Radiographers' practice and perceptions of gonad shielding in paediatric pelvic radiography at a general hospital

Abstract

Purpose and Objectives: This study evaluated the perception and practice of radiographers working in a local general hospital on the use of gonad shielding in paediatric pelvic radiography. The objectives of this study were to analyse the practice and positioning of gonad shields and to identify the number of radiographs repeated due to mispositioning of gonad shields. The study also appraised radiographers’ perceptions on the use of gonad shielding in paediatric pelvic radiography.

Methodology: The study had two phases. The first phase consisted of a retrospective review of paediatric pelvic radiographs taken over a period of time, using a self-designed image review sheet. Phase two of the study consisted of an evaluation of radiographers’ perceptions on the use of gonad shields in paediatric pelvic radiography through a self-designed questionnaire. Data was then analysed using IBM-SPSS Statistics 23.

Results: In phase 1, 135 radiographs were reviewed (59% boys, 41% girls). Gonad shields were only used in 17.8% (n=24) radiographs, 23 male and 1 female. The shields were correctly positioned in 20.8% (n=5) of the images, all of which were male. 15.8% (n=3) of radiographs had to be repeated due to mispositioned shields. The use of gonad shielding was predominately more common in boys than girls (pvalue < 0.05). In phase 2, 64.2% (n=34) of the participants perceived gonad shields to be effective and 85% (n=45) recommended their use. 62.3% (n=33) of the participants stated that they are more likely to use gonad shields on male paediatric patients. Radiographers also stated that they often, or occasionally, encounter difficulty while positioning gonad shields and suggested further training.

Conclusions: The results obtained indicated high rates of omission and incorrect positioning of gonad shields by radiographers in paediatric pelvic radiographs. Results showed that gonad shields have almost been completely omitted from practice in girls. In boys, omission of shields may also be considered, and more focus on other optimisation techniques emphasised. If the gonad shields are to be used, more education and training is required. A dichotomy between practice and theory was also noted. Although most of the radiographers recommended the use of gonad shields in paediatrics, this was not reflected in practice.