Knowledge, Attitudes, and Practices Regarding Their Own Urinary Incontinence Among Female Clinical Nurses in Shenzhen, China: A Cross-Sectional Study.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) affects 31-46.7% of female clinical nurses, adversely impacting their work performance and quality of life, yet remains underreported and undertreated. On the basis of the Knowledge, Attitudes, and Practices (KAP) framework, this study aimed to: (1) develop and validate a questionnaire about the KAP of clinical nurses with UI regarding their own condition; and (2) investigate the current KAP status and examine the associations between demographic and occupational factors and KAP levels. The findings are expected to inform targeted interventions to improve awareness, early recognition, and self-management of UI among clinical nurses with UI.

METHODS

This multicenter cross-sectional study (March-May 2025) recruited clinical nurses with UI from eight tertiary hospitals via convenience sampling. A 32-item Nurses' Self-UI KAP Scale was developed and validated to assess their KAP levels, followed by an analysis of influencing factors based on the questionnaire data. Descriptive statistics and multiple linear regression were performed.

RESULTS

The validated 32-item Nurses' Self-UI KAP Scale demonstrated high reliability (Cronbach's α = 0.956; S-CVI = 0.913). Among 415 clinical nurses with UI, the mean scores were: knowledge 7.08 ± 2.9, attitude 36.98 ± 7.54, and practice 36.37 ± 7.69. The two lowest-scoring knowledge items revealed key misconceptions: that UI is a normal part of aging and that one should urinate immediately upon feeling the urge. Additionally, more than half of the clinical nurses with UI concealed their condition despite expressing willingness to seek treatment, and only 50.6% adhered to recommended management strategies. Multiple linear regression revealed significantly lower KAP scores in clinical nurses with UI aged 25 years or older relative to those under 25 years (β25-35 years = -13.582, β36-44 years = -12.929, β>44 years = -15.943), and in those working 3-4 or 5-6 night shifts per month relative to those with no night shifts (β3-4 shifts = -4.304, β5-6 shifts = -6.086). Conversely, clinical nurses with UI with 1-2 pregnancies or ≥ 3 pregnancies had significantly higher KAP scores relative to those who had never been pregnant (β1-2 pregnancies = 4.304, β≥3 pregnancies = 9.431).

CONCLUSIONS

Clinical nurses with UI had basic UI knowledge, positive attitudes, and proactive behaviors. However, several issues persisted, including voiding management strategies and concerning its etiology, a tendency to conceal the condition despite willingness to seek treatment, and low adherence to management protocols. Age, night shifts, and parity influenced KAP, supporting targeted education to improve awareness and care engagement.