Understanding therapeutic radiographers' confidence in assessing, managing & teaching radiation induced skin reactions (RISR): A national survey in the UK

N Julka-Anderson; C Thomas; R Harris; H Probst

doi:10.1016/j.radi.2024.04.006

Understanding therapeutic radiographers' confidence in assessing, managing & teaching radiation induced skin reactions (RISR): A national survey in the UK

Radiography (Lond). 2024 Apr 24;30(3):978-985. doi: 10.1016/j.radi.2024.04.006. Online ahead of print.

Authors

N Julka-Anderson¹, C Thomas², R Harris³, H Probst⁴

Affiliations

¹ The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, United Kingdom. Electronic address: naman.julka-anderson@rmh.nhs.uk.
² The Society and College of Radiographers, Professional Practice and Education, London, United Kingdom. Electronic address: corinnet@sor.org.
³ The Society and College of Radiographers, Professional Practice and Education, London, United Kingdom. Electronic address: RachelH@sor.org.
⁴ Sheffield Hallam University, Health Research Institute, Sheffield, United Kingdom. Electronic address: h.probst@shu.ac.uk.

PMID: 38663217
DOI: 10.1016/j.radi.2024.04.006

Abstract

Introduction: The standard toxicity tools adopted for assessing Radiation Induced Skin Reactions (RISR) do not currently reflect how skin changes occur across all skin tones. A one size fits all approach is adopted currently for RISR assessment. The aim of this study was to understand what evidence-based practice and RISR tools are being used across the therapeutic radiography workforce and the levels of confidence in using these tools.

Methods: A survey using Likert scales to assess confidence in RISR assessment and management was made available to 77 departments in the UK between August-November 2021. Descriptive statistics were used to understand respondents' confidence in assessing, managing, and teaching RISR between white, brown, and black skin tones; Fisher's exact test was used to assess the significance of differences between groups.

Results: Complete responses were received from 406 therapeutic radiographers. Radiation Therapy Oncology Group (RTOG) was the most used RISR assessment tool (58% of respondents n = 237). Most respondents (74.2% n = 303) reported use of locally produced patient information on skin care, rather than the Society and College of Radiographers evidence-based patient leaflets. Confidence in assessing and managing RISR in white skin was higher than that in brown and black skin. Similarly, confidence was higher in teaching of appropriate RISR assessment and management in white skin tones when compared to brown and black skin.

Conclusion: White skin tones appear to be more confidently assessed and managed for RISR along with taught appropriate assessment and management, than brown and black skin tones in the sample of the workforce that responded.

Implications for practice: A greater understanding of the reasons for these differences is required but this study aims to instigate change and positive growth within this area.

Keywords: Assessment; Health inequalities; Management; Radiation induced skin reactions; Radiotherapy; Teaching.