ABSTRACT
The study aims at evaluating the attitude of radiographers towards the geriatric patients using three tertiary hospitals in Enugu urban which includes University of Nigeria Teaching Hospital (UNTH), National Orthopaedic Hospital Enugu (NOHE) and Enugu State University Teaching Hospital (ESUTH). The objectives of this study are: a) to determine the attitude of radiographers towards geriatric patients, b) to determine which gender of radiographers have a more specific attitude towards geriatric patients, c) to determine the knowledge of radiographers about the challenges of geriatric management. A cross-sectional and non-experimental survey was carried out using two different structured questionnaires- one for the radiographers and the other for the geriatric patients. A total of 175 questionnaires were shared to geriatric patients and 52 questionnaires to radiographers in the three hospitals. The entire questionnaire given to the geriatric patients was collected by the researcher but 50 were collected back from the radiographers. The result shows that the radiographers are knowledgeable about geriatric patients care and management; the patients are properly received on arrival into the examination rooms by the radiographers in the hospitals, the patients were called by their first name and surname by radiographers into the examination room. Radiographers do not introduce themselves to the geriatric patients before handling them, the radiographers do not ask the patients about their illness and how they are faring, there exist a very poor communication gap between the geriatric patients and the radiographers and the radiographers are confirmed by the geriatric patients to have a very good positive attitude towards them. Also the radiographers are trained on geriatric care and management but the training was not enough, the attention given to geriatric patients in the hospital is adequate and finally, female radiographers have relatively more negative attitude towards the geriatric patients.
For the profession to improve, the department should organize seminars on geriatric management and care to enlighten radiographers on the ways and methods of geriatric handling. This will also help to remind radiographers of difference between young patients and geriatric patients due to anatomical and physiological changes in them also the radiography curriculum should be revisited to inculcate enough programs pertaining geriatric care and management. This will go a long way in enhancing professional development.
List of Tables
Table 1 showing the age and sex distribution radiographers- – – – – – – – 41
Table 2 showing the age and sex distribution of geriatric patients- – – – – – – 42
Table 3 showing the educational qualification of radiographers- – – – – – – – – – 42
Table 4 shows the patients response on how they were received and their satisfaction on the kind of reception accorded to them by the radiographers- -44
Table 5: Patients response on how their names were called by the radiographers-45
Table 6: Shows the level of communication and relationship between the radiographers and geriatric patients- – – – – – – – – – – – – – – -45
Table 7: Shows the response of geriatric patients on the general attitude of radiographers towards them- – – – – – – – – – – – – – – – – – – – 47
Table 8 shows the response of geriatric patients based on the attention given to them in the department- – – – – – – – – – – – – – – – – – – – – 48
Table 9: Response of radiographers on whether gender has an influence on their attitude towards geriatric patients.- – – – – – – – – – – – – – – – – 48
Table 10: Radiographers response on which gender has more negative attitude towards geriatric patients.- – – – – – – – – – – – – – – – – – – – 49
Table 11: Radiographers response on whether they are likely to encounter difficulty while handling geriatric patients- – – – – – – – – – – – – -49
Table 12: Response of radiographers on the possible problems they will encounter while performing geriatric investigation.- – – – – – – – – – – – – – -50
Table 13 showing the response of radiographers on whether they underwent any training on geriatric care and management as undergraduate and whether the training was enough.- – – – – – – – – – – – – – – – – – – – – – -51
List of Figures
Figure 1 showing the lateral thoracic radiograph of a geriatric patient showing
an accentuated forward upper thoracic curve- – – – – – – – – – – – – -21
Figure 2 showing the postero-anterior chest radiograph of a geriatric patient showing diminished lung capacity due to a stiffened chest wall- – – – – – 22
Figure 3 showing the lateral chest radiograph of a geriatric patient showing a displaced arch of aorta that is dilated and elongated- – – – – – – – – – 24
Figure 4 showing antero-posterior contrast radiograph of the abdomen of a geriatric patient showing a mobile colon with pneumoperitoneum- – – – 26
Figure 5 showing the antero-posterior hip radiograph of a geriatric patient that have undergone hip arthroplasty- – – – – – – – – – – – – – – – – -33
Figure 6 showing the antero-posterior knee radiograph of a geriatric patient that have undergone knee arthroplasty- – – – – – – – – – – – – – – – -34
Figure 7 showing picture of a knee arthroplasty of a geriatric patient – – – 34
Figure 8: A simple bar chart showing number of radiographer against their number of years of work experience- – – – – – – – – – – – – – – – – – – 43
TABLE OF CONTENTS
Title Page- – – – – – – – – – – – – – – – – – – – – i
Approval Page- – – – – – – – – – – – – – – – – – – ii
Certification- – – – – – – – – – – – – – – – – – – – -iii
Dedication- – – – – – – – – – – – – – – – – – – – – iv
Acknowledgement- – – – – – – – – – – – – – – – – – -v
Abstract- – – – – – – – – – – – – – – – – – – – – – -vi
List of Tables- – – – – – – – – – – – – – – – – – – -vii
List of Figures- – – – – – – – – – – – – – – – – – – viii
Table of Content- – – – – – – – – – – – – – – – – – –ix
CHAPTER ONE
1.0 Introduction- – – – – – – – – – – – – – – – -1
1.1 Background- – – – – – – – – – – — – – – -1
1.2 Statement of Problems- – – – – – – – – – – – – 4
1.3 Objectives of the Study- – – – – – – – – – – -5
1.4 Significance of the Study- – – – – – – – – – – – -5
1.5 Scope of the Study- – – – – – – – – – – – – -5
1.6 Review of Related Literature- – – – – – – – – – -6
CHAPTER TWO
2.0 Theoretical Background- – – – – – – – – – – -17
2.1 The Geriatric Patient- – – – – – – – – – – – – –17
2.2 Changes Associated with Ageing – — – – – – – – 17
2.2.1 Changes in the Integumentary System- – – – – – -19
2.2.2 Changes in the Head and Neck- – – – – – – – – 20
2.2.3 Changes in the Pulmonary System- – – – – – – -22
2.2.4 Changes in the Cardiovascular system- – – – – – 23
2.2.5 Changes in the Gastrointestinal System- – – – – -25
2.2.6 Changes in the Hepatic System- – – – – – – – – -27
2.2.7 Changes in the Genitourinary System- – – – – – -27
2.2.8 Changes in the Musculoskeletal System – – – – – -28
2.2.9 Changes in the Neurologic System- – – – – – – – 30
2.3 The Patient who has had Arthroplastic Surgery- – – – -32
CHAPTER THREE
3.0 Research Methodology- – – – – – – – – – – – -36
3.1 Research Design- – – – – – – – – – – – – – – 36
3.2 Target Population- – – – – – – – – – – – – – – 36
3.3 Area of Study- – – – – – – – – – – – – – – – 36
3.4 Subject Selection Criteria- – – – – – – – – – – – 37
3.4.1 Inclusion Criteria- – – – – – – – – – – – – – 37
3.4.2 Exclusion Criteria- – – – – – – – – – – – – – 37
3.5 Method of Data Collection- – – – – – – – – – – 39
3.5.1 Sources of Data- – – – – – – – – – – – – – – 39
3.5.2 Instrument for Data Collection- – – – – – – – – 39
3.5.3 Procedure for Data Collection- – – – – – – – – 39
3.6 Data Analysis- – – – – – – – – – – – – – – 40
CHAPTER FOUR
4.0 Data Presentation, Results and Discussion- – – – – – – – -41 4.1 Data Presentation- – – – – – – – – – – – – – -41
4.2 Discussion- – – – – – – – – – – – – – – – – 51
CHAPTER FIVE
5.0 Conclusion- – – – – – – – – – – – – – – – – –60
5.1 Summary of Findings- – – – – – – – – – – – – – 60
5.2 Recommendations- – – – – – – – – – – – – – 61
5.3 Limitations- – – – – – – – – – – – – – – – – 62
5.4 Area of Further Research- – – – – – – – – – – – 63
References
Appendix
CHAPTER ONE
- INTRODUCTION
1.1 Background:
As populations grow older, we can question the effect this has on our attitudes towards old age. Negative attitudes lead only to ageism, a process of systematic stereotyping of, and discrimination against people because they are old(1). Ageism generates and reinforces a fear and denigration of the ageing process and legitimizes the use of chronological age to mark out classes of people who are systematically denied resources and opportunities(2). Old people apart from being segregated and stereotyped by the younger generation in different occasions in the society (3), seems to be experiencing the same issue in the hospital setting while being attended to by the medical and healthcare professionals which includes the radiographers. The essence of this research is to find out the attitudes the healthcare professionals and in particular the radiographers, exhibit towards the geriatric patients.
A geriatric patient is an older person with impaired overall function. There is no set age, but he or she is usually over 75years old with chronic illness(es), physical impairment, and/or cognitive impairment. Most developed world countries have accepted the chronological age of 65years as a definition of ‘elderly’ or older person, but like many westernized concepts, this does not adapt well to the situation in Africa. Realistically, if a definition in Africa is to be developed, it should be either 50 or 55 years of age, but even this is somewhat arbitrary and introduces additional problems of data comparability across nations. According to the World Health Organization, the traditional African definition of an elder or ‘elderly’ person correlate with the chronological ages of 50 to 65years depending on the setting, region and the country(4). Adding to the difficulty of establishing a definition, actual birthdates are quite often unknown because many individuals in Africa do not have an official record of their birth date. In addition, chronological or “official” definitions of ageing can differ widely from traditional or community definitions of when a person is older.
As these people advance in age, the ageing process is of course a biological reality which has its own dynamic, largely beyond human control. Due to the fact that there exists so many changes in both the anatomical and physiological make up of these people which is beyond their control, many of them takes to chronic sickness and visits the hospital on regular basis and some are even hospitalized. In the hospital, these geriatric patients meet with different medical and healthcare professionals including the radiographers in the radiology department.
An attitude can be defined as a positive or negative evaluation of people, object, event, activities, ideas, or just about anything in your environment (5). An attitude can also be defined as a favourable or unfavourable evaluation of something (6). People can also be conflicted or ambivalent towards an object, meaning that they simultaneously posses both positive and negative attitudes toward the item in question. Certain attitudes and behavioural displays are being exhibited by medical professionals to their patients especially the geriatric patients in their different places of work. The medical radiographer is not an exception to those behavioural displays. By the way, a radiographer or medical imaging technologist is a trained health professional who performs medical imaging by producing high quality x-ray pictures or images used to diagnose and treat injury or disease. It is an important part of medicine and a patient’s diagnoses and treatment is often dependent on the x-ray images produced. Just as it is confirmed that the radiographer and the radiology department plays an important role in the general wellbeing of the geriatric patients, it is important for the radiographer to know that some of their attitudinal displays send some form of signals to their patients especially the geriatric patients. These signals might be a positive one which may aid in the overall good result being achieved between the radiographer and the geriatric patient. It may also send a negative signal which may worsen the condition of both the radiographer and the patient, for instance, a radiographer may disgust every time he or she encounters a geriatric patient and in which he may lose control of the situation thus ending up making the patient’s condition worsened. Or for a radiographer that lacks a proper manner of talking and addressing these people, will succeed in aggravating the patients.
Hence, the research is geared towards evaluating the attitude of radiographers towards their geriatric patients in tertiary hospitals within Enugu urban.
1.2 STATEMENT OF PROBLEMS
- Old people apart from being segregated and stereotyped by their younger counterparts in the society (3) may be experiencing the same issue in the hands of radiographers in the radiology department.
- There is no reference on which gender of radiographers has a more specific attitude towards the geriatric patients.
- As more of our older persons consume health care services, radiographers seem to be unaware of the challenges they will face to appropriately care for this segment of the population.
1.3 OBJECTIVES OF THE STUDY
- To determine the attitude of radiographers towards geriatric patients.
- To determine which gender of radiographers have a more specific attitude towards geriatric patients.
- To determine the knowledge of radiographers about the challenges of geriatric management.
1.4 SIGNIFICANCE OF STUDY
- The research will help to show the attitude of radiographers towards geriatric patients which can be used as a reference by young radiographer graduands.
- The research will help to know the group of radiographers that certain programs on geriatric management should be directed to mostly for the purpose of professional development.
- The research will help to determine the knowledge of radiographers about geriatric handling and management and whether there is need to for more enlightenment courses to be organized for radiographers in geriatric care and management.
1.5 SCOPE OF THE STUDY
This study will cover all radiographers in tertiary hospitals in Enugu urban, which includesUniversity of Nigeria Teaching Hospital (UNTH), Enugu State University Teaching Hospital (ESUTH) andNational Orthopaedic Hospital Enugu (NOHE). It will include intern radiographers and radiographers presently undergoing their youth service in the above named hospitals. The scope also covered all the geriatric patients in the hospitals of study.
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