Survey of radiation protection amongst non-radiology staff working in fluoroscopy-guided operating theatres at public health institutions in the eThekwini district of KwaZulu-Natal

Abstract

Background Although fluoroscopy facilitates the performance of less invasive surgical techniques and therefore an increase in its use outside the radiology department, it carries with it the burden of radiation exposure. Several studies on radiation exposure during fluoroscopy-guided surgical procedures have been conducted in South Africa, but no known knowledge, attitude and practices (KAP) study has been conducted on radiation protection. Together with inadequate radiation protection practices among non-radiology theatre staff, the dearth of reported research on this subject has created the need for this study. This study therefore aimed to determine the KAP relating to non-radiology staff during fluoroscopy-guided operating procedures at public health institutions in the eThekwini district of KwaZulu-Natal. The relationships between KAP, demographic factors and intentions to implement radiation protection practices were related to the theory of planned behaviour. Methodology Ethical approval and gatekeeper permissions were obtained from the relevant stakeholders. A quantitative cross-sectional survey was adopted to collect data from non-radiology staff in fluoroscopy-guided operating theatres at eThekwini district public health institutions. Random stratified sampling was used to obtain a sample of 179 participants. A validated questionnaire was administered over 12 weeks. Respondents signed a consent form prior to participating and no names were provided on the questionnaire for purposes of confidentiality. Data were analysed using descriptive and inferential statistical tests such as the Chi- square test, Fisher‟s exact test and Spearman‟s rho correlation coefficient. Results The response rate was 54%, the respondents‟ mean age was 38.46 ± 9.47 years, and the majority (66.7%) were female. The respondents demonstrated moderate radiation-related knowledge (61.22%) and exceptional attitude (98.98%), but poor radiation protection practices (3.06%). The respondents‟ specialty, profession and hospital where they are working demonstrated a significant association with their KAP scores (p < 0.05). There are significant positive correlations between knowledge and attitude (r = 0.270, p = 0.021), and attitude and intention (r = 0.348, p = 0.008), and significant negative (inverse) correlations between knowledge and practice (r = -0.264, p = 0.017), and attitude and practice (r = -0.280, p = 0.014). There are no significant correlations between knowledge and intention, and intention and practice (p > 0.05). Conclusion Although the respondents have good knowledge and attitude, their radiation practices are poor. This indicates a need for further radiation protection training and improved awareness of and research into exact levels of radiation exposure and the consequences of such exposure.