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Ionizing Radiation Testing: Literature Critical Appraisal

Introduction

Understanding the nature of the current problem with the provision of ionizing radiation testing to patients is vital for proper diagnosis. However, there are indications that a substantial number of healthcare providers do not have the required skills or tools. For this reason, a closer examination of the problem has been conducted. Due to the reasonable choice of a research method and an appropriate selection of a sampling strategy, the studies at hand demonstrate accurate and credible outcomes that point to the need for offering healthcare providers guidance and crucial resources for conducting ionizing radiation testing.

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Qualitative Perspective

The obstacles to deploying the ionizing radiation testing approach in the clinical setting have been outlined quite a number of times. For example, the paper by Kruger et al. (2014) demonstrates the existence of a problem. The researchers cite studies that have found limitations ins using radiation in terms of the adverse health outcomes for patients. the study addresses the problem of healthcare providers showing no clear awareness of the impact of radiation exposure tests. In addition, the fact ethics was approved by the Institutional Review Board at the University of California San Francisco. Informed consent was obtained from all participants before their division into focus groups shows the legitimacy of the claims that Kruger et al. (2014) make.

Furthermore, the research methodology selected by Kruger et al. (2014) aligns with the goals and the main statement of the paper. Namely, the researchers chose focus groups, which is a subset of qualitative research, with primary care clinicians and subspecialty physicians in hospital-based outpatient clinics and related community health centers. The sample was geographically diverse and recruited via email to ensure representativeness. The data were collected employing semi-structured interviews in focus groups. The data were analyzed using thematic analysis of the interviews during focus groups, and the results are presented in the form of themes that were found during the process of analysis.

Most importantly, the discussion points out that the study was the first to show how clinicians approach outpatient care delivery when radiation exposure is involved. The researchers point out the main themes and accompany them with illustrative quotes. Unfortunately, there is no clearly identified conclusion section even though the researchers identify study limitations, such as the limited demographic information, which is an obvious omission. The exploratory research was investigation-oriented by its nature, which entails that the findings need confirmation in the future. Unfortunately, the researchers point out that the findings may not be generalizable to clinicians who practice in other regions and market settings.

Another study worth pointing out as a crucial bit of information in relation to the issue of ionizing radiation testing, the paper by Uri (2012) is worth attention. The researcher states that in recent decades, there has been a significant increase in investigations focusing on ionization radiation due to its adverse effects. Uri (2012) urges that the problem of referrers’ lack of awareness as to the use of ionization radiation and its adverse impact on the health of patients must be addressed as a vital issue affecting the quality of care. Surprisingly, the study does not feature a discussion of ethical issues that could have taken place during the research.

At the same time, the methodology appears to be fully justified. Specifically, the study involved qualitative questionnaires administered to a 100-participant representative sample. There were three main themes in which the questionnaires were divided, such as plain X-ray and fluoroscopy studies, cross-sectional and radionuclide studies, and the estimation of radiation-induced cancer risk. In turn, the results were presented for 57 consultants/associate specialists, 21 registrars or equivalent, 20 junior doctors, and two nurse practitioners. The results were divided into three themes aligning with questionnaire sections to show how participants approached each of the themes. By providing robust discussion, the researchers establish whether the participants of the study have a correct view of the use of ionization radiation for the purposes of diagnosing conditions. The lack of awareness can only be improved by continuous education for the professionals involved. Even though the study is UK-based, there are findings to suggest that many professionals fail to understand the importance of correct dosage and the widespread use of radiation-based tests.

Quantitative Perspective

Introducing a quantitative perspective, the research by Faggioni et al. (2016) also examines the issues faced when performing ionized radiation testing on patients. For instance, the researchers identify the concerns of the increased use of CT imaging and the adverse effect of exposure to increased radiation. Thus, the authors advocate for the assessment of the degree of subjectively perceived knowledge and sufficient knowledge of essential protection against radiation. To their credit, the scholars clearly identify the problem of healthcare providers being unable to make correct distinctions between the various types of radioactive imaging. However, no account of possible ethical issues is provided.

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At the same time, the study entailed the implementation of a quantitative survey (questionnaire) among young doctors and radiology residents. The surveys were differentiated into three sections (demographic data, standards assessment, and knowledge rates). The questions were formulated in a multiple-choice format with five to six options and only one correct answer. Each correct answer was given one mark and zero points were given for errors or missed responses. Descriptive statistics, Kruskal-Wallis test, and Mann–Whitney tests with Bonferroni correction were utilized.

In turn, the results are clearly described, including the demographics of survey participants, the internal reliability, the internal consistency, as well as other related findings. The P-value was presented for the perceived knowledge of practitioners and their training in using CT tests. The total questionnaire scores were also reported. The specified approach toward representing the results has led to a fruitful and comprehensive discussion, which, in turn, has resulted in an overarching conclusion. Both the discussion and conclusion were comprehensive and clearly presented and showed high applicability rates.

Alghamdi et al. (2020) bring another important issue to the discussion, raising the question of radiation awareness rates among healthcare experts. The researchers clearly stated that ionizing radiation has adverse dose-dependent effects on humans. The paper can be considered ethically conducted since it received ethical approval from the institutional review board committees in the nursing department of the University of Tabuk. It was ensured that the participants agreed to participate voluntarily.

Methodologically, the paper meets the criteria for reliability as well. Specifically, the researchers identified the cross-sectional descriptive online study. The convenience sample included 207 respondents, with a total of 196 questionnaires returned. The data was collected in the context of the King Khaled Hospital and King Fahad Specialist Hospital. The surveys included closed-ended questions on the knowledge of basic radiation protection principles and were processed in SPSS.

The paper also features a separate discussion section in which researchers explore the findings and make recommendations for healthcare specialists. A conclusion section is present as well; there is a recommendation to implement educational programs and training for medical staff. In addition, future research is needed to evaluate the effects of interventional education on the level of awareness of the risks of ionizing radiation, and the limitations are also discussed. Finally, because the sample was large, the findings are applicable to the wider population of healthcare workers.

The extent of knowledge of radiological exposure in patients during respective testing processes has also been revisited by Lee et al. (2012). Even though radiological examinations are essential to daily medical practice, patients are not adequately informed about the implications of being tested with the help of radiation-based methods. The researchers mention that many doctors do not understand the adverse effect of high radiation dosages. The study was approved by the institutional review board, and the participants’ anonymity was preserved while informed consent was obtained.

Additionally, the methodological approach used by Lee et al. (212) is also very robust. Specifically, the researchers implemented a quantitative questionnaire involving 386 participants that included doctors in emergency medicine, general internal medicine, radiology, surgery, and pediatrics in a teaching hospital. Questionnaires were distributed both by hand copies and by email, asking to fill the average radiation doses and estimating the doses of radiation for common radiological procedures.

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Furthermore, the results section is comprehensive and includes a table breaking down the knowledge of professionals’ radiation doses of commonly performed radiological examinations among radiologists and non-radiologists. The difference in knowledge is important to note because it illustrates a gap in awareness, which leads to adverse health outcomes for populations. Both the discussion and the conclusion are comprehensive and note the fact that radiation impact should not be overlooked by non-radiologists, who often do not realize how their patients may be affected by the testing. As for the findings, even though the setting is a teaching university in Hong Kong, the large sample size facilitates generalizability to the large population of practitioners.

Finally, nurses’ perspective on the issue of radiation protection is examined thoroughly in the study by Hirvonen et al. (2019)., The researchers detail their rationale by noting that nursing roles are changing, with countries amending legislation for nurses to make referrals for medical imaging examinations that employ ionizing radiation. The study was also conducted according to the principles of good research practice and respect for human dignity.

To investigate the issue, the researchers applied quantitative cross-sectional research with self-administered questionnaires completed by 252 participants out of 1500 that were initially sent the surveys. Participants had to attain scores of their radiation knowledge specified in the items using a 10-point Likert scale. The data was collected through the Webpropol survey program that participants could access via a link and analyzed using SPSS.

The proposed methodological approach has led to conclusive results. The researchers point out the differences in radiation knowledge based on nurses’ gender, age, work experience, and education. It was found that higher levels of knowledge in nurses were associated with prior education on the issue. Although the research findings are applicable to the wider population, further research is needed for identifying optimal interventions for addressing deficiencies in nurses’ knowledge of radiation.

Conclusion

Overall, the studies under analysis can be considered authoritative and highly credible since they deploy appropriate research methods that correspond to their goals and select the strategies that allow for minimizing the biases associated with specific research strategies. Thus, the studies can be added to the current constellation of works that contribute to the understanding of key impediments to implementing ionizing radiation testing for most modern healthcare organizations. As a result, patients’ needs will be promptly met, and patient outcomes will be subsequently improved.

References

Alghamdi, A., Alsharari, Z., Almatari, M., Alkhalailah, M., Alamri, S., Alghamdi, A., … Alabthani, I. (2020). Radiation risk awareness among health care professionals: An online survey. Journal of Radiology Nursing, 39(2), 132-138. Web.

Faggioni, L., Paolicchi, F., Bastiani, L., Guido, D., & Caramella, D. (2016). Awareness of radiation protection and dose levels of imaging procedures among medical students, radiography students, and radiology residents at an academic hospital: Results of a comprehensive survey. European Journal of Radiology, 86, 135-142. Web.

Hirvonen, L., Schroderus-Salo, T., Henner, A., Ahonen, S., Kääriäinen, M., Miettunen, J., & Mikkonen, K. (2019). Nurses’ knowledge of radiation protection: A cross-sectional study. Radiography, 25(4), e108-e112.

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Kruger, J., Chen, A., Rybkin, A., Leeds, K., Frosch, D., & Goldman, E. (2014). Clinician perspectives on considering radiation exposure to patients when ordering imaging tests: A qualitative study. BMJ Quality & Safety, 23, 893-901. Web.

Lee, R. K., Chu, W. C., Graham, C. A., Rainer, T. H., & Ahuja, A. T. (2012). Knowledge of radiation exposure in common radiological investigations: A comparison between radiologists and non-radiologists. Emergency Medicine Journal: EMJ, 29(4), 306-308. Web.

Uri I. F. (2012). Lack of radiation awareness among referrers: Implications and possible solutions. International Journal of Clinical Practice, 66(6), 574-581. Web.

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