Introduction: Communicating radiation dose to nurses using Sievert-based units may be difficult to interpret and may heighten anxiety. Chest Equivalent Dose (CED) is a symbolic approach that anchors dose information to a familiar chest imaging reference frame. Objective: To compare the effects of Chest Equivalent Dose (CED) versus conventional Sievert-based dose communication on nurses’ radiation knowledge, radiation anxiety, and radiation-related feelings/experiences. Methods: A quasi-experimental pretest–posttest comparative study was conducted among nurses in Jordan. Participants received Sievert-based education (n=40) or CED-based education (n=31). Radiation knowledge (RKQ), radiation anxiety (RAQ), and radiation-related feelings and experiences (RREF) were measured immediately before and after the session. Paired- and independent-samples tests were used, and time effects were explored using mixed-model analyses. Results: Baseline scores did not differ between groups (all p> 0.05). In the CED group, RKQ increased from 59.76± 8.32 to 79.76± 10.16, while RAQ decreased from 57.97± 1.33 to 36.74± 1.83 and RREF decreased from 77.58± 2.87 to 47.12± 2.90 (all p< 0.001). In the Sievert group, RKQ was unchanged (56.08± 10.89 to 58.32± 9.04; p=0.329), with small decreases in RAQ (58.23± 1.19 to 56.45± 1.58; p< 0.001) and RREF (77.67± 3.02 to 75.67± 3.17; p=0.005). Posttest outcomes favoured CED for RKQ, RAQ, and RREF (all p< 0.001). Conclusion: CED-based symbolic dose communication produced larger improvements in knowledge and larger reductions in anxiety and radiation-related experiences than Sievert-based education. Plain Language Summary: Radiation dose is usually reported using scientific units such as millisieverts (mSv), which many nurses find difficult to interpret. When dose information is hard to interpret, it can increase worry, reduce confidence when answering patient questions, and weaken consistent risk communication across teams. Healthcare leaders and nurse educators are responsible for selecting training approaches and communication standards that support staff understanding and psychological safety. In this study, nurses received a brief educational session using either conventional Sievert-based teaching or a symbolic approach called Chest Equivalent Dose (CED), which explains dose using a familiar reference (the dose from a standard chest X-ray). We measured nurses’ radiation knowledge, anxiety, and radiation-related feelings before and after training. Compared with Sievert-based teaching, CED led to larger improvements in knowledge and larger reductions in anxiety and radiation-related concerns. These findings suggest that leaders can improve staff communication by standardizing an interpretable dose message that is accurate but easier to use in daily practice. For leaders, CED can be implemented through onboarding, annual competency training, and short, standardized scripts for staff-to-staff and staff-to-patient communication, supported by local champions and periodic audits to ensure consistent use. Keywords: radiation dose communication, chest equivalent dose, nurses, radiation anxiety, radiation knowledge, risk perception
Ayasrah et al. (Fri,) studied this question.