This randomized controlled trial aims to evaluate the effect of a Protection Motivation Theory (PMT)-based radiation protection training program on nurses' knowledge, awareness, motivation, and safety behaviors. The study includes 54 operating room nurses randomly assigned to experimental (n=27) and control (n=27) groups. The intervention targets both threat appraisal (perceived severity and vulnerability) and coping appraisal (response efficacy, self-efficacy, and response cost) processes. It is hypothesized that PMT-based training will improve nurses' radiation protection knowledge, increase awareness, strengthen motivation, and enhance safety behaviors. The findings are expected to contribute to nursing curricula, institutional radiation safety policies, and the development of a safety culture in healthcare settings.

The increasing use of ionizing radiation in medical procedures has raised concerns about occupational exposure among healthcare professionals, including nurses, who may be directly or indirectly exposed during their clinical duties. Evidence from the literature indicates that nurses often have insufficient knowledge and awareness regarding radiation protection, which may lead to suboptimal safety practices and increased health risks. Enhancing radiation safety among nurses is crucial for both occupational health and patient safety.

Protection Motivation Theory (PMT), developed by Rogers, provides a comprehensive framework for understanding and influencing health-related protective behaviors. PMT posits that behavior change is influenced by two cognitive processes: threat appraisal (perceived severity and perceived vulnerability) and coping appraisal (response efficacy, self-efficacy, and response cost). Educational interventions structured according to PMT can effectively promote protective health behaviors by addressing both risk perception and the perceived ability to perform protective actions.

This randomized controlled trial aims to evaluate the effectiveness of a PMT-based radiation protection training program in improving nurses' knowledge, awareness, motivation, and safety behaviors related to radiation protection. A total of 54 operating room nurses will be randomly assigned to either the experimental group (n=27), which will receive structured PMT-based radiation safety education, or the control group (n=27), which will not receive the intervention during the study period. The training program targets both threat and coping appraisal processes and is delivered in a structured format designed to address the cognitive and behavioral components of radiation safety.

Primary and secondary outcome measures will be assessed before and after the intervention using validated instruments. The primary outcome is the change in radiation protection behavior scores, while secondary outcomes include changes in knowledge, awareness, and motivation scores. It is hypothesized that the intervention group will demonstrate significant improvements in all outcome measures compared to the control group.

The results of this study are expected to inform the integration of radiation safety content into nursing curricula, guide the development of institutional policies on radiation protection, and contribute to fostering a culture of safety in healthcare settings.

Inclusion Criteria:

• Registered nurses working in the operating room or intervention areas where ionizing radiation is used.
• Willing to participate and provide informed consent.
• Able to attend the full radiation protection training program (for the experimental group).

Exclusion Criteria:

• Nurses not working in areas with exposure to ionizing radiation.
• Nurses who have previously received formal radiation protection training within the last 12 months.
• Inability to complete the study questionnaires or training program due to language or cognitive barriers.

No masking is applied in this study; both participants and investigators are aware of group assignments (open label).