Exploring influences on radiation protection compliance: a directed acyclic graph-based cross-sectional study in a non-teaching hospital in western China.

Lulu Cao, Jinwen Wu, Li Jiang, Yi Tao, Huaping Huang, XiaoJing Xue

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Article in PeerJ, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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Lulu Cao *Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Jinwen Wu *Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Li JiangDepartment of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Yi TaoDepartment of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Huaping HuangDepartment of Nursing, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

XiaoJing XueDepartment of Radiation Oncology Center, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.

Funding

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6 · The paper itself

Abstract

Background: Occupational radiation exposure poses significant health risks to medical personnel. However, the causal pathways linking protective knowledge, attitudes, and behavior (KAB) remain underexplored. Therefore, this study aimed to apply directed acyclic graphs (DAGs) to clarify the mechanistic relationships among these factors. Methods: A cross-sectional survey of 335 radiation workers from a non-teaching level III general hospital in western China used validated scales to measure KAB. DAGs were constructed based on theoretical frameworks and previous evidence, complemented by correlation analyses, multivariate linear regression, and structural equation modeling. Results: Radiation protection knowledge exerted the strongest direct effect on protective behavior (β = 0.55 5, Conclusions: This study applied DAGs to clarify causal mechanisms in radiation protection, highlighting knowledge acquisition as a key driver of safe practices. Age-specific interventions and standardized training programs are recommended to address knowledge deficits and mitigate age-related behavioral decline. These findings provide a methodological foundation for optimizing occupational health strategies, with implications for policy design and future longitudinal validation.

Indexed as

Health Knowledge, Attitudes, PracticeOccupational ExposureRadiation ProtectionAdultChinaCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesDirected acyclic graphs (DAGs)Healthcare workersKnowledge, attitude, and behavior (KAB)Occupational healthRadiation protection

Identifiers

PMID41112772

DOI10.7717/peerj.20083

PMCPMC12530198

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