Abstract: Objective: To explore barriers to implementing evidence-based guidelines for Radiation-Induced Oral Mucositis (RIOM) among healthcare professionals, providing insights for guideline implementation and promotion. Methods: This descriptive qualitative study employed semi-structured interviews guided by the Theoretical Domains Framework. Fourteen healthcare professionals from oncology department across four tertiary grade A hospitals in Hunan province were purposively sampled in May 2025. Framework content analysis was used for data analysis. Results: Seven barrier factors and 19 sub-themes were extracted from 9 theoretical domains (knowledge, skills, beliefs about capabilities, motivation and goals, memory/attention and decision processes, environmental context and resources, social influences, emotion, and behavioural norms). The seven identified barriers included: insufficient professional knowledge reserves and gaps in translating external evidence; low self-efficacy, lack of motivation, and unclear goals; delayed intervention timing, low patient engagement, and insufficient family support; lack of resources and environmental constraints; inadequate top-down support systems and insufficient interdisciplinary collaboration; emotional exhaustion and negative implementation experiences of medical professions; and abstract workflows and lack of concrete measures. Conclusion: Healthcare professionals encounter multifaceted barriers at individual, organizational, and societal levels in implementing evidence-based RIOM guidelines. Multi-level, systematic intervention strategies are needed to advance evidence-based RIOM management.

Key words: Radiation-Induced Oral Mucositis; Theoretical Domains Framework; evidence; barrier; qualitative study