Radiographers' conceptualisation of trauma imaging in Gauteng, South Africa.

Background: Radiographers form part of the healthcare team and are integral in the diagnosis and treatment of trauma patients. Additionally, they are required to provide their services to multiple departments within the hospital, including the emergency department. Healthcare workers who work with trauma patients experience changes in their psychological functioning. Therefore, diagnostic radiographers may have similar experiences; however, limited studies were found on radiographers' conceptualisation of trauma imaging. Aim: The aim of this study was to explore and describe radiographers' conceptualisation of trauma imaging. Setting: One-on-one in-depth interviews were conducted virtually with radiographers in both the private and public healthcare sectors in Gauteng, South Africa. Method: In this qualitative, explorative and descriptive study, 20 radiographers were interviewed virtually through Zoom or WhatsApp video calls or telephone interviews. Participants were asked a central question: 'What does trauma imaging mean to you?' Detailed notes were taken during the interviews, and interviews were audio-recorded. The data was transcribed and underwent thematic analysis. Trustworthiness and ethical principles were adhered to throughout the study. Results: Thematic analysis identified four themes: (1) COVID-19 pandemic; (2) road accidents; (3) gender-based violence (GBV); and (4) paediatric injuries that participants conceptualised as trauma imaging. Conclusion: Participants conceptualised trauma imaging as COVID-19, road accidents, GBV and paediatric patients. It was noted that participants' personal experiences were significant contributors to their meaning-making and responses to trauma imaging. Contribution: The study has contributed to the understanding of the conceptualisation of trauma imaging from the perspective of diagnostic radiographers.

Theory of optimising radiation protection among diagnostic radiographers depicted as a model.

Background: When radiation protection practices are suboptimal, it becomes necessary to take additional steps to optimise practices. Aim: Therefore, this study aimed to develop a model to facilitate radiation protection among diagnostic radiographers. Setting: The study was conducted in South Africa. Methods: A theory-generating design consisting of three steps was used to develop the model: (1) the central concept was identified, defined and classified; (2) relationship statements were created and (3) the model was developed, described and evaluated. Results: The model was premised on the central concept of facilitating a transformative radiation protection environment and occurs in four phases: (1) relationship, (2) working, (3) termination and (4) independent phases. The radiography manager and radiographer enter the relationship phase of the model because of discord regarding radiation protection in their department and work together to optimise radiation protection. The model's purpose, assumptions, context, structure and process are described. Conclusion: A model to facilitate radiation protection among radiographers was conceptualised to optimise radiation protection. The model details the steps the radiography manager and radiographer take to co-create optimal radiation protection practices. Radiation protection compliance among radiographers is paramount to ethical radiography practice, and the model provides a guide to optimise radiation protection. Contribution: In any radiography department where radiation protection may be lacking, the model provides a road map of possibilities for change. Ultimately, radiation protection compliance improves patient care and outcomes.

Two years on and four waves later: Johannesburg diagnostic radiographers' experiences of COVID-19.

INTRODUCTION: At the onset of COVID-19 diagnostic radiographers from Gauteng, South Africa, shared their experiences of the new workflow and operations, their well-being and their resilience during this time. They experienced emotional, physical and financial fatigue. It is now over two years later, and South Africa has experienced four waves of COVID-19. Therefore, this study explored diagnostic radiographers' experience of COVID-19 after two years and four waves. METHODS: A qualitative explorative, descriptive and contextual study was conducted by collecting data through nine virtual individual in-depth interviews. Responses from the diagnostic radiographers in Johannesburg, Gauteng, South Africa, underwent thematic analysis. RESULTS: Thematic analysis revealed two themes and related categories. Theme one: participants shared synchronistic experiences with the four COVID-19 waves, the heterogeneous vaccination ideologies and their support and coping skills. Theme two: lessons learnt and the way forward. CONCLUSION: Participants shared feeling overwhelmed at the onset of COVID-19 and feared infecting their family, friends and colleagues. However, their anxiety and fear decreased with time. They experienced the Delta variant as the worst and felt supported by their colleagues more than by management. They recounted observations of vaccine hesitancy but acknowledged that vaccination had alleviated some of the fear and anxiety. Participants' coping skills varied, and reflecting on their experience, they shared the lessons learnt and the way forward.

Radiation Protection among South African Diagnostic Radiographers-A Mixed Method Study.

ABSTRACT: Worldwide, radiographers' radiation protection practices vary. In South Africa, evidence of diagnostic radiographers' suboptimal radiation protection practices has been reported, but the reasons for these practices and suggestions to improve practices were lacking. Therefore, this study explored radiation protection among South African diagnostic radiographers. This study used an explanatory, sequential, mixed-method approach. Data were collected in three phases. Phase I, the quantitative phase, used an online questionnaire and respondents from Phase I interested in participating in Phase II, the qualitative phase, were interviewed, yielding 13 in-depth semi-structured telephone interviews. In Phase III, eight radiography managers co-constructed change strategies to optimize radiation protection in South Africa in two focus group interviews. Radiation protection was suboptimal despite diagnostic radiographers having a good attitude, subjective norm and perceived behavioral control toward radiation protection and optimal radiation protection knowledge. Varying attitudes to radiation protection, lack of resources, and support from radiography management and healthcare teams contributed to suboptimal radiation protection practices. Radiography managers suggested increasing radiation protection awareness, ameliorating the diminished stature of the radiographer in the healthcare team, and increasing the availability of optimal quality resources. South African diagnostic radiographers' radiation protection knowledge was optimal, but the implementation of radiation protection varied and was influenced by multiple factors. A radiation protection culture supported by management is advocated to optimize radiation protection. However, ultimately radiation protection practices are incumbent on the individual radiographers' choice to practice radiation protection.

Australian graduate radiographers' perspectives and experiences of work readiness.

INTRODUCTION: Graduate radiographers entering their qualified positions need to orientate and familiarise themselves with a rapidly changing work environment to deliver a high standard of diagnostic imaging services. During this transitional phase, these newcomers also strive to meet self-expectations and workplace expectations. This study was performed to understand the work readiness perspectives and initial experiences of graduate radiographers on beginning their newly qualified roles. METHODS: The study used a qualitative phenomenological approach to collect data through individual semi-structured in-depth telephone interviews with 14 purposively sampled undergraduate and postgraduate radiographers. The rich data were transcribed verbatim and then thematically analysed. RESULTS: Four major themes emerged: (1) preparing to be 'work-ready', (2) initial encounters as qualified radiographers, (3) personal and professional challenges and (4) support strategies and advice for new graduates. CONCLUSIONS: New graduate radiographers face many personal and professional challenges but agree that they thrive in supportive collegial environments. Most participants had a high perspective of their work readiness strongly related to their clinical placements as students, workplace familiarity, support networks and coping strategies. Further review into individual workplace orientations by organisation leaders may benefit the immersion and enhancement of graduate radiographers' initial experiences in their new role.

An exploratory study on recently qualified Australian radiographers' expectations and experiences in emergency and trauma imaging.

BACKGROUND: Radiographers provide imaging services in multiple healthcare settings, including emergency and trauma. Transitioning to a qualified radiographer is already a time of vulnerability - with the increasing complexity and unpredictable nature of the emergency and trauma healthcare environment, recently qualified radiographers may experience this environment distinct from other service delivery areas. OBJECTIVE: The study explored recently qualified radiographers' expectations and experiences in emergency and trauma imaging service delivery. METHODS: An inductive qualitative phenomenological approach with a purposive sampling technique recruited recently qualified radiographers (n=19) involved in the delivery of emergency and trauma imaging services. Transcribed semi-structured individual interviews were thematically analysed. RESULTS: Two themes and related categories were identified: 1. The multiplexity of diagnostic emergency and trauma imaging service delivery and 2. Approaching the complex nature of emergency and trauma imaging. CONCLUSION: The expectations and experiences of emergency and trauma imaging varied, aligned to previous exposure to emergency and trauma imaging. Even though emergency and trauma imaging was challenging, the fast pace, patient dynamics and multidisciplinary deliverance; the experience was considered rewarding and an opportunity to improve skills. Participants coped through debriefing and calming strategies; however, radiology-specific debriefing was recommended to further foster the recently qualified radiographers' well-being.

July 2021 civil unrest: South African diagnostic radiography students' experiences.

Background: South Africa (SA), in 2021, experienced a wave of civil unrest following political events that led to mass looting and the destruction of property. Civil unrests, among other disruptions, have been seen to cause ripple effects on healthcare education, particularly for radiography students who undergo work integrated learning within hospitals and universities, even during these times of unrest. Aim: This study aimed to explore and describe the undergraduate diagnostic radiography students' experience of the civil unrest that occurred in SA in 2021. Setting: The study was conducted across five universities in South Africa, offering the diagnostic radiography programme. Methods: A qualitative, interpretive phenomenological design was employed as it enabled the researchers to facilitate focus group interviews to gain insight into the lived experiences of the students during this time. Results: Four themes emerged from the study data, namely: (1) Negative effects on students' emotional and psychological well-being, (2) Academic and clinical support mechanisms during disruptions, (3) The influence of disruptions on clinical training, (4) Recommendations to support students for future disruptions. Conclusion: The participants from this study described the negative effects that the civil unrest had on their emotional and mental well-being. There is a need for increased support mechanisms during times of disruptions from universities across South Africa. Contribution: The findings highlight the ripple effects that disruptions, such as civil unrests, have on radiography students. This can assist universities to relook at their institutional support structures, in order to enhance the current support given to students across universities in times of disruptions.

The lived experiences of radiotherapists treating paediatric patients: Gauteng, South Africa.

BACKGROUND: Paediatric cancers are rare and more complex than adult cancers. Consequently, treatment for paediatric cancers is complex, requiring absolute precision and accuracy in delivering the prescribed dose. For radiotherapists, the complexity of performing paediatric radiotherapy treatment is augmented by its rarity, time and pressure constraints, the patient's lack of cooperation, anxiety and emotional challenges. These multiple challenges may affect the quality of patient care if they are not recognised and reduced. Therefore, this study explored radiotherapists experience of treating paediatric patients. OBJECTIVE: The purpose of this study was to explore and describe the lived experiences of radiotherapists treating paediatric patients. METHODS: This qualitative phenomenological study purposively sampled qualified radiotherapists involved in paediatric treatment planning and delivery in Gauteng, South Africa. Data were collected through 17 individual, in-depth interviews and underwent thematic analysis. RESULTS: Thematic analysis identified the emotional context in which radiotherapists work when treating paediatric patients and how radiotherapists' familiarity affects their experience of treating paediatric patients. The closeness of contact with the paediatric patient, parents and family dimension impacted participants positively and negatively. CONCLUSION: The study confirmed that radiotherapists treating paediatric patients work within a highly intense emotional context. The importance of gaining familiarity and experience in paediatric radiotherapy to enhance competency, was identified. Radiotherapist's experienced both positive and negative implications due to their close contact with the paediatric patient, parents and family dimension. The necessity to advance the practical infrastructural areas and strive for enhanced professionalism to improve paediatric radiotherapy was thus emphasised.

Using the theory of planned behaviour to determine radiation protection among South African diagnostic radiographers: a cross-sectional survey.

INTRODUCTION: The use of ionising radiation in medicine accounts for the majority of radiation exposure from artificial sources. Therefore, all measures to safeguard against unnecessary radiation exposure must be taken. As radiographers are central to radiation protection, this study aimed to determine South African radiographers' attitude towards radiation protection, subjective norm and perceived behavioural control concerning radiation protection. METHODS: This quantitative cross-sectional study used an online theory of a planned behaviour radiation protection questionnaire shared through social media platforms from August 2019 to February 2020. Diagnostic radiographers registered with the Health Professions Council of South Africa and employed at radiology departments in South Africa were invited to participate in the study. RESULTS: Four hundred and seventeen radiographers in South Africa responded to the questionnaire. The majority of respondents (90%, n = 376) plan to use radiation protection; however, only 16% continuously used radiation protection in the past. Respondents felt that using radiation protection was extremely good (72.2%), pleasant (47%), beneficial (74.1%), rewarding (55.2%) and worth the time (52.5%); 57% of respondents indicated that using radiation protection takes longer to complete the examination. Respondents report that approval from patients (43.5%), patients' family (32%), radiographer coworkers (31%), radiology managers (47%) and radiologists (43.9%) is very much important to them. CONCLUSION: The study shows that even though fewer respondents use radiation protection at present, most respondents plan and intend to use radiation protection measures. Respondents felt that radiation protection was good and beneficial, with some respondents feeling that radiation protection is not worth the time, which coincide with lengthening the examination. Overall, South African radiographers' attitudes towards radiation protection, subjective norm, perceived behavioural control and radiation protection intention were high.

Diagnostic radiography students' experiences of a practical method demonstrating the effect of milliampere-second in digital X-ray imaging systems.

BACKGROUND: The effect of exposure technique factors varies between analogue and digital X-ray imaging systems (DR). Understanding these variations is paramount to optimising radiation protection, yet radiographers are unclear about these effects. A practical method to demonstrate milliampere second (mAs) effect in DR was developed to assist diagnostic radiography students in understanding exposure technique factors in DR. OBJECTIVES: To explore second-year diagnostic radiography students' experiences of a practical method to demonstrate the effect of mAs in DR. METHODS: A qualitative research approach employing an open-ended questionnaire explored second-year diagnostic radiography students' experiences of the practical method demonstrating the effect of mAs in DR. Twenty students participated in the study, and the data collected underwent thematic analysis. RESULTS: Students appreciated working in small groups and provided suggestions to improve the practical method's instruction sheet. Most students' predicted outcome differed from the actual outcome of the demonstration. Seeing and documenting the effect of mAs in DR not only enhanced students' understanding of it but showed the implications of increasing mAs on image quality and radiation exposure. CONCLUSION: Students found that the practical method enhanced their understanding of mAs and exposure technique factors in DR. Additionally, the practical method highlighted exposure creep in DR and radiographers' role in protecting patients from overexposure to ionising radiation in the digital era.

Retrospective evaluation of exposure indicators: a pilot study of exposure technique in digital radiography.

INTRODUCTION: Digital radiography lacks visual clues of exposure techniques used to obtain radiographs, therefore manufacturers have included exposure indicators (EIs). EIs provides feedback about exposure techniques used and evaluating EIs will yield much needed information about exposure trends used in digital radiography. METHODS: A retrospective explorative quantitative study was conducted at nine randomly selected imaging departments in Gauteng, South Africa. Data pertaining to EI was retrospectively collected using quota sampling and compared to manufacturer recommended (MR) standards. RESULTS: A total of 1422 EIs were collected. 50% of these were within the MR standard. 27% of EI indicated overexposure and 23% indicated underexposure. CONCLUSIONS: Greater evidence of overexposure was noted in the retrospective analysis of the EI. This pilot study shows the need for further investigation into exposure technique practices in digital radiography and the need for measures to halt the evidenced overexposure.