Faculty of Health Sciences

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Student radiographers’ knowledge and practices of ethical responsibilities for the radiography profession at a selected university in Gauteng province
(2024) Mosathupa, Jane Granny; Nkosi, Pauline Busisiwe
Abstract Background Student radiographers’ knowledge and practices with regard to the ethical responsibilities for the Radiography profession at Sefako Makgatho Health Sciences University is described in the study. The study explored their knowledge, practices and suggestions for improvement of ethical responsibilities. Knowledge differed widely because of the differential practical experiences that participants were exposed to in the clinical environment. All the students acknowledged that they received theory lectures about ethics, although they are not entirely convinced that it is practiced at selected clinical training institutions. Aim of the study The study explored student radiographers’ knowledge and practices of ethical responsibilities for the Radiography profession and ultimately provided recommendations to improve their knowledge and practices at the workplace. The study was conducted at a selected university in Gauteng province. Methodology A qualitative, exploratory study was undertaken in order to comprehend student radiographers’ knowledge and practices of their ethical responsibilities in the Radiography profession. Although there have been a few studies on ethics with reference to qualified radiographers, qualitative studies on the subject of ethics regarding students is limited. Recommendations for qualitative research on the subject are elaborated in a number of existing studies as a way of acquiring more information from the respondents and gaining more insight on the subject. Findings The code of conduct was clearly outlined to students on each level of the programme during their theory lectures, but was not well articulated in practice. The first and second levels of the programme offer limited knowledge on ethics, which is only incorporated into one of the core modules. Effective patient care is the primary focus of healthcare services; hence it needs more thoughtful attention in the Radiology department. Quality healthcare should be patient-centred to give patients a say in the service they receive. The findings of the study suggested that the revised scope of practice, which is currently under review, will add to their responsibilities and will require specific focus on ethical matters, patients’ rights and medical law. The General Medical Council has stated that medical ethics and law should constitute core components of the medical curriculum. When the students were questioned about their knowledge of ethical issues, they were reasonably confident of their knowledge of professional duties, such as confidentiality and scope of duties. Conclusion Teaching ethics to students in the clinical environment is complex and cannot be compared to teaching the knowledge of ethics in Radiography. Role-modelling and integration of ethics into the clinical education curriculum needs to be critically re visited. The scope of radiographic practice should be broad enough to include additional ethics and medical law. Ethical practice means that a radiographer must be competent to be able to demonstrate professional judgments and practice by upholding professional and ethical behaviours.
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 Emmanuel
Background: 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.
The epidemiology of work-related neck pain in diagnostic radiographers working in the eThekwini Municipality
(2023-05-31) Devnarain, Akshoy; Abdul-Rasheed, Ashura
Diagnostic radiography is a branch of radiography that is primarily involved with the diagnosis of disease through diagnostic imaging. Additionally, diagnostic radiographers are predisposed to work-related risk factors due to the work that they perform daily and, as result, they are at risk of developing work-related neck pain (WRNP). Investigating the prevalence and work-related risk factors associated among diagnostic radiographers will create awareness amongst diagnostic radiographers and healthcare providers. Furthermore, in a South African context, this will add updated knowledge to the current literature that exists. AIM The aim of the study was to determine the epidemiology of work-related neck pain in diagnostic radiographers working within the eThekwini municipality. METHODOLOGY The study used a quantitative approach and a descriptive cross sectional survey design. A total 130 participants were recruited for this study. The population sample included qualified diagnostic radiographers who were employed within the eThekwini municipality in the public and private sectors. The questionnaire was distributed and answered either via Hardcopies or QUESTIOPRO® link. All the data were then imported into SPSS version 26 for analysis RESULTS A total of 61 participants had reported WRNP and hence the prevalence rate was 65.6%. The study also reported that females are more likely to have WRNP. Furthermore, the selected risk factors showed that more than 50% of radiographers with WRNP had worked over-time shifts, 75.4% of radiographers experienced neck pain from wearing lead protective gear, 78.7% of radiographers from the study had neck pain from lifting and positioning heavy equipment and machinery, and 47.5% of the participants who had WRNP had a history of a previously diagnosed neck condition. Additionally, 59% of participants had taken leave from work because of WRNP. CONCLUSION This study revealed a high WRNP prevalence rate among diagnostic radiographers working within the eThekwini municipality. The results found in this study shared similar findings from various local and international studies. Due to the high prevalence of WRNP, it is highly recommended that management protocols at work should be investigated to aid diagnostic radiographers.
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 Emmanuel
Introduction: 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.
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 Nokuthula
Background 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.
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.
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.
Experiences of diagnostic radiographers in the workplace and its effect on service quality : a case study in the eThekwini health district of KwaZulu-Natal
(2019-09-05) Govindasami, Keshini; Sunder, R.; Orton, P.
The South African public health system (SAPHS) has been plagued by a burden of diseases and ill health. Although there are many Acts and policies in place in South Africa (SA) to maintain the constitutional rights of all citizens using public health facilities, suboptimal service quality and unfair treatment of patients in public health facilities continue to be documented. At the same time, staff employed within the SAPHS perceive themselves to be overworked, overburdened, stressed and to receive no support. The workplace environment of an employee is considered a vital component in ensuring employee motivation and satisfaction; a suitable work environment improves employee productivity and service quality. Several studies on other similar health disciplines, both local and international, have found that there is a reciprocal relationship between suboptimal service quality and the workplace environment (Mosadeghrad 2014: 85-87; Nkosi 2014: 67-70; Segnon 2014: 90-93). Radiographers constitute a fundamental component of the public health service and an understanding of how they experience their workplace environment is imperative. PURPOSE The purpose of this case study was to explore the workplace experience of diagnostic radiographers and to examine the effect/s of their experience on radiography service quality in the regional public health sector. METHOD The study was based on a qualitative, case study design that was explorative and descriptive in nature. A constructivist approach was used to construct the workplace experiences of regional diagnostic radiographers regarding their workplace environment. A purposeful sampling technique was utilised to select the radiography managers and the snowball sampling technique was utilised to select the diagnostic radiographers. In total, 24 regional diagnostic radiographers were interviewed for this study, both at management and non-managerial/operational levels. Both semi-structured interviews and focus group interviews were employed in this study. An audio recorder was used to capture the interviews and all interview transcripts were transcribed verbatim. The data was analysed using qualitative content analysis. All emergent themes were analysed and understood in relation to the study’s conceptual framework namely: (physical workplace environment, workplace rewards and incentives, managers’ support and communication) and the theoretical framework was used to guide the study findings. RESULTS The findings show that there was a reciprocal relationship between suboptimal radiography service quality and the workplace environment that participant radiographers were exposed to whilst conducting their duties. The main study findings include the following: there were limited functional units to service the large workloads that were encountered; faulty and old equipment resulting in frequent repeats which cause a radiation hazard; and using faulty equipment physically compromises staff and results in an occupational health risk and as potential iatrogenic injuries for patients too. Radiography equipment is not ergonomically friendly and results in radiographers experiencing discomfort and strain whilst conducting their duties. These experiences are compounded by staff shortages, unmanageable workloads and inadequate ventilation and space limitations. Further to this, unsatisfactory rewards and poor incentives, together with inadequate employee management performance and development systems and employee assistance programmes, demotivate diagnostic radiographers. Some managerial concerns reported by radiographers included: suboptimal implementation of standard operating procedures; suboptimal support for orientation and professional training and development; suboptimal motivation through rapport, recognition and support; poor management of workplace conflict; unapproachable managers; and no contribution in decision-making. Other areas of concern were the communication challenges experienced due to suboptimal departmental communication channels, poor communication skills of diagnostic radiographers, and language and translation. All of these workplace experiences were seen to have a negative effect on radiography service quality.DISCUSSION Maslow’s (1968) hierarchy of needs was used to provide a meaningful interpretation of the results. Diagnostic radiographers require the realisation of these workplace needs. In relation to the physiological needs, diagnostic radiographers require adequate staffing and manageable workloads. The safety needs are to work with and provide patients with a safe environment in respect to x-ray equipment, ventilation and space. Safety needs also require that diagnostic radiographers have effective communication channels within all levels of the radiography department. They also need to be able to interact effectively with clinicians and other health professionals in conveying information regarding patients. There needs to be proper communication techniques when obtaining informed consent and positioning patients during radiography examinations. Regarding social needs, diagnostic radiographers require support for proper orientation, professional training and development, adequate implementation of standard operating procedures (SOPs), adequate workplace conflict resolution, and effective and adequate support from employee assistance programmes. Diagnostic radiographers’ esteem needs appear to be addressed when they are provided with adequate compensation packages, allowances and receive recognition through well implemented employee performance management and development systems. Lastly diagnostic radiographers’ self-actualisation needs appear to be attained when they are included in decision-making and are provided with adequate managerial motivation, recognition and support. This need is also attained when diagnostic radiographers are given the ability to manifest innovation and creativity in the workplace, have a sense job autonomy and an increased sense of responsibility. CONCLUSION Diagnostic radiographers working within regional public health institutions experience various challenges relating to their workplace environment and this affects their radiography service quality. In keeping with Maslow’s (1968) theory of hierarchy of needs, this study affirms that it may be possible to achieve high performance from diagnostic radiographers, when their’ hierarchical needs are satisfied. The findings of this study may contribute toward policy changes that may address the challenges experienced by diagnostic radiographers and bring about change to improve their motivation and job satisfaction. The results may benefit the National Health Insurance scheme to better implement their strategic goals and plans and could have the potential to positively influence the radiography workplace environment and ultimately bring about change in the radiography service quality.
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.
Factors influencing radiographer’s decision making in relation to postgraduate education
(2020-06-10) Mohabir, Ishan; Naidoo, S.; Sibiya, M. N.
Background The research and knowledge produced by postgraduate (PG) alumni is vital in improving the knowledge base of relevant fields. Postgraduate education is essential for an individual’s academic growth and a nation’s economic growth and development. South Africa is lagging behind with regard to PG outputs in various disciplines and radiography is one of them. Radiography is a relatively young academic profession in South Africa. Therefore, PG qualifications are critical to the development of the profession of radiography, both academically and clinically, to strengthen the academic force. The loss of academics, due to retirement and other reasons, necessitates the development of new academic professionals to replenish this expertise. Aim of the study The aim of the study was to explore the factors influencing radiographers’ decision making with regard to postgraduate (PG) education using Cross’s Chain-ofResponse (COR) Model as the theoretical framework to improve the enrolment and quality of PG education. Methodology The study employed an exploratory qualitative research method, using semistructured one-on-one interviews. The interview questions were based on Cross’s Chain-of-Response (COR) Model. The study was carried out at three provincial hospitals in the eThekwini district of KwaZulu-Natal (KZN) as well as three private facilities within the district. The sample consisted of 20 qualified radiographers within these institutions. This research utilized an exploratory design and interpretivist paradigm. Thematic analysis of the collected data was performed with the use of the Atlas.ti software and the implementation of the code, re-code strategy. Findings Seven major themes that emerged from the data analysis were: (a) self-perception (b) attitude towards education (c) goals and expectations (d) life transitions (e) opportunities and barriers (f) information and (g) participation. The emerged themes were aligned to Cross’s Chain-of-Response Model. Conclusion The study revealed that the practicing radiographers in KZN exhibit a high selfperception of their capability of successfully completing PG programmes in radiography. However, many of the participants demonstrate little or no interest in pursuing these programmes. Their attitude and decision making towards pursuing these programmes are negatively influenced by a multitude of factors such as the absence of incentives, lack of time and institutional grievances. Participants consider PG programmes in radiography to simply provide opportunities in the academic field to achieve personal growth and satisfaction. Incentives such as potential growth in their field, monetary gain and/or a subsidy would be the strongest motivating factors to positively influence radiographers’ decision-making towards PG education.

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