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Bolejko A, Andersson BT, Debess J, Fridell K, Henner A, Sanderud A, Saukko E, Mussmann BR. Facilitators for and barriers to radiography research in public healthcare in Nordic countries. Radiography (Lond) 2021; 28:88-94. [PMID: 34474944 DOI: 10.1016/j.radi.2021.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION It has been suggested that the future of diagnostic imaging relies on engagement in research and evidence-based practice. This implies a role transition from a clinical radiographer to a clinical radiographer-researcher. Clinical radiographers' stimuli for engaging in research in Nordic countries are unknown. This study aimed to address this gap. METHODS Cross-sectional data collection via an online questionnaire on facilitators for and barriers to participation in radiography research was carried out among 507 clinical radiographers in public healthcare in the Nordic countries: Denmark, Finland, Norway and Sweden. RESULTS Support from colleagues (odds ratio [OR] 2.62) and other professionals (OR 2.74), and self-esteem in research skills (OR ≥ 2.21), were facilitators for radiography research. Lack of knowledge and skills to conduct research (OR 2.48) was revealed to hinder radiographers' participation in research. The absence of a radiography research culture in the workplace explained non-participation in research (OR 1.75). CONCLUSION This study revealed significant factors for clinical radiographers' participation in research. IMPLICATIONS FOR PRACTICE A strategy for establishing a radiography research culture in healthcare is proposed that is novel for the context. Management support for knowledge development and activity leading to inter-professional research projects across knowledge fields, provision of a radiography research lead and acknowledgement of radiography research among colleagues signify the establishment of the culture. These prerequisites might provide a paradigm change towards not only the symbiosis of a clinical radiographer and an autonomous researcher but also a partner who adds radiography research to evidence-based practice in diagnostic imaging.
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Affiliation(s)
- A Bolejko
- Department of Translational Medicine, Department of Medical Imaging and Physiology, Lund University, Skåne University Hospital, Malmö, Sweden.
| | - B T Andersson
- Department of Health Sciences, Lund University, Lund, Sweden
| | - J Debess
- University College of Northern Jutland, Aalborg, Denmark
| | - K Fridell
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden
| | - A Henner
- School of Health and Social Care, Oulu University of Applied Sciences Ltd, Oulu, Finland
| | - A Sanderud
- Department of Life Sciences and Health, Oslo Metropolitan University, Oslo, Norway
| | - E Saukko
- Department of Radiology, Turku University Hospital, Turku, Finland
| | - B R Mussmann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
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Saukko E, Andersson B, Bolejko A, Debess J, Fridell K, Henner A, Mussmann B, Sanderud A. Radiographers' involvement in research activities and opinions on radiography research: A Nordic survey. Radiography (Lond) 2021; 27:867-872. [DOI: 10.1016/j.radi.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
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Ukkola L, Kyngäs H, Henner A, Oikarinen H. Barriers to not informing patients about radiation in connection with radiological examinations: Radiographers' opinion. Radiography (Lond) 2020; 26:e114-e119. [PMID: 32052758 DOI: 10.1016/j.radi.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/25/2019] [Accepted: 12/05/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In some instances, little knowledge regarding radiological examinations is provided to patients. The purpose was to investigate whether radiographers inform patients about radiation, and if not, the reasons for it. METHODS A questionnaire was sent to radiographers working in the public sector in Northern Finland. Radiographers were asked whether they had informed patients about the radiation dose and risks during the last year. If information was not provided, the reasons for it were investigated using multiple-answer type multiple-choice questions with the option for free text responses. The results were compared between a University Hospital and other departments and between different lengths of work experience. Altogether 174/272 (64%) radiographers responded to the questionnaire; 50% were from the University Hospital and 50% from other departments. RESULTS Altogether 103/174 (59%) respondents did not inform patients about the radiation dose and 93/174 (53%) did not inform them about the associated risks. Regarding a passive approach to dose information, respondents thought that the referrer had already informed the patient (49/103, 48%), information was not needed (51/103, 50%), or it might cause unnecessary fear (47/103, 46%). Reasons for a passive approach to risk information were similar (66/93, 71%; 33/93, 36%; 47/93, 51%, respectively). Regarding the results, there were no differences between the institutions or work experience levels. According to the open question, some radiographers expected patients to ask questions before informing them. Lack of time was rarely mentioned as a reason. CONCLUSION The main reasons for inadequate information were ignorance regarding responsibilities, assumption that information is not needed, and concern about causing unnecessary fear. IMPLICATIONS FOR PRACTICE Education, guidelines specifying responsibilities and contents for information, and easy-access digital educational material for public and professionals are needed.
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Affiliation(s)
- L Ukkola
- Master of University of Applied Sciences, Master of Health Science, Department of Diagnostic Radiology, Oulu University Hospital, POB 50, 90029 OYS, Oulu, Finland.
| | - H Kyngäs
- Department of Nursing Science and Health Administration, University of Oulu, Finland
| | - A Henner
- Oulu University of Applied Sciences, Finland
| | - H Oikarinen
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
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Hirvonen L, Schroderus-Salo T, Henner A, Ahonen S, Kääriäinen M, Miettunen J, Mikkonen K. Nurses' knowledge of radiation protection: A cross-sectional study. Radiography (Lond) 2019; 25:e108-e112. [PMID: 31582253 DOI: 10.1016/j.radi.2019.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Nursing roles are changing, as several countries have amended legislation so that nurses can make referrals for medical imaging examination that utilize ionising radiation. Nevertheless, nurses' radiation knowledge remains a poorly studied concept. The aim of the study was to characterize Finnish nurses' knowledge of radiation use and radiation safety. In this study, nurses were working in operating theaters, first aid clinics and cardiology laboratories. METHODS A cross-sectional design was applied in which data were simultaneously collected from nurses working in eight hospitals. All nurses working in operating theaters, first aid clinics and cardiology laboratories (N = 1500) at the hospitals in Finland were invited to participate in the study. The response rate was 17% (n = 252). The employed Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale included three areas of knowledge: radiation physics, biology and principles of radiation use; radiation protection; and guidelines of safe ionizing radiation use. Descriptive statistics and logistic regression analyses were used to identify factors that influence these three areas. RESULTS Nurses reported high knowledge levels in radiation protection but low knowledge levels in radiation physics, biology and principles of radiation use. Moreover, nurses who had not received radiation education reported lower knowledges across all three areas than the nurses who had completed education. CONCLUSION This study identified one major factor that significantly affects nurses' radiation knowledge, namely, having completed medical radiation education, as this factor positively influenced all three of the included areas of radiation knowledge factors. Therefore, healthcare organizations should concentrate on providing education to all nurses working with, or exposed to, radiation.
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Affiliation(s)
- L Hirvonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Central Finland Health Care District, Jyväskylä, Finland.
| | - T Schroderus-Salo
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland.
| | - A Henner
- Degree Programme in Radiography and Radiation Therapy, Oulu University of Applied Sciences, Kiviharjuntie 4, 90220, Oulu, Finland.
| | - S Ahonen
- University of Oulu, Oulu, Finland.
| | - M Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - J Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - K Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
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Schroderus-Salo T, Hirvonen L, Henner A, Ahonen S, Kääriäinen M, Miettunen J, Mikkonen K. Development and validation of a psychometric scale for assessing healthcare professionals' knowledge in radiation protection. Radiography (Lond) 2019; 25:136-142. [PMID: 30955686 DOI: 10.1016/j.radi.2018.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Healthcare professionals must sufficiently understand ionising radiation and the associated protection measures to avoid unnecessarily exposing patients and staff to ionising radiation. Hence, a proper safety culture is important to lowering health risks. The development and establishment of an instrument that can indicate healthcare professionals' understanding/knowledge of radiation protection concepts can greatly contribute to a good safety culture. The purpose of the present study was to develop and psychometrically test the Healthcare Professional Knowledge of Radiation Protection (HPKRP) self-evaluation scale, which was designed to measure the knowledge level of radiation protection by healthcare professionals working with ionising radiation in a clinical environment. METHODS The presented research employed a cross-sectional study design. Data were collected from eight Finnish hospitals in 2017. A total of 252 eligible nurses responded to the newly developed HPKRP scale. The face and content validity were tested with the Content Validity Index (CVI). Explorative factor analysis was used to test construct validity, whereas reliability was tested with Cronbach's alpha. RESULTS Overall S-CVI for the HPKRP scale was 0.83. Exploratory factor analysis revealed a three-factor model for the HcPCRP scale containing 33 items. The first factor was defined by Radiation physics and principles of radiation usage, the second factor by Radiation protection, and the third factor by Guidelines of safe ionising radiation usage. These three factors explained 72% of the total variance. Cronbach's alpha coefficient for the scale ranged from 0.93 to 0.96. CONCLUSION The results provide strong evidence for the validity and reliability of the HPKRP scale. Additionally, educators can use the scale to evaluate healthcare students' understanding in radiation safety before and after education.
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Affiliation(s)
- T Schroderus-Salo
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland.
| | - L Hirvonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland.
| | - A Henner
- Degree Programme in Radiography and Radiation Therapy, Oulu University of Applied Sciences, Kiviharjuntie 4, 90220 Oulu, Finland.
| | - S Ahonen
- Academic Affairs, University of Oulu, Oulu, Finland.
| | - M Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - J Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - K Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland.
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Ukkola L, Oikarinen H, Henner A, Haapea M, Tervonen O. Patient information regarding medical radiation exposure is inadequate: Patients' experience in a university hospital. Radiography (Lond) 2017; 23:e114-e119. [DOI: 10.1016/j.radi.2017.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/31/2017] [Accepted: 04/01/2017] [Indexed: 11/30/2022]
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England A, Geers-van Gemeren S, Henner A, Kukkes T, Pronk-Larive D, Rainford L, McNulty JP. Clinical radiography education across Europe. Radiography (Lond) 2017; 23 Suppl 1:S7-S15. [PMID: 28780956 DOI: 10.1016/j.radi.2017.05.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/17/2017] [Accepted: 05/20/2017] [Indexed: 11/17/2022]
Abstract
PURPOSE To establish a picture of clinical education models within radiography programmes across Europe by surveying higher education institutions registered as affiliate members of the European Federation of Radiography Societies (EFRS). METHOD An online survey was developed to ascertain data on: practical training, supervisory arrangements, placement logistics, quality assurance processes, and the assessment of clinical competencies. Responses were identifiable in terms of educational institution and country. All educational institutions who were affiliate members at the time of the study were invited to participate (n = 46). Descriptive and thematic analyses are reported. RESULTS A response rate of 82.6% (n = 38) was achieved from educational institutions representing 21 countries. Over half of responding institutions (n = 21) allocated in excess of 60 European Credit Transfer and Accumulation System (ECTS) credits to practical training. In nearly three-quarters of clinical placements there was a dedicated clinical practice supervisor in place; two-thirds of these were employed directly by the hospital. Clinical practice supervisors were typically state registered radiographers, who had a number of years of clinical experience and had received specific training for the role. Typical responsibilities included monitoring student progress, providing feedback and completing paperwork, this did however vary between respondents. In almost all institutions there were support systems in place for clinical placement supervisors within their roles. CONCLUSIONS Similarities exist in the provision of clinical radiography education across Europe. Clinical placements are a core component of radiography education and are supported by experienced clinical practice supervisors. Mechanisms are in place for the selection, training and support of clinical practice supervisors. Professional societies should work collaboratively to establish guidelines for effective clinical placements.
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Affiliation(s)
- A England
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Directorate of Radiography, School of Health Sciences, University of Salford, Allerton Building, Salford M5 4WT, United Kingdom.
| | - S Geers-van Gemeren
- Nederlandse Vereniging Medische Beeldvorming en Radiotherapie, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands.
| | - A Henner
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; School of Health and Social Care, Oulu University of Applied Sciences, Kiviharjuntie 8, FI-90220 Oulu, Finland.
| | - T Kukkes
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Tartu Health Care College, Nooruse 5, 50411, Tartu, Estonia.
| | - D Pronk-Larive
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands.
| | - L Rainford
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
| | - J P McNulty
- European Federation of Radiographer Societies, Catharijnesingel 73, 3511 GM Utrecht, The Netherlands; Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Health Sciences Centre, Belfield, Dublin 4, Ireland.
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Saukko E, Henner A, Nieminen MT, Ahonen SM. THE ESTABLISHMENT OF LOCAL DIAGNOSTIC REFERENCE LEVELS IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: A PRACTICAL TOOL FOR THE OPTIMISATION AND FOR QUALITY ASSURANCE MANAGEMENT. Radiat Prot Dosimetry 2017; 173:338-344. [PMID: 26932805 DOI: 10.1093/rpd/ncw018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
Fluoroscopic procedures are an area of special concern in relation to radiation protection. The aim of this study was to describe the current level of patient radiation doses in endoscopic retrograde cholangiopancreatography (ERCP) collected from a single centre, as well as to establish and review local diagnostic reference levels (DRLs) in ERCP. A total of 100 patients' radiation doses in ERCP were recorded, and the third-quartile method was adopted to establish local DRLs for ERCP. The mean dose area product (DAP) was 2.05 Gy cm2, fluoroscopy time (FT) 1.7 min and the number of images was 3. The proposed local DRLs for ERCP were 3.00 Gy cm2 and 3.0 min. Local DRLs were reviewed in a sample of 25 patients 5 y after they had been established. In reviewing data, the averages of DAP and FT were below the local DRLs. Local DRLs help in the optimisation process of fluoroscopic procedures and guides to a good clinical practice.
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Affiliation(s)
- E Saukko
- Turku University Hospital, The Medical Imaging Centre of Southwest Finland, Kiinamyllynkatu 4-8, PO Box 52, 20521 Turku, Finland
| | - A Henner
- Oulu University of Applied Sciences, School of Health and Social Care, Kiviharjuntie 8, 90220 Oulu, Finland
| | - M T Nieminen
- University of Oulu, Research Unit of Medical Imaging, Physics and Technology, PO Box 5000, 90014 Oulu, Finland
- Oulu University Hospital, Department of Diagnostic Radiology, PO Box 50, 90029 Oulu, Finland
| | - S-M Ahonen
- University of Oulu, Research Unit of Nursing Science and Health Management, PO Box 5000, 90014 Oulu, Finland
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McNulty J, Rainford L, Bezzina P, Henner A, Kukkes T, Pronk-Larive D, Vandulek C. A picture of radiography education across Europe. Radiography (Lond) 2016. [DOI: 10.1016/j.radi.2015.09.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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