# Understanding the Relationship Between Chinese Nurses' Attitudes Toward Incontinence-Related Dermatitis and Achievement Motivation Through a Person-Centered Method: A Theory-Driven Cross-Sectional Study

## TL;DR

This study explores how Chinese nurses' attitudes toward preventing incontinence-related skin issues relate to their motivation, revealing two distinct groups with different coping strategies.

## Contribution

The study introduces a person-centered approach to identify subgroups of nurses with distinct attitudes and links these to achievement motivation using Self-Determination Theory.

## Key findings

- Two nurse subgroups were identified: a low-level group and a high-level, low-personal-responsibility group.
- Positive attitudes correlate with success-driven motivation, while negative attitudes correlate with failure-avoidance motivation.
- Work environment satisfaction and training participation influence nurses' preventive attitudes.

## Abstract

Incontinence-associated dermatitis (IAD) is a common nursing challenge in clinical practice, imposing a significant burden on both patients and healthcare providers. Studies have reported that nurses' preventive attitudes toward IAD significantly influence its prevalence, and there may be a potential association between achievement motivation and these attitudes. Previous research on nurses' preventive attitudes toward IAD has primarily focused on overall levels, overlooking potential heterogeneity within the population.

This study aimed to investigate the heterogeneity in clinical nurses' preventive attitudes toward IAD using a person-centered approach and to identify the influencing factors for different subgroups. A secondary aim was to utilize Self-Determination Theory (SDT) to elucidate the relationship between the identified attitude profiles and nurses' achievement motivation, thereby providing targeted strategies to enhance their preventive attitudes.

This study selected 1058 clinical nurses from a tertiary hospital in Fujian, China, as research participants from September to October 2024. The study utilized the following instruments: a general information questionnaire, the Attitude Toward the Prevention of Incontinence-Associated Dermatitis Instrument, and the Achievement Motivation Scale. Latent profile analysis (LPA) was employed to identify the latent profiles of nurses' attitudes toward IAD prevention. At the same time, t-tests, chi-square tests, and binary logistic regression analysis were conducted to explore the factors influencing nurses' attitudes across different latent profiles.

Two subgroups of nurses' attitudes toward IAD prevention were identified: the low-level group (63.42%) and the high-level, low-personal-responsibility group (36.57%). A significant correlation was found between nurses' attitudes toward IAD prevention and achievement motivation. Nurses with a more positive preventive attitude scored higher on the motivation for success dimension, while those with a less positive attitude scored higher on the motivation to avoid failure dimension. Factors influencing nurses' attitudes toward IAD prevention included position, department, number of participants in wound/ostomy/incontinence care training, satisfaction with the work atmosphere, and achievement motivation scores.

This study revealed heterogeneity in nurses' attitudes toward IAD prevention. Nurses with positive attitudes tended to adopt a success-driven approach, while those with relatively negative attitudes leaned toward a failure-avoidance strategy, reflecting two fundamentally distinct coping mechanisms.

Nursing managers should address these individual differences by targeting achievement motivation as an intervention point. Management strategies should be tailored to the distinct profiles; for instance, interventions for the “low-level group” should prioritize building competence through structured training, while strategies for the “high-level, low-personal-responsibility group” should focus on enhancing autonomy and personal accountability. By adopting such targeted approaches, managers can more effectively enhance nurses' preventive attitudes, thereby improving care quality and reducing IAD incidence.