ASSESSMENT OF PATIENT ATTITUDE AND PERCEPTION TOWARDS XRAY EXAMINATION

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ABSTRACT

The use of X-rays in medical diagnostic radiology has increased globally. The medical use of X-ray for diagnosis of illness is subject to the principles of justification and optimization for the protection of exposed individuals. Medical X-ray accounts for the largest exposure of humans to man-made ionizing radiation. Exposure of individuals can lead to long-term stochastic effects. Over exposure of humans in interventional procedures can also lead to deterministic effects such as skin burns in the short term. Even though, measures are put in place to protect the operators of the X-ray equipment, including radiologists, there are no systems to protect patients undergoing radiological examinations. To circumvent this problem therefore, this study was conducted to determine whether safety precautionary measures necessary for shielding patients contact to unsafe dose of radioactivity were being adhered to or not. The factors that affect patient protection include equipment performance, operator knowledge and skills in exposing the patient correctly to obtain the best diagnostic image with a minimum dose to the patient and monitoring and evaluation of patient dose to ensure consistency with Institutional Diagnostic reference level. 

To achieve the study objectives therefore, the level of protection patients received during simple radiographic examinations in the Korle-Bu Teaching hospital and the Ridge hospital, was evaluated.

A cross-sectional study design was used in this research. A total of 175 participants were selected conveniently from the Korle-Bu Teaching and the Ridge hospitals. A selfadministered structured questionnaire was administered to obtain scientific and personal data. The entrance surface dose of radiation was measured using Multi-Purpose Detector. From the study, the performance indicator of protection measured was 1.6 (80%), Safety operations by management 1.06 (53%), Safety operations by radiographers 1.79 (89.5%), patients’ safety and knowledge 0.89 (44.5%), investigations and quality assurance 1.6 (80%), local rules and supervision 1.29 (64.5) and clinical dosimetry 1(50%).

There were no radiation survey meters in both facilities. Radiographers did not weigh patients to estimate their doses. Majority of Physicians were unaware of the accepted exposure dose of various segments of the human body. Due to poor record keeping, enquiries of previous radiographic examinations from patients were not conducted. Finally, patients at Ridge Hospital were exposed to relatively higher doses of radiation even though both facilities were within the diagnostic reference range for Akwa Ibom.

CHAPTER ONE

INTRODUCTION

1.1 Background

In November 1895, Von Rontgen of Wurzburg, Germany, discovered the X-ray while working with a Crookes’ tube (Berkeley, 1989). In 1896, Henri Becquerel also discovered radioactivity while working on X-ray (Radiation Protection Dosimetry, 2015). Radiology is the scientific use of X-rays and other high energy radiations for diagnosis and treatment (Sharma et al., 2016). Radioactive material or device is any substance that emits electromagnetic waves. The emission of electromagnetic particles is called radiation and the disintegration or breaking down of the atoms into ions is called ionization. Electromagnetic waves that are capable of disintegrating atoms into ions are known as ionizing radiations.

The knowledge of the harmful effects of ionizing radiation has since been documented. However, accidents that result in people getting injured still persist irrespective of the considerable development in radiation safety (Bengtsson, 1978). 

Every material in nature has energy called the latent energy, which is an inherent property of the material. All materials have a fundamental elementary unit known as the atom. Each atom has subdivisions know as protons, neutrons and electrons. When the atoms of a particular substance have an unequal number of protons and neutrons, the substance is rendered unstable in electromagnetic energy and will therefore emit the excess energy in order to become stable. A radioactive material is therefore any substance that is unstable due to an unequal number of protons and neutrons and will release energy in a process called radioactive decay in order to be stable.