Faculty of Health Sciences
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Item Knowledge, attitude, and practices of final-year diagnostic radiography students on setting exposure factors, at the University of Technology, in the eThekwini District(2024) Rajendra, Yashodha; Khoza, Thandokuhle EmmanuelBackground: This study focused on the ability of diagnostic radiography students to set accurate imaging exposure factors and their knowledge, attitude and practice of the factors that influence these imaging parameters. The setting of imaging exposure factors refer to exposure technique while exposure factors refer to the kilovoltage and milliamperes that are required to produce a radiographic image. The importance of understanding the relationship between these factors permits radiographers to maintain optimal image quality whilst keeping the radiation dose to the patient as low as reasonably achievable (ALARA). Aim of the study: The aim of the study was to determine the knowledge, attitude and practice of final-year diagnostic radiography students in terms of setting exposure factors. Methodology: The type of study conducted was a quantitative cross-sectional survey of final-year diagnostic radiography students at the University of technology in Kwa-Zulu Natal regarding the application of factors that affect radiation dose and image quality. The sampling technique selected for this study was probability stratified sampling. Total sampling was used due to the small number of final-year students. Results: Various statistical tests such as Descriptive statistics, the Analysis Of Variance Model, Binomial test, Pearson's correlation coefficient, One-sample t-test, Cronbach alpha and Independent samples t-test were adopted to analyse the data yielded by the collection tool. There were no significant differences in demographics. The mean value for knowledge was 67.71%. Attitude and practice were moderately correlated with p=0.004 and r=-0.474. This correlation was measured using Person’s correlation coefficient test. The study demonstrated that despite having adequate knowledge of imaging exposures and a positive attitude, students did not always practice accurately. Conclusion: This study investigated final-year diagnostic radiography students’ competence in their final year and focused on their readiness for community service in terms of their knowledge, attitude and practice of imaging exposure factors. The overall benefit of this study highlighted the final-year diagnostic radiography students’ ability to set correct exposure factors thus identifying any weaknesses that will prevent them from practicing radiography correctly. Additional support from training institutions and universities, in the areas of weakness would provide students with the necessary tools to practise radiography during their community service without radiating their patients unnecessarily.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 A quality framework for radiographic service delivery in regional hospitals in the eThekwini District, KwaZulu-Natal(2021-12-01) Gam, Nkululeko Phalson; Sibiya, M. N.Background Generally, diagnostic imaging services in Africa are challenged by many factors including lack of equipment and personnel, quality assurance and quality control measures, quality management and monitoring and evaluation frameworks. These challenges are further compounded by a lack of understanding of the factors responsible for poor imaging service delivery and the mitigation strategies. Furthermore, there is paucity of context specific research on diagnostic imaging service delivery in African counties including South Africa. A practice framework was deemed necessary to guide quality of services in diagnostic imaging services in regional hospitals within the eThekwini district of KwaZulu-Natal. Aim The aim of this study was to explore the factors affecting quality in diagnostic imaging departments of the regional hospitals in the eThekwini District of KwaZuluNatal in order to develop a framework that can be used to improve quality. Method A convergent parallel mixed methods design was employed to explore factors affecting quality in medical imaging departments in regional hospitals in the eThekwini District of KwaZulu-Natal in South Africa. In addition, a stratified random sampling strategy was used for quantitative data collection whilst a purposive sampling strategy was used for the qualitative strand. The quantitative strand of the study used a questionnaire administered to patients to measure their levels of satisfaction with service delivery rendered by the diagnostic imaging departments. Data in the quantitative strand were analysed using Version 26.0 of the SPSS and tests such one sample t-test, univariate analysis, Analysis of Variance (ANOVA), Levene's Test for Equality of Variances, Spearman’s rho and independent sample t-tests were used. Furthermore, the quantitative strand consisted of an image reject analysis to investigate rates at which images were rejected and reasons for rejection. The qualitative strand involved in-depth one-on-one interviews with doctors, radiographers, Radiography Managers and hospital wide Quality Assurance Managers. Questions regarding quality of service delivery, possible areas and strategies to improve quality were posed to participants. Responses were recorded through notes made by the primary researcher together with voice recordings. Content analysis was used to analyse qualitative data. Findings The construct that emerged from analysis of results from the patient satisfaction survey were cleanliness, staff, comfort, communication and booking times. There was significant agreement that all the aspects investigated were acceptable to the patients (M>3.5, SD>7). However, although patients were satisfied with comfort in the imaging departments in general, they were dissatisfied with the comfort of the waiting area. Reject rate analysis was conducted in three regional hospitals and the reject rates were different for each hospital (Hospital A = 12.67%, Hospital B = 10.67% and Hospital D = 4%). The average reject rate for all the hospitals was higher than the WHO benchmark of 10%. Twenty eight participants including nine doctors, 13 radiographers, three QA Managers and three Radiography Managers were interviewed across the four regional hospitals during the qualitative strand. Four themes emerged following analysis of qualitative data and these included definition of quality of imaging services by the participants, inadequacy of clinical provisions, leadership and management of medical imaging departments as well as facilities and resources. Issues expressed by the participants regarding inadequacy of clinical provisions included patient referral protocols, communication, image quality and radiology reports. Furthermore, regarding leadership and management participants expressed opinions on roles and responsibilities, accountability, monitoring of working hours and National Core Standards. Lastly, facilities resources included issues such as inadequacy of imaging equipment, inadequacy of staffing, and inservice training. Conclusion The findings reported in the current thesis and the resulting framework are highly relevant to policy and practice particularly in the eThekwini District. The involvement of patients and healthcare professionals in identifying challenges and solutions is a major strength of the current research. The current study has also uncovered the deficiencies in diagnostic imaging services in the eThekwini district around radiographers’ knowledge of the National Core Standards. Finally, if implemented, the framework developed can be used to enhance equipment testing and maintenance policies and improve staff and patient satisfaction as well as staff development. These should increase quality in diagnostic imaging servicesItem Work related stressors that affect diagnostic and ultrasound radiographers in a public hospital in the Gauteng province(2017) Gumede, Lindiwe; Sibiya, Maureen Nokuthula; Nkosi, Pauline BusisiweIntroduction Work related stressors are identified as the main reason for the decline in patient care in Radiography in public hospitals. Radiographers opt to leave the public sector because of stressful experiences. Research has shown that the scarcity of qualitative studies on the phenomenon makes it difficult to understand work related stress in relation to radiography as a profession. Aim of the study The aim of the study was to explore and describe work related stressors in Radiography at a public hospital in Gauteng, South Africa. Methodology This study was a qualitative, exploratory, descriptive study. An interview guide was used to elicit information from 10 participants through semi-structured interviews. All the interviews were one-on-one and were audio-recorded. The data were analysed through Tesch’s eight steps of thematic analysis. Findings The following three themes emerged during data analysis, namely: personal well-being of Radiographers; decline in quality patient care and impaired radiography service; and, environmental enablers. The findings of the study revealed that the participants’ general health was compromised by various factors pertaining to work related stress. Conclusion Interventions necessary for dealing with work related stressors are highlighted as a way of enabling improvement of the working environment conditions. The participants in the study felt that hiring more staff could alleviate their work related stressors. The study has shown that it is also imperative that staff and management are constantly communicating well.Item Occupational stressors in diagnostic radiographers working in public health facilities in the eThekwini district of KwaZulu-Natal(2015-06) Gam, Nkululeko Phalson; Puckree, Threethambal; Naidoo, SubhadranaleneIntroduction Occupational stress has negative effects on both the organisation and individuals employed by the organisation. In the organisation it can result in high levels of absenteeism, reduced productivity and compromised levels of patient care. Furthermore individuals affected by stress may suffer from raised levels of tension, mental fatigue, insufficient sleep, anxiety, and anger. Interventions to prevent both organisational and individual effects of occupational stress may only be implemented once stressors in an occupa-tional group have been identified hence the need for the current study. Purpose The purpose of the study was to investigate occupational stress in diagnostic radiographers working in public healthcare institutions in the eThekwini District of KwaZulu-Natal using a quantitative research approach. Method A cross sectional survey using a validated questionnaire with some open and closed-ended questions was utilised. Radiographers working in public hospitals in the eThekwini District of KwaZulu-Natal were invited to parti-cipate in the study. Respondents were asked to answer 60 closed ended and four open ended questions. Open ended questions afforded the respondents an opportunity to express their opinions. Quantitative data was analysed using the Statistical Package for Social Sciences (SPSS) version 21.0. Inferential statistics included the use of reliability coefficients, correlations and chi square test at a 95% confidence level. Open ended questions were analysed using thematic analysis. Results One hundred and one questionnaires were administered and forty three were returned which resulted in a 43% response rate. The mean age of respondents was 31.7 years and 88.4% were females. The majority (67.4%) were in possession of a National Diploma in Radiography. Seventy two percent worked in regional hospitals. The majority (41.8%) were employed as chief radiographers. Most radiographers affected by stressors were those working in regional hospitals. The three main sources of stress in order of response were workload, faulty equipment and staff shortages. In addition, bullying, long and strenuous shifts as well as training of students were also found to be stressors. Physical exercises, counselling and wellness days were used to reduce stress whilst employment of more staff, attending to faulty equipment, team building, reducing workload, and improved working conditions were suggested as methods of reducing stress amongst radiographers. Conclusion Radiographers working in the eThekwini District were stressed by a number of factors in their work places. Radiographers suggested ways that can be employed to reduce stress in their departments. A close cooperation between radiographers; radiography supervisors; institutional, district and provincial managers is recommended in order to address the challenges faced by radiographers.Item Knowledge, skills and perceptions of diagnostic radiographers on image interpretation of chest diseases in eThekwini public hospitals(2014-05-20) Gqweta, Ntokozo; Naidoo, Subhadranalene; Peer, F.ABSTRACT Escalating current healthcare needs coupled with the dire shortage of radiologists created a climate in countries abroad to extend the role of the radiographer (Williams 2006). The South African radiography profession demonstrates similar if not worse challenges within the radiology services (Gqweta 2012). The human resource needs in the healthcare sector creates a gap in the provision of radiology services (Brandt et al 2007). Often under these circumstances radiographers are asked by emergency department's personnel to comment on radiographic appearances (Hardy and Snaith 2007). Radiographers do provide opinions in order to facilitate patient management (Gqweta 2012). Since the chest x-ray is the most commonly performed x-ray examination in x-ray departments (Manning, Leach and Bunting, 2000), it is assumed that most requests for an opinion may be directed for the clarification of this x-ray examination. Therefore radiographers need to have an in-depth understanding of the knowledge and skills related to the identification of patterns on chest images. The aim of the study was to establish and describe the current chest image interpretation skills, knowledge and perceptions of diagnostic radiographers in eThekwini Health District of KwaZulu-Natal (KZN) with regard to image interpretation. METHOD: A quantitative study using a descriptive design with a qualitative aspect using an interpretive design was employed. A simple random sample of hospitals within the eThekwini health district that have x-ray departments was drawn. All diagnostic radiographers that met the inclusion criteria from within these hospitals were invited to partake in the study and all were registered with the Health Profession Council of South Africa (HPCSA). A questionnaire was utilised to collect data on the perceptions and knowledge of diagnostic radiographers on radiographic appearances. A reporting template was provided for the respondents to report on ten (10) chest images and to standardise responses . Accuracy , specificity and sensitivity measurements were utilised to determine the image interpretation knowledge and skills of radiographers without formal training on image interpretation. The SPSS (Statistical Package for the Social Sciences) version 21 was utilised for the raw data capture and analysis. RESULTS Forty two (42) radiographers participated in the study. Almost half (46%) of the respondents were chief radiographers and twenty four point four percent (24.4%) of the respondents were senior radiographers . X-ray department managers and community service radiographers each had twelve (12%) percent representation. The majority of the respondents frequently performed chest x-rays. Furthermore they regularly observe Pulmonary Tuberculosis (PTB) abnormal patterns more than those of pneumonia and lung cancer on chest radiographs. The respondents indicated that there is a need for them to extend their roles to include image interpretation. This will ensure that radiographers are responsive to current health care needs perpetuated by the absence of radiologists and the ever rapidly increasing population. The majority of the respondents were able to identify abnormal appearances on the radiographs (high sensitivity). However there was a proportional decrease on the identification and recognition of the normal appearances (specificity). There was no respondent that obtained a mark of eighty (80%) on the image interpretation knowledge assessment section. CONCLUSION Radiographers are able to identify abnormal patterns on chest images. However they are unable to adequately exclude an abnormality (low specificity). Furthermore they lack the ability to adequately describe abnormal radiographic/radio logical appearances. The image interpretation knowledge base of radiographers is limited and specific. Therefore there is a need for an intensive education and training for prospective reporting radiographers.Item A determination of normal reference ranges for bone mineral density for Indian women of varying age groups in KZN : the impact of local data on the diagnosis of osteoporosis(2006) Sunder, Roshnee; Naidoo, Subhadranalene; Jackpersad, Dennis R.The aim of this research was to determine normal bone mineral density (BMD) reference ranges (means and standard deviations) for the lumbar spine, total hip and distal forearm, for Indian women of varying age groups in KwaZulu-Natal. The aim also included a comparison of the study population reference ranges with those provided by the manufacturer in order to evaluate any diagnostic implications.