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Nigerian Journal of Physiological Sciences
Physiological Society of Nigeria
ISSN: 0794-859X
Vol. 22, Num. 1-2, 2007, pp. 123-127
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Nigerian
Journal of Physiological Sciences, Vol. 22, No. 1-2, 2007, pp. 123-127
Incidence of Occupational
Stress Among Medical Radiographers: A Population Based Zonal Survey.
A. C. Ugwu1, O.
A. Egwu2, K. Ochie3, E. O. Ewunonu 2, K. N.
Ovuoba2, C. O. Njoku2.
1Department of Radiology, Federal Medical Center, Abakaliki,
2Department of Anatomy, Ebonyi State University, Abakaliki,
3Department of Radiography, University of Nigeria, Enugu Campus E-mal: tonybullng@yahoo.ca
Received: 24/7/2007
Accepted: 15/11/2007
Code Number: np07021
Summary
Biomechanical and Psychosocial stresses
are capable of destabilizing any health care professional. The current health
sector reform in Nigeria, which lays emphasis on service delivery on a
background of very few radiographers, may lead to an increase in stress level.
This study investigated the incidence of occupational stress among
radiographers in southeastern Nigeria. 50 self-completion questionnaires were
delivered to radiographers in the southeastern Nigeria. The questionnaires
included questions seeking information on the demographic profile of the
radiographer, anatomical regions of biomechanical systems/stress and Visual
analogue scale (VAS), which rated job satisfaction and anxiety levels. 32
questionnaires were returned and analyzed statistically. Biomechanical stress
was observed in all anatomical regions studied. Job satisfaction rating was
61.3% and anxiety level was 45.3%. This study has provided a baseline stress
level and prevalence among radiographers with which future studies in view of
the on going health sector reform in Nigeria could be compared.
Key Words:
Biomechanical stress, psychosocial stress, radiographers.
Introduction
Stress is
defined as an interference disturbing individuals well being physically and
mentally (Akpa and Afoke, 2005). It is caused by physical and emotional
stimuli leading to response by different organs system and the organism as a
whole in order to cope with the situation. When it occurs in relation to work,
it is called occupational stress, which has 2 divisions; Biomechanical stress
and Psychosocial stress.
In
southeastern Nigeria where radiographers are very few, theres a tremendous
increase in workload, which in theoretical terms predisposes the individual to
increased occupational stress and if this is not checked, burnout ensures.
Burnout is an individuals reaction to chronic stress (Daughterly, 2002).
Compassion fatigue, work environment and job satisfaction have been described
as factors that contribute to burnout (Walvwood, 2006). These factors are made
more potent by the current health sector reform in Nigeria, which emphasizes
service delivery that anchors seriously on patients satisfaction even though
there is no parallel increase in the number of service providers especially among
the radiographers.
Numerous
authors have described occupational stress in various ways. Tarlo et al (2004)
described Dark Room Disease (DRD) as unexplainable multiple symptoms attributed
by radiographers to the work environment and stated that it showed significant
association with psychosocial stress. Pike et al (1997) and Muir et
al (2004) have equally reported the prevalence, nature and cause of
musculoskeletal symptoms among medical sonographers.
This study
investigated the incidence of occupational stress among radiographers in
south-east Nigeria where excess work load persists due to their few number. It
is believed that with this study and follow up studies, adequate knowledge of
the work limiting factor-occupational tress, will be established in this
environment and possible control measures put in place to make the health
reforms and the attendant service delivery philosophy in Nigeria an all
encompassing effort.
Materials and Method
Fifty (50)
self-completion questionnaires were designed and sent to 50 radiographers in
the five (5) South-Eastern States of Nigeria. Questionnaires were used for
data collection due to the geographical spread and resources available.
Questionnaire
Design
The questionnaire was designed to elicit
quantitative and qualitative data in order to gather factual and attitudinal
information. It contained 29 questions, which were divided into 3 sections.
These sections related to:
a) Demographic data completed by all the respondents
b) Knowledge of occupation stress including its biomechanical (anatomical
regions where symptoms are experienced) and psychosocial (job satisfaction and
anxiety rating levels) components. Job satisfaction rating and anxiety level
were studied using the visual analogue (VAS) of 0% to 100%.
c) Open ended question on ways to reduce occupational stress among
radiographers.
Sampling and Data Collection
A convenient and purposive sample of radiographers
in 10 hospitals across the five States of South-East Nigeria was approached to
participate in this study. All the radiographers were registered with the
radiographers registration board of Nigeria (RRBN). Ethical clearance from
the Ebonyi State Chapter of Association of Radiographers of Nigeria was
obtained. The period of distribution of questionnaire lasted for 3 months and
another period of 2 months was allowed before any data analysis took place.
Radiographers
who had any form of debilitating illness like diabetes mellitus, arthritis or
used walking aids were excluded from this study. A total of 32 questionnaires
were returned from the 50 radiogrpahers who were served with questionnaires.
The questionnaires were analyzed statistically with SPSS 11.0 software.
Descriptive statistical techniques (means and percentages) were used.
Results
A total of 32 questionnaires were returned within 2
months. They were completed by twenty-eight males (28) and four (4) females.
Responses were received from all the South-Eastern hospitals used in this
cohort study. Sixteen (16) more questionnaires were received after 3 months
but were not included in the data analysis for this paper.
Table 1: Prevalence of Symptoms Experienced by Radiographers
Anatomical Region |
Symptoms
Experienced |
% Prevalence |
Neck |
Pain
Ache
|
18.8%(n=6)
6.3% (n=2)
18.8%(n=6)
|
Shoulder |
Pain |
12.5% (n=4) |
Elbow |
Pain |
18.8% (n=6) |
Wrist |
Pain |
6.3% (n=2) |
Finger/hand |
Pain |
6.3% (n=2) |
|
Ache
Numbness
|
12.5% (n=4)
6.3% (n=2)
|
Dorsum of hand |
Numbness |
6.3% (n=2) |
Eyes
|
Pain
Ache
Itching
|
6.3% (n=2)
6.3% (n=2)
6.3% (n=2)
|
Upper-back |
Pain
Ache
|
37.5% (n=12)
6.3% (n=2)
|
Middle-Back |
Pain |
25.0% (n=8) |
Middle-Back
Hip |
Ache
Pain
Ache
|
12.5% (n=4)
25.5%(n=8)
6.3% (n=2)
|
Lower-Back |
Pain
Ache
|
31.3% (n=10)
6.3% (n=2)
|
Table 2: Descriptive Statistics
for Job satisfaction Rating and Anxiety Level
|
Number (N) of Radiographer |
Mean Score |
Standard Deviation (SD) |
Job satisfaction |
30 |
61.3% |
11.9 |
Anxiety level |
30 |
45.75 |
18.8 |
Table 1shows the percentage
prevalence of symptoms in the anatomical regions studied. Upper back pain was
the most prevalent (37.5%). This was followed by lower back pain (31.3%), Hip
pain and midback pain (25.0%), and shoulder, Neck and wrist pains 918.8%).
Table 2 shows descriptive data
for job satisfaction and anxiety level. With job satisfaction rating being 61.3± 11.9% and anxiety level being 45.7± 18.8%.
Table 3 shows number of
working days in a week and that 60.0% (18) respondents work for 5 days in a
week. Table 4 shows descriptive data on the kind of chair used with most of the
respondents (60%) using stationary and soft seats. 50% of the respondents
observe break period at most once a day while 50% do not have time for breaks.
Table 3: Working Days in a
week
No of days |
1 |
2 |
3 |
4 |
5 |
No of Radiographer |
2 |
2 |
2 |
18 |
6 |
% No of Radiographer |
6.7% |
67% |
6.7% |
60.0% |
20.0% |
Table 4: Kinds of Chair used in the Resting Room/receptor
|
Rotating and soft |
Rotating and hard |
Stationary and hard |
Stationary and soft |
No chair |
Total |
No of Radiographer |
(2) |
(2) |
(2) |
(12) |
(2) |
20 |
% No of
Radiographer |
10.0% |
10.0% |
10.0% |
10.0% |
10.0% |
10.0% |
Discussion
Result from this study have
shown that radiographers in South-East Nigeria experience work-related
biomechanical stress symptoms in almost all anatomical regions examined. Upper
back musculoskeletal symptoms of pain were the most prevalent (37.5%). This
could be traced to the constant stress and strain of muscles of the upper back,
like the trapezius, Rhomboids major and minor, levator scapula and some
scalenei muscles in the course of moving static and possibly old x-ray units.
These muscles especially the trapezius are usually affected by excess hand
activities (Roman Lui et al 2001), which occurs during manipulation of
imaging equipment like X-ray machines. The accompanying prevalence of lower
back, middle back, neck and even eyes could be attributed to the indirect
concerted effort by the musculoskeletal components of the back and neck to keep
the head steady, permitting vertical and horizontal scanning adopted for eye
head co-ordination (Rabischong, 1992) and mental attentiveness. This is done during
the assessment and passing of radiographs prior to reporting. The occurrence of
upper extremity biomechanical symptoms could be explained from the fact that
the extremity is used to control movement of tube head and operation of other
radiographic equipment.
In a similar
study involving medical students, 83.4% of the students experienced
musculoskeletal symptoms, which were attributed to stress related work overload
(Egwu et al, 2006). Thus, biomechanical and psychosocial components of
occupational stress are strongly interwoven. Stress experienced in the practice
of radiography has the potentials to deter not only students from continuing
with the training but also could cause brain drain. Psychosocial stress among
radiographers was assessed using job satisfaction rating and anxiety induced by
workload. Job satisfaction ratings by respondents were less than 70%. It is
known that psychological conflicts and the individuals inability to adapt to
work are capable of generating negative moods, emotional upsets and other
maladies that affect not only mental health but also the neurovegetative
functioning of the mental but also the neurovegetative functioning of the
organism (Casanova-sotolongo et al, 2003). Among Sonographers, three
major stressors have been reported: clinical correlation ambiguity, demanding
work schedule and taking call (Penny, 2005). Clinical correlation ambiguity
may occur when a radiographer lacks enough clinical knowledge of his imaging
findings that will give a good base for judgement. This was not reported by
any radiographer in this study and could probably be caused by the fact that
radiographers are not always involved in film interpretation unlike their
counterparts in the U.K. and other developed countries.
Anxiety level of respondents
(45.7%) relates mainly to psychosocial stress. With its persistence, there
could be a gradual build up of stress on the individual leading to palpitation,
dilation of pupil, increased velocity of blood flow and increased muscle
activation.
Limitations of the Study
Although
this study yielded some very useful information, it does have limitations that
should be addressed in future studies. The sample population consisted of
radiographers in southeastern Nigeria who were registered with radiographers
registration board of Nigeria (RRBN), which does not represent the whole
southern Nigeria that habours the greatest percentage of radiographers in
Nigeria.
Future Research
A number of questions can
emerge from this study, which could be addressed, in future research in a
larger sample population from the southern Nigeria. In this study, anxiety and
job satisfaction as sources of psychosocial stress were studies. A logical
question to investigate are the extent to which workload, poor remuneration.
Governments disinterest in staff welfare, family influence, fear and
avoidance, illness behaviours and other psychosocial variables affect anxiety
and job satisfaction in radiography practice. The research could focus on
trying to determine whether radiographers are developing apathetic attitude to
deal with chronic stressors on work place environment. Research control groups
of radiographers with specific stress management situations could possibly help
determine how best to evaluate solutions to the ramifications of the problems
of stress within the radiography profession in Nigeria.
Further research could include
more variables, such as coping, adaptation techniques, intervention, support
group, social environment, and quality-of-life programs. Another research
project could include identifying if the curriculum in radiography education in
Nigeria attempts in any way to prepare students for realistic clinical
environments. It should further investigate if these graduates have different
coping and managing skills for stress than the graduates from programmes
without this preparation. A research study comparing how levels of stress for
radiographers compare to other health professions could be performed in a
larger sample population.
Conclusion
Finally, medical examination of radiographers should
be encouraged from time to time to avert the setting in of degenerating
psychosocial and musculoskeletal stress conditions. Such studies, as this,
should be carried out frequently and used as particular detectors of
occupational stress in the study serves as a baseline.
References
- Akpa, A. O. C. and Afoke, A. O. (2005). Stress: Causes, effects and
human survival strategies. J. Biomed. Africa. 3: (2): 3-5).
- Casanova-sotolongo, P., Lima-Mompo, g., Aldana-Vilas, L.,
Cassanovacarrillo, P., Casanova-Carrilo, C. (2003). Occupational Stress as one
of the concerns of present day public health services. Rev. Neurol. 36
(6): 565-567.
- Daughterly, J. M. (2002). Burnout: How Sonographers and vascular
technologists react to chronic stress. J. Diag. Med. Sonography. 18 (5):
305-312.
- Egwu, O. A., Ewunonu, E. O., Eteudo, A. N., Ovuoba, K. N., Ugwu, A.
C., Akpa, A. O. C., Okechi, O. O. (2006). Prevalence of Neck, Upper back and
chest musculoskeletal symptoms among, medical students. J. Expt. & Clin.
Anat. 5(1).
- Miur, M., Hrynkow, P., Chase, R., Boyce, D., Mdean, O. (2004). The
Nature case and extent of occupational musculoskeletal injuries among
sonographers. J. Diag. Med. Sinography. 20(5): 317-325.
- Penny, S. M. (2005). Stressors and employee retention in diagnostic
medical sonography department. J. Diag. Med. Sonography. 21:152-155.
- Pike, I. Russo, A., Baker, J. P., Lessoway, V. A. (1997). The
prevalence of Musculoskeletal disorders among diagnostic medical sonographers. J.
Diag. Med. Sonography. 13(5): 219-227.
- Rabischong, P. (1992).
Functional Anatomy of the Spine and spinal cord in manelf. C (ed) Imaging of
the spine and spinal cord. Raven Press New York.
- Roman Liu, D., Tokarski, T. Kaminska, J. (2001). Assessment of the
musculoskeletal load of trapezius and deltoid muscle during hand activity. Int.
J. Occup. Saf. Ergon. 7 (2):179-193.
- Tarlo, S. M., Liss, G. M., Greene, J. M., Purdham, J. Maccaskell, L.
N., Kippen, H. Kerr, M. (2004). Work attributed symptom clusters (darkroom
disease) among radiographers versus physiotherapists: associations between self
reported exposures and psychosocial stressors. Am. J. Ind. Med. 45(6):
513-521.
- Walvwood, H. (2006). Understanding sonographers burnout. J. Diag.
Med. Sonography. 22 (3): 200-205.
©Physiological Society of Nigeria, 2007
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