Perspective of radiography science - a document analysis of dissertations.

INTRODUCTION: The aim of this study was to clarify the perspective of radiography science as an academic discipline. A discipline can be studied by discovering the collective use of concepts, especially core concepts. We have previously identified the core concepts as clinical practices in radiography, radiographers' profession, safe and high-quality radiation use, and technology in radiography. The relationships between these concepts have not been studied previously. In order to clarify the perspective of radiography science we have investigated further the core concepts, their interrelationships and interdependencies. METHODS: Altogether, 53 dissertations meeting the inclusion criteria were selected for a qualitative document analysis. The data were first analysed deductively using an extraction matrix comprising four core concepts developed from previous studies, then relational statements were synthesised, and the statements were analysed semantically. RESULTS: Analysis revealed the bilateral interrelationships between the concepts and their dependencies. All the concepts were used within healthcare. The rationale for radiography science research was the clinical practice of radiography and the improvement of services in a complex environment as a part of patients' pathways. Safe and high-quality radiation use was investigated as a means to deliver optimal services. Technology was studied as being functional or a means to deliver services. The perspective of the discipline was seen as the combination of humanistic interaction with advanced technology, where safety and quality were a necessity. CONCLUSIONS: Defining core concepts and their interrelations clarifies the perspective of the discipline and gives radiography researchers a way to argue their viewpoint.

Breast cancer screening and immigrant women-A scoping review of attendance, knowledge, barriers and facilitators.

AIM: The aim of this study was to summarize the latest research reports about immigrant women and attendance in breast cancer screening. DESIGN: Scoping review. METHODS: Literature searches were made in CINAHL, PubMed, Web of Science, Google Scholar, Oatd and Oalster. Twenty-three articles were included in the study. Data were analysed with inductive content analysis. RESULTS: Out of data four main categories were formed: attendance rates, incidence, barriers and facilitators, and knowledge and perception. The results show that attendance rates, barriers and facilitators for attendance, knowledge and experience of breast cancer and breast cancer screening differ between several factors such as the woman's migrant background, country of origin, religion, length of stay in the new home country and sociodemographic factors.

The Factors for Success and Lack of Success in the Breast Cancer Patient Care Pathway: A Qualitative Study From the Health Care Staff Perspective.

Objective: To produce information about factors related to successful and unsuccessful breast cancer care pathways from the health care staff perspective. Materials and Methods: An electronic qualitative survey was used to collect data simultaneously from hospitals located in four different countries, focusing on four professional groups: diagnostic radiographers; radiation therapists; breast cancer nurses; and biomedical laboratory scientists (n = 23). The hospitals participating in the study treat breast cancer patients and research permits were applied from all of them. Data was analysed by deductive thematic analysis. Results: At the core of a successful breast cancer care pathway is the right content and timely information provided to the patient at the pace the patient is able to adopt. This is especially highlighted at the beginning of the treatment process. In regards to diagnostic services, rigorous execution of mammography, sampling techniques and analyses were seen as important. Staff also valued the importance of aftercare and follow-up, and highlighted the fact that the patient should be given a chance to keep in close contact with care and treatment staff, even after their active treatment process has finished. Conclusion: Health care staff recognized the same success factors for optimal breast cancer care and treatment pathways as patients reported in previous studies, yet more emphasis was put on patient characteristics and the technical performance features of the process. Both patient and staff viewpoints should be taken into account in planning breast cancer care pathways.

Identification of research priorities of radiography science: A modified Delphi study in Europe.

Radiography science is a new discipline among health sciences. It is a discipline that investigates phenomena in medical imaging, radiation therapy, and nuclear medicine. It has merged from the need to provide research evidence to support these services. The domain of the discipline needs clarification and more research should be focused on its paradigmatic issues. Radiography research priorities have been previously charted on a national level in different countries but the viewpoint has been that of the needs of the profession, not of the discipline. This study aimed to identify the priorities of the discipline. The method chosen was a modified version of the Delphi technique with two rounds. The expert panel consisted of 24 European radiography researchers with long professional experience. This study shows that the research priorities in radiography science are related to the phenomena of radiographers' profession, clinical practices, and the safe and high-quality use of radiation and technology for medical imaging, radiotherapy, and nuclear medicine. Identifying these priorities can help focus research onto most important topics and clarify disciplinary perspective.

Characterization of radiographers' mammography practice in five European countries: a pilot study.

OBJECTIVES: This pilot study aimed to characterize and compare radiographers' mammography practice, including quality control and continuous professional development in five European countries. METHODS: Online survey was performed to collect data regarding participants' profile, institution's profile, mammography practice, quality control and continuous professional development. The questionnaire was sent to clinical radiographers working in Estonia, Finland, Norway, Portugal and Switzerland. Descriptive statistical and subgroup analyzes were performed. RESULTS: The amount of returned questionnaires was 140. Most respondents were female (92%), having radiography bachelor. The majority (89%) of radiographers was working with full-field digital mammography. The majority (97%) of mammography images were acquired using AEC, and half of the radiographers were using dose saving programmes suggested by the manufacturers. The most typical (50%) compression force ranged from 8 to 11 kg. Part of the radiographers (44%) did not know if their practice followed specific guidelines. The most challenging tasks in mammography identified by radiographers were patient positioning (86%), coping with pain (88%), managing anxiety (83%) and imaging breast implants (71%). The majority (88%) of the respondents undertook continuous professional development activities. CONCLUSIONS: The mammography practice varies across the five countries. We found country-specific traits related to mammography image acquisition, patient-centered care and quality management procedures. The lack of evidence-based knowledge suggests the importance of well-designed studies on these topics. The variability found in this pilot study encourages radiographers to question their own practice and teachers to review and revise the training programmes. Validation in larger studies including more countries is needed.

Correction to: European radiographers' challenges from mammography education and clinical practice-an integrative review.

Affiliation number 2 was rendered incorrectly.

European radiographers' challenges from mammography education and clinical practice - an integrative review.

OBJECTIVES: This study aims to identify European radiographers' challenges in clinical performance in mammography and the main areas of mammography that require more and better training. METHODS: An extensive search was performed to identify relevant studies focused on clinical practice, education and training in mammography published between January 2010 and December 2015 in the English language. The data were analysed by using deductive thematic analysis. RESULTS: A total of 27 full text articles were read, evaluating their quality. Sixteen articles out of 27 were finally selected for this integrative review. The main challenges of radiographers' mammography education/training can be divided into three groups: training needs, challenges related to radiographers, and challenges related to the organization of education. The most common challenges of clinical performance in mammography among European radiographers involved technical performance, the quality of practices, and patient-centeredness. CONCLUSIONS: The introduction of harmonized mammography guidelines across Europe may serve as an evidence-based tool to be implemented in practice and education. However, the variability in human and material resources as well as the different cultural contexts should be considered during this process. TEACHING POINTS: • Radiographers' awareness of their professional identity and enhancing multiprofessional cooperation in mammography. • Radiographers' responsibilities regarding image quality (IQ) and optimal breast imaging performance. • Patient-centred mammography services focusing on the psychosocial needs of the patient. • Challenges: positioning, QC-testing, IQ-assessment, optimization of breast compression, communication, teamwork, and patient-centred care. • Introduction of evidence-based guidelines in Europe to harmonize mammography practice and education.

Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

Reducing psychological distress in patients undergoing chemotherapy.

Psychological distress is a common problem among patients with cancer, yet it mostly goes unreported and untreated. This study examined the association of a psycho-educational intervention with the psychological distress levels of breast cancer and cervical cancer patients undergoing chemotherapy. The design of the study was quasi-experimental, pretest-posttest design with a comparison group. One hundred patients at a cancer hospital in Jakarta, Indonesia, completed Distress Thermometer screening before and after chemotherapy. Fifty patients in the intervention group were given a psycho-educational video with positive reappraisal, education and relaxation contents, while receiving chemotherapy. Patients who received the psycho-educational intervention had significantly lower distress levels compared with those in the control group. Routine distress screening, followed by distress management and outcome assessment, is needed to improve the wellbeing of cancer patients.

Aseptic practice recommendations for circulating operating theatre nurses.

Aseptic practices prevent exposure of a surgical wound to microbes, operating theatre environment and personnel. The circulating nurse assists the operating theatre personnel and supervises aseptic practices preventing surgical site infections. In the absence of analytical tools, few studies exist on intraoperative nursing-related aseptic practices. This study introduces recommendations to assess the role of the circulating nurse in aseptic practices. The authors used international recommendations and research findings to construct a 20-item self-report instrument with a demonstrated reliability across the scale. The authors structured the scale based on three phases: establishment; maintenance; and disestablishment of a sterile operating field. The tool was tested among operating theatre and day surgery nurses, and compared the differences in the mean acceptance rates of aseptic practice recommendations based on background characteristics. College-level nurses and nurses with 15 or more years' work experience accepted the recommendations at higher levels than bachelor-level nurses and nurses with less work experience. Continual assessment of the evidence base and comprehensive evaluation represent important components in further developing the tool. A reasonable number of items covering clinical practice are necessary for assessing the effectiveness and cost-effectiveness of aseptic practices, and a larger response rate is needed to validate the tool in future.

Medication errors in elderly acute care--a systematic review.

AIMS: Medication safety is a part of quality of care and patient safety. Old age brings many challenges for safe use of medication. In order to improve the prerequisites of medication safety in acute care of the elderly, we systematically reviewed studies to find out what kind of medication errors happen in elderly acute care. METHODS: Cinahl, Medline, Cochrane, JBI Connect+ databases and Finnish healthcare databases Medic and Ohtanen were used in the search. The search was performed using both MeSH terms and keywords by the option 'search all text'. The original keywords were pharmacy or drugs, medical error or deviation and their Finnish synonyms. These keywords were united to the terms elderly, nursing or acute care or intensive care. Studies published between 2001 and 2011 were chosen. RESULTS: Medication errors mentioned in the studies were associated with (i) nursing competence, (ii) prescription- and patient-related factors, (iii) medication work organisation and nursing process and (iv) safety culture. This paper presents several practical implications for improving medication safety in the acute care of the elderly. LIMITATIONS: The grey literature was not included because the authors wanted to limit to the best-quality research. In some studies, elderly acute care was not their exact context or the elderly formed only a part of study population. This may have undermined some types of medication errors typical to elderly acute care. CONCLUSIONS: To improve the prerequisites of medication, safety in acute care of the elderly management of the medication process should be improved. Also, cooperation within the medical team in making the medical care plans and checking out the medication of the elderly people should be improved. This is an important topic of lifelong education for nurses and other healthcare staff as well.

Quality assurance in digital dental imaging: a systematic review.

OBJECTIVES: Doses induced by individual dental examinations are low. However, dental radiography accounts for nearly one third of the total number of radiological examinations in the European Union. Therefore, special attention is needed with regard to radiation protection. In order to lower patient doses, the staff performing dental examinations must have competence in imaging as well as in radiation protection issues. This paper presents a systematic review about the core competencies needed by the healthcare staff in performing digital dental radiological imaging quality assurance. MATERIALS AND METHODS: The following databases were searched: Pubmed, Cinahl, Pro Quest and IEEXplore digital library. Also volumes of some dental imaging journals and doctoral theses of the Finnish universities educating dentists were searched. The search was performed using both MeSH terms and keywords using the option 'search all text'. The original keywords were: dental imaging, digital, x-ray, panoramic, quality, assurance, competence, competency, skills, knowledge, radiographer, radiologist technician, dentist, oral hygienist, radiation protection and their Finnish synonyms. RESULTS: Core competencies needed by the healthcare staff performing digital dental radiological imaging quality assurance described in the selected studies were: management of dental imaging equipment, competence in image quality and factors associated with it, dose optimization and quality assurance. CONCLUSIONS: In the future there will be higher doses in dental imaging due to increasing use of CBCT and digital imaging. The staff performing dental imaging must have competence in dental imaging quality assurance issues found in this review. They also have to practice ethical radiation safety culture in clinical practice.

Breast cancer worry in further examination of mammography screening--a systematic review.

AIMS: In this systematic review, we explored which factors are associated with breast cancer (BC) worry in further examination (FE) of mammography screening and for how long women experience BC worry associated with FE. METHODS: Medline, Cochrane, Cinahl and the International Network of Agencies for Health Technology Assessment databases were used in the search. In addition to this, reference lists of the selected articles were inspected. The subject headings and keywords searched included breast screening, mammography screening, BC worry, distress or anxiety, additional test, further examination and recall. These were used separately and in combination. The databases gave 598 references. From the selected titles, 83 abstracts were read; from these, 23 publications were selected for full-text review. On the basis of full texts, 15 articles were chosen. FINDINGS: There were very few studies about the associations between FE and BC worry. In those found, the amount of measured variables was limited. BC worry in FE of breast screening was associated with several sociodemographic and psychosocial factors of recalled women, as well as those related to the FE process. About half of the recalled women were quite or very anxious in the prediagnostic phase. CONCLUSIONS: The review gave implications for interventions in the FE process of mammography screening. These interventions should predominantly be made in the preclinical phase and should differ according to the type of recall visit and characteristics of recalled women. In communicating the diagnosis to the women, the time from the examination process to diagnosis should be as short as possible, and in addition to physicians being present, other health care professionals should also be there to ensure the necessary emotional and practical support a woman needs in such a situation.