Knowledge, attitudes, and practices of care workers regarding skin tear prevention in long-term care facilities: A multicenter cross-sectional study

Skin tear (ST) is a common skin injury in hospitals and long-term care (LTC) facilities, often overlooked or misdiagnosed due to insufficient cognition. For care workers with limited medical expertise, their ability to prevent ST is particularly concerning. This study aims to investigate their knowledge, attitudes, and practices for preventing ST and explore influencing factors from individual and institutional perspectives.

Using the Knowledge, Attitude, and Practice for Preventing Skin Tears (KAP-ST), General Self-Efficacy Scale (GSES), Occupational Commitment Scale (OCS), and Person-centered Climate Questionnaire-Staff Version (PCQ-S), a multi-center cross-sectional survey was conducted across 18 LTC facilities in a city of western China, involving 400 care workers.

A total of 373 (93.3%) valid responses were included. This KAP-ST survey reported standardized scores of 77.6%, 69.8%, 76.6%, and 79.9% in the overall, knowledge, attitude, and practice dimensions, respectively, and moderate positive correlations with the GSES, OCS, and PCQ-S scores (r = 0.325-0.438, P < 0.001) except for the knowledge dimension. The partial correlation analysis derived from the multiple linear regression revealed independent associations of the operational nature, age, workload, knowledge source, and training frequency with the knowledge dimensional scores (|r_partial| = 0.120-0.230, P ≤ 0.022); and independent associations of operational nature, leader attention, gender, workload, salary level, GSES, OCS, and PCQ-S with the attitude dimensional scores (|r_partial| = 0.106-0.286, P ≤ 0.043); and independent associations of operational nature, leader attention, age, residence, career reason, professional certification, GSES, and PCQ-S with the practice dimensional scores (|r_partial| = 0.108-0.302, P ≤ 0.039). The KAP-ST deficiencies among care workers were evident in inducing factors, common site, and grading assessment (knowledge dimension); prevention confidence and responsibility attribution (attitude dimension); and inadequate measures for maintaining skin integrity (practice dimension).

The findings indicate that care workers in LTC facilities show significant deficits in KAP-ST. Targeted vocational training and standardized prevention programs are warranted to improve ST management effectiveness. Furthermore, multi-department collaborative management might be valuable and should be explored in future interventions.