Radiation therapists’ experiences of disruptions in radiotherapy service delivery during the Covid-19 pandemic at public oncology hospitals in KwaZulu-Natal, South Africa

Abstract

Background The novel coronavirus (COVID-19) rapidly impacted all human life following its escalation to a pandemic status in early March 2020. This viral pandemic severely affected the world’s developed and developing countries, resulting in disruptions within healthcare delivery systems, including radiotherapy. Although the government guidelines and restrictions to mitigate the risk of viral transmission were implemented, radiotherapy departments were amongst multiple departments forced to promptly adjust in order to encourage continuous clinical care. However, to provide this service, radiation therapists work closely together and in close proximity to their patients. These inherent working conditions resulted in changes in the number of treatments for some patients, clinical working patterns and conventional radiotherapy practice during the pandemic era. This challenge was faced by numerous radiotherapy departments globally, hence there is a need to explore how radiation therapists in South Africa coped to ensure continuous clinical service delivery. Aim The aim of this study was to explore radiation therapists’ lived experiences of the COVID-19 pandemic disruptions on their radiotherapy service delivery at public oncology hospitals in the KwaZulu-Natal (KZN) province, and ultimately recommend strategies to support them to cope with the changes due to the pandemic. Methodology To conduct this research, the researcher employed a constructivist paradigm and a qualitative phenomenological approach. Criterion purposive sampling was used to select two public oncology hospitals, whereby the critical case sampling selected a radiotherapy manager as well as simulator, planning and treatment machine radiation therapists from each to constitute a minimum sample size of ten. Findings The study interview data was analysed using Colaizzi’s Seven-step Method of data analysis to identify themes which were then presented as findings. This resulted in four major themes that revealed the radiation therapists’ common narrative during the COVID-19 pandemic as: Changes in hospital settings, working conditions, radiation therapists’ practices and wellbeing; barriers to radiotherapy service delivery; facilitators to radiotherapy service; and support needed. Conclusion and recommendations In exploring radiation therapists’ lived experiences of disruptions in radiotherapy service delivery in a developing country such as South Africa, there can be strategies that aid in supporting radiation therapists to continue providing clinical service delivery. As part of the recommendations to attain this, the study brought forth managerial training, similar study conduction to validate study, interviewing of patients, psychological support to employees concerned, educational programmes for both patients and employees, remote treatment planning for radiation therapists, as well as routine screening for concerned employees.