Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study
Abstract Introduction The incidence of obesity has been steadily rising over the last few decades and is having a significant impact upon the health system. In radiography, a particular challenge of imaging obese patients is implementing the as low as reasonably achievable (ALARA) principle when det...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-03-01
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| Series: | Journal of Medical Radiation Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jmrs.543 |
| _version_ | 1818907112035581952 |
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| author | Grace Seo John Robinson Amanda Punch Yobelli Jimenez Sarah Lewis |
| author_facet | Grace Seo John Robinson Amanda Punch Yobelli Jimenez Sarah Lewis |
| author_sort | Grace Seo |
| collection | DOAJ |
| description | Abstract Introduction The incidence of obesity has been steadily rising over the last few decades and is having a significant impact upon the health system. In radiography, a particular challenge of imaging obese patients is implementing the as low as reasonably achievable (ALARA) principle when determining radiation dose, and technical and patient‐care adaptations. This study aimed to better understand the decision‐making strategies of experienced radiographers in determining imaging and exposure factor selection in the context of imaging obese patients. Methods This study employed a ‘think‐aloud,’ methodology, and eight experienced diagnostic radiographers working in clinical education were recruited to perform routine AP abdominal X‐ray projections on an anthropomorphic phantom. They were asked to simultaneously verbalise emerging thoughts as they considered positioning, exposure selection and image evaluation. This process was repeated with three different phantom sizes, each representing an increased BMI from ‘healthy,’ to, ‘morbidly obese.’ Audio recordings were transcribed and interpreted via Bowman’s (1997) theory of radiographic judgement and decision‐making. Results Analysis of interview transcripts identified 12 key concepts considered by experienced radiographers. Differences in radiographic concepts were considered when imaging phantoms of different sizes was demonstrated. A shift from segmental (e.g. positioning) to more environmental factors (e.g. patient comfort) and an increase in the number of verbal considerations with increasing phantom size were identified. The shift in focus of decision‐making stages identified the greater need to consider contextual factors such as patient comfort and repeatability when imaging obese patients. Conclusion Experienced radiographers find imaging obese patients challenging and alter their perception of image quality to accommodate for patient presentation. The findings will help inform future research, practice guidelines and learning resources to provide optimal imaging and care for obese patients, especially for student education. |
| first_indexed | 2024-12-19T21:49:56Z |
| format | Article |
| id | doaj.art-4c28898c1bab43478d02efbad616ab21 |
| institution | Directory Open Access Journal |
| issn | 2051-3895 2051-3909 |
| language | English |
| last_indexed | 2024-12-19T21:49:56Z |
| publishDate | 2022-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Medical Radiation Sciences |
| spelling | doaj.art-4c28898c1bab43478d02efbad616ab212022-12-21T20:04:26ZengWileyJournal of Medical Radiation Sciences2051-38952051-39092022-03-01691132310.1002/jmrs.543Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud studyGrace Seo0John Robinson1Amanda Punch2Yobelli Jimenez3Sarah Lewis4Discipline of Medical Radiation Sciences, Faculty of Medicine and Health The University of Sydney City Road Camperdown NSW AustraliaDiscipline of Medical Radiation Sciences, Faculty of Medicine and Health The University of Sydney City Road Camperdown NSW AustraliaDiscipline of Medical Radiation Sciences, Faculty of Medicine and Health The University of Sydney City Road Camperdown NSW AustraliaDiscipline of Medical Radiation Sciences, Faculty of Medicine and Health The University of Sydney City Road Camperdown NSW AustraliaDiscipline of Medical Radiation Sciences, Faculty of Medicine and Health The University of Sydney City Road Camperdown NSW AustraliaAbstract Introduction The incidence of obesity has been steadily rising over the last few decades and is having a significant impact upon the health system. In radiography, a particular challenge of imaging obese patients is implementing the as low as reasonably achievable (ALARA) principle when determining radiation dose, and technical and patient‐care adaptations. This study aimed to better understand the decision‐making strategies of experienced radiographers in determining imaging and exposure factor selection in the context of imaging obese patients. Methods This study employed a ‘think‐aloud,’ methodology, and eight experienced diagnostic radiographers working in clinical education were recruited to perform routine AP abdominal X‐ray projections on an anthropomorphic phantom. They were asked to simultaneously verbalise emerging thoughts as they considered positioning, exposure selection and image evaluation. This process was repeated with three different phantom sizes, each representing an increased BMI from ‘healthy,’ to, ‘morbidly obese.’ Audio recordings were transcribed and interpreted via Bowman’s (1997) theory of radiographic judgement and decision‐making. Results Analysis of interview transcripts identified 12 key concepts considered by experienced radiographers. Differences in radiographic concepts were considered when imaging phantoms of different sizes was demonstrated. A shift from segmental (e.g. positioning) to more environmental factors (e.g. patient comfort) and an increase in the number of verbal considerations with increasing phantom size were identified. The shift in focus of decision‐making stages identified the greater need to consider contextual factors such as patient comfort and repeatability when imaging obese patients. Conclusion Experienced radiographers find imaging obese patients challenging and alter their perception of image quality to accommodate for patient presentation. The findings will help inform future research, practice guidelines and learning resources to provide optimal imaging and care for obese patients, especially for student education.https://doi.org/10.1002/jmrs.543adaptive techniqueeducationobesityobesity decision‐makingradiography |
| spellingShingle | Grace Seo John Robinson Amanda Punch Yobelli Jimenez Sarah Lewis Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study Journal of Medical Radiation Sciences adaptive technique education obesity obesity decision‐making radiography |
| title | Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study |
| title_full | Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study |
| title_fullStr | Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study |
| title_full_unstemmed | Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study |
| title_short | Understanding radiographic decision‐making when imaging obese patients: A Think‐Aloud study |
| title_sort | understanding radiographic decision making when imaging obese patients a think aloud study |
| topic | adaptive technique education obesity obesity decision‐making radiography |
| url | https://doi.org/10.1002/jmrs.543 |
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