Exploring influencing factors on fall prevention intentions among nursing assistants: a qualitative study

Objective: Guided by the Theory of Planned Behavior (TPB), this study explored key factors influencing fall prevention intentions among nursing assistants in Chinese tertiary hospitals. Methods: A qualitative descriptive study was conducted. Twenty nursing assistants from a tertiary hospital in China were recruited via purposive sampling. Semi-structured interviews were analyzed using thematic analysis, with reporting guided by the COREQ checklist. Results: Three core themes consistent with the TPB emerged: (1) Ambivalent behavioral attitudes, characterized by a disconnect between valuing fall prevention and assuming responsibility, and conditional proactivity; (2) Conflicted subjective norms, including situational compromises among institutional, family, and peer expectations, and a punitive feedback culture; (3) Limited perceived behavioral control, challenges in complex situations and structural resource constraints (time, equipment, support). Conclusion: Nursing assistants' fall prevention intentions are shaped jointly by ambivalent attitudes, conflicting norms, and limited control. Multi-level interventions empowering nursing assistants, fostering a constructive organizational culture, and optimizing resources are needed to enhance their intentions and translate policy into consistent bedside practice.