Work motivation profiles and work engagement among nursing assistants in Chinese aged care institutions: a cross-sectional latent profile analysis

Abstract

Background Geriatric nursing assistants are central to long-term care, but average-score analyses may conceal differences in how autonomous and controlled forms of work motivation combine within individuals. Objective To identify latent work motivation profiles among geriatric nursing assistants, compare the primary outcome of work engagement across profiles, and examine factors associated with profile membership. Methods A cross-sectional survey was conducted between May and August 2025 in nine aged care institutions in Xi’an and Weinan, Shaanxi Province, China. Eligible participants were currently employed as geriatric nursing assistants, had worked continuously for at least 6 months, and provided informed consent. Using convenience and snowball sampling, 445 questionnaires were distributed; 396 were returned (response rate, 89.0%), and 330 met the eligibility and predefined data-quality criteria and were included in the analysis. Work motivation was assessed using four Motivation at Work Scale subscales, and work engagement was assessed using the Utrecht Work Engagement Scale-9. Latent profile analysis, group comparisons, and multinomial logistic regression were conducted. Results Three profiles were identified: passive externally driven (5.2%; n = 17), partially internalised (52.4%; n = 173), and highly integrated (42.4%; n = 140). The three-profile model showed high classification quality (entropy = 0.937). Mean total work-engagement scores were 15.18, 31.09, and 43.56 across the three profiles, respectively; all pairwise differences were statistically significant (p < 0.001), with a large between-profile effect (eta squared = 0.527). In the primary multinomial model, which simultaneously included all four perceived organisational-climate dimensions and selected covariates, higher fair support was associated with lower odds of membership in the passive externally driven profile (odds ratio = 0.034, 95% confidence interval 0.007–0.166) or the partially internalised profile (odds ratio = 0.054, 95% confidence interval 0.021–0.140) rather than the highly integrated profile. Conclusions Work motivation was heterogeneous and was strongly associated with work engagement in this two-city sample. Aged care managers should consider structured orientation and mentoring for workers with low motivation, vocational-development pathways and participatory feedback for the largest partially internalised group, transparent workload allocation and appraisal procedures for workers reporting low fair support, and workload monitoring for highly engaged workers who may also experience internal pressure. Longitudinal and intervention studies are needed to determine whether profile membership changes over time.