Patterns of unfinished care among nursing assistants in long-term care homes in China: a latent class analysis

Objectives The present study was designed to identify patterns of unfinished care among nursing assistants in Chinese long-term care homes and to examine how these patterns are associated with sociodemographic and work-related characteristics. Design A cross-sectional study. Setting The survey was conducted in 11 long-term care homes in China. Participants Between September 2024 and May 2025, 251 nursing assistants completed the survey. Outcome measures Unfinished care was assessed using the Chinese version of the Basel Extent of Rationing of Nursing Care for Nursing Homes instrument. Latent class analysis (LCA) was used to identify patterns of unfinished care, and multinomial logistic regression was used to examine associations with sociodemographic and work-related characteristics. Results LCA identified three patterns of unfinished care: the multidimensional high-level group (13.55%), the low-level group (51.79%) and the moderate-level group (34.66%). Nursing assistants with junior or senior high school education were less likely to belong to the multidimensional high-level group compared with those with primary school education or below (OR=0.27, 95% CI 0.08 to 0.96, p=0.043). Compared with nursing assistants with 6 months to 1 year of service at the current facility, those with more than 3 years of service were less likely to belong to the multidimensional high-level group (OR=0.21, 95% CI 0.05 to 0.85, p=0.028). Heavier workload was associated with a higher likelihood of belonging to the multidimensional high-level group; nursing assistants caring for 7–9 older adults were more likely to belong to this group than those caring for ≤6 older adults (OR=9.12, 95% CI 1.49 to 55.75, p=0.017). Shift patterns (eg, alternating 24-hour shift with 24-hour rest vs 8-hour day shift) did not show significant associations with unfinished care group membership. Conclusion Unfinished care among nursing assistants in long-term care homes in China was heterogeneous. This population may require more targeted workforce support, differentiated training, better workload organisation and broader organisational and policy support for sustainable care delivery.