Environmental sustainability in radiography in low-resource settings: A qualitative study of awareness, practices, and challenges among Zimbabwean and Zambian radiographers.

INTRODUCTION: Evidence suggests that radiography activities have a significant impact on the environment. With growing awareness of the negative environmental consequences of radiography services, there is an increasing call for radiographers to adopt sustainable practices. However, little is known about the levels of awareness, current practices, and challenges faced by radiographers working in low-resource settings on this subject. Therefore, this study aimed to explore the awareness, practices, and challenges among Zimbabwean and Zambian radiographers about environmental sustainability in radiography. METHODS: An exploratory descriptive qualitative research design was used in this study. Two focus group discussions (FGDs) were conducted with 19 purposively sampled participants (N = 8 and N = 11) in Zimbabwe and Zambia, respectively. The audio recordings were transcribed verbatim and analysed using Braun and Clarke's thematic analysis six-phase framework. RESULTS: Following thematic data analysis three main themes emerged: awareness of the concept of sustainability among radiographers, sustainability practices in radiography, and challenges of implementing sustainability in radiography. The study found that some radiology departments continue to rely on film-screen imaging systems due to insufficient financial resources to transition to digital imaging systems. Consequently, this constraint emerged as the central obstacle thwarting the implementation of sustainable practices in radiography. CONCLUSION: Most radiographers understood the concept of sustainability in radiography; however, they were concerned about the negative impact of radiography practices on the environment and wanted more training and financial support to mitigate this impact. IMPLICATIONS FOR PRACTICE: Environmental sustainability should be integrated into the radiography curriculum and provision of continuing professional development (CPD) to impart radiographers with knowledge and the best practices. Periodical audits should be conducted to monitor sustainable practices and reward deserving radiology departments.

Promoting sustainability activities in clinical radiography practice and education in resource-limited countries: A discussion paper.

OBJECTIVE: Urgent global action is required to combat climate change, with radiographers poised to play a significant role in reducing healthcare's environmental impact. This paper explores radiography-related activities and factors in resource-limited departments contributing to the carbon footprint and proposes strategies for mitigation. The rationale is to discuss the literature regarding these contributing factors and to raise awareness about how to promote sustainability activities in clinical radiography practice and education in resource-limited countries. KEY FINDINGS: The radiography-related activities and factors contributing to the carbon footprint in resource-limited countries include the use of old equipment and energy inefficiency, insufficient clean energy to power equipment, long-distance commuting for radiological examinations, high film usage and waste, inadequate training and research on sustainable practices, as well as limited policies to drive support for sustainability. Addressing these issues requires a multifaceted approach. Firstly, financial assistance and partnerships are needed to adopt eco-friendly technologies and clean energy sources to power equipment, thus tackling issues related to old equipment and energy inefficiency. Transitioning to digital radiography can mitigate the environmental impact of high film usage and waste, while collaboration between governments, healthcare organisations, and international stakeholders can improve access to radiological services, reducing long-distance commuting. Additionally, promoting education programmes and research efforts in sustainability will empower radiographers with the knowledge to practice sustainably, complemented by clear policies such as green imaging practices to guide and incentivise the adoption of sustainable practices. These integrated solutions can significantly reduce the carbon footprint of radiography activities in resource-limited settings while enhancing healthcare delivery. CONCLUSION: Radiography-related activities and factors in resource-limited departments contributing to the carbon footprint are multifaceted but can be addressed through concerted efforts. IMPLICATIONS FOR PRACTICE: Addressing the challenges posed by old equipment, energy inefficiency, high film usage, and inadequate training through collaborative efforts and robust policy implementation is essential for promoting sustainable radiography practices in resource-limited countries. Radiographers in these countries need to be aware of these factors contributing to the carbon footprint and begin to work with the relevant stakeholders to mitigate them. Furthermore, there is a need for them to engage in education programmes and research efforts in sustainability to empower them with the right knowledge and understanding to practice sustainably.

Attitudes and barriers to interprofessional collaboration among radiographers: A multi-country perspective.

INTRODUCTION: To promote effective interprofessional collaboration (IPC), it is crucial to understand the attitudes of healthcare workers towards IPC and identify any barriers they may face. This is particularly important in the radiography profession where IPC is vital for providing holistic care and ensuring radiation protection and safety. However, there is limited research available on the attitudes and barriers to IPC specifically among radiographers. Therefore, this study aimed to assess the attitudes and barriers to IPC among radiographers from multiple countries. METHODS: A quantitative descriptive cross-sectional online survey was conducted using the adapted attitudes toward healthcare teams scale (ATHCT) and barriers scale towards IPC. Data analysis was performed using descriptive statistics, Wilcoxon rank-sum, Kruskal-Wallis tests, and exploratory factor analysis. RESULTS: A total of 233 radiographers across the globe participated in this survey. The study found that the overall mean score on the ATHCT scale was 54.68 (SD = 5.75). Although not statistically significant, radiographers with over 15 years of experience tended to strongly agree with all the statements, indicating a more positive attitude towards IPC. The study also identified three subscales related to IPC: quality of care, team efficiency, and time constraint. The top three barriers to IPC reported by radiographers include i. a lack of clearly defined, shared, and measurable purpose, ii. poor communication, and iii. a lack of commitment from team members. CONCLUSIONS: The findings highlight the need for interventions and programs that promote effective communication and establish a shared vision among healthcare team members.

Factors affecting the ability of radiographers to deliver imaging services in rural parts of Zambia.

INTRODUCTION: Medical imaging in healthcare plays a vital role in the assessment, confirmation, and documentation of the course of many diseases and injuries. However, literature reports that the urban population in Sub-Saharan Africa have more access to imaging services than the rural population. This imbalance can affect radiographers working in rural areas. The aim of this study was to explore factors affecting the ability of radiographers to deliver imaging services in rural parts of Zambia. METHODS: This study employed a qualitative exploratory research design. Semi-structured interviews were used to collect data from a stratified and purposive sample of six rural radiographers and three stakeholders [Ministry of Health (MOH), Radiological Society of Zambia (RSZ), and Schools of Radiography] across the country. Data were audio-recorded, transcribed, and subjected to manual thematic analysis. RESULTS: Four themes emerged following thematic analysis: procurement processes and resources, imaging equipment, job satisfaction, and education and training. Factors, such as donated equipment, the introduction of new imaging services and continuous professional development (CPD) were positive elements that assisted rural radiographers in the delivery of imaging services. However, an unequal distribution of equipment between urban and rural areas, old and obsolete equipment, lack of maintenance and servicing, lack of postgraduate courses, bureaucratic procurement processes, lack of consumables, workload, and low salaries, negatively affected the ability of rural radiographers. CONCLUSION: Lack of maintenance and servicing of equipment, as well as bureaucratic procurement processes were the main challenges identified by radiographers to imaging services in rural Zambia. There is a need to decentralise the procurement processes and establish a culture of regular maintenance and servicing of equipment. IMPLICATIONS FOR PRACTICE: This research highlights the importance of supporting rural radiographers in the delivery of imaging services.