Barriers to not informing patients about radiation in connection with radiological examinations: Radiographers’ opinion

Abstract

Introduction: In some instances, little knowledge regarding radiological examinations is provided to patients. The purpose was to investigate whether radiographers inform patients about radiation, and if not, the reasons for it. Methods: A questionnaire was sent to radiographers working in the public sector in Northern Finland. Radiographers were asked whether they had informed patients about the radiation dose and risks during the last year. If information was not provided, the reasons for it were investigated using multiple-answer type multiple-choice questions with the option for free text responses. The results were compared between a University Hospital and other departments and between different lengths of work experience. Altogether 174/272 (64%) radiographers responded to the questionnaire; 50% were from the University Hospital and 50% from other departments. Results: Altogether 103/174 (59%) respondents did not inform patients about the radiation dose and 93/ 174 (53%) did not inform them about the associated risks. Regarding a passive approach to dose information, respondents thought that the referrer had already informed the patient (49/103, 48%), information was not needed (51/103, 50%), or it might cause unnecessary fear (47/103, 46%). Reasons for a passive approach to risk information were similar (66/93, 71%; 33/93, 36%; 47/93, 51%, respectively). Regarding the results, there were no differences between the institutions or work experience levels. According to the open question, some radiographers expected patients to ask questions before informing them. Lack of time was rarely mentioned as a reason. Conclusion: The main reasons for inadequate information were ignorance regarding responsibilities, assumption that information is not needed, and concern about causing unnecessary fear. Implications for practice: Education, guidelines specifying responsibilities and contents for information, and easy-access digital educational material for public and professionals are needed.

Communicating Radiation Risk to Patients: Experiences Among Radiographers in Norway

“…During the last decade, risk communication related to the use of radiation in medical imaging has become more important and there have been several publications on the subject. [1][2][3][4] Risk communication can be defined as information about the recommended examinations, benefits and risks, and alternative imaging methods. 5 For the patients to make an informed decision this must be known to the patients, and also the risks occurring if they decided not to attend the examination.…”

“…4 The patients themselves also want information concerning radiation doses and potential risks, related to their diagnostic x-ray examination. 2,4 Both referrers, radiologists, and radiographers should be able to give information about doses and risks to the patients. However, the radiographer is most likely to provide information during the examination.…”

“…1 Studies have shown that radiographers do not provide patients with adequate information about doses and risks. 2,3,6 One study shows that about 60% of radiographers (103/ 174) do not inform patients about doses and 53% did not inform about potential risks, 2 while another study shows that only 23% informs about potential risks. 6 When they provide information about radiation doses, they often compare it to the equivalent of background radiation or transatlantic flights, or in the number of chest x-rays, and rarely in actual doses (milliSievert, mSv).…”

“…Radiographers are afraid of creating unnecessary worry for the patients and are concerned that patients may refuse justified examinations. 2,3 Further, if the radiographers do not have enough knowledge about radiation doses and risks, they cannot provide adequate information, which further could lead to reluctance in discussing risks with patients. 3,6 .…”

“…Some radiographers assume that information already has been provided by referrer and therefore there is no need to provide information about radiation doses and risks, 2,6 and some radiographers also think there is no need for giving this information. 2 There is a disparity between what the patients expect of information and the information provided by the radiographers. 2 The patients want to know about the dose and potential risks.…”