• Nor Atiqah Binti Mohd Fouzi

2. RESEARCH TITLE

Awareness and attitude of radiographers towards radiation protection

3. PROBLEM STATEMENT

The term ‘radiation’ covers a wide spectrum of different forms of energy, most of which have been suspected to cause ill health to human-beings (Mubeen et al., 2008). The use of ionizing radiation in diagnostic radiography may lead to hazards such as somatic and genetic damages. In addition to the use of ionizing radiation for diagnosis could be have slight chances of damage to living tissues. The effects of low level exposure to ionizing radiation are of a concern to large number of people. For example radiology department has the potential to present the harmful effects of radiation (Mojiri and Moghimbeigi, 2011). Thus Personal protection devices is an important way to address the ‘as low as reasonably achievable’ (ALARA) requirement in radiography. However, its use relies on the attitudes of radiographer to consistently adhere to professional conduct requirements relating to the application of protection devices especially for lead apron, thyroid shield, gonad shield, radiation sign, lead glove and lead goggles (MacKay et al., 2012). Awareness and knowledge of application protection guidelines and instruments among radiology technicians is vital to ensure a safe workplace. Compliance with work and safe radiation protection practices can reduce these risks. The protective measures provided are implemented, to ensure that the risks associated with the use of diagnostic ionizing radiation can be reduced.

Therefore, the effect of radiation to the patient or the person responsible for the use of radiation would increase the risk of harm to them. Thus this research intended to answer the question, does radiographer aware of radiation protection and its attitude toward radiation protection?

4. OBJECTIVES

1. General objective

The objective of this research to assess the awareness and attitude of radiographers on radiation protection at medical imaging department.

2. Specific objectives

1. To evaluate awareness regarding radiation safety among radiographers.
2. To evaluate personal practices regarding the use of protection devices among radiographers.

5. RESEARCH HYPHOTHESIS

1. Hypothesis 1

1. Null Hypothesis: The radiographers with low level of work experiences had less knowledge about adverse effects due of radiation.
2. Alternative Hypothesis: The radiographers with high level of work experiences had more knowledge about adverse effects due of radiation.

2. Hypothesis 2

1. Null Hypothesis: The radiographers with low level of education had less personal practice regarding the use of protection devices.
2. Alternative Hypothesis: The radiographers with high level of education had further personal practice regarding the use of protection devices.

6. LITERATURE REVIEW

Radiological examinations are an essential tool for the evaluation of many disorders in daily practice. Ionizing radiation in medical imaging is one of the powerful diagnostic tools in medicine. Radiation which is applied in radiology departments has hazardous effects on biological systems. They produce some type of injury that is incurable. Although all medical interventions have potential benefits, but it’s potential risks should not be ignored. The cancers risks arise with radiation have been known. Ionizing radiation may effects on gastrointestinal system, central nervous system, gonads or even whole body. These effects may appear as somatic effects or in next generation as genetic effects (Mojiri and Moghimbeigi, 2011).

Doses of whatever magnitude are assumed by International Commission on Radiological Protection (ICRP) to be able to induce what are referred to as ”stochastic effects” such as cancers and hereditary disorders (Yucel et al., 2009). Dose-dependent effects are called as “deterministic effects” that may be responsible for teratogenicity in diagnostic radiology. These effects are also useful for cancer therapy. Radiation therapy uses high-energy radiation to shrink tumors and kill cancer cells. Radiation therapy is sometimes given with curative intent that is, with the hope that the treatment will cure a cancer, either by eliminating a tumor, preventing cancer recurrence, or both (Yucel et al., 2009). To minimize the probability of stochastic effects and prevent deterministic effects, the practice of radiology is guided by the radiation protection framework established by the ICRP.

One of the important principles of this framework is that of optimization, meaning the use of as low as reasonably achievable (ALARA) dose without compromising the quality of the image. Optimization, therefore, involves strategies to manage the radiation dose to the patient (Seeram et al., 2013). In addition, a common pattern was the use of automatic exposure control (AEC) and the measurement of constant effective dose, and the use of a dose-area product (DAP) meter (Warlow et al., 2014). Many studies showed that knowledge about ionizing radiation was insufficient among radiographer and physicians who requested radiological procedures, even radiologists who should have had more information than non-radiologists (Yucel et al., 2009).

Radiation protection is the science and art of protecting people and the environment from the harmful effects of ionizing radiation. It is also described as all activities directed towards minimizing radiation exposure of patients and personnel during x-ray exposure. Thus occupational radiation protection is necessity whenever radiation is used in the practice of medicine. Occupational radiation protection measures are necessary for all individuals who work in the diagnostic imaging departments. This includes not only technologists and nurses, but also individuals who may be in a radiation environment only occasionally. All of these individuals may be considered radiation workers, depending on their level of exposure and on national regulations.

All workers require appropriate monitoring continuously by common personnel dosimeters like film badge and thermo luminescence dosimeter. They must also receive education and training appropriate to their jobs and protect by tools and equipment. The amount of absorbed dose is related to exposure factors such as kV/ potential difference and mA/ intensity of the beam and time. Personnel protective devices applied for the employee to work safely with the construction of a dose reduction of exposure to personnel. Moreover development and refinement of basic safety standards has a great important role to protect radiology staffs. The level of awareness concerning with radiation protection influences in staff behavior is important. If they have not enough information related to mentioned issue, their action will not be safe and resulted to adverse effects (Mojiri and Moghimbeigi, 2011).

7. METHODOLOGY

1. Study Design

Study design will be the cross-sectional study in which the information gather from at least 40 respondents, randomly pick and will be analyzed. Time is provided to them to answer all of the questions in the questionnaire and they need to return back the questionnaire after they finished answering it. All of the data that get from the questionnaires is considered as confidential and all the data will key-in to evaluate the knowledge and attitude of radiographers towards radiation protection.

2. Study Setting

This study will be conducted at the hospital will be my practical.

3. Sampling Design and Sample Size

In this study, a sample selection of 40 radiographers who have answered the designated questionnaire will be randomly taken out from the target population.

1. Inclusion criteria

1. All radiographer who work in that hospital.

2. Exclusion criteria

1. Clinical students.

4. Research Flow

5. Data Collection Procedures

The data collection of 40 respondents will be collected using questionnaires. Radiographers are given questionnaires. They will be asked to fill up the questionnaire. The questionnaire will be asses their awareness regarding radiation safety and their personal practices regarding the use of these protection devices.

In producing the questionnaires, I adapted the questionnaires from the previous study which are Takakuwa et al., 2010, Baumann et al, 2011, Sin et al., 2012 & Larson et al., 2007. The questionnaires were divided into two sections. The questionnaire has mainly two parts with various questions around radiation protection and safety related to staff and patients. The first part contained information about demographic data like age, sex, work experiences and etc. The second section was about awareness and attitude of employees around protection acts, protection device and dose limit.

All the data and details then will be gathered using the standard version of SPSS version 18.0 for windows will be used in a statistical analysis. Data analyzed by Chi square and Fisher exact tests to detect relationship between categorical data.

7.6 Research Tools

This study will use hand-out questionnaires in order to obtain data from respondents. Participants for this research are selected when they had finished doing a case related to medical imaging and research done during radiographer have free time. The set of questionnaires set for response are attached in Appendix 1.

7.7 Statistical Consideration

The data will be analyzed using SPSS version 18.0. All the data from the data collection form will be gathered to and key in into this software. Descriptive statistics such as frequencies and percentages were used to show the relative proportion of radiographer selecting given answers for each question. Chi square and Fisher exact tests will be used to detect relationship between categorical data.

8. ETHICAL CONSIDERATION

Research questions pursued in this study are relevant to important health care issues. This study also justified based on the potential scientific value of its results. Statistical procedures to be carried out during this study will be appropriate, and will not be used to manipulate the data just to get significant results. This final result of this study will be published in a thorough and honesty during reporting.

Data information that will collect from the respondent will be private and confidential. Approval for this study will be sought from the Faculty of Health Science, MARA University of Technology, which is associated with Imaging Diagnostic Department at the hospital that I would practically then. Furthermore, researchers will complete and sign the application of research ethics to be approved by the Faculty of Health Sciences, MARA University of Technology, to declare that the research has been tied to ethical principles. A copy of the proposal and agreement of the investigation will be included. Head of department and institution approval will submit personally to the respective institutional by the researcher for approval.

9. BUDGET

The calculation of estimated budget for this research includes the travelling cost, printing cost, and photocopy. Below is the table of the estimating cost.

Table 1: Estimated Cost of the Project

10. PROPOSED TIME FRAME FOR THE PROJECT

A Gantt chart is a planning tool that shows graphically the order in which various tasks must be completed and the duration of each activity. Look at table 2 below on the planning of the study to be conducted.

Table 2: Gant’s Chart of the Project