Concept analysis of 'Facilitating a transformative radiation protection environment'

INTRODUCTION

Suboptimal radiation protection evidenced in literature necessitated the development of a theory to optimise radiation protection. To develop a theory, concept analysis of the central concept guiding the theory is required to provide explicit theoretical and operational definitions. This article presents the concept analysis of the central concept of 'facilitating a transformative radiation protection environment' used to develop a theory to optimise radiation protection.

METHODS

The study used Walker and Avant's concept analysis process of selecting a concept, determining the aims and purpose of analysis, identifying all uses of the concept, and determining the defining attributes by identifying a model case, a borderline case and a contrary case.

RESULTS

The central concept was dissected into the individual concepts of facilitating, transformative, radiation, protection, and environment to enhance the definition and conceptual meaning of the central concept. The essential and related attributes of the individual concepts informed the summative definition of the central concept, and a model, borderline and contrary case contributed to the conceptual meaning.

CONCLUSION

The summative definition of the central concept of "facilitating a transformative radiation protection environment" was determined to be through the essential attributes of help, process, change, X-rays, keeping safe considering the benefits versus risks of ionising radiation exposure and the total internal, external context within which persons exist and the related attributes.

IMPLICATIONS FOR PRACTICE

Explored extensively in nursing literature, concept analyses in radiography are limited. Therefore, this article articulates the process of concept analysis and its use in radiography. Concept analysis provides a systematic process to analyse concepts often assumed to be understood, highlighting its importance in radiography literature and to educational praxis.

Radiographers' organisational commitment and occupational stress: First Covid-19 wave

INTRODUCTION

Radiographers, like many health professionals, are in a high-risk group for succumbing to workplace demands beyond their ability to cope, particularly in the context of the COVID-19 pandemic resulting in occupational stress. Occupational stress has been linked to poor organisational commitment. Therefore, the purpose of this research was to evaluate radiographers' organisational commitment and occupational stress after the first wave of the COVID-19 pandemic.

METHODS

A mixed method approach entailed data collected from purposively sampled Australian radiographers working during the first COVID-19 wave. The quantitative phase used an online commitment questionnaire, and 21 semi-structured individual virtual interviews were conducted in the qualitative phase. Data interpretation and analysis used statistical and thematic approaches.

RESULTS

The quantitative data revealed a higher level of continuance than affective and normative commitment. Whereas the qualitative findings showed participants high levels of affective commitment to their occupation and, together with leadership support, working collectively towards a positive outcome.

CONCLUSION

Despite the variety of occupational stressors that arose during the COVID-19 crisis, Australian radiographers enjoy a high level of occupational and organisational commitment.

IMPLICATIONS FOR PRACTICE

Radiographers' organisational commitment represents their emotional and psychological attachment to their workplace, and radiographers experiencing occupational stress represent high levels of psychosomatic distress and burnout. Therefore, considering radiographers' organisational commitment and occupational stress is essential in the delivery of services, quality of patient care and radiographers well-being.

Radiographers' experiences and perspectives of forensic imaging in Australia: A qualitative study

INTRODUCTION

Forensic imaging plays a pivotal role regarding medico-legal issues by investigating the cause(s) of injuries to living or deceased individuals. There is currently a gap in the literature on forensic imaging due to limited national and international guidelines, protocols and scope of duties and responsibilities of radiographers undertaking forensic imaging. Thus, this study aimed to investigate the gap by exploring the experiences and perspectives of radiographers on forensic imaging in Australia.

METHODS

A qualitative approach collected data from fifteen purposively sampled qualified Australian radiographers through individual in-depth interviews. The verbatim transcribed data were thematically analysed.

RESULTS

Two themes were identified: 1) Radiographers' experiences of forensic imaging; 2) Radiographers' perceptions of forensic imaging within the job scope of a qualified radiographer.

CONCLUSIONS

Participants' experiences of forensic imaging ranged from anxiety to a positive experience, and others posed ethical and situational dilemmas heightened by the lack of dedicated forensic imaging protocols. While some radiographers expressed that every radiographer should conduct forensic imaging, others felt it was not mandatory.

IMPLICATIONS FOR PRACTICE

Radiographers' shared subjective experiences, thoughts and feelings provided insight into forensic imaging and the need for more significant support from educational and governing bodies.

Ethnography and medicine: the utility of positivist methods in research

This commentary discusses the methodological utility of ethnography within the medical space. Whilst a general consensus affirms that ethnography aligns with qualitative approaches, as identified within the existing medical literature, here, we demonstrate how quantitative [positivist] methods can also be incorporated. This paper begins by contextualising ethnographic approaches within medical contexts by demonstrating its empirical value within the existing literature. Next, we discuss the interconnection between the practice of 'doctoring' and ethnographic research, whereby doctors themselves use forms of inductive and deductive reasoning to treat and manage patients in their everyday context. This philosophical discussion not only links to the everyday practice of medical practitioners, but also critically reflects on the role of the first author, as a diagnostic radiographer. Lastly, this paper identifies the virtues of ethnographic research for medical students and/or medical doctors whereby the combination of qualitative and quantitative methods (within an ethnographic methodology) can lead to new empirical and methodological insights, enabling the creation of alternate research strategies and evidence. This methodological strategy may be best considered amongst medical students and/or early career medical researchers, but we also anticipate it to resonate and open further discussion with experienced medical practitioners and researchers transnationally.

How effective are lead-rubber aprons in protecting radiosensitive organs from secondary ionizing radiation?

INTRODUCTION

The purpose of this experiment was to explore the direction of scattered secondary ionizing radiation to a patient. A left lateral radiographic examination of the elbow was deemed appropriate due to its close proximity to radiosensitive organs and record dose limiting opportunities upon wearing a lead-rubber apron.

METHODS

An anthropomorphic phantom and lead-rubber apron (Pb 0.35 mm) was used with a 15 cc ionization chamber (model 10,100 AT TRIAD) to measure scattered radiation to radiosensitive organs. Dose readings were recorded before and after in order to quantify dose reduction. Pearson's correlation, linear regression, t-test and one way analysis of variance (ANOVA) statistics were used to affirm how likely dose limitation was attributed to chance (p < 0.05).

RESULTS

The lead-rubber apron offered dose reduction to most radiosensitive organs. Notably, ionizing radiation was significantly reduced to the left breast 0.0083 μGy (98%), right breast 0.0000 μGy (99.9%) and spleen 0.0262 μGy (99.9%). No empirical benefit was recorded for testes and ovaries. Interestingly, the thyroid recorded an increase in dose (0.1733 μGy; p = 0.01). This was later mitigated using a thyroid collar but identifies increased stochastic risks if lead-aprons are worn alone. Scattered radiation was also reduced to both eyes, which were not directly covered.

CONCLUSION

Lead-rubber aprons are generally utilized to limit ionizing radiation, yet this article offers insight whereby increases to ionizing radiation to the thyroid are plausible when wearing a lead-rubber apron alone. Whilst these findings cannot be generalized to other radiographic examinations it provides insight into a potential increase risk of scatter to a radiosensitive organ.

IMPLICATIONS FOR PRACTICE

This paper has implications because it identifies that lead-rubber has an impact on scattered ionizing radiation to radiosensitive organs for a lateral elbow examination. Further, it identifies the potential for ionizing radiation to be increased to the thyroid upon wearing a lead-rubber apron alone.

Image acquisition in general radiography: The utilisation of DDR

OBJECTIVE

This article explores image acquisition with DDR. General radiographic technology continues to advance therefore it remains paramount to continually reflect on DDR hardware and software amongst radiographers in an imaging modality that constitutes approximately 90% of all radiological examinations.

METHOD

This article reports findings from a wider ethnographic study of two general radiography environments in the United Kingdom (UK). Participant observation and semi-structured interviews were the methods used to uncover original data.

RESULTS

Two key themes are discussed. Firstly, 'the extent of DDR knowledge' amongst radiographers is examined. The findings uncover that not all radiographers have an adequate knowledge base with DDR technology. Secondly, 'pitfalls and near misses with DDR' is discussed. This theme highlights the potential danger of radiographers 'over-repeating' X-ray examinations, coincided with the occurrence of radiological incidents whereby a patient is exposed to ionising radiation with no added benefit.

CONCLUSION

This paper concludes by challenging the current 'skill base' to operate DDR equipment. In addition, new pitfalls and near misses are highlighted, which may help forestall radiation incidents in the future. Dose and image optimisation remain central tenets to the role of the radiographer.

ADVANCES IN KNOWLEDGE

Few studies have challenged image acquisition with DDR. This study adds to existing knowledge by uncovering original phenomena that may initiate discussions within the radiography community and continually enhance healthcare delivery.