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Factors Influencing Radiation Protection Behavior of Nurses in Intensive Care Units

중환자실 간호사의 방사선 방어 행위 영향 요인

  • Received : 2024.06.08
  • Accepted : 2024.10.02
  • Published : 2024.10.31

Abstract

Purpose : The purpose of this study was to identify the factors that influence the behavior of intensive care unit (ICU) nurses regarding radiation protection, and to provide basic data to improve radiation protection educational programs. Methods : This descriptive research study included 143 nurses working in ICUs. Data were collected through a self-reported structured questionnaire and analyzed using t-test, Pearson's correlation coefficients, and hierarchical multiple regression analysis. Results : Radiation protection environment (β=.35, p =.001), radiation protection self-efficacy (β=.25, p =.002), type of hospital (β=-.25, p =.002) and experience in ICU (β=-.18, p =.022) affected the radiation protection behavior of ICU nurses. The total explanatory power of model was 60.0% (R2=.64, Adj. R2=.60, F=17.71, p <.001). Conclusion : In order to enhance the standards of radiation protection behavior among intensive care unit nurses and improve radiation protection self-efficacy, educational and training programs should be developed. Additionally, administrative support should be considered to create environments with better radiation protection at the organizational level.

Keywords

References

  1. United Nations Scientific Committee on the Effects of Atomic Radiation. Sources, effects and risks of ionizing radiation, united nations scientific committee on the effects of atomic radiation 2016 report: Report to the general assembly, with scientific annexes. United Nations Scientific Committee on the Effects of Atomic Radiation; 2017. https://doi.org/10.18356/2055d684-en 
  2. Korea Disease Control and Prevention Agency. 2022 Annual report on personal radiation exposure to radiation workers at medical institutions [internet]. Seoul: Korea Disease Control and Prevention Agency; 2023 [cited 2024 April 26]. Available from: https://www.kdca.go.kr/board/board.es?mid=a20305050000&bid=0003 
  3. Dianati M, Zaheri A, Talari HR, Deris F, Rezaei S. Intensive care nurses' knowledge of radiation safety and their behaviors towards portable radiological examinations. Nursing and Midwifery Studies. 2014; 3(4):e23354. https://doi.org/10.17795/nmsjournal23354 
  4. Nelson EM, Monazzam SM, Kim KD, Seibert JA, Klineberg EO. Intraoperative fluoroscopy, portable X-ray, and CT: Patient and operating room personnel radiation exposure in spinal surgery. The Spine Journal. 2015;15(4):799-800. https://doi.org/10.1016/j.spinee.2014.12.022 
  5. Lesyuk O, Sousa PE, Rodrigues SI, Abrantes AF, Almeida RP, Pinheiro JP, et al. Study of scattered radiation during fluoroscopy in hip surgery. Radiologia Brasileira. 2016;49(4):234-40. https://doi.org/10.1590/0100-3984.2014.0146 
  6. Lee SJ, Boo S, 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 
  7. Kim MY, Yang YK. Factors influencing the behavior of the nurses in the radiology department regarding radiation protection. Journal of Learner Centered Curriculum and Instruction. 2021;21(10):203-13. https://doi.org/10.22251/jlcci.2021.21.10.203 
  8. Choi J, Lee J, Lee B. Analysis of case characteristics of occupational diseases and epidemiological investigation of healthcare workers. Korean Journal of Occupational Health Nursing. 2023;32(4):131-40. http://doi.org/10.5807/kjohn.2023.32.4.131 
  9. Harding K, Thomson WH. Radiological protection and safety in medicine. European Journal of Nuclear Medicine and Molecular Imaging. 1997;24(10):1207-9. 
  10. Korea Disease Control and Prevention Agency. Radiation exposure and protection. [internet]. Seoul: Korea Disease Control and Prevention Agency; 2019 [cited 2024 April 22]. Available from: https://www.kdca.go.kr/contents.es?mid=a20305010000 
  11. International Commission on Radiological Protection. The 2007 recommendations of the international commission on radiological protection. Annals of the ICRP. 2007;37(2-4):1-332. https://doi.org/10.1016/j.icrp.2007.10.003 
  12. El-Benhawy SA, Fahmy EI, Mahdy SM, Khedr GH, Sarhan AS, Nafady MH, et al. Assessment of thyroid gland hormones and ultrasonographic abnormalities in medical staff occupationally exposed to ionizing radiation. BMC Endocrine Disorders. 2022;22(1):287. https://doi.org/10.1186/s12902-022-01196-z 
  13. Sernia S, Bongiovanni A, De Giorgi A, Cafolla A, De Sio S, La Torre G. Thyroid parameters variations in healthcare workers and students exposed to low-dose ionizing radiations. Giornale Italiano di Medicina del Lavoro ed Ergonomia. 2022;44(3):338-46. 
  14. Kang SG, Lee EN. Knowledge of radiation protection and the recognition and performance of radiation protection behavior among perioperative nurses. Journal of Muscle and Joint Health. 2013;20(3):247-57. https://doi.org/10.5953/jmjh.2013.20.3.247 
  15. Batista VMD, Bernardo MO, Morgado F, Almeida FA. Radiological protection in the perspective of health professionals exposed to radiation. Revista Brasileira de Enfermagem. 2019;72(supple 1):9-16. https://doi.org/10.1590/0034-7167-2017-0545 
  16. Hong S, Shin SH. Factors influencing endoscopy nurses' protective behavior against radiation exposure. Journal of Korean Clinical Nursing Research. 2014;20(2):177-88. 
  17. Shabani F, Hasanzadeh H, Emadi A, Mirmoham-madkhani M, Bitarafan-Rajabi A, Abedelahi A, et al. Radiation protection knowledge, attitude, and practice in interventional radiology. Oman Medical Journal. 2018;33(2):141-7. https://doi.org/10.5001/omj.2018.26 
  18. Kim J, Kim JS, Kim H. Factors affecting radiation protection behaviors among operating room nurses. Korean Journal of Adult Nursing. 2016;28(6):680-90. https://doi.org/10.7475/kjan.2016.28.6.680 
  19. 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):305-13. https://doi.org/10.22650/JKCNR.2020.26.3.305 
  20. Han EO, Kwon DM, Dong KR, Han SM. A model for protective behavior against the harmful effects of radiation based on medical institution classifications. Journal of Radiation Protection. 2010;35(4):157-62. 
  21. Duran A, Hian SK, Miller DL, Le Heron J, Padovani R, Vano E. Recommendations for occupational radiation protection in interventional cardiology. Catheterization Cardiovascular Interventions. 2013;82(1):29-42. https://doi.org/10.1002/ccd.24694 
  22. Doyen B, Vlerick P, Soenens G, Vermassen F, Van Herzeele I. Team perception of the radiation safety climate in the hybrid angiography suite: A cross-sectional study. International Journal of Surgery. 2020;77:48-56. https://doi.org/10.1016/j.ijsu.2020.03.027 
  23. Griffin MA, Neal A. Perceptions of safety at work: A framework for linking safety climate to safety performance, knowledge, and motivation. Journal of Occupational Health Psychology. 2000;5(3):347-58. https://doi.org/10.1037/1076-8998.5.3.347 
  24. Marin LS., Lipscomb H, Cifuentes M, Punnett L. Perception of safety climate across construction personnel: Association with injury rate. Safety Science, 2019;118(1):487-96. https://doi.org/10.1016/j.ssci.2019.05.056 
  25. Kim KJ, Jung HR, Hong DH. Factors influencing protective behavior against radiation exposure of radiological technologist in computed tomography examination room. Journal of Radiological Science and Technology. 2018;41(6):581-6. https://doi.org/10.17946/JRST.2018.41.6.581 
  26. 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 
  27. Khandaker MU, Abuzaid MM, Mohamed IA, Yousef M, Jastaniah S, Alshammari QT, et al. Investigation of the radiographer's adherence and compliance with radiation protection and infection control practices during COVID-19 mobile radiography. Radiation Physics and Chemistry. 2023;210:111023 https://doi.org/10.1016/j.radphyschem.2023.111023 
  28. Kim SJ, Chang KO. Factors influencing radiation protection behavior of nurses in operating rooms of small and medium hospitals. Journal of the Korea Academia-Industrial Cooperation Society. 2023;24(7):325-35. https://doi.org/10.5762/KAIS.2023.24.7.325 
  29. Kang J, Lim YM. The relationship between the work environment and persion-centered critical care nursing for intensive care nurses. Journal of Korean Critical Care Nursing. 2019;12(2):73-84. https://doi.org/10.34250/jkccn.2019.12.2.73 
  30. 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. 37-47. 
  31. Lee JH. Awareness, behavior and anxiety of occupational radiation exposure of nurses in intensive care unit [master's thesis]. Seoul: Korea University; 2019. p. 4-56. 
  32. Choi JI, Yang YO. 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):461-7. https://doi.org/10.17946/JRST.2019.42.6.461 
  33. Riggs ML, Knight PA. The impact of perceived group success-failure on motivational beliefs and attitudes: A causal model. Journal of Applied Psychology. 1994;79(5):755-66. https://doi.org/10.1037/0021-9010.79.5.755 
  34. Kim KS, Park YS. The effects of safety climate on safety behavior and accidents. The Korean Journal of Industrial and Organizational Psychology. 2002;15(1):1. 
  35. Jang SY, Kim HS, Jeong SH, Kim YM. Factors affecting radiation protective behaviors in perioperative nurses applying the theory of planned behavior: Path analysis. Journal of Korean Academy of Nursing. 2023;53(2):222-35. https://doi.org/10.4040/jkan.22099 
  36. 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):343-54. https://doi.org/10.5762/KAIS.2017.18.5.343 
  37. Yoon YS. A survey about the knowledge, attitudes and behavior for radiation safety management for operating room nurse. The Journal of Korean Nursing Research. 2018;2(3):1-10. 
  38. 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):278-88. https://doi.org/10.5953/JMJH.2020.27.3.278 
  39. Korea Institute for Healthcare Accreditation. Announcement of the 4th cycle acute care hospital accreditation criteria and standard guidelines [Internet]. Korea Institute for Healthcare Accreditation. 2021 [cited 2024 Apr 26]. Available from: https://www.koiha.or.kr/web/kr/library/establish_board.do 
  40. UK Government. The ionising radiations regulations 2017 [Internet]. UK Government Legislation. 2017 [cited 2024 Jul 15]. Available from: https://www.legislation.gov.uk/uksi/2017/1075 
  41. FDA. Medical x-ray imaging [Internet]. US Food and Drug Administration. 2023 [cited 2024 Jul 15]. Available from: https://www.fda.gov/radiation-emitting-products/medical-imaging/medical-x-ray-imaging#regulations 
  42. WHO. Global initiative on radiation safety in healthcare settings [Internet]. World Health Organization. 2023 [cited 2024 Jul 15]. Available from: https://www.who.int/initiatives/global-initiative-on-radiation-safety-in-health-care-settings 
  43. Jung HG, Yang YK. Factor influencing self-efficacy on defensive behaviors againest radioactive rays of nursing students. Journal of Learner-Centered Curriculum and Instruction. 2020;20(19):91-113. https://doi.org/10.22251/jlcci.2020.20.19.91 
  44. International Atomic Energy Agency. Radiation protection and safety in medical uses of ionizing radiation. IAEA Safety Standards Series No. SSG-46, IAEA, Viennna; 2018. 
  45. Goula A, Chatzis A, Stamouli MA, Kelesi M, Kaba E, Brilakis E. Assessment of health professionals' attitudes on radiation protection measures. International Journal of Environmental Research and Public Health. 2021;18(24):13380. https://doi.org/10.3390/ijerph182413380 
  46. Wang T, Voss JG, Dolansky MA. Promote radiation safety for nurses: A policy perspective. Journal of Radiology Nursing. 2021;40(2):179-82. https://doi.org/10.1016/j.jradnu.2020.12.003 
  47. Shiratori S, Oishi F, Hayama Y. Status and issues of occupational exposure protection for nurses involved in radiation therapy - a nationwide survey in Japan. American Journal of Nursing Science. 2023;12(3):56-63. https://doi.org/10.11648/j.ajns.20231203.11 
  48. Moon KS, Chang YC. An empirical analysis of safety climate constructs within Korea companies. Quarterly Journal of Labor Policy. 2014;14(1):131-54.