Operating within the legal and ethical framework to gain co-operation when imaging paediatric patients

A qualitative analysis of the role of the diagnostic radiographer in child safeguarding

BACKGROUND

The role of medical imaging in the investigation of suspected child abuse is well documented. However, the role of the radiographer as an instigator of such concerns is less well understood. The fast-paced development of related technology and the evolution of the profession into new areas of work is argued to have impacted upon the traditional interaction between patient and professional; thus requiring a contemporary analysis of current practice.

OBJECTIVE

As part of a wider multimethod thesis, this qualitative study sought to fill a gap in the literature with regard the role of the radiographer in child safeguarding by exploring their knowledge of, attitude towards and practical experience of the phenomenon.

PARTICIPANTS AND SETTING

Online, semi-structured interviews were conducted with n=12 radiographers from across England between 2020 and 2021. Recruitment occurred via an initial survey and interviews were conducted online.

METHODS

Verbatim transcripts were analysed using a framework analysis approach to create initial codes which led to themes for discussion.

RESULTS

The framework analysis approach resulted in the identification of three constituent themes: (1) Patient, (2) Examination and (3) Radiographer. Each constituent themes were built from a comprehensive coding of the data. Analysis of these themes are presented in terms of quotes and diagrammatic depiction.

CONCLUSION

For radiographers to be able to identify child safeguarding concerns, alignment of these constituent themes is necessary with the radiographer being the theme that can be greater controlled in terms of knowledge and attitude. Conceptually, this analysis could be extended to other professionals. Contemporary practice within medical imaging has made it more challenging to assess some physical and social signs of child safeguarding concern, and thus for the alignment to occur, as compared with previous generations. To maximise the contribution, education needs to account for wider paediatric practice and the imaging modality utilised by the radiographer. A case study approach demonstrating the potential that exists for the profession to contribute would be beneficial. Interprofessionally, greater involvement of radiographers in the assessment and escalation of any concerns could provide benefit to the patient.

Diagnostic radiographers' experiences when interacting with the custodians of paediatric patients presenting for general radiographic imaging

INTRODUCTION

Radiographic imaging of children presents several complexities, one of which includes their reliance on an adult to take care of them. Literature reports on investigations that focused on interactions of healthcare professionals with children and their parents or guardians in the healthcare setting, but little is known about radiographers' interactions with different custodians of paediatric patients. This study sought to explore and describe the experiences of radiographers with the different custodians of paediatric patients and assess how these custodians contribute to the outcomes of radiographic examinations.

METHODS

A qualitative, exploratory descriptive design was undertaken. Purposive sampling was used to select 25 radiographers from four health institutions in the Tshwane region of South Africa. Semi-structured interviews, audiotapes and field notes were used to collect data. Qualitative content analysis was used to analyse the transcribed data.

RESULTS

The following three themes emerged, namely; a) communication with different custodians, b) a radiographer's role in suspected physical abuse (SPA) and c) radiographers' responsibilities and associated radiation concerns.

CONCLUSION

Radiographers experienced different communication and interaction challenges in the imaging department with various custodians of paediatric patients. These impacted service deliveries. The paediatric patient's reaction in the imaging room might further affect the interaction between the radiographer and the custodian.

IMPLICATIONS FOR PRACTICE

There is a need for further studies that explore the concerns that radiographers have regarding their limited role in SPA. In addition, the study also adds to increasing awareness of both health professionals and the general public on radiation protection and safety.

The role of pediatric radiologists and radiographers: a different future from the past

The author of this paper reflects on the reality of pediatric radiology practice and pinpoints several constraints identified in the literature, constraints that limit the development of the role of pediatric radiologists and radiographers and therefore compromise the quality of medical imaging care delivered to the children. There is a need to build a pediatric imaging family of dedicated radiographers and radiologists at every hospital that has a radiology department. This strategy could improve the quality of the 350 million pediatric imaging procedures performed every year.

Staff's Experiences of Preparing and Caring for Children With Cancer and Their Families During the Child's Radiotherapy

BACKGROUND

Approximately one-third of children diagnosed with cancer are treated with radiotherapy (RT). Staff experiences of preparing and distracting the children and their families during a child's RT are sparsely described.

OBJECTIVE

The aim of this study was to describe staff experiences of preparing and caring for children with cancer and their families during the child's RT.

INTERVENTION/METHODS

Semistructured interviews with staff were performed at 3 Swedish RT centers. The interviews were analyzed using inductive qualitative content analysis.

RESULTS

The analysis revealed 5 categories summarizing the staff members' experiences. These include the following: experiences of various emotions; care for the child and the child's family; commitments before, during, and after RT; organizational issues; and experiences of the intervention and suggestions for improvement.

CONCLUSIONS

The preparatory intervention facilitated the ability of staff members to conduct their work, although the intervention should be specifically tailored to each child. Meeting children and their families and providing care to both during RT were challenging. The staff strived to provide optimal care for each child and family. Interdisciplinary teamwork and organizational acceptance for the importance of preparation and distraction were essential.

IMPLICATIONS FOR PRACTICE

A future challenge will be to provide opportunities for all staff involved in the treatment of children with cancer to develop their skills continuously in order to provide high-quality preparation and distraction to all children undergoing RT, regardless of the geographical location of the RT center.

It Is Tough and Tiring but It Works--Children's Experiences of Undergoing Radiotherapy

Approximately 300 children ages 0 to 18 are diagnosed with cancer in Sweden every year, and 80 to 90 of them undergo radiotherapy treatment. The aim was to describe children's experiences of preparing for and undergoing radiotherapy, and furthermore to describe children's suggestions for improvement. Thirteen children between the ages of 5 and 15 with various cancer diagnoses were interviewed. Data was analyzed using qualitative content analysis. The findings revealed five categories: positive and negative experiences with hospital stays and practical arrangements; age-appropriate information, communication, and guidance to various degrees; struggle with emotions; use of distraction and other suitable coping strategies; and children's suggestions for improvement during radiotherapy. An overarching theme emerged: "It is tough and tiring but it works". Some key areas were: explanatory visits, the need for information and communication, being afraid, discomfort and suffering, the need for media distraction, dealing with emotions, and the need for support. A systematic, family-centered preparation program could possible help families prepare and individualized distraction during radiotherapy could contribute to reducing distress. Further studies with interventions could clarify successful programs.