Nurses’ radiation protection behaviour: a concept analysis using Walker and Avant’s method

Background Nurses in radiation-exposed clinical areas, particularly interventional catheterisation laboratories and operating rooms, face occupational radiation risk and also influence patients’ exposure. However, “nurses’ radiation protection behaviour” is used inconsistently and often overlaps with knowledge, attitudes and adherence, leaving its conceptual boundaries unclear. This paper aims to undertake a concept analysis of nurses’ radiation protection behaviour. Methods A framework based on Walker and Avant’s stages of concept analysis was used. Literature was accessed via Web of Science, PubMed, Scopus, Embase, CINAHL, CNKI and SinoMed, combining nurse-related and radiation-protection search terms. Of 3,979 records identified, 2,604 remained after duplicates were removed, and 42 studies were included in the final analysis to determine the uses, attributes, antecedents and consequences of the concept. Results Five attributes were identified: self-protective behaviour; patient-protective behaviour; organisational–environmental maintenance behaviour; cognitive–collaborative behaviour; and health self-management behaviour. Antecedents included cognitive, behavioural-cost and resource/organisational factors, while consequences included radiation-related health and dose outcomes and improved patient safety and radiation safety culture. Conclusion This concept analysis has clarified the meaning of nurses’ radiation protection behaviour and presents a working definition and conceptual model. These findings can improve understanding and communication of the concept in practice, education and research, and provide a foundation for future application and measurement-tool development.