ASSESSMENT OF PATIENTS’ ATTITUDE AND PERCEPTION TOWARDS X-RAY EXAMINATION IN FEDERAL TEACHING HOSPITAL ABAKALIKI

ABSTRACT
 This study aimed to assess the reluctant attitude of patients toward x-ray examination, to know the cause of this reluctant attitude and to assess the reluctant attitude of the patients through the Radiographers and other radiological workers. convinience sampling method was used for this study. A survey was conducted using a questionnaire designed to suit the purpose of this study; data collected from patients, Radiographers and other radiological workers from federal teaching hospital Abakaliki was statistically analyzed using frequency and percentage score tables. A total of 150 questionnaires were distributed to the patients and 114 finally returned duly completed, while 50 questionnaires were distributed to the Radiographers and other radiological workers and 47 were retuned duly completed. The results showed that fear of big x-ray machine, fear of possible pain, Lack of knowledge and Fear of radiation and its negative effect were the reasons why they were feeling reluctant to enter for x-ray examinations. Also based on the responses of patients concerning some facts about x-ray examinations; it showed that the patients are becoming increasingly aware of x-ray examinations. The result also showed that the reluctant attitude of more than half of the patients were gender based for instance 58(50.9%) would either prefare male or female Radiographer to examine them,  while 56(49.1%) have no choice  of male or female Radiographer. However from the second set of questionnaire for Radiographers and other radiological workers, the result showed that (78.7%) of the respondents opined that patients are always uncomfortable and afraid of heavy x-ray machine, (72.2%) of the respondents opined that male patients co-operate more than female.. Based on these findings there is need to reassure the patients so as to alleviate their reluctance feelings most especially the female patients.                             
   
TABLE OF CONTENTS 
Title Page i
Approval Page ii
Certification iii
Dedication iv
Acknowledgement v
Abstract vi
Table of Contents vii
List of Tables x
List of Figures xi
CHAPTER ONE: BACKGROUND OF STUDY
1.0 Introduction 1 
1.1 Statement of the Problem 6 
1.2 Purpose of Study 7 
1.4 Significance of the Study 7
1.5 Scope of study   
CHAPTER TWO: REVIEW OF RELATED LITERATURE
2.0 literature Review 9 
2.1 Theoretical background 23
2.2 Attitude 23 
2.3 Types of Attitude 23 
2.4 Components of Attitude 24 
2.5 Measuring Attitude 25 
2.6 Perception 26 
2.7 Patient 28
2.8 Classification of patients based on age 29
2.9 X-ray Examinations 31  
CHAPTER THREE: RESEARCH METHODOLOGY 
3.1 Research Design 40 
3.2 Target Population 40
3.3 Sample size 40 
3.4 Sampling method 41
3.5 Source of Data Collection 41 
3.6 Instrument of Data Collection 42                                             
3.7 Description of questionnaire 42                                                      
3.8 Location of study 42                                                
3.9 Selection criteria 42
3.10 Method of data analysis 43
CHAPTER FOUR: RESULTS
Data Presentation and Analysis of Result 44 
CHAPTER FIVE : DISCUSSION AND CONCLUSION 
5.1 Discussion 60 
5.2 Summary of Findings 68 
5.3 Conclusion 69 
5.4 Limitations of the Study 69 
5.5 Recommendation 69
5.6 Areas of Further Study 70
References 
Appendix 
                                                            
LIST OF TABLES 
Table 1: Age and sex Distribution of the Respondents 42 
Table 2: The response of patients in the x-ray department 43 
Table 3: Patients’ knowledge of x-ray department 45 
Table 4: Patients’ reactions towards gender of the Radiographers 47
Table 5: Patients’ reasons for choosing male Radiographers 48
Table 6: Patients’ reasons for choosing female Radiographers 49
Table 7: The reasons for considering any gender 50
Table 8: The reasons for considering  gender depending on the nature of the examination 51 
Table 9: Age and sex Distribution of the Respondents 52
Table 10: Categories of radiological worker 53 
Table 11: Attitude of patients as perceived by the Radiographer and other radiological workers 54
Table 12: Further reasons given by Radiographers and other radiological workers concerning the attitude of patients 56                                                                                 
LIST OF FIGURES
Fig 1:  A female radiographer examining a paediatric patient 29   
Fig 2: The rotationary anode x-ray tube insert 32

INTRODUCTION
      Attitude can be said to be the way that you think and feel about somebody or something; the way that you behave towards somebody or something that shows how you think and feel.1 It can be positive and negative evaluation of people, objects, event, activities, ideas, or just about anything in your environment. Attitude is therefore made of three parts: emotion, belief and behaviour. Patients’ attitude is therefore an indication of his evaluation, emotional feelings and reaction towards the hospital environment in general and radiology department in particular. Several factors; including patients’ level of awareness and education influence his attitude. Every accessory in the radiology department may appear contaminated in the eye of uninformed patient and there could also be misconception about x-ray examination. Therefore to gain the patients’ confidence, adequate communication is vital.  
      Perception on the other hand is an idea, a belief or an image you have as a result of how you see or understand something.1 It is an impression, an attitude or understanding based on what is observed or thougth. Perception is our sensory experience of the world around us and involves both the recognition of environmental stimuli and actions in response to these stimuli. Through the perceptual process, we gain information about properties and elements of the environment that are critical to our survival. Perception not only creates our experience of the worlds around us; it allows us to act within our environment. 
      Patient is somebody who receives medical treatment or care. The word patient originate from the Latin word ‘patiens’ meaning ‘one who suffers.’  The patient is most often ill or injured and in need of treatment by a physician or other healthcare providers.3 There are two main categories of patient that comes for x-ray examination and they include the ‘out-patient’ and ‘in-patient.’ An out-patient is a patient who is not hospitalized for twenty four (24) hours or more but who visit a hospital, clinic or associated facility for diagnosis or treatment. Treatment provided in this fashion is called ‘Ambulatory Care.’ An in-patient on the other hand is ‘Admitted’ to the hospital and stays overnight or for an indeterminate time, usually several days or weeks (though some case, such as coma patients have been in hospital for years). Treatment provided in this fashion is called in-patient care.  
      Patient attitude and perception towards other department of hospital set up including nursing, physiotherapy, pharmacy, and medical laboratory science departments etc varied widely among these departments. Their attitude and perception are highly subjective depending on the individual characteristics.  In physiotherapy department for instance continued compliance of physical therapy depends on a person's perception of their symptoms, the effectiveness of the intervention, their ability to incorporate it into everyday life and support from physiotherapists. Therapists should consider using the model of concordance to ensure patients' lay beliefs and social circumstances are explored and understood and that patients are enabled to participate fully in decisions about physical therapy. Patient waiting time in outpatient surgery clinics is often the major reason for patients’ complaints about their experiences of visiting outpatient clinics. Therefore patient satisfaction with waiting time plays a crucial role in the process of health quality assurance or quality management. A review of the literature by Scandinavian researchers4 indicated that patients’ satisfaction with nursing care is influenced by the nurses’ technical competence, as well as the interpersonal relations between the nurses and the patients. When 40 patients in a private teaching hospital in California were asked what happened when a nurse was taking care of them, they almost exclusively described the interpersonal skills of the nurse, rather than the task that was being done5. A pilot study conducted in Qatar6 revealed that patients have a poor understanding of the pharmacist’s role in monitoring drug therapy, performing health screening, and providing drug information and this poor understanding of the pharmacist’s role affect the patients’ attitude and perception towards pharmacists.
      An x-ray examination creates two- dimensional images of the body’s internal organs or bones to help diagnose conditions or diseases. An x-ray examination is a painless procedure; a special machine emits a small amount of ionizing radiation. This radiation passes through the body and falls on a photographic film or similar devices to produce the image. X-ray imaging is the fastest and easiest way of for a physician to view and asses a broken bones, cracked skull and injured backbone. At least two films are taken of a bone and often three films if the problem is around a joint (knee, elbow, or wrist). X-ray also play a key role in orthopedic surgery and the treatment of sports injuries, it is useful in detecting micro-calcification in breast as in mammography and in detecting more advanced forms of cancer in bones. Two health practioners are involved in x-ray examinations: A radiographer who conducts the examination and a radiologist (a medical specialist) who interprets x-ray images.  Before the radiologic procedure, the topic of ionizing radiation should be part of the conversation between the radiographer and the patient. In general, there seems to be a high acceptance of diagnostic procedures. Patients do not seem to regard the risk as high and seem to care more about having their problem being solved than considering radiation risk. Patients appear more confident when CT is part of their medical evaluation but have a poor understanding of the concomitant radiation exposure and risk, and they have a poor understanding of the concomitant radiation exposure and risk associated with the CT scan, or with previous X-ray imaging examinations they may have passed. This suggests that patient perception is not necessarily an impediment to the use of radiation.7 Conversely, some patients perceive the risk of radiation as so high that they forgo critical diagnostic procedures. The perception of patients, as odd as it may seem to experts, forms a strong basis for the decisions that patients make. For that reason, the concepts that patients share with their radiographer during informational conversations must be considered before an investigation or therapy can begin.8 Above all there is need to reassure the patient because some of the patients are not only afraid of the diagnostic procedures but also the diagnostic facilities.  
      The issue of attitude and perception of the patient on different aspect of medical services can never be over emphasized. Above all there is need to assess the attitude and perception of the patients towards x-ray examinations. Research on this topic will help to identify the wrong impression or misconception the patients may have and to correct it; it will go a long way in improving their attitude and perception towards, x-ray examinations. Above all it is the responsibility of every health care practitioner (including radiographers) to ensure that patient has positive attitude and ensure that the standard of care delivered is of high quality and is appropriate to the age and level of understanding displayed by the patient.