Portuguese translation, validity and psychometric evaluation of the healthcare professional knowledge of radiation protection scale

Purpose: The main objective of this study is to explore the physician's knowledge on patient radiation exposure during pediatric Computed Tomography (CT). Materials and methods: A questionnaire from various questions was developed during this work. The questions have focusing on prescribers' practices and their knowledge of patient radiation protection. It was distributed and completed by 44 doctors of various medical specialties in the regional hospital center of Agadir. Results: Forty-four questionnaires survey were analyzed. All physicians disregard the three principles of radiation protection. Only 11% of physicians estimate correctly the dose delivered for an adult during a standard thoracic radiological examination. The delivered dose for a 1 year old child during a standard thoracic radiological examination was disregard by 98% of prescribers.16% of physicians estimate correctly the dose delivered for an adult during a thoracic CT scan. The dose delivered for a 5-year-old child during a thoracic CT scan was underrated by 84% of physicians. One for five prescribers assigns a dose of irradiation higher than 0.01 mSv during a thoracic Magnetic Resonance Imaging (MRI) exam for child. Finally, 34% of physicians choose CT scan (not indicated) as the first choice for abdomino-pelvic mass and epileptic syndromes. Conclusion: The radiation doses in CT scan are poorly mastered, and indications of CT exams are not correctly applied by our clinicians. The risk of developing a malignant neoplasm after a radiological exposure in pediatric CT scan has been confirmed by all our prescribers. There is a need for arising awareness about this topic and both initial and continuing training in radiation protection for patients could significantly improve our practitioners' knowledge of radiation protection for patients..

Ionizing radiation aids in diagnosing and treating diseases. However, without proper knowledge and practice of radiation protection, it can be harmful, especially among healthcare professionals. This study aims to examine the knowledge and practice of radiation protection among healthcare workers at the HPUniSZA. A cross-sectional study was conducted in the HPUniSZA from March 2022 to June 2023 for healthcare professionals in HPUniSZA. The questionnaire was distributed online and through face-to-face interviews. Descriptive statistics were used to analyze sociodemographic, knowledge, and practice of radiation protection while Pearson’s correlation was used to determine the relationship between knowledge and practice of radiation protection among the respondents. A total of 60 healthcare professionals in HPUniSZA participated in this study. The mean knowledge level was found to be 6.20 (SD, 2.905) indicating a range of medium-good level of knowledge of radiation protection while for practice was found to be 8.20 (SD, 2.394) indicating a good practice of radiation protection among healthcare professionals. A significant positive and fair correlation (r = 0.48, p < 0.001) was demonstrated between knowledge and practice levels on radiation protection in radiological imaging. The knowledge level and the practice of radiation protection among healthcare professionals are in the range of medium-good level and good levels respectively. There is a correlation between knowledge and practice of radiation protection among healthcare professionals in HPUniSZA. Assessing the knowledge and practice of radiation protection among healthcare professionals is of utmost importance to ensure patient safety, minimize radiation risks, and facilitate effective and efficient healthcare delivery both now and in the future.

The use of radiological activity in the operating room (OR) and a regulatory decrease of the eye lens dose warrant an assessment of how medical staff are protected from radiation. This study aims to evaluate practices and knowledge in radiation protection (RP) for OR doctors before and after training. A descriptive study of surgeons and anesthetists in a French public hospital center was conducted in 2016. An ad hoc questionnaire concerning occupational practices and knowledge about RP was distributed before and one month after RP training. Among 103 doctors attending the training, 90 answered the questionnaire before the training. Results showed a lack of knowledge and good practice in RP. Most of the participants (86.7%) had never been trained in RP and recognized insufficient knowledge. Most of them (92.2%) wore a lead apron, 50.0% a thyroid-shield, 5.6% lead glasses, 53.3% a passive dosimeter and 17.8% an electronic dosimeter. None of them benefitted from collective protective equipment such as a ceiling suspended screen. The questionnaire following the training was completed by only 35 doctors. A comparison before and after training results showed an improvement in knowledge (scores of correct responses: 5.5/16 before and 9.5/16 after training) but not in RP good practices (scores of correct responses: 3.2/7 before and 3.3/7 after training). One training session appears to be insufficient to improve the application of the safety rules when x-rays are used. Communication needs to be improved regarding RP among anesthetists and surgeons, such as training renewal, workstation analysis in OR related to x-ray use and occupational medical follow-up. Otherwise, radiological risks in OR need to be given better consideration, such as radio-induced cataract risk. It is necessary to encourage the use of dosimeters and protective equipment and to strengthen access to lead glasses and collective protective equipment, such as ceiling suspended screens. All these recommendations ensure the received dose is reduced to as low as is reasonably achievable.

Training in radiation protection is a basic aspect of the optimisation of medical exposures. Council Directive 97/43/EURATOM establishes the need for an adequate theoretical and practical training of the staff working in radiological practices, and competence in radiation, for which Member States shall ensure the establishment of appropriate curricula. Keeping in mind the different specialities and professional responsibilities, training curricula must be proposed and endorsed to achieve a common core of knowledge in radiation protection throughout Europe, for different groups of health workers. In interventional radiology, previous initiatives led to the definition of a syllabus of educational objectives and to its testing in a specific course. The present paper presents educational objectives for interventional radiology, developed in the framework of the DIMOND European concerted action.

Introduction: Radiation protection is a core component of radiographic practice and provides optimal patient safety and control of radiation hazards. In this study, we aim to determine the knowledge of radiation protection among dental students in a medical college, in Nepal.Materials and methods: Bachelor’s degree dental final year students studying at Gandaki Medical College (GMC), Pokhara, Nepal were included in this study. A questionnaire survey tool was developed by consulting with two lecturers of medical imaging technology who have more than 10 years of experience. 10 multiple-choice questions (MCQs) were handed to each participant. Each correct answer was given a “1” score and each incorrect answer was given a “0” score. There were no negative markings. The knowledge score was categorized as <60 % inadequate, 60–80 % adequate, and 80–100% excellent. Data were coded and analyzed in IBM SPSS statistics, version 28, Chicago, United States. The normality of the data was checked by using the Shapiro-Wilk test. The equality of variance was assessed by Levene’s test. The p-value was set at a 5% level of significance. Two sample ttest was applied since the data followed a normal distribution. Results: A total of 16 dental students, 5 males, and 11 females, 22.06±0.77 mean age, 20-23 age range were included in this study. Participants did not have prior training in radiation protection. The mean knowledge of radiation protection score was 52.5%, 5.25±1.52, with a maximum score of 8 and a minimum 3 of which was inadequate. There was a statistically significant difference in knowledge according to gender, p=0.01, t(14)=2.92. The mean response was 60% (adequate) for 21-year-old participants and was inadequate at other ages. Conclusion: The knowledge of radiation protection should be improved among dental students. Adequate course materials and training should be included in their curriculum. Radiation protection national regulations should be implemented as soon as possible.

This descriptive cross-sectional study evaluated radiation protection knowledge and practices among 206 Moroccan operating room nurses through a tailored 42-item self-administered questionnaire. The study population exhibited a predominance of male participants (81.1%) and a significant proportion of young professionals (42.2% aged 20–29). Notably, 91.7% of participants reported no prior formal radiation protection training. Data analysis revealed a mean global knowledge score of 4.98 ± 1.02 out of 10, with only 1.9% of participants achieving a high level of knowledge. Specifically, the mean scores for ionizing radiation (IR) and radiation protection (RP) knowledge reached 5.17 ± 1.05 and 4.79 ± 1.18, respectively, with 1.5% of participants demonstrating high-level understanding in both domains. Statistical analysis revealed significant positive correlations between ionizing radiation (IR) and radiation protection (RP) knowledge scores (r2 = 0.446, p < 0.001), as well as between global knowledge and practice scores (r2 = 0.481, p < 0.001). This investigation highlights a significant gap between theoretical understanding and practical application, emphasizing the need for preliminary training programs before operating room assignments and ongoing education initiatives. Such training should prioritize hands-on experience while addressing resource limitations and the influence of existing operational procedures to improve radiological safety in Moroccan operating rooms.

IntroductionRadiation protection aims to reduce unnecessary exposure to ionizing radiation, protecting patients and healthcare workers. Although diagnostic imaging techniques contribute minimally to overall exposure, risks still exist. Radiologic technologists perform X-ray procedures in diverse settings, collaborating with medical teams to ensure quality patient care. The Radiological Sciences program delivers comprehensive education and clinical training in anatomy, radiation safety, patient positioning, and imaging techniques. This study assesses the effectiveness of educational interventions in enhancing students’ understanding of principles of radiation physics, protection, and safety guidelines, preparing them for responsible clinical and research practices.MethodsA cross-sectional, in-person survey was conducted among undergraduate and intern students in the Radiological Sciences Department at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah. The Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale was distributed via Google Forms. Data were analyzed using SPSS (v.29). Differences in HPKRP components between students’ stages were examined using an unpaired samples t-test and ANOVA.ResultsUndergraduate students in their third and fourth years, as well as interns who completed post-educational courses, scored significantly higher than second-year students without prior coursework in medical radiation imaging. Participants with post-educational courses and training in ionizing radiation demonstrated the highest knowledge levels in radiation physics, biology, and principles of radiation use (mean: 9.2 ± 0.8), followed by radiation protection (mean: 8.9 ± 1.2). Knowledge of safe ionizing radiation use guidelines scored slightly lower (mean: 8.5 ± 1.6).ConclusionStructured radiation education significantly enhances students’ knowledge of radiation physics, protection, and safety guidelines. Significant improvements were observed between the second and third academic stages, as well as among interns, with stable retention in later stages. Early integration and continuous education for promoting a strong culture of radiation safety and responsible practice across clinical and research environments.

Objectives. This study evaluated radiation protection knowledge among oral and dental healthcare professionals in Turkey, focusing on medical imaging technicians (MITs), dentists and dental assistants (DAs). Methods. A cross-sectional online survey was conducted with 236 participants using the validated Turkish version of the healthcare professional knowledge of radiation protection (Tr-HPKRP) scale. Knowledge was assessed across three domains: radiation physics and principles; radiation protection; and safe use of ionizing radiation. Mann–Whitney U tests and Kruskal–Wallis tests were applied for group comparisons. Results. MITs achieved significantly higher scores than dentists and DAs across all domains (p < 0.01). Structured education through academic programs or formal in-service training was positively associated with knowledge (p < 0.01), while reliance on informal sources such as media or colleagues showed no effect (p > 0.05). Professional experience was not correlated with knowledge (p > 0.05). Conclusions. Substantial knowledge gaps exist among dentists and DAs compared with MITs. Integrating standardized and regularly updated radiation safety training into undergraduate curricula and continuing professional development is essential to improve compliance with best practices and ensure patient and practitioner safety in dental diagnostic imaging.

Development and validation of a psychometric scale for assessing healthcare professionals' knowledge in radiation protection

This study aimed to develop and evaluate the validity and reliability of dentists' radiation protection knowledge, attitudes, and practices (DRP-KAPs) questionnaire. This study was conducted using a stepwise approach. In the first step, items were generated to determine the relevant content and domains after a thorough literature review. In the second step, the content validity of the questionnaire was assessed by seven experts using face and content validity. The content validity index for relevance and clarity (I-CVI, S-CVI/Av, and S-CVI/UA) and the content validity ratio (CVR) were performed. Then, the questionnaire was pre-tested with 10 dentists for face validation. In the third step, reliability was assessed using internal consistency (Kuder-Richardson-20 (KR-20) and Cronbach's alpha) and test-retest (Kappa and intraclass correlation coefficient [ICC]) methods by filling out the questionnaire by 100 dentists practicing in the Rabat-Salé-Kénitra region, in Morocco. The finalized DRP-KAPs questionnaire contains 41 items covering knowledge, attitudes and practices (KAPs). The I-CVIs, S-CVI/UA and S-CVI/AV and CVR values of the 41 items were ≥0.86 for each item, ≥0.82, ≥0.97, and ≥0.71, respectively. With regard to internal consistency reliability, the KR-20 coefficients for the knowledge and practice domains were 0.70 and 0.68, respectively, and the Cronbach alpha for the attitude domain was 0.73. The DRP-KAPs questionnaire has good reliability with the ICC coefficients for attitude items ranging from 0.57 to 0.95 and Kappa coefficients for knowledge and practice items ranging from 0.64 to 1 and 0.77 to 1, respectively. The developed DRP-KAPs questionnaire was found to be a noteworthy tool for assessing radiation protection among dentists, with acceptable internal consistency, good ICC and Kappa coefficients, and good content validity indices.

Nurses' understanding of radiation protection and their awareness of safety procedures are essential in reducing occupational exposure and maintaining a safe clinical environment. This study aims to examine how nurses' radiation protection knowledge and their level of safety awareness influence their safety behaviours. A cross-sectional correlational design was used. The study was conducted between June and August 2023 with 321 nurses employed in a hospital in the largest province of Türkiye. Data were collected using the Healthcare Professional Knowledge of Radiation Protection Scale, the Safety Awareness and Competence Scale and the Safety Behaviour Scale. Multiple linear regression analysis was performed to evaluate the predictive effects of radiation knowledge and safety awareness on safety behaviour. Nurses demonstrated low levels of radiation protection knowledge (3.29 ± 1.88), whereas their safety awareness was high (4.01 ± 0.65), and their safety behaviour scores were above average (3.70 ± 0.73). Safety behaviour showed a moderate positive correlation with radiation protection knowledge (r = 0.270, p < 0.001) and a strong positive correlation with safety awareness (r = 0.608, p < 0.001). Regression results demonstrated that both variables significantly predicted safety behaviour (R2 = 0.385, p < 0.001). Radiation protection knowledge and safety awareness together explained 38.5% of the variance in nurses' safety behaviour. These findings highlight the need for structured and continuous in-service training on radiation protection. In addition, institutional and national policies should be strengthened to support sustainable radiation protection practices in clinical settings.

Context and objective. Ionizing radiation plays a central role in modern medical practices, but occupational exposure to ionizing radiation represents a major global public health issue. This study aimed to assess the exposure of imaging service providers in the city-province of Kinshasa to ionizing radiation. Methods. A descriptive cross-sectional study was conducted in thirty health care facilities that offer medical imaging services in Kinshasa. Data were collected through interviews with imaging providers, measurements, environmental observations, and ionizing radiation dosimetry inside and around imaging rooms. Results. The majority of medical imaging personnel (95%) had no knowledge of radiation protection, and only 26.7% had received training in radiation protection. Furthermore, 90% of the personnel did not have dosimeters; no facility had qualified radiation protection personnel, and workers did not benefit from any medical monitoring related to their profession. Most of the health care facilities (93.3%) had lead aprons, but none had lead vests. None of the services had signage indicating radiation hazards. Most staff were exposed to an average dose of 19.04 ± 10.93 mSv/h, and nearby members of the public were exposed to 19.33±17.50 mSv/h. Conclusion. Radiation protection practices in health facilities in the city-province of Kinshasa suffer from numerous shortcomings. Practical radiation protection measures for personnel in health care settings must be significantly strengthened and strictly observed. Received: May 23rd, 2024Accepted: April 7th, 2025 https://dx.doi.org/10.4314/aamed.v18i3.19

The objective of this study was to assess the level of knowledge and awareness among referring physicians regarding diagnostic procedures involving ionizing radiation. A total of 350 physicians with varying levels of education and experience participated in a structured questionnaire. They were employed across all levels of healthcare in Vojvodina. Group 1 (G1) included physicians who had received additional training in radiation protection, while group 2 (G2) had not received this training. In G2, 44 % of respondents rated their knowledge of ionizing radiation as insufficient for routine clinical practice, and only 16.5 % were familiar with the ALARA principle. Just 20 % correctly identified diagnostic procedures that do not involve ionising radiation, whereas nearly 40 % incorrectly classified fluoroscopy, mammography and PET scans as non-ionizing. One third of participants stated that radiation exposure does not increase lifetime cancer risk. The 89 % of respondents expressed a strong demand for clear guidelines to help select diagnostic modalities based on clinical indication and patient age. Regarding unnecessary imaging referrals, 55 % cited excessive reliance on imaging, while 44 % attributed it to patient requests. This pilot study highlights the pressing need to improve education on radiation protection, especially given the increasing accessibility of advanced and hybrid imaging technologies.

Radiology is a vital diagnostic tool for multiple disorders that plays an essential role in the healthcare sector. Nurses are majorly involved in a healthcare setting by accompanying patients during the examination. Thus, nurses tend to be exposed during inward X-ray examination, requiring them to keep up with radiation use safety. However, nurses' competence in radiation is still a concept that has not been well studied in Malaysia. The study aimed to define the level of usage understanding and radiation protection among Malaysian nurses. In this research, a cross-sectional survey was conducted among 395 nurses working in hospitals, clinics, and other healthcare sectors in Malaysia. The survey is based on the developed Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale, distributed via the online Google Forms. SPSS version 25.0 (IBM Corporation) was used to analyze the data in this study. Malaysian nurses reported the highest knowledge level in radiation protection with a mean of 6.03 ± 2.59. The second highest is safe ionizing radiation guidelines with 5.83 ± 2.77, but low knowledge levels in radiation physics and radiation usage principle (4.69 ± 2.49). Therefore, healthcare facilities should strengthen the training standards for all nurses working with or exposed to radiation.

Nurses’ knowledge of radiation protection: A cross-sectional study