{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:03:06Z","timestamp":1789660986186,"version":"4.0.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population aging has made frailty a major public health concern. Frailty is potentially reversible when identified and managed early, and nurses are well positioned to deliver such care; however, nurses\u2019 frailty-related competencies vary considerably, and evidence remains scarce in southwestern China, where the aging burden is disproportionately high. We therefore conducted a multicenter study to assess nurses\u2019 knowledge, attitudes, and practices (KAP) regarding frailty, explore their associated factors, and clarify their educational needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An anonymous online survey was administered to a convenience sample of nurses at 41 tertiary general hospitals in Chongqing Municipality and Sichuan Province, China, between January and March 2025. Frailty-management competency was measured with a validated 31-item KAP questionnaire (total score 31\u2013127; higher indicates better competency), and educational needs with an 11-item questionnaire. Associations were assessed using linear mixed-effects models with a random intercept for hospital; multivariable models entered 11 prespecified covariates, and reporting followed STROBE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 637 nurses recruited, 610 (95.76%) provided valid questionnaires. The mean total KAP score was 103.07\u202f\u00b1\u202f12.65 (81.16% of maximum). Attitude scored highest (88.53%), followed by knowledge (81.38%) and practice (74.40%), with practice corresponding to the lowest percentage of its maximum. In fully adjusted mixed-effects models, more recent frailty education was independently associated with the total KAP score (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.019; never-trained vs. trained within the past month,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f\u22126.820, 95% CI\u202f\u2212\u202f13.220 to \u22120.430,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.036), whereas the association with recency of frailty-related reading was borderline (overall\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.051). Geriatric nurse specialist certification was independently associated only with knowledge (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f2.070, 95% CI 0.660 to 3.490;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004), not with overall KAP, attitude, or practice; sociodemographic characteristics were not associated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nurses held positive attitudes, whereas self-reported practice corresponded to the lowest percentage of its maximum. Recency of frailty education was the factor most consistently associated with KAP and represents a potentially modifiable correlate. Given the cross-sectional design, these associations are consistent with a potential role for regularly refreshed, blended, and practice-oriented training. Longitudinal and interventional studies are needed to confirm clinical benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1920309","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:14:16Z","timestamp":1789658056000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurses\u2019 knowledge, attitudes, practices, and educational needs regarding frailty: a multicenter cross-sectional survey in southwestern China"],"prefix":"10.3389","volume":"14","author":[{"given":"Jie","family":"Lyu","sequence":"first","affiliation":[{"name":"Department of General Practice, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Practice, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling-Na","family":"Kong","sequence":"additional","affiliation":[{"name":"School of Nursing, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fen","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Nursing, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Nursing, Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Liao","sequence":"additional","affiliation":[{"name":"Chonggang General Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","article-title":"Frailty: implications for clinical practice and public health","volume":"394","author":"Hoogendijk","year":"2019","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.m146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"101498","DOI":"10.1016\/j.arr.2021.101498","article-title":"Prevalence of multidimensional frailty and pre-frailty in older people in different settings: a systematic review and meta-analysis","volume":"72","author":"Veronese","year":"2021","journal-title":"Ageing Res Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"656","DOI":"10.7507\/1672-2531.201901056","article-title":"Epidemiological characteristics of frailty in Chinese elderly population: a systematic review","volume":"19","author":"Tian","year":"2019","journal-title":"Chin J Evid-Based Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1007\/s12603-019-1273-z","article-title":"Physical frailty: ICFSR international clinical practice guidelines for identification and management","volume":"23","author":"Dent","year":"2019","journal-title":"J Nutr Health 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in eastern, central, and western China","volume":"47","author":"Zhang","year":"2025","journal-title":"J Ningxia Med Univ"},{"key":"ref24","first-page":"378","article-title":"The sample size estimation in quantitative nursing research","volume":"45","author":"Ni","year":"2010","journal-title":"Chin J Nurs"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1177\/07334648231206321","article-title":"Identifying and managing frailty: a survey of UK healthcare professionals","volume":"43","author":"Frost","year":"2024","journal-title":"J Appl Gerontol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1111\/medu.13895","article-title":"Effectiveness of the spaced education pedagogy for clinicians\u2019 continuing professional development: a systematic review","volume":"53","author":"Phillips","year":"2019","journal-title":"Med 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