%, 90.9%, and 69.9% respectively; key low-scoring items in knowledge were "IAD care products" (2.04 ± 1.019) and "IAD assessment tools" (2.12 ± 0.923), while low-scoring practice items included "actively participating in IAD seminars" (60%) and "using IAD assessment tools" (66%). Demographic and professional information collected included gender, age, highest educational attainment, work experience, job position, job grade, department, wound/ostomy/incontinence (W/O/I) team membership, and participation in W/O/I care training. Results showed that clinical nurses had insufficient IAD knowledge (only 15.3% with high knowledge levels) and inadequate practices, but held positive attitudes (75.4% with positive attitudes). Notably, male nurses demonstrated more comprehensive IAD knowledge than female nurses (p < 0.05), though no significant gender difference was observed in practice (p = 0.883); this knowledge difference may be associated with male nurses' more frequent assignment to IAD-high-incidence departments (e.g., ICUs) and higher participation in W/O/I training. Factors influencing nurses' IAD-KAP included: 1) Common factors across KAP: job position (specialist nurses and head nurses performed better) and W/O/I team membership; 2) Dimension-specific factors: department affiliation (ICU nurses outperformed general ward nurses in knowledge and practice), participation in W/O/I training (improved knowledge and practice), gender (influencing knowledge only), and work experience (longer tenure correlated with more positive attitudes). Highest educational attainment was not a significant influencing factor, possibly due to inconsistent quality of part-time continuing education for nurses. In conclusion, participating nurses exhibited insufficient IAD knowledge and inadequate practices despite positive attitudes, presenting a notable "attitude-practice gap". Nursing administrators should develop targeted training (e.g., scenario-based training on IAD assessment tools and care products) and encourage female nurses to rotate in high-incidence departments (e.g., ICUs), strengthen resource allocation (e.g., ensuring supply of IAD care products) and promote W/O/I team construction, and optimize continuing education quality to address knowledge disparities, thereby enhancing nurses' understanding of IAD prevention and improving their related practices.
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