Abstract
Radiation protection practices in medical imaging vary globally, and in South Africa, literature evinces suboptimal radiation protection. However, the reasons for the suboptimal practice and suggestions to improve it remained unexplored. Therefore, the study undertook to understand South African radiographers’ radiation protection practices and develop, describe and evaluate a model to facilitate radiation protection among radiographers in order to implement and optimise radiation protection. Guidelines to implement the model are also described.
The study was conducted using Chinn and Kramer’s four steps of theory generation. Step one consisted of four phases based on organisational development inquiry situated in a pragmatic paradigm. It was framed by the theory of planned behaviour using an explanatory, sequential, mixed-method approach, and data were collected in the first three phases of step one. Phase one, the quantitative phase, used the online theory of planned behaviour questionnaire to collect data from purposively sampled South African diagnostic radiographers. Four hundred and seventeen responses were received and statistically analysed. Respondents from phase one who were interested in participating in phase two, the qualitative phase, were interviewed, yielding 13 in-depth, semi-structured telephone interviews. In phase three, eight purposively sampled radiography managers co-constructed change strategies to optimise radiation protection in SA during two focus group interviews. Data collected from the individual and focus group interviews underwent thematic analysis. Reliability and validity of the quantitative data were achieved through a pilot study, Cronbach’s alpha and factor analysis. The trustworthiness of the qualitative processes was ensured through credibility, dependability, transferability, confirmability and authenticity. In phase four of step one, central concepts were identified from the findings of the preceding phases. The central concepts were then defined using Walker and Avant’s concept analysis process, and were classified through Dickoff, James and Wiedenbach’s survey list. In the second step, the central concepts were placed into relationship statements, and in the third phase, the model was developed, described and evaluated. In the fourth step, guidelines to implement the model were provided. Ethical research practices of obtaining permission and informed consent, respect for autonomy, non-maleficence, justice and ethical data management were adhered to throughout the study. The study contributed to an understanding of South African radiographers’ radiation protection practices and offered suggestions for implementing and optimising radiation protection.