Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지
DOI QR코드

DOI QR Code

Factors Affecting Radiation Protective Behaviors in Perioperative Nurses Applying the Theory of Planned Behavior: Path Analysis

계획된 행위이론을 적용한 수술실 간호사의 방사선 방어행위에 대한 영향요인: 경로분석

  • Jang, Se Young (Department of Nursing, Jeonbuk National University Hospital) ;
  • Kim, Hee Sun (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University) ;
  • Jeong, Seok Hee (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University) ;
  • Kim, Young Man (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University)
  • 장세영 (전북대학교병원 간호부) ;
  • 김희선 (전북대학교 간호대학.간호과학연구소) ;
  • 정석희 (전북대학교 간호대학.간호과학연구소) ;
  • 김영만 (전북대학교 간호대학.간호과학연구소)
  • Received : 2022.08.25
  • Accepted : 2023.04.30
  • Published : 2023.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to identify the factors explaining protective behaviors against radiation exposure in perioperative nurses based on the theory of planned behavior. Methods: This was a cross-sectional study. A total of 229 perioperative nurses participated between October 3 and October 20, 2021. Data were analyzed using SPSS/WIN 23.0 and AMOS 23.0 software. The three exogenous variables (attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control) and two endogenous variables (radiation protective intention and radiation protective behaviors) were surveyed. Results: The hypothetical model fit the data (χ2/df = 1.18, SRMR = .02, TLI = .98, CFI = .99, RMSEA = .03). Radiation protective intention (β = .24, p = .001) and attitude toward radiation protective behaviors (β = .32, p = .002) had direct effects on radiation protective behaviors. Subjective norm (β = .43, p = .002) and perceived behavior control (β = .24, p = .003) had direct effects on radiation protective intention, which explained 38.0% of the variance. Subjective norm (β = .10, p = .001) and perceived behavior control (β = .06, p = .002) had indirect effects via radiation protective intention on radiation protective behaviors. Attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control were the significant factors explaining 49.0% of the variance in radiation protective behaviors. Conclusion: This study shows that the theory of planned behavior can be used to effectively predict radiation protective behaviors in perioperative nurses. Radiation safety guidelines or education programs to enhance perioperative nurses' protective behaviors should focus on radiation protective intention, attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control.

Keywords

References

  1. Ugurlu Z, Karahan A, Unlu H, Abbasoglu A, Ozhan Elbas N, Avci Isik S, et al. The effects of workload and working conditions on operating room nurses and technicians. Workplace Health & Safety. 2015;63(9):399-407. https://doi.org/10.1177/2165079915592281
  2. Mohapatra A, Greenberg RK, Mastracci TM, Eagleton MJ, Thornsberry B. Radiation exposure to operating room personnel and patients during endovascular procedures. Journal of Vascular Surgery. 2013;58(3):702-709. https://doi.org/10.1016/j.jvs.2013.02.032
  3. Yun JH. Paper operration room nurses experience in using radiation suegery: Phenomenological research. Journal of the Korea Academia-Industrial Cooperation Society. 2020;21(1):426-438. https://doi.org/10.5762/KAIS.2020.21.1.426
  4. Ozbas A, Turkmen A, Dundar GY. Determining the attitude of operating room nurses to radiation exposure: A descriptive study. Journal of Perioperative Nursing. 2021;34(2):e14-e18. https://doi.org/10.26550/2209-1092.1112
  5. Girgin R. An Anatolian study on the current knowledge and attitudes of urology operating room staff on ionizing radiation. African Journal of Urology. 2021;27(1):21. https://doi.org/10.1186/s12301-020-00117-7
  6. Association of Perioperative Registered Nurses (AORN). Guidelines for perioperative practice; safe surgery together [Internet]. Denver: Association of Perioperative Registered Nurses; 2021 [cited 2021 Nov 30]. Available from: http://www.aorn.org/Guidelines/About-AORN-Guidelines
  7. Lim CS. Problems of the act and subordinate statutes related to the regulation of radiation safety for diagnosis. The Korean Society of Law and Medicine. 2022;23(2):97-118. https://doi.org/10.29291/kslm.2022.23.2.097
  8. Korea Institute for Healthcare Accreditation (KOIHA). 4th cycle acute hospital accreditation criteria [Internet]. Seoul: KOIHA; c2021 [cited 2021 Sep 20]. Available from: http://www.koiha.or.kr/web/kr/library/establish_board.do
  9. Korea Disease Control and Prevention Agency (KDCA). 2021 Report occupational radiation exposure in diagnostic radiology in Korea [Internet]. Cheongju: KDCA; c2022 [cited 2022 Dec 21]. Available from: https://www.kdca.go.kr/board/board.es?mid=a20305050000&bid=0003
  10. Behzadmehr R, Doostkami M, Sarchahi Z, Dinparast Saleh L, Behzadmehr R. Radiation protection among health care workers: Knowledge, attitude, practice, and clinical recommendations: A systematic review. Reviews on Environmental Health. 2021;36(2):223-234. https://doi.org/10.1515/reveh-2020-0063
  11. Yun BY, Park JY. Factors influencing radiation protection behaviors of endoscopy nurses during endoscopic interventional radiology. Journal of Korean Clinical Nursing Research. 2020;26(3):305-313. https://doi.org/10.22650/JKCNR.2020.26.3.305
  12. Lee SJ, Boo SJ, Ahn JA, You MA. Factors affecting radiation protection behaviors among emergency room nurses. Journal of Korean Critical Care Nursing. 2020;13(1):15-26. https://doi.org/10.34250/jkccn.2020.13.1.15
  13. Choi JI, Yang YO. A study on knowledge, attitude and behavior for radiation protection of nurses: Focus on the operating rooms and intensive care units. Journal of Radiological Science and Technology. 2019;42(6):461-467. https://doi.org/10.17946/JRST.2019.42.6.461
  14. Kim BH, Kim HJ. A study on knowledge, perception, self-efficacy, and performance on radiation protection among perioperative workers in terms of radiation protection. Journal of the Korea Academia-Industrial Cooperation Society. 2017;18(5):343-354. https://doi.org/10.5762/KAIS.2017.18.5.343
  15. Hirvonen L, Schroderus-Salo T, Henner A, Ahonen S, Kaariainen M, Miettunen J, et al. Nurses' knowledge of radiation protection: A cross-sectional study. Radiography. 2019;25(4):e108-e112. https://doi.org/10.1016/j.radi.2019.04.011
  16. Kim J, Kim JS, Kim HL. Factors affecting radiation protection behaviors among operating room nurses. Korean Journal of Adult Nursing. 2016;28(6):680-690. https://doi.org/10.7475/kjan.2016.28.6.680
  17. Kim SH, Lee EN. Factors affecting the radiation protection behavior of nurses using the educational diagnostic stage of the PRECEDE model. Journal of Muscle and Joint Health. 2020;27(3):278-288. https://doi.org/10.5953/JMJH.2020.27.3.278
  18. Bwanga O. Nurses' knowledge of radiation protection in medicine: A review of literature. Professional Nursing Today. 2020;24(3):21g-21l.
  19. Jang HJ. Survey of status and educational needs of radiation protection among perioperative nurses in general hospitals. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2016;6(10):131-144. https://doi.org/10.35873/ajmahs.2016.6.10.012
  20. Cote F, Gagnon J, Houme PK, Abdeljelil AB, Gagnon MP. Using the theory of planned behaviour to predict nurses' intention to integrate research evidence into clinical decision-making. Journal of Advanced Nursing. 2012;68(10):2289-2298. https://doi.org/10.1111/j.1365-2648.2011.05922.x
  21. Armitage CJ, Conner M. Efficacy of the theory of planned behaviour: A meta-analytic review. British Journal of Social Psychology. 2001;40(Pt 4):471-499. https://doi.org/10.1348/014466601164939
  22. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50(2):179-211. https://doi.org/10.1016/0749-5978(91)90020-T
  23. Rollon R. Using the theory of planned behavior to improve perioperative practice. AORN Journal. 2020;111(3):327-331. https://doi.org/10.1002/aorn.12959
  24. Kim NY, Jeong SY. Patient safety management activities of clinical nurse: A modified theory of planned behavior. Journal of Korean Academy of Nursing Administration. 2019;25(5):384-392. https://doi.org/10.11111/jkana.2019.25.5.384
  25. Appleby BE. Implementing guideline-checklists: Evaluating health care providers intentional behaviour using an extended model of the theory of planned behaviour. Journal of Evaluation in Clinical Practice. 2019;25(4):664-675. https://doi.org/10.1111/jep.13075
  26. Sin CS, Rochelle TL. Using the theory of planned behaviour to explain hand hygiene among nurses in Hong Kong during COVID-19. The Journal of Hospital Infection. 2022;123:119-125. https://doi.org/10.1016/j.jhin.2022.01.018
  27. Gu JE, Ha YK, Hwang SH, Gong KH. Path analysis of performance of multidrug-resistant organisms management guidelines among intensive care unit nurses: With focus on the theory of planned behavior and patient safety culture. Journal of Korean Critical Care Nursing. 2018;11(1):89-100.
  28. Javadi M, Kadkhodaee M, Yaghoubi M, Maroufi M, Shams A. Applying theory of planned behavior in predicting of patient safety behaviors of nurses. Materia Socio-Medica. 2013;25(1):52-55. https://doi.org/10.5455/msm.2013.25.52-55
  29. Jeong KW, Jang HJ. Correlation between knowledge and performance of radiation protection among operating room nurses. International Journal of Bio-Science and Bio-Technology. 2016;8(1):275-284. https://doi.org/10.14257/ijbsbt.2016.8.1.24
  30. Hagger MS, Chan DKC, Protogerou C, Chatzisarantis NLD. Using meta-analytic path analysis to test theoretical predictions in health behavior: An illustration based on meta-analyses of the theory of planned behavior. Preventive Medicine. 2016;89:154-161. https://doi.org/10.1016/j.ypmed.2016.05.020
  31. Park JH, Jang YS. Nurses' attitude, subjective norm, perceived behavioral control, and behavior regarding pressure ulcer prevention behavior based on theory of planned behavior. Journal of the Korea Academia-Industrial Cooperation Society. 2019;20(12):212-223. https://doi.org/10.5762/KAIS.2019.20.12.212
  32. Kim HY, Jang KS. Development of a clinical ladder system for operating room nurses. Journal of Korean Academy of Nursing Administration. 2011;17(3):301-314. https://doi.org/10.11111/jkana.2011.17.3.301
  33. Stevens J. Applied multivariate statistics for the social sciences. 3rd ed. Mahwah (NJ): Lawrence Elbaum Publication; 1996. p. 1-371.
  34. Han SS, Lee SC. Nursing and health statistical analysis. Rev. ed. Seoul: Hannarae; 2018. p. 1-520.
  35. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. https://doi.org/10.1002/nur.20199
  36. Han EO. A protective behavior model against the harmful effects of radiation for radiological technologists in medical centers [dissertation]. Seoul: Ewha Womans University; 2009. p. 1-145.
  37. Ji YO. Instrument development for the application of the theory of planned behavior. Korean Journal of Nursing Query. 1993;2(2):102-115.
  38. Noh JS, Lee BH, Bea SY, Park HS, Ryu SY, Park J. Analysis of radiology students' behavior in wearing radiation protection equipment-based on the theory of planned behavior. The Journal of the Korea Contents Association. 2011;11(9):443-452. https://doi.org/10.5392/JKCA.2011.11.9.443
  39. Ajzen I. The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies. 2020;2(4):314-324. https://doi.org/10.1002/hbe2.195
  40. Jang T, Song R. A structural model explaining the health behaviors among adults with metabolic syndrome: Theory of planned behavior approach. Korean Journal of Adult Nursing. 2020;32(1):98-108. https://doi.org/10.7475/kjan.2020.32.1.98
  41. Kim AY, Cha JE. Measurement of self-efficacy. Korean Society for Industrial and Organizational Psychology. 1996;9(1):51-64.
  42. Kim AY. A study on the academic failure-tolerance and its correlates. Journal of Educational Psychology. 1997;11(2):1-19.
  43. Lee IH. EasyFlow statistics macro: EXCEL macro ver 1.5 [Internet]. Iksan: StatEdu; 2020 [cited 2021 Nov 17]. Available from: http://doi.org/10.22934/StatEdu.2020.01
  44. Hair JF Jr, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 8th ed. Andover: Cengage; 2018. p. 1-813.
  45. Yoon YS, Ryu SY, Park J, Choi SW, Oh HJ. The associated factors of protective behaviors for radiation exposure based on health belief model Honam province radiologic technologists. Journal of the Korea Academia-Industrial Cooperation Society. 2020;21(3):96-107. https://doi.org/10.5762/KAIS.2020.21.3.96
  46. Mohebbi Z, Ershadpoor R, Ostovari M, Rakhshan M. Radiation protection capability of operating room personnel: Development and psychometric properties of a questionnaire. Journal of Biomedical Physics and Engineering. 2021;11(5):603-612. https://doi.org/10.31661/jbpe.v0i0.2008-1161
  47. Khames EAR, Ahmed RF, Abed Elazeem YFM. The effect of brachytherapy safety education on knowledge, performance, and attitude of radiology nurses. Evidence-Based Nursing Research. 2019;1(3):216-225. https://doi.org/10.47104/ebnrojs3.v1i3.144
  48. Roh M, Kim O. Structural model of hospital nurse'' compliance with antineoplastic drugs safety management guidelines based on theory of planned behavior. Korean Journal of Adult Nursing. 2022;34(5):466-477. https://doi.org/10.7475/kjan.2022.34.5.466
  49. Kim O, Kim MS, Jang HJ, Lee H, Kang Y, Pang Y, et al. Radiation safety education and compliance with safety procedures- the Korea Nurses' Health Study. Journal of Clinical Nursing. 2018;27(13-14):2650-2660. https://doi.org/10.1111/jocn.14338