Effects of Social Learning Theory–Based Training on Pressure Injury Competence in Chinese Nursing Home Assistants: A Cluster RCT

Objectives: Pressure injury poses significant challenges in nursing homes, exacerbated by aging populations and gaps in caregivers' training. This study evaluated the efficacy of the social learning theory–based training program in improving Chinese nursing home assistants’ pressure injury prevention and management competence. Design: Two-arm, cluster randomized controlled trial. Setting and Participants: Nursing assistants in 4 Chinese nursing homes. Methods: A cluster randomized controlled trial allocated 95 participants from 4 nursing homes to intervention (n = 46) or control (n = 49). The intervention group received a social learning theory–based training program, which involved a blended teaching-learning model combining online (15 short videos for a total of 2 hours of online sessions) and traditional face-to-face offline (a total of 5 hours of offline sessions) methods spanning over 4 weeks. Outcomes (knowledge, attitudes, practices, visual identification skills, and self-efficacy) were assessed at baseline, immediately postintervention, and 3 months postintervention using validated tools. Results: The intervention group showed significant improvements immediately postintervention (P < .001) in all outcomes, with sustained gains in knowledge, attitudes, practices, and self-efficacy. Visual identification skills declined to baseline by 3 months postintervention (P > .05). Between-group differences favored the intervention at all time points (P < .001). Satisfaction exceeded 90%, highlighting program feasibility. Conclusions and Implications: A social learning theory–based training program can effectively enhance nursing assistants’ pressure injury prevention and management competence; however, visual identification skill retention requires reinforcement. This scalable, theory-driven model addresses global workforce training gaps in long-term care, offering actionable strategies to reduce pressure injury incidence and improve care quality for aging populations.