The development of a mobile application to enhance fetal radiation dose monitoring among pregnant Radiographers

Abstract

Introduction: Ionising radiation has the potential to have harmful effects on cells. The risk of these effects increases in a fetus whose tissues are still developing. The effects of radiation, which depend on the amount of exposure received, can present as deterministic or stochastic effects. Based on this theory, occupational health and safety are heightened for the pregnant radiographer who is required to wear a special dosimeter to record and monitor the fetal dose exposure. This process is self-regulated by the pregnant radiographer. In the clinical department, it was observed that pregnant radiographers have inconsistent methods of recording and monitoring their fetal dose. Therefore, the study aimed to develop a mobile application to support and enhance fetal dosimetry among pregnant radiographers. Methods: The research followed a design science research (DSR) paradigm and the behaviour change, user-centred and social marketing (BUS) framework, which guided the objectives of this study. The study adopted a mixed methods research design, incorporating five major phases, aligned with the DSR paradigm, namely 1) Problem Awareness, 2) Suggestion, 3) Development, 4) Evaluation and 5) Conclusion. In Problem Awareness, the reviewed literature highlighted the problem as it exists in the literature as well as a situational analysis into the problem as it exists in the context of this study. In the Suggestion phase, recommendations are made towards addressing the problems identified in literature and the situational analysis. In the Development phase, two cycles took place. Firstly, prototype design, which adopted a design thinking methodology. Secondly, the Mobile App Development Lifecycle (MADL) to develop and test the final app. In the Evaluation phase, pregnant radiographers engaged with the app in the real-life setting. Qualitative interviews were then conducted to ascertain the usability and usefulness of the app. Results: In DSR Step 1, the study identified a lack of literature regarding pregnant radiographer compliance towards fetal dosimetry, presenting a gap in the literature. The problem awareness through the situational analysis revealed inconsistent fetal dose recording and monitoring. The study concluded that pregnant radiographers needed support regarding fetal dosimetry. This suggestion is a mobile application encompassing core functional areas such as dose tracking and education to address some of these challenges. In DSR Step 3, the prototype was designed by its actual users, who named the app PregiDose. The users further uncovered that pregnant radiographers suffer from decreased emotional well-being in the clinical setting and required support. The final app was then developed in collaboration with software engineers. In DSR Step 4, the pregnant radiographers who had been interviewed after engaging with the app revealed that it was both easy to use (usability) and useful. However, they recommended automation, whereby the doses from the dosimeter could be linked to the app automatically.

Conclusion: DSR Step 5 corresponds to the conclusion of the research process. The study has highlighted that a mobile application for pregnant radiographers can enhance fetal dose monitoring. The research made the following contributions: first, to the field of research by describing the rigorous process of development and evaluation, and second, to the field of radiography and radiation protection, demonstrating that technology can be used to facilitate occupational health and safety and, in line with the pragmatic nature of the DSR paradigm, solve a real-life problem.