Symptom heterogeneity and factors associated with dignity-related distress in older adults with incontinence-associated dermatitis

Abstract

To identify latent symptom profiles of dignity-related distress among older adults with incontinence-associated dermatitis (IAD) and to explore the associated sociodemographic and clinical factors, aiming to inform targeted care strategies. A cross-sectional study was conducted from June 1 to 20, 2025, involving 382 older adults with IAD recruited from 39 tertiary hospitals across Sichuan Province, China. Participants completed a general information questionnaire and the Patient Dignity Inventory (PDI). Latent profile analysis (LPA) was used to identify distinct subgroups of dignity-related symptoms, and multivariate logistic regression analysis was performed to identify factors associated with latent profile membership. Two distinct symptom profiles of dignity-related distress were identified: Class 1 (64.4%) was characterized by low levels of psychological distress, symptom burden, and dependency, but relatively high needs for spiritual and social support, and was thus labeled as the “Low Symptom Distress and Spiritual Support Needs” group. Class 2 (35.6%) showed markedly higher levels of psychological distress, social support deficiency, and dependency, despite relatively milder symptom burden, and was designated the “High Dependency and Severe Psychological Distress” group. Multivariate logistic regression revealed that personality traits (OR = 0.469, 95% CI: 0.276–0.798), employment status (OR = 3.666, 95% CI: 1.978–6.795), self-rated family harmony (OR = 0.729, 95% CI: 0.573–0.928), and the clinical grading of incontinence-associated dermatitis (OR = 0.440, 95% CI: 0.211–0.961) were significant associated with class membership. Dignity-related distress in older adults with incontinence-associated dermatitis (IAD) presents heterogeneous symptom profiles shaped by individual, familial, and disease-related factors. Tailored psychological and dignity-focused care strategies should be developed according to patients’ symptom patterns to enhance overall well-being and clinical outcomes.