Assessment Of Awareness And Attitude Of Students Towards Risks Associated With Medical X-ray Procedures. A Case Study Among Non-medical Students In University Of Nigeria Enugu Campus

Awareness is knowing that something exists and attitude is the way people behave towards something that shows how they think and feel concerning it. Medical X-ray investigation is an indispensable arm of modern medicine that uses X-ray for diagnosis and management of diseases. It is one of the most powerful medical imaging tool and the second most commonly used medical test after medical laboratory tests which aids in diagnosis. With the advent of X-rays as a diagnostic technique, radiological procedures are increasingly being used in diagnosis and management of wide range of diseases, resulting in increased population exposure. The increase in utilization has led to a parallel increase in concern regarding radiation risks because X-ray procedures utilize ionizing radiation which is harmful to health. Although the exposure amount from these exams is very small to the extent that the health risks associated with such low levels of exposure is debated in scientific meetings. Nonetheless, the prevailing scientific view is that there is a finite (though small) amount of risk involved with such exposure and so, should not be ignored no matter how insignificant such risk is. This research was done with the aim of assessing the awareness and attitude of non medical students (16 – 30 years) in University of Nigeria Enugu Campus towards risks associated with medical imaging. The sample size used in this study was 344 students using a convenience sampling technique. The study utilized questionnaire as a source of data collection. Results showed that more than half (57.1%) of the students are aware that X-ray is harmful to health, 12% knows that the reason why X-ray is harmful to health is because of its’ ionizing ability, 43% knows that X-ray can cause cancer.  34.5% of the students are scared, (5.1%) are comfortable while (12%) feel less concern towards risks associated with medical imaging. The findings shows that more than half of the students are aware that X-ray used in medical imaging is associated with some risks though very few knows the rationale why X-ray is harmful. Students that feel scared towards risks associated with medical imaging are greater in number than those who feel comfortable and less concern towards risks it. 

Title Page i

Dedication ii

Approval Page iii

Certification iv

Acknowledgement v

Table of Contents v

Abstract ix 

CHAPTER ONE: INTRODUCTION 

1.1 Background of Study 1 

1.2 Statement of Problem 3 

1.3 Purpose of Study 3 

1.4 Significance of Study 4 

1.5 Scope of Study 4 

CHAPTER TWO 

2.1 Literature Review 5

2.1.1 Assessment of Awareness of Risk Associated with Medical X-ray investigation 5 

2.1.2 Assessment of Attitude Towards Risk Associated with medical X-ray procedures 12 

2.1.3 Assessment of Perception of Risk Associated with Medical X-ray procedures 13 

2.2 Theoretical background 15 

2.2.1 Radiation Exposures from Medical Sources 15 

2.2.2 Origin of Medical X-ray procedures 15 

2.2.3 Diagnostic Modalities that uses X-ray 16 

2.2.4 The Fate of Radiation on Contact with the Body 17 

2.2.5 How Ionizing Radiation Cause Cancer 24 

2.2.6 Awareness 26 

2.2.7 Attitude 26 

CHAPTER THREE: RESEARCH METHODOLOGY 

3.1 Research Design 28 

3.2 Sample Population and Sample Size 28

3.3 Sampling Techniques 28

3.4 Instrument for Data Collection 28 

3.5 Method of Data Collection 29 

3.6 Method of Data Analysis 29 

CHAPTER FOUR: RESULTS 

4.1 Data Presentation 30 

CHAPTER FIVE: DISCUSSION, SUMMARY OF FINDINGS AND RECOMMENDATIONS 

5.1 Discussion 40

5.2 Summary of Findings 43

5.3 Conclusion 44 

5.4 Recommendations 44 

References

Awareness is knowing that something exists and attitude is the way people behave towards something that shows how they think and feel concerning it. The main source of human attitude lies in the perceptions, awareness and life experiences of the individual. This strengthens the long–standing emphasis on using reason and facts as the bases for voluntary and purposeful change of behaviour in oneself or in the other.1 That is to say, peoples’ level of awareness about risks associated with X-ray investigations influences their attitude towards X-ray procedures. The days of ignorance are gone so it is important that the general public including students is aware of risks associated with medical X-ray procedures to have the right attitude towards medical X-ray procedures and so be able to make clearer decisions about their healthcare.

Radiation may be defined as energy travelling through space 2 and the energy can be inform of non-ionizing and ionizing radiation. The ionizing radiation may come from either an external source such as x-ray machine, or an internal source such as an injected radioisotope as applied in medical imaging. The mention of the word “radiation” often evokes fear in patients, families, and health care professionals alike therefore, radiation is perceived as a unique hazard. 3 The unique hazard as it is perceived is due to inherent property of ionizing radiation to dislodge orbital electrons to form ions as it  pass through matter and these ions can  destabilize molecules within cells and lead to tissue damage.4 The extent of this damage on living tissue is complicated by the type of radiation, the amount and duration of radiation exposure, the variety of tissues and the effects of this damage are not always easy to separate from other factors, making it a challenge at times for scientists to isolate.4

Medical X-ray investigations is an indispensable arm of  modern medicine that uses X-ray  for diagnosis, management of disease5. It is one of the most powerful medical imaging tool and the second most commonly used medical test after medical laboratory tests which aids in diagnosis. With the advent of X-rays as a diagnostic technique, radiological procedures are increasingly being used in diagnosis and management of wide range of diseases, resulting in increased population exposure. The increase in utilization has led to a parallel increase in concern regarding radiation risks because X-ray procedures utilize ionizing radiation which is harmful to health. Although in X-ray investigations, low dose of ionizing radiation are utilized so that the exposure amount from these exams is very small to the extent that the health risks associated with such low levels of exposure is frequently debated in scientific meetings. Nonetheless, the prevailing scientific view is that there is a finite (though small) amount of risk involved with such exposures which is increased with the amount of exposure, with repeated exposures and when the patient is young.7  However the risk associated with x-ray investigation is far outweighed by the medical benefit of having the diagnosis. Also radiologists/radiographers tries to reduce the probability of radiation risks occurrence by making radiation dose from medical imaging as low as reasonably achievable (ALARA Principle), yet no risk should be over looked no matter how insignificant such risk is.

Many epidemiological studies have documented the health consequences of exposure due to medical imaging.8-10 Awareness among people by media on radiation risks is aggressive but often exaggerated11, this creates several misconception, confusion and erroneous beliefs that exits on risks associated with x-ray procedures and several attitude on patients undergoing medical x-ray investigations. Some patients due to misconceptions rejects the diagnosis even at the risk of deleterious health outcomes while some will prefer to have the investigation done first rather than worrying about the risks involved. Several studies have shown that there is poor awareness about radiation risks associated with radiological examinations and that patients’ decisions against undergoing an imaging procedure are frequently based on partial and sometimes incorrect information. The rising increase on the use of x-ray investigations and the curiosity to know whether students are aware of such risks associated with X-ray investigations and their attitude towards it triggered the researcher to assess the students’ awareness and their attitude towards risks associated with medical X-ray investigations.