Individual patient radiation dose tracking guidelines for the South African healthcare system

Koch, Gerhardus George Visser

Individual patient radiation dose tracking guidelines for the South African healthcare system

Author(s)

Koch, Gerhardus George Visser

Date Issued

2026

Type

doctoral thesis

Publisher

Cape Peninsula University of Technology

Abstract

Medical imaging plays a pivotal role in delivering healthcare services. Despite its invaluable benefits, it also represents a major source of ionising radiation. The exposure of patients to increased amounts of ionising radiation is no longer a rare event, and there is a potential for radiation-induced injuries and cancers to develop. In the past, patient radiation safety was mostly driven by studies on average population dose, but these do not account for the unique, individual patient characteristics and their associated risks. As a potential solution, literature advocates for the implementation of individual patient radiation dose tracking (IPRDT) as an approach to strengthen the justification and optimisation principles associated with radiation safety. Although international efforts provide valuable input towards the implementation of IPRDT, little is known from the South African perspective. This study, therefore, explored how IPRDT could be achieved within the South African healthcare system, based on the perspectives of local stakeholders in patient radiation safety: radiographers, radiologists, and medical physicists. Following ethical approval, a qualitative, exploratory, contextual, descriptive, and model development research design was employed to develop IPRDT guidelines for the South African healthcare system. A purposive snowball sampling method was used for selecting potential participants from the Western Cape Province of South Africa. Participants were invited for a once-off, semi-structured, one-on-one interview. The study yielded a total of 26 participants and represents the perceptions of 10 radiographers, 8 radiologists, and 8 medical physicists. Data saturation was reached in all three professional groups respectively; and the interviews were transcribed verbatim by an independent transcriber. A reflexive thematic analysis was used to organise and describe the data. Four themes were developed from the data: 1) Knowledge and perceptions of IPRDT; 2) Factors affecting the implementation of IPRDT; 3) Considerations for clinical practice; and 4) A collaborative effort from stakeholders. Inductive reasoning allowed for a critical reflection on the collective story shared by the participants and led to the development of the central concept: A collaborative approach to create an improved and radiation-conscious environment. Following an analysis of the central concept, relationship statements were established, and a model was developed and described. Following this, guidelines to operationalise the same model were developed through deductive reasoning. This thesis presents novel findings and bridges the knowledge gap with a framework of guidelines to implement IPRDT that is tailored to the unique needs and considerations of the South African healthcare system. The study provides further insights into individual patient radiation safety and complements the notion and delivery of person-centred care and quality improvement initiatives within a continuously evolving field.

Additional information

Thesis (Doctor of Radiography)--Cape Peninsula University of Technology, 2026

File(s)

Name

Gerhardus_Koch_208070362.pdf

Size

1.96 MB

Format

Adobe PDF

Checksum

(MD5):02c6f0d9f04ccc7941a33d739a98c1ba