Theses and dissertations (Health Sciences)
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Item The perceptions of diagnostic radiography clinical tutors transitioning from being radiographers to clinical educators in public hospitals in the eThekwini District(2023-05-31) Ncwane, Vukani Siphiwesihle; Khoza, Thandokuhle EmmanuelIntroduction: Clinical tutors display competence in the practice of their craft. However, that competence does not automatically transfer to the area of clinical instruction. A unique aspect of teaching radiologic sciences is the need to be didactically and clinically proficient. Clinical instructors are known as having practical knowledge of teaching, but few understand the basic principles, theories, and concepts of the teaching and learning process. Furthermore, radiographers who transition into the role of clinical tutors are usually expert practitioners but may lack knowledge of best practices regarding student instruction and evaluation. The lack of adequate clinical education and supervision can result in low performance and students failing to apply theory to practice. There is a lack of data studying these issues which might shed light on the perceptions of clinical tutors’ transition. These factors generated the researcher’s interest in formally investigating the perceptions of radiography clinical tutors on the transition from being a radiographer to a clinical educator in the eThekwini district of KwaZulu-Natal. Aim: The study aimed to explore the perceptions of radiography clinical tutors on the transition from being a radiographer to an educator in public hospitals. Ultimately, the study aimed to recommend measures to be put in place to allow for the effective transitioning of radiographers to being clinical educators at public hospitals. Methodology: A non-probability sampling method using purposive sampling was used to select five hospitals within the eThekwini District. From these hospitals, a minimum of seven diagnostic radiography clinical tutors were selected and interviewed. A qualitative methodology design was employed in this study, in which semi-structured and in-depth interviews using open-ended questions were used to collect data from participants. Covid19 rules and protocols were followed. Four main themes generated from the study’s theoretical framework were used for data analysis. Findings: Thematic analysis of the transcribed interviews revealed four main themes, namely: situation, social support factor, strategy, and self-factor. The findings of the study indicated that the majority of participants have had major challenges in the transition process, which has led to negative experiences and only a few had a positive experience. Research participants further revealed that they are experiencing high workloads due to a shortage of staff, which was one of the major barriers that also affected students’ learning and participants’ effective transition. Research participants suggested that the appointed clinical tutor must undergo training before starting their job, whereby the job description will be clearly stated, including the required skills. Lastly, participants postulated that clinical tutors and teaching institutes must create a forum for clinical tutors where they will engage with the university to discuss the issues and challenges of students during clinical training and assist each other with teaching skills. Conclusion: Clinical tutors who participated indicated that they are facing challenges in transitioning from being a radiographer. These challenges affected their abilities to supervise students, which in turn affected the clinical learning progress of students. This, therefore, calls for an extensive intervention of both the learning institution, the hospital management, and other relevant stakeholders to best figure out how these challenges can be tackled. This will allow for a smooth transition and improve students’ supervision and ability to learn at the clinical venues.Item Knowledge, clinical competencies and medico legal responsibilities required by diagnostic radiographers for the interpretation of radiographs(2022-09-29) Budhu, Reshel; Nkosi, Pauline Busisiwe; Khoza, Thandokuhle EmmanuelIn SA, image interpretation and reporting by diagnostic radiographers have yet to be validated. Currently, the only training exposure and formalized education that diagnostic radiography students get in the four-year undergraduate degree relates to pattern recognition and pathological conditions However, a review of the regulations on the scope of practice of radiographers is currently being undertaken by the Health Professions Council of South Africa (HPCSA) to include formal reporting in South Africa. Aim The aim of the study was to explore the knowledge, clinical competencies and medico-legal responsibilities required by diagnostic radiographers for the interpretation of radiographs and ultimately, to recommend training guidelines for radiographers in the interpretation of radiographic images. Methodology A qualitative descriptive study employing criterion sampling of qualified radiologists practicing within the eThekwini district of KZN province was conducted. Ethics approval to perform this study was obtained from the Durban University of Technology’s (DUT’s) Institutional Research Ethics Committee (IREC). All the participants were contacted in their personal capacity. The research tool used for this study was face-to-face, one-on-one, semi-structured and in-depth interviews, which included various questions related to radiographic image interpretation. The data from the interviews were analysed by the researcher using Tesch’s eight steps for analysing qualitative data. Moreover, all the data obtained from this research study was kept confidential and under password protection by the researcher. Findings Findings reveal that Radiologists support the interpretation of radiographic images by radiographers in rural settings, and for the radiographer’s scope of practice to be restructured to include the chest and the musculoskeletal system. Extension in the scope of practice would result in increased job satisfaction, as the overall costs, rates and turnaround time will be affected if radiographers interpret images. Moreover, image interpretation training should begin 3-5 years post degree. An in-depth knowledge of anatomy, radiological anatomy and pathophysiology is required to understand pattern recognition during image interpretation. The training would be between 6 months and 5 years. Findings also indicated that there should be continuous monitoring and accreditation for image interpretation courses, with accreditation being in the form of a diploma for each system, a degree or a certificate of competence. Assessments for image interpretation should be carried out by radiologists. The participants of this study found that clinical competency for radiographers who are performing image interpretation has to do with the assessment of the patient, with assessment determining the history, the background, the past medical history of relevance and the current presenting symptoms. The study also suggested that apart from having stringent criteria for radiographers entering the image interpretation course, radiographers must be able to triage patients and all assessments should be done by a radiologist. The findings also indicated that no harm is to be done to the patient; patient information must not be disclosed to others; radiographers should be covered in the event of adverse outcomes when interpreting images; there should be decision-making regarding the radiologic/radiographic report; and the rights of a healthcare provider are to be protected.Item Framework to mitigate disruptive behaviours involving radiographers at central hospitals in Harare Metropolitan Province, Zimbabwe(2022-09-29) Chinene, Bornface; Nkosi, Pauline Busisiwe; Sibiya, Maureen NokuthulaBackground Disruptive behaviours in healthcare have become an unprecedented global problem, transcending borders, work settings and professional groups. Concerns about their impact on patient safety has led many international medical organisations and other healthcare professions to escalate the urgency of knowing the prevalence, causes and consequences of these unprofessional behaviours in different healthcare settings. Evidence shows that assessing and mitigating disruptive behaviours is critical to empowering health workers to focus on delivering high-quality, cost-effective and safe patient care. However, there is a paucity of literature exploring disruptive behaviours involving radiographers in Zimbabwe. Additionally, there is no written policy to monitor and mitigate disruptive behaviours in the Zimbabwean radiography workforce. The challenge of disruptive behaviours is of significant concern for radiographers because they use radiation that has hazardous effects on living organism cells. Aim The aim of the research was to explore disruptive behaviours involving radiographers and the consequences thereof at central hospitals in Harare Metropolitan Province in order to develop a framework to mitigate these behaviours so that healthy radiography work environments are promoted. Methodology A mixed-methods convergent parallel approach using the parallel databases variant was employed. Disruptive behaviours from 100 randomly sampled radiographers were evaluated using a semi-structured questionnaire. In addition, in-depth interviews were conducted with 11 radiography managers selected by criterion purposive sampling, in order to explore factors and strategies to mitigate these behaviours. Findings Disruptive behaviours involving radiographers in HMP are rampant and create an unhealthy work environment that can lead to compromised patient radiation protection by negatively affecting the implementation of radiation protection protocols or procedures. Cultural and environmental factors relating to disruptive behaviours in Harare Metropolitan Province include a power hierarchy, the work environment and the absence of a reporting framework. Nevertheless, the strategies to mitigate these behaviours may include awareness, willingness to address the behaviours and conflict resolution.Item A model for training radiographers in image interpretation in Kenya(2021-09-19) Rugut, Daniel Kipkemoi; Sibiya, Maureen Nokuthula; Nkosi, Pauline BusisiweBackground In Kenya, there is an acute shortage of radiologists, particularly in the County and Sub-county hospitals in the rural and remote areas. Radiographs are sent to national and referral hospitals for radiological reports. This often results in a delay in the treatment of patients. According to the Kenya government’s strategic Plan of Vision 2030, it is set to provide equitable and affordable healthcare to all her citizens. This vision may not be realized in the radiology sector due to the shortage of radiologists. Aim This study aimed to explore the perceptions of Kenyan radiographers about training in image interpretation of the chest and musculoskeletal systems, to supplement the shortage of radiologists. Methodology An exploratory sequential mixed methods design was used to conduct this study in two phases. Phase 1 was conducted through focus group discussions interviews with thirty radiographers employed in five public hospitals in Uasin-Ngishu County. The findings of Phase 1 were used to develop the questionnaire for Phase 2 of the study. A self-administered questionnaire was used to collect data from participants in thirty-five purposively selected public hospitals. A total of 336 questionnaires were distributed. Three hundred and eleven questionnaires were completed and returned. The questionnaires were analyzed resulting in a response rate of 93%. The results of the two phases were integrated. Thematic analysis of the qualitative data was used to identify themes. SPSS Statistics Version 26 was used to analyze quantitative data. Findings The results from the two phases of data collection indicated that there was an acute shortage of radiologists in Kenya, resulting in a huge gap in the provision of radiological reports. It was the perception of the participants that if radiographers were trained in image interpretation of the chest and musculoskeletal systems, patients would receive prompt image interpretation reports. Hence, a model for training radiographers in image interpretation to supplement the shortage of radiologists was developed. Conclusion This study has revealed that there is a gap in the provision of radiological reports due to the shortage of radiologists. There is a need to train radiographers in image interpretation to supplement the shortage of radiologists. Therefore, the radiography education curriculum needs to be reviewed to incorporate image interpretation.Item A model for staff retention for radiographers employed at selected tertiary hospitals in the KwaZulu-Natal province, South Africa(2021-05-27) Pillay, Melisa; Sibiya, M. N.; Nkosi, P. B.Background Radiography as a profession is evolving, with an increased demand for the retention of radiographers. The staffing crisis in radiography is not only a South African concern but also global a one, with public hospitals in the KwaZulu-Natal province being evidence to the shortage. This crisis is exacerbated by the challenge in retaining radiographers. Various factors have led to the turnover of radiographers from the public to the private sectors, as well as emigration to other countries. Therefore, there is a dire need to identify these factors and retain radiographers in KZN‟s public hospitals. Aim The aim of this study was to explore the factors that influence the retention of radiographers employed by tertiary hospitals in the KZN province in order to develop a model to improve staff retention. Method The explanatory sequential mixed methods design was used to conduct this study in two phases. Phase 1 was conducted in the form of questionnaires with closed-ended questions. These questionnaires were answered by the radiographers and managers employed in public tertiary hospitals in the KZN province. A total of 138 questionnaires were completed, returned and analysed. The findings from phase 1 were used to develop a semi-structured interview with open-ended questions. A total of 10 participants from the five selected hospitals were included to participate in the interviews. The results of the two phases were then integrated. The Statistical Package for the Social Sciences (SPSS version 22) and statistical analysis tests were used to analyse the quantitative data, whilst thematic analysis was used to identify themes from the qualitative data. The Herzberg‟s two-factor theory was used as a guide to the factors that influence the retention of staff. Findings The results from the two phases of data collection indicated that a lack of career pathing was the primary motivational factor affecting staff retention. There were also three hygiene factors that affected staff retention, namely the influence of working conditions on staff retention, government policies and inadequate remuneration. Factors that were identified as having a negative effect on staff retention were related to the increase in resignations and the factors that had a positive effect were related to a lesser intent to leave. The outcome of the study led to the development of a model for the staff retention of radiographers. Conclusion The factors that influenced resignation and the factors that were conductive to staff retention were explored. This led to the development of a model for staff retention.Item Knowledge and practices of radiographers when imaging children with non-accidental injuries at a public hospital in KwaZulu-Natal, South Africa(2020-11-30) Lekaota, Olehile Edward; Nkosi, P. B.Non-accidental injury (NAI) in children is defined as an abuse, where injury is inflicted intentionally. Radiographers are the first point of care to identify the area with injury and provide x-ray films to show that the injuries result from NAIs. The research shows a dearth of studies on knowledge and practice of radiographers when imaging children with NAIs. It is imperative to understand this information in order to provide training for radiographers, and ultimately improve the diagnosis of NAIs, so that children can be protected from the abuse. Aim of the study The purpose of the study was to explore radiographers’ knowledge and practice when imaging children with NAI in order to develop them in this aspect and ultimately recommend training required. Methodology An exploratory, qualitative research design using a case study approach was employed in this research. Criterion sampling was used to select a public hospital that treats children with injuries in KwaZulu-Natal. Homogenous sampling was used to select radiographers employed by this hospital to participate in the study and a sample size of 10 radiographers participated in this study. Semi-structured, face-to-face and one-on-one interviews utilising open-ended questions were used to collect data from the participants. Data collection stopped with the 8th participant when data became saturated. Data was transcribed verbatim before data analysis. Tesch’s method of data analysis was used in the analysis. Findings Collected raw data was transcribed and proceeded with thematic analysis where the following themes merged; knowledge of NAI in children, care of children with NAI, practice when imaging children with NAI, quality of images in children with NAI and acquiring knowledge of NAI in children. The study revealed that radiographers lack knowledge and practice on imaging children with NAI. The study findings also identified factors that compromise a lack of knowledge and practice. Conclusion It is vital for radiographers to attain knowledge and practice on imaging children with NAI so as to enable them to detect a suspected NAI case. The intervention of Government on the implementation of relevant policies pertaining NAI, will assist radiographer and other medical team to follow all required procedures elicit the evidence of NAI. The participants of the study insist they require training on how to treat and classify NAI cases, and the ultimately goal is to secure the safety and protection of children.Item Postgraduate education : personal, organisational and higher educational barriers experienced by radiographers in KwaZulu-Natal(2020-11-30) Moonsamy, Angela; Swindon, Lynda Dawn; Ally, FazilaINTRODUCTION Radiography is a profession of rapidly advancing technology, changing scope of profession and practice and intolerance for anything but quality service delivery. The profession demands competent and relevant radiographers who are engaged in Postgraduate Education (PGE) which will facilitate consistence, relevance, competence and excellence. Participation in PGE is critical therefore barriers need to be eliminated. PURPOSE This study sought to investigate the barriers to PGE that radiographers in KwaZulu Natal (KZN) experienced at personal, organisational and higher educational levels. In addressing these, participation in PGE should increase and an improvement in the quality of radiographic services will then result to the end users, in this case the people of South Africa. METHOD A quantitative, descriptive research approach using surveys, was used to collect primary data from a randomly selected sample of 283 radiographers across all categories of radiography in the public and private sectors within KwaZulu-Natal. A questionnaire comprising of closed questions with a five-point Likert scale, and open-ended questions was utilised. SPSS and inferential statistics were used to identify relationships and associations between the variables. A p-value ˂0.05 was considered to indicate a significant result. The return of 121 responses yielded a response rate was 42.8%. RESULTS Significant differences were identified between variables in the personal, organisational and higher educational barriers. Personal barriers such as nonrecognition for PGE and non-remuneration that would elevate personal status and self-esteem were identified as the main barriers to PGE. Lack of time, lack of motivation, and lack of funding were also noted. PGE was found to be a lower personal priority for males than for females (p<0.05). Personal health was not a hindering factor for females (p<0.05). The lack of financial support by the employer (p<0.05) and heavy workloads created organisational barriers. No time off to study, staff shortages as well as lack of incentives or rewards for PGE were also identified at the organisational level. A significant difference was found for employee development and remuneration for additional training between the public and private sector (p<0.05). Higher educational barriers included a lack of quality local courses, inequalities in the admission criteria and quota system and instability such as protest action and untimely disruptions. CONCLUSION To effectively address the barriers to PGE, recommendations were made to radiographers to take responsibility for their professional development by adopting a culture of life-long learning to remain competent. Return on investment is guaranteed for organisations that support employee development. HEIs need to ensure quality supervision and support for appropriate PGE in order to meet industry demands for high quality, standardised courses. Barriers to PGE have no place in radiography where participation in PGE is critical.Item Experiences of community service radiographers during their transition into the workplace within the eThekwini District(2019-09-05) Chipere, Tawanda Alfred Gilbert; Nkosi, P. B.; Motaung, T.INTRODUCTION Community service diagnostic radiographers have high professional expectations, but their initial workplace experiences often deviate sharply from these. As they transition into the workplace, they may experience a myriad of negative events, and these have a greater individual impact when experienced during the fragile transitional phase. Negative early career experiences may lead to reduced quality output, and eventual attrition from the already short-staffed profession. In South Africa, no studies have been carried out that detail the transitional phase in the careers of radiographers. Understanding the professional transitional phase as detailed by community service radiographers may help to address their needs, which can assist in shaping support structures for future community service radiographers. This may ultimately assist in radiographer retention within hospitals for the benefit of patients and the healthcare industry. AIM To explore and describe the lived experiences of community service radiographers during their transition into the workplace, in order to ensure improved transitional experiences for future community service radiographers. METHODOLOGY Criterion sampling was used to select five hospitals within the eThekwini District. From these hospitals, seven community service radiographers were interviewed, using a phenomenological approach. Face-to-face, one-on-one interviews were conducted by means of semi-structured questions, and the obtained data was transcribed verbatim. Interpretive phenomenological analysis was then employed to identify themes. FINDINGS Thematic analysis of the transcribed interviews revealed three main themes, namely reality shock, work environmental factors, and adaptation. Reality shock affects workplace retention, and needs to be minimised. The environment should meet participants’ expectations and learning needs for them to be satisfied. Lastly, research participants suggested that formalised support, and prior exposure to institutions could help facilitate a smooth workplace adaptation. CONCLUSION AND RECOMMENDATIONS Minimising reality shock and ensuring that institutionalised support is available are essential measures required to ensure a smooth workplace adaptation and ultimately improve radiographer retention. Universities, students, and the Department of Health need to join forces to help ensure that community service radiographers integrate smoothly into the workplace.Item A model to enhance job satisfaction for radiographers employed at selected public tertiary hospitals in the Gauteng province, South Africa(2019-11-27) Khoza, Thandokuhle Emmanuel; Sibiya, M. N.; Nkosi, P. B.Background In South Africa, there is maldistribution of health care professionals between the public and the private sector and between rural and urban areas. Radiographers are no exception to this maldistribution as only 29% are employed by the public sector and 70% are employed by the private sector. Therefore, there is a need to attract and retain radiographers in the public sector to deliver efficient imaging and therapeutic services. Hence, job satisfaction has been identified as one of the important factors in attracting and retaining health care professionals. Aim The aim of this study was to explore the role of intrinsic and extrinsic factors of job satisfaction amongst radiographers employed by public tertiary hospitals in the Gauteng province and develop a model to enhance job satisfaction and improve retention in the public sector. Methodology Exploratory sequential mixed methods design was used to conduct this study in two phases. Phase 1 was conducted through focus group discussions with five purposefully selected radiographers employed by public tertiary hospitals in the Gauteng province. The findings of Phase 1 were used to develop a questionnaire for conducting a survey in Phase 2 of the study. A self-administered questionnaire was used to collect data from participants in four selected public tertiary hospitals. A total of 182 questionnaires were completed, returned and analysed. The results of the two phases were integrated. Thematic analysis of data was used to identify themes from qualitative data. SPSS, version 23 and statistical analysis tests were used to analyse quantitative data. Findings The results from the two phases of data collection showed that the lack of career pathing was the intrinsic factor that affected job satisfaction. There were four extrinsic factors that affected job satisfaction, namely, government policies, unsatisfactory remuneration, working conditions and the inefficiency of the human relations department. The factors that were identified by participants as having a negative effect on job satisfaction were associated with a greater intent to leave and those that had a positive effect were associated with organizational commitment. The outcome of the study led to the development of a model to enhance job satisfaction for radiographers.Item The epidemiology of low back pain in radiographers working in the eThekwini Municipality(2018) Erasmus, Mynhardt; Maharaj, Praveena; Ally, FazilaBackground Low back pain (LBP) is one of the most common causes of occupational disability in healthcare professionals, including radiographers. Radiographers experience several difficulties at work, which include continuous radiation exposure, long working hours; shift work; high physical work load; inadequate staffing; heavy weight of the mobile x-ray machine; wearing a lead apron; bending and lifting patients. There is a paucity in the literature on the epidemiology of LBP in radiographers working in the public and private sectors of South Africa. To date no study has been performed which determines the risk factors for developing LBP in diagnostic radiographers within the eThekwini Municipality. Aim The aim of the study was to determine the epidemiology of LBP in diagnostic radiographers working in the public and private sectors of the eThekwini Municipality, and to identify the risk factors for LBP to which diagnostic radiographers are exposed. Research methodology The research conducted was a quantitative study with a descriptive design which targeted diagnostic radiographers working in both the public and private sectors of the eThekwini Municipality. The research tool was an online survey administered through ‘SurveyMonkey’ which included questions and statements relating to the epidemiology of LBP in order to meet the study objectives. Results and discussion One hundred and thirty-one radiographers (55,0%) participated in this study, of which 43 had to be excluded as per the exclusion criteria. The final response rate was 37,0% (n=88), with 43,2% of the respondents from the public sector and 56,8% from the private sector. The point prevalence of LBP was found to be 42,1% and 36,0% in the private sector. The period prevalence rates of LBP in the public sector were i) 0-3 months 10,5%; ii) 3-6 months 2,6%; iii) 4-9 months 15,8%; and iv) 9-12 months 23,7%. The private sector LBP period prevalence rates were i) 0-3 months 6,0%; ii) 3- 6 months 0%; iii) 4-9 months 4,0%; and iv) 9-12 months 34,0%. The cumulative annual LBP prevalence rate was 52,6% in the public sector and 44,0% in the private sector. Lifetime prevalence for LBP in the public sector and private sector radiographers was 89,5% and 90,0% respectively. The participants were characterised with bilateral, intermittent LBP that was moderate in nature, described as stiffness, a dull ache or sharp/shooting pain that was worse at work, reduced on days off work and affecting their daily and leisure activities. Work-related LBP activities reported by radiographers included sitting for long periods; lifting heavy objects and patients; twisting; working at a computer; bending; continuous pulling; and working with forward positioned arms. Other activities included wearing a lead apron; transferring patients to a bed/chair; positioning of the overhead x-ray tube; sitting and standing for >3 hours; pushing hospital bed patients; carrying imaging cassettes; and working fast due to radiation exposure. Radiographers involved in these activities had an 80,0-100,0% risk of experiencing LBP. The were 45% of the participants who reported previously injuring their lower back at work. Female radiographers were more prone to LBP compared with male radiographers. High stress levels and smoking were associated with an increased incidence of LBP, and exercise was found to reduce the incidence of LBP