Challenges of Imaging Obese Patients in General Radiography: A Qualitative Systematic Review to Guide the Training and Practice in Zambia

O. Bwanga, M. Bwalya
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Abstract

Background: Obese patients are increasingly being referred for medical imaging examinations across the world. Obese patients require a modified standard of care to compensate for challenges caused by both technical and psychological issues related to their weight and body habitus. There have been research studies conducted on this issue, but no systematic review has brought the findings of these studies together to inform training and practice.  Aim: This study was aimed at synthesising primary studies on the challenges faced by radiographers and radiography students in imaging obese patients to guide the training and practice in Zambia. Methods: This qualitative systematic review was conducted using the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. Two databases (PubMed and ScienceDirect) were systematically searched to identify relevant literature. This was supplemented by other sources: radiography journals, grey literature, and cited references. Data from the included studies were assessed for quality, extracted, and synthesised using thematic analysis. Results: Five studies were identified and included in this review. Following data analysis, four themes related to challenges faced in imaging obese patients in general radiography emerged: difficulties in communicating without causing psychosocial distress, manual handling risks, limitation of the equipment, and difficulties in positioning and determining the exposure factors for diagnostic radiographic images.  Conclusion: This review provides an in-depth understanding of the challenges faced by radiographers and radiography students in imaging obese patients. Strategies to enhance radiography training and practice have been identified to help educators and radiographers.
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普通放射摄影中肥胖患者成像的挑战:指导赞比亚培训和实践的定性系统回顾
背景:全世界越来越多的肥胖患者被转诊进行医学影像学检查。肥胖患者需要修改护理标准,以弥补与体重和身体习惯相关的技术和心理问题带来的挑战。关于这个问题已经进行了一些研究,但没有系统的综述将这些研究的结果结合起来,为培训和实践提供信息。目的:本研究旨在综合关于赞比亚放射技师和放射学学生在为肥胖患者成像时面临的挑战的初步研究,以指导培训和实践。方法:采用提高定性研究综合报告透明度(ENTREQ)指南进行定性系统评价。系统检索两个数据库(PubMed和ScienceDirect)以确定相关文献。这是由其他来源补充:放射学期刊,灰色文献和引用的参考文献。采用专题分析对纳入研究的数据进行质量评估、提取和综合。结果:本综述确定并纳入了5项研究。根据数据分析,出现了四个与肥胖患者在普通放射成像中面临的挑战相关的主题:在不引起心理社会困扰的情况下沟通困难,人工处理风险,设备的局限性,以及诊断放射图像定位和确定暴露因素的困难。结论:本综述深入了解了放射技师和放射学学生在肥胖患者成像中面临的挑战。加强放射学培训和实践的策略已确定,以帮助教育工作者和放射技师。
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