Radiology Department, The Princess Alexandra Hospital NHS Trust, Harlow, Essex, United Kingdom.
Department of Radiography, School of Allied Health Professions, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Kent, United Kingdom.
Radiography (Lond). 2024 Oct;30(6):1695-1703. doi: 10.1016/j.radi.2024.08.011. Epub 2024 Aug 30.
The horizontal beam lateral (HBL) position technique for X-ray imaging has been used for nearly a century; however, this can be challenging for the patient and the practitioner, as it potentially compromises patient dignity. This study explores student radiographers' knowledge and experience of lateral hip positions and their impact on diagnostic quality and patient dignity.
A cross-sectional mixed-method online survey of undergraduate diagnostic radiography students was completed. Likert scale assessments, rank ordering questions, and free-test qualitative responses were utilised for questions on knowledge and experience of different positioning, ease to obtain, patient dignity, diagnostic quality, and need for repeats. Data analysis included descriptive statistics and cross-tabulation non-parametric analysis against variables of age, gender and year of study.
Responses were received by n = 42/158 students, a response rate of 27%. The HBL position was the most commonly repeated image (76.6%); the qualitative themes included HBL image quality issues and difficulty in the HBL positioning for elderly or frail patients, often in discomfort and pain. Analysis of student responses to perceived patient dignity in positioning identified 73.8% found the HBL undignified, and 85.7% agreed the Clements-Nakayama (CN) position would be more dignified for patients. The diagnostic image quality of the HBL position (64.2%) was compared to the CN alternative axiolateral (66.6%). Comparison of ease of obtaining the correct position for HBL (47.6%) was higher than CN position (28.6%); this could be due to the lack of experience n = 3/42 (7.1%) of this position.
Overall, student radiographers' experience and knowledge of various lateral hip positions observed in clinical practice was good. The CN position scored high for diagnostic image (66.6%) and dignity for the patient (85.7%), over the often repeated HBL position (76.6%), which scored lower for image quality (64.2%) and dignity (76.6%).
Radiographers should advocate for professional autonomy and explore alternative positioning techniques. Further investigation into the CN position's utilisation, image quality and radiation dose in England is recommended.
X 射线成像的水平束侧位（HBL）技术已经使用了近一个世纪；然而，对于患者和从业者来说，这可能具有挑战性，因为它可能损害患者的尊严。本研究探讨了学生放射技师对侧髋部位置的知识和经验，以及它们对诊断质量和患者尊严的影响。
对本科诊断放射学学生进行了横断面混合方法在线调查。使用了李克特量表评估、排序问题和自由测试定性反应，用于不同定位、获取难易程度、患者尊严、诊断质量和重复需求的知识和经验问题。数据分析包括描述性统计和针对年龄、性别和学习年限的变量的交叉表非参数分析。
共收到 158 名学生中的 42 名（27%）的回复。HBL 位置是最常重复的图像（76.6%）；定性主题包括 HBL 图像质量问题和老年或体弱患者的 HBL 定位困难，患者经常感到不适和疼痛。对学生对定位时患者尊严的感知进行分析，发现 73.8%的人认为 HBL 不体面，85.7%的人同意 Clements-Nakayama（CN）位置对患者更有尊严。HBL 位置的诊断图像质量（64.2%）与 CN 替代轴外（66.6%）进行比较。HBL 正确位置的获取难易程度（47.6%）与 CN 位置（28.6%）比较更高；这可能是由于缺乏经验 n=3/42（7.1%）。
总的来说，学生放射技师在临床实践中对各种侧髋部位置的经验和知识都很好。CN 位置在诊断图像（66.6%）和患者尊严（85.7%）方面得分较高，优于经常重复的 HBL 位置（76.6%），后者在图像质量（64.2%）和尊严（76.6%）方面得分较低。
放射技师应倡导专业自主权，并探索替代定位技术。建议在英格兰进一步调查 CN 位置的使用、图像质量和辐射剂量。
