Hospital Preparedness and Nurses' Risk Perception of Radiation Accidents.

OBJECTIVE: This study examined hospital preparedness and radiation risk perception among nurses in Iran, uniquely applying the Transtheoretical Model to identify behavioral predictors of emergency readiness. METHODS: This cross-sectional study was conducted among 152 health care workers in three teaching hospitals. Four validated tools assessed hospital preparedness, knowledge, risk perception, and stages of change. Linear regression identified predictors of behavioral progression. RESULTS: While the hospital equipment domain scored highest (mean 18.3/21), the education domain scored lowest (mean 2.3/4). Notably, 85.5% of nurses remained in the passive stages of change, with only moderate levels of risk perception. Cognitive (β = 0.937) and behavioral processes (β = 0.763) strongly predicted stage advancement, extending previous findings on behavioral determinants of disaster preparedness. CONCLUSION: This study suggests that psychological readiness may play an important role in radiation emergency preparedness. Stimulus control and reinforcement management represent critical behavioral targets that are often overlooked in traditional training. Policymakers should consider shifting from awareness-only approaches to stage-matched, behaviorally driven interventions that address nurses' emotional barriers and support sustained readiness.