Journal of Medical Radiation Sciences最新文献

Introduction: In radiotherapy for head and neck cancer, a mask is used to immobilise the head and shoulders. An open mask that does not cover the face is expected to cause less anxiety, but there is need to further investigate the patients' experience of open versus closed masks. Therefore, the aim of this study is to evaluate patient preferences for open or closed masks and whether an open mask can reduce discomfort and anxiety for patients.

Methods: Twenty participants were treated in alternating weeks using open and closed masks. Their distress was evaluated through semi-structured interviews and patient-reported outcome measures.

Results: When using the open mask, it took longer to position the patient correctly. The closed mask felt more confining and could induce a sense of claustrophobia. Participants employed both internal and external strategies to cope with the stressful situation. The Hospital Anxiety and Depression Scale (HADS) showed a significant reduction in anxiety over time during the treatment period, but no significant difference between the masks. When participants chose which mask to use for the final treatments, 12 chose the open mask, while 8 chose the closed mask. In addition to the 20 analysed participants, two participants withdrew from the study because they could only tolerate the open mask, one due to anxiety and the other due to swelling.

Conclusions: The open mask seems to provide a less confined experience but may lead to greater difficulties in achieving the correct treatment position. While both masks can be viable options for most patients, some cannot tolerate closed masks but do tolerate open masks.

In a stretched healthcare system, radiographer preliminary image evaluation in the acute setting can be a means to optimise patient care by reducing error and increasing efficiencies in the patient journey. Radiographers have shown impressive accuracies in the provision of these initial evaluations, however, barriers such as a lack of confidence and increased workloads have been cited as a reason for radiographer reticence in engagement with this practice. With advances in Artificial Intelligence (AI) technology for assistance in clinical decision-making, and indication that this may increase confidence in diagnostic decision-making with reporting radiographers, the author of this editorial wonders what the impact of this technology might be on clinical decision-making by radiographers in the provision of Preliminary Image Evaluation (PIE).

Introduction: Safety and quality improvement are essential to clinical practice in radiation therapy as planning and treatment increase in complexity and sophistication. An incident learning system (ILS) is a safety and quality improvement tool that can aid risk mitigation to improve patient safety and quality of care. The aim of this study was to quantify the impact of implementing a new e-ILS, Learning In Radiation ONcology (LIRON), on reporting and safety culture within a local health district (LHD).

Methods: The ILS (LIRON) was implemented in 2020 with the intent of tracking actual incidents, near misses and procedural non-compliances for analysis of root causes and contributing factors. A survey was conducted after 12 months of LIRON use, and distributed to radiation oncologists, radiation therapists and radiation oncology medical physicists within the LHD. Results were compared with the responses to a pre-ILS implementation survey, to review changes in staff perceptions of safety culture, barriers to reporting and ILS understanding.

Results: Survey response rates were similar at baseline and at the 12-month follow-up, 64% and 63%, respectively. Findings showed increased ILS participation (49-71%), increased perception of no barriers to reporting (34-43%) and increased encouragement to report (37-43%). Greater confidence in the department's ability to learn from the ILS was evident (24-46%).

Conclusion: Initial findings of LIRON implementation show positive impact but warrant further long-term review for greater understanding of its impact on staff perceptions, safety culture and improving departmental processes.

Introduction: Improvements in computed tomography (CT) technology in terms of image quality and reduction in absorbed dose have increased its applications in medical imaging. Diagnostic reference levels (DRLs) help to identify high radiation doses that are unusually delivered to patients undergoing exposure to ionising radiation. The aim of this review was to provide an overview of published studies by African researchers towards establishing paediatric CT DRLs in Africa.

Methods: The search for articles was conducted using some relevant literature search engines including PubMed, Scopus, Science Direct, Google Scholar and Web of Science. Two reviewers were involved in the article selection process which involved a three-stage screening process of identifying; article titles, abstracts and full-test reading.

Results: One hundred and seventy-four articles were identified from the database, PubMed (30), Scopus (21), Google Scholar (53), Web of Science (25) and Science Direct (45). Fifty duplicated articles were excluded before screening. Twelve peer-reviewed articles were included in this study based on the inclusion criteria. DRL values in terms of computed tomography dose index volume of head for the age groupings 0-1, 1-5, 5-10 and 10-15 were 27, 36.6, 39.5 and 47.5 mGy while the dose length product values were 461.6, 664, 872 and 978 mGy.cm respectively. The DRLs were calculated as 75th percentile of the local DRLs reported by the 12 articles included in this review.

Conclusion: This review has shown that only few of the African countries (19%) have published studies on paediatric CT DRLs. There were variations in the DRLs published by the various authors which indicate that harmonisation and standardisation of paediatric CT protocols is essential for the optimisation of paediatric doses.

Introduction: Professional Supervision (PS) is a common approach used to reduce the fallout from stress and burnout. It involves monthly face-to-face meetings between a supervisor and supervisee to address well-being and professional goals. This pilot study examines 12 radiation therapists (RTs) perceptions of participating in PS.

Methods: Conducted in the Christchurch Radiation Oncology Centre, this mixed-methods pilot study introduced PS in March 2022. In August 2023, 12 RTs completed a QUALTRICS online questionnaire consisting of 33 questions, including the Supervisor Working Alliance Inventory (SWAI). The SWAI assessed the alliance of supervision from a supervisee's perspective and comprised of 19 questions on a 7-point Likert scale and nine yes/no statements with optional comments. Five demographic questions were also included.

Results: All 12 RTs completed the questionnaire, with quantitative results indicating a positive alliance between supervisors and supervisees. RTs found PS to be a safe and comfortable space for reflective practice and support. Thematic analysis of qualitative data from additional comments revealed PS enabled RTs to reflect on career achievements, appreciate highlights of being an RT and consider future career paths within the profession.

Conclusions: Radiation therapists responded positively to PS, suggesting its potential in managing workplace stressors, promoting career advancement and providing dedicated time for reflection, support and guidance. RTs endorsed the efficacy of PS in enhancing their practice and advocated for its widespread adoption among RTs.

Reducing health disparities for Aboriginal and Torres Strait Islander peoples requires the integration of cultural safety into healthcare education. This commentary paper addresses cultural safety in the context of the radiation therapy profession and emphasises the importance of making practitioners aware of the knowledge gaps in healthcare practice. The educational strategies to improve cultural awareness amongst undergraduate students and qualified radiation therapists (RTs) are explored. The authors propose a range of recommendations to enhance cultural awareness amongst RTs in the context of Indigenous Australian care, aimed at promoting improved experiences for Aboriginal and Torres Strait Islander peoples receiving cancer care. Curriculum integration and development of initiatives such as workshops and interactive yarning groups are highlighted as pivotal platforms that foster continuous learning in radiation therapy.

Introduction: Radiography students complete professional placements in various clinical settings and must adhere to distinct infection prevention and control (IPC) protocols. The aim of this study was to explore radiography students' training, knowledge, attitudes, and practice (KAP) relating to IPC in the use of contrast media injectors in computed tomography (CT).

Methods: An online survey study was undertaken with radiography students enrolled at two Australian universities. Survey questions related to contrast media training and KAP regarding IPC in CT. Data was summarised using descriptive statistics, with comparisons between experience in public and private practice. One free-text response question focused on non-adherence to IPC best practice, analysed using content analysis.

Results: In total, 40 students completed the survey (9% response rate). Reports of IPC and contrast media equipment training was high, with disposition for further training. Regarding IPC knowledge, 65% of students responded correctly to all 'knowledge' items (individual scores range: 60-100%). Low consensus was observed regarding whether gloves replace the need for hand hygiene and if CT contrast tubing poses risk to healthcare workers (85% each). Mean scores ranged from 41% to 100% regarding identification of sterile syringe and tubing components. Responses to the open-ended question were categorised into four themes: 'High non-adherence risk working conditions', 'attitudes and practice', 'knowledge', and 'prioritise good IPC practice'.

Conclusions: Radiography students demonstrate varied comprehension of IPC regarding contrast media equipment, and results suggest need for collaborative efforts between academic institutions and clinical training sites to integrate IPC protocols into curricula and on-site training.

Introduction: Preliminary image evaluation (PIE) is a system where radiographers alert emergency department referrers to the presence or absence of abnormalities on acute extremity X-ray examinations. PIE and similar systems have been utilised in the United Kingdom (UK) and Australia due to a shortage of radiologists to provide a timely report. As New Zealand (NZ) faces a similar shortage, PIE should be considered to address the negative impact this has on patients. The aim of this study was to determine the effect of regular feedback and education on radiographers' performance when detecting and describing acute abnormalities on extremity X-ray examinations in ED.

Methods: A prospective longitudinal study design was utilised for this study. The sensitivity, specificity, accuracy, and accuracy of PIEs performed by seven radiographers at a public provincial district in NZ were assessed over a 6-month period, with the participants provided monthly results along with regular e-mailed feedback on common errors.

Results: The mean for sensitivity, specificity, and accuracy calculated with a 95% confidence interval over the 6-month period were 92.8% (89.9, 95.8), 94.9 (93.1, 96.8), and 94.2 (91.9, 96.5), respectively. When the month-to-month results were analysed, the results demonstrated an improvement in participants' sensitivity, specificity, and accuracy over the 6-month period.

Conclusion: The results of this study demonstrated that radiographers who participated in the study can perform PIE to a high standard that is comparable with the findings from international studies and demonstrated an improvement over 6 months. Therefore, PIE may be useful in NZ to aid ED clinicians in their clinical decisions when a radiology report is unavailable.