Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of muscle mass and/or decline in somatic function associated with aging (Dent E et al., 2018). Sarcopenia increases the risk of falls and disability, and nurses' awareness and attention to sarcopenia can assist in preventing and lessening its onset. However, nurses' level of knowledge and belief in sarcopenia is unclear. Therefore, it is important to study the current status and influencing factors of nursing staff with sarcopenia.

In October 2016, sarcopenia was included in the International Classification of Diseases (ICD-10) disease codes, gaining official recognition as a separately characterized, independent disease. Numerous clinically significant unfavorable outcomes, such as an increased incidence of falls, fractures, and impairment in older persons, are independently predicted by hypomelanosis (Lynch et al., 2022), apart from interacting with underlying conditions such as rheumatoid arthritis, diabetes mellitus, chronic heart failure, osteoporosis, nutritional deficits, and oncology (Sepúlveda-Loyola et al., 2020, Verstraeten et al., 2023; Cano-García et al., 2022; Ter Beek et al., 2016). These results showed a negative impact on senior patients' quality of life, lengthens the time it takes for them to recover from an illness, leads to more hospital admissions and readmissions, raises the rates of morbidity and mortality rates, and drives up healthcare expenditures. (Chew et al., 2021) It may also put a significant financial strain on the healthcare system in our country (Larsson et al., 2019).

Sarcopenia has become a pressing concern, with a global prevalence ranging between 10% and 27% (Boshnjaku., 2022). In China, the prevalence of sarcopenia varies from 5.7% to 23.9% (Chen et al., 2021, Muralidhar and Madhivanan, 2023). In the coming years, the proportion of China's elderly population will also continue to rise, and the prevalence of sarcopenia will continue to rise (Zeng et al., 2018, Yang et al., 2018). Sarcopenia has become a significant public health concern (Zhang et al., 2023). However, due to its gradual onset, it is frequently undetected and untreated in hospitals and the community. As a result, the Asian sarcopenia working group advocates for the timely identification of at-risk populations to enable effective intervention (Chen et al., 2020). However, nurses are the specialists for contact with patients who conduct sarcopenia screening, evaluate the results, and administer preventative therapies depending on the results (Warnier et al., 2021). Nurses are the "front office" of patient contact, and their level of knowledge, attitudes, and behaviors related to sarcopenia affect the care of patients with sarcopenia. They play an indispensable role in promptly identifying and screening patients for sarcopenia (Silva et al., 2020). The notion of sarcopenia was introduced more than 30 years ago, but there is still little research on the understanding and perception of sarcopenia among nurses today. Thus, it is crucial to investigate and assess the existing knowledge and beliefs regarding sarcopenia in nursing.

While only 8% of doctors used the phrase in their practice, even most physicians have a serious lack of knowledge of the tests and instruments available to measure sarcopenia. Consistent findings were also available in the Netherlands, Australia, and New Zealand. (Guralnik et al., 2023, Cruz-Jentoft and Sayer, 2019). However, China's understanding and research on sarcopenia started late. The research primarily focuses on diagnostic modalities of sarcopenia management and expert consensus. However, hospital nursing staff recognize that prevention, screening, and constant vigilance for sarcopenia are prerequisites for preventing and minimizing its development. The level of knowledge and practice of nurses is unclear, and there are numerous issues with linked investigations. For example, the category of nurses was not precisely classified according to whether or not they were geriatric specialist nurses. (Hongxia Gao et al., 2022) Respondents did not observe nursing staff individually or in an inadequate proportion of nursing staff. Only the clinical practice of diagnosing and treating sarcopenia among geriatric rehabilitation healthcare professionals or dietitians were evaluated (Kiss et al., 2020, Yeung et al., 2020; Yao et al., 2018).

Therefore, this study conducted a questionnaire based on Kirsty's information, attitude, practice (KPA) theoretical model (Gu et al., 2023) to understand the current status of caregivers' knowledge and belief in sarcopenia. This study provides strong recommendations for the improving of future sarcopenia care, and the results enrich the database to prepare for future targeted training and development of sarcopenia screening and evaluation methodologies. To establish a benchmark for directing relevant training, developing strategies for sarcopenia screening and assessment, and improving the sarcopenia nursing practice of clinical nurses, the following objectives are pursued: enhance the quality of life for patients, alleviate the strain on family caregivers, reduce unnecessary overtreatment, and minimize resource wastage. From this point of view, this study has significant theoretical and practical implications, and it is essential to research the state of nurses' knowledge and practice about sarcopenia at this time.

Overall, this study aimed to understand the current state of clinical nurses' knowledge, attitudes, and behaviours regarding sarcopenia in southern Jiangsu and to analyze the factors. Specifically, the following aspects can be identified. First, assess the nurses' understanding of sarcopenia, including their familiarity with its definition, vulnerable population, risk factors, etiology, screening and evaluation techniques, intervention strategies, and potential negative effects. Second, the purpose of this study is to examine the perspectives of nurses regarding sarcopenia. Specifically, it aims to determine the extent to which nurses consider the significance of sarcopenia in career development and employability, whether they acknowledge the detrimental effects on quality of life, families, and society, and whether they comprehend the criticality of early detection, prevention, and management approaches toward sarcopenia. Third, ascertain if clinical nurses have completed the initial examination for newly admitted patients and attend to patients and families regarding health education on sarcopenia prevention. The influencing factors affecting the knowledge, attitude, and practical behavior of nurses with sarcopenia were examined, and the influence of nurses' demographic characteristics, education and training backgrounds, and occupational environment on their knowledge and belief in sarcopenia was studied.