Obesity bias in diagnostic radiography students: A survey of attitudes, perceptions and technical confidence

Journal article


Tamburrini, N. and Lockwood, P. 2023. Obesity bias in diagnostic radiography students: A survey of attitudes, perceptions and technical confidence. Radiography. 30 (1), pp. 202-208. https://doi.org/10.1016/j.radi.2023.11.006
AuthorsTamburrini, N. and Lockwood, P.
Abstract

Introduction: Obesity bias exists in healthcare professionals and students from numerous disciplines and negatively impacts the quality of care, outcomes, engagement, and satisfaction of their patients. With obesity rates continuing to rise in the United Kingdom (UK), more patients will be affected than ever, and it is becoming an increasingly important issue to tackle. This study aims to assess the attitudes to obesity of student diagnostic radiographers and determine if obesity bias exists in this population.

Method: Student radiographers (n=140) at a single university in the UK were invited to complete an online survey comprising measures designed to assess levels of bias and attitudes towards obesity, including the Attitude Towards Obese Persons (ATOP) scale. Likert-type scales were used to collect quantitative data, and data analysis included descriptive statistics, frequencies, and Spearman’s rank correlation coefficient.

Results: Responses were received from n=38 students. The mean ATOP score for participants was 70.37 (SD=19.26). With 26% (n=10) scoring below 60, demonstrating strong negative attitudes towards obese individuals. Additionally, students (76.3%; n=29) indicated that they observed high levels of obesity bias whilst on clinical placement. There was a statistically significant correlation between levels of weight bias and students’ confidence in working with obese patients (r(36)=0.4, p 0.01). Students who are less confident working with obese patients had higher levels of obesity bias.

Conclusions: Obesity bias exists in radiography students at levels comparable to those that have been found previously in other healthcare professionals and students. Furthermore, radiography students lacked confidence in their technical ability to work with obese patients and lower confidence levels were associated with higher levels of obesity bias.

Implications for Practice: The findings of this study provide preliminary knowledge upon which future research can be built.

KeywordsObesity; Attitudes; Confidence; Radiography students; Patient care
Year2023
JournalRadiography
Journal citation30 (1), pp. 202-208
PublisherElsevier
ISSN1078-8174
Digital Object Identifier (DOI)https://doi.org/10.1016/j.radi.2023.11.006
Official URLhttps://www.sciencedirect.com/science/article/pii/S1078817423002225
Publication dates
Print29 Nov 2023
Publication process dates
Accepted08 Nov 2023
Deposited04 Dec 2023
Accepted author manuscript
License
All rights reserved
File Access Level
Restricted
Publisher's version
License
Output statusPublished
References

1. Hu G., Ding J., Ryan DH. Trends in obesity prevalence and cardiometabolic risk factor control in US adults with diabetes, 1999–2020. Obesity 2023;31(3):841–51. Doi: 10.1002/oby.23652.
2. World Health Organisation. Obesity and overweight. Obesity and Overweight. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overwei... [accessed June 19, 2023].
3. Baker C. Obesity statistics, London; 2023.
4. Puhl RM., Heuer CA. The Stigma of Obesity: A Review and Update. Obesity 2009;17(5):941–64. Doi: 10.1038/oby.2008.636.
5. World Health Organisation. Weight bias and obesity stigma: considerations for the WHO European Region, Copenhagen; 2017.
6. Puhl R., Brownell KD. Bias, Discrimination, and Obesity. Obes Res 2001;9(12):788–805. Doi: 10.1038/oby.2001.108.
7. Latner JD., O’Brien KS., Durso LE., Brinkman LA., MacDonald T. Weighing obesity stigma: the relative strength of different forms of bias. Int J Obes 2008;32(7):1145–52. Doi: 10.1038/ijo.2008.53.
8. Flint S. Obesity stigma: Prevalence and impact in healthcare’. British Journal of Obesity 2015;1(1):14–8.
9. Wee CC., Phillips RS., Francis Cook E., Haas JS., Louise Puopolo A., Brennan TA., et al. Influence of body weight on patients’ satisfaction with ambulatory care. J Gen Intern Med 2002;17(2):155–9. Doi: 10.1046/j.1525-1497.2002.00825.x.
10. Alberga AS., Edache IY., Forhan M., Russell-Mayhew S. Weight bias and health care utilization: a scoping review. Prim Health Care Res Dev 2019;20:e116. Doi: 10.1017/S1463423619000227.
11. Phelan SM., Burgess DJ., Yeazel MW., Hellerstedt WL., Griffin JM., Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity Reviews 2015;16(4):319–26. Doi: 10.1111/obr.12266.
12. Maskell G. Why does demand for medical imaging keep rising? BMJ 2022:o2614. Doi: 10.1136/bmj.o2614.
13. NHS England. Digital Imaging Dataset Statistical Release, London; 2023.
14. Lawrence BJ., Kerr D., Pollard CM., Theophilus M., Alexander E., Haywood D., et al. Weight bias among health care professionals: A systematic review and meta‐analysis. Obesity 2021;29(11):1802–12. Doi: 10.1002/oby.23266.
15. Lacroix E., Alberga A., Russell-Mathew S., McLaren L., von Ranson K. Weight Bias: A Systematic Review of Characteristics and Psychometric Properties of Self-Report Questionnaires. Obes Facts 2017;10(3):223–37. Doi: 10.1159/000475716.
16. Swift JA., Hanlon S., El-Redy L., Puhl RM., Glazebrook C. Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. Journal of Human Nutrition and Dietetics 2013;26(4):395–402. Doi: 10.1111/jhn.12019.
17. O’Donoghue G., McMahon S., Holt A., Nedai M., Nybo T., Peiris CL. Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study. Physiotherapy 2021;112:55–63. Doi: 10.1016/j.physio.2021.03.016.
18. Modica MJ., Kanal KM., Gunn ML. The Obese Emergency Patient: Imaging Challenges and Solutions. RadioGraphics 2011;31(3):811–23. Doi: 10.1148/rg.313105138.
19. Buckley O., Ward E., Ryan A., Colin W., Snow A., Torreggiani WC. European obesity and the radiology department. What can we do to help? Eur Radiol 2009;19(2):298–309. Doi: 10.1007/s00330-008-1154-z.
20. Aweidah L., Robinson J., Cumming S., Lewis S. Australian diagnostic radiographers’ attitudes and perceptions of imaging obese patients: A study of self, peers and students. Radiography 2016;22(4):e258–63. Doi: 10.1016/j.radi.2016.06.002.
21. Thanh Le NT., Robinson J., Jayne Lewis S. A Study of Student Radiographers’ Learning Experiences in Imaging Obese Patients. J Med Imaging Radiat Sci 2015;46(3):S61-S68.e1. Doi: 10.1016/j.jmir.2015.05.002.
22. Sim J., Wright C. Research in Health Care, Cheltenham: Nelson Thomas Ltd; 2000.
23. Bowling A. RResearch Methods in Health, Investigating Health and Health Services, 4th ed., Berkshire: Open University Press; 2014.
24. Information Commissioner’s Office. Lawful basis for processing. Guide to the General Data Protection Regulation (GDPR). Available from: https://ico.org.uk/for-organisations/guide-to-data-protection/guide-... [accessed October 17, 2022].
25. UK Government. The Data Protection Act 2018: Chapter 2 The GDPR. , England: UK Government; 2018.
26. Information Commissioner’s Office. What is personal data? . Guide to the General Data Protection Regulation (GDPR). Available from: https://ico.org.uk/for-organisations/guide-to-data-protection/guide-... [accessed October 17, 2022].
27. Crandall CS. Prejudice against fat people: Ideology and self-interest. J Pers Soc Psychol 1994;66(5):882–94. Doi: 10.1037/0022-3514.66.5.882.
28. Puhl RM., Luedicke J., Grilo CM. Obesity bias in training: Attitudes, beliefs, and observations among advanced trainees in professional health disciplines. Obesity 2014;22(4):1008–15. Doi: 10.1002/oby.20637.
29. Allison DB., Basile VC., Yuker HE. The Measurement of Attitudes and Beliefs about Obese Persons. International Journal of Eating Disorders 1991;10(5):599–607. Doi: https://doi.org/10.1002/1098-108X(199109)10:5%3C599::AID-EAT2260100512%3E3.0.CO;2-%23.
30. Thanh Le NT., Robinson J., Lewis SJ. Obese patients and radiography literature: what do we know about a big issue? J Med Radiat Sci 2015;62(2):132–41. Doi: 10.1002/jmrs.105.
31. Peacock JL., Peacock PJ. Oxford Handbook of Medical Statistics, 2nd ed., Oxford: Oxford University Press; 2020.
32. Canterbury Christ Church University. Research Ethics Policy , Canterbury; 2023.
33. Wynn T., Islam N., Thompson C., Myint KS. The effect of knowledge on healthcare professionals’ perceptions of obesity. Obes Med 2018;11:20–4. Doi: 10.1016/j.obmed.2018.06.006.
34. Vroman K., Cote S. Prejudicial Attitudes Toward Clients Who Are Obese: Measuring Implicit Attitudes of Occupational Therapy Students. Occup Ther Health Care 2011;25(1):77–90. Doi: 10.3109/07380577.2010.533252.
35. Oliver TL., Qi B., Diewald LK., Shenkman R., Kaufmann PG. Development of a weight bias reduction intervention for third‐year nursing students. Clin Obes 2022;12(2). Doi: 10.1111/cob.12498.
36. Moore CH., Oliver TL., Randolph J., Dowdell EB. Interventions for reducing weight bias in healthcare providers: An interprofessional systematic review and meta‐analysis. Clin Obes 2022;12(6). Doi: 10.1111/cob.12545.
37. Wang Q., Cao X., Du T. First-year nursing students’ initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity. BMC Nurs 2022;21(1):234. Doi: 10.1186/s12912-022-01016-8.

Permalink -

https://repository.canterbury.ac.uk/item/967vx/obesity-bias-in-diagnostic-radiography-students-a-survey-of-attitudes-perceptions-and-technical-confidence

Download files


Publisher's version
  • 67
    total views
  • 12
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

A survey of the NHS reporting radiographer workforce in England
Lockwood, P., Burton, C., Shaw, T. and Woznitza, N. 2024. A survey of the NHS reporting radiographer workforce in England. Radiography Open. 10 (1), pp. 1-18. https://doi.org/10.7577/radopen.5635
Comparing the standard knee X-ray exposure factor, 10 kV rule, and modified 10 kV rule techniques in digital radiography to reduce patient radiation dose without loss of image quality
Lockwood, P. and Wenman, A. 2024. Comparing the standard knee X-ray exposure factor, 10 kV rule, and modified 10 kV rule techniques in digital radiography to reduce patient radiation dose without loss of image quality. Radiography. 30 (2), pp. 574-581. https://doi.org/10.1016/j.radi.2024.01.013
Care of transgender patients by diagnostic radiographers: What can be learnt from the literature
Hammond, C and Lockwood, P. 2023. Care of transgender patients by diagnostic radiographers: What can be learnt from the literature. Radiography. 30 (1), pp. 145-150. https://doi.org/10.1016/j.radi.2023.10.020
Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review
Lockwood, P., Burton, C., Woznitza, N. and Shaw, T. 2023. Assessing the barriers and enablers to the implementation of the diagnostic radiographer musculoskeletal X‑ray reporting service within the NHS in England: a systematic literature review. BMC Health Services Research. 23 (1270), pp. 1-41. https://doi.org/10.1186/s12913-023-10161-y
Impostor phenomenon traits in radiography students: findings from a UK pilot survey
Gibson, C. and Lockwood, P. 2023. Impostor phenomenon traits in radiography students: findings from a UK pilot survey . Radiography. 30 (1), pp. 61-65. https://doi.org/10.1016/j.radi.2023.10.005
Investigating the adjacent patient radiation dose received during a simulated ward chest X-ray examination
Langfield, H and Lockwood, P. 2023. Investigating the adjacent patient radiation dose received during a simulated ward chest X-ray examination. Radiography Open. 9 (1), pp. 1-14. https://doi.org/10.7577/radopen.5354
Research ethics applications: Back to basics: What you ought to know about research ethics applications
Lockwood, P. 2023. Research ethics applications: Back to basics: What you ought to know about research ethics applications. Insights into Imaging. Spring (7), pp. 39-45.
An investigation into the clinical scope of practice of MRI reporting radiographers within the United Kingdom
Mitchell, M. and Lockwood, P. 2023. An investigation into the clinical scope of practice of MRI reporting radiographers within the United Kingdom. Radiography. 29 (3), pp. 489-495. https://doi.org/10.1016/j.radi.2023.02.015
Assessing the barriers and enablers to the diagnostic radiographer X-ray reporting service within the NHS in England: A systematic literature review
Lockwood, P. 2022. Assessing the barriers and enablers to the diagnostic radiographer X-ray reporting service within the NHS in England: A systematic literature review. York University.
Lead-rubber shielding effect on radiation dose to the gonads from a bilateral hand X-ray examination
Welborn, D. and Lockwood, P. 2022. Lead-rubber shielding effect on radiation dose to the gonads from a bilateral hand X-ray examination. Radiography. 28 (2), pp. 360-365. https://doi.org/10.1016/j.radi.2021.12.013
Could posterior-anterior projection cervical spine radiographs improve image quality and dose reduction
Faulkner, R. and Lockwood, P. 2022. Could posterior-anterior projection cervical spine radiographs improve image quality and dose reduction . Radiography Open. 8 (1). https://doi.org/10.7577/radopen.5004
Diagnostic radiography students' perceptions towards communication with service users who are deaf or hearing impaired.
Nolan-Bryant, A. and Lockwood, P. 2022. Diagnostic radiography students' perceptions towards communication with service users who are deaf or hearing impaired. Radiography. 29 (1), pp. 207-214. https://doi.org/10.1016/j.radi.2022.11.008
A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England
Hinds, Z. and Lockwood, P. 2022. A cross-sectional student survey of the impact of the Covid-19 lockdowns on clinical placement in England. Radiography. 29 (1), pp. 190-199. https://doi.org/10.1016/j.radi.2022.11.006
Pre-registration UK diagnostic radiography student ability and confidence in interpretation of chest X-rays
Lockwood, P. and Khan, A. 2021. Pre-registration UK diagnostic radiography student ability and confidence in interpretation of chest X-rays. Radiography Open. 7 (1), pp. 1-13. https://doi.org/10.7577/radopen.4529
Efficacy, utility, and validity in Computed Tomography head reporting by radiographers
Lockwood, P. 2021. Efficacy, utility, and validity in Computed Tomography head reporting by radiographers. PhD Thesis Canterbury Christ Church University School of Allied and Public Health Professions
COVID-19: A literature review of the impact on diagnostic radiography students
Astirbadi, D. and Lockwood, P. 2021. COVID-19: A literature review of the impact on diagnostic radiography students. Radiography. https://doi.org/10.1016/j.radi.2021.09.009
Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs
Lockwood, P. and Pittock, L. 2019. Multi-professional image interpretation: performance in preliminary clinical evaluation of appendicular radiographs. Radiography. https://doi.org/10.1016/j.radi.2019.04.013
Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy
Lockwood, P., Elliott, J., Nelson, A. and Harris, S. 2019. Computed tomography head and facial bones review of a 2,700 year old Egyptian mummy . BJR Case Reports. https://doi.org/10.1259/bjrcr.20190076
Visual function assessment of diagnostic radiography students
Lockwood, P. and Blackman, A. 2019. Visual function assessment of diagnostic radiography students. Radiography. https://doi.org/10.1016/j.radi.2019.10.012
An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom
Lockwood, P. 2019. An evaluation of CT head reporting radiographers' scope of practice within the United Kingdom. Radiography. 26 (2), pp. 102-109. https://doi.org/10.1016/j.radi.2019.09.001
Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Image Interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.05.009
Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients
Hopkinson, G., Lockwood, P. and Dolbear, G. 2018. Evaluation of an equilibrium phase free-breathing dynamic contrast-enhanced MRI prototype sequence compared to traditional breath-held MRI acquisition in liver oncology patients. Radiography. https://doi.org/10.1016/j.radi.2018.01.001
Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module
Lockwood, P. and Dolbear, G. 2018. Nuclear medicine image interpretation by radiographers: findings of an accredited postgraduate module. Radiography. https://doi.org/10.1016/j.radi.2018.11.007
CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme
Lockwood, P. 2017. CT Sinus and facial bones reporting by radiographers: findings of an accredited postgraduate programme. Dentomaxillofacial Radiology. 46 (4). https://doi.org/10.1259/dmfr.20160440
Exploring variation and trends in adherence to national occupational standards for reporting radiographers
Lockwood, P. 2017. Exploring variation and trends in adherence to national occupational standards for reporting radiographers. Journal of Social Science & Allied Health Professions. 1 (1), pp. 20-27.
Observer performance in Computed Tomography head reporting
Lockwood, P. 2017. Observer performance in Computed Tomography head reporting. Journal of Medical Imaging and Radiation Sciences. 48 (1), pp. 22-29. https://doi.org/10.1016/j.jmir.2016.08.001
Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective
Lockwood, P. 2016. Exploring the benefits of magnetic resonance imaging reporting by radiographers: A UK perspective. Journal of Medical Imaging and Radiation Sciences. 47 (2). https://doi.org/10.1016/j.jmir.2015.12.083
An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice.
Lockwood, P. 2016. An economic evaluation of introducing a skills mix approach to CT head reporting in clinical practice. Radiography. https://doi.org/10.1016/j.radi.2015.09.004
Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study
Lockwood, P., Pittock, L., Lockwood, C., Jeffery, C. and Piper, K. 2015. Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study. Radiography. 2015, pp. 1-5. https://doi.org/10.1016/j.radi.2015.06.005
Out of the comfort zone (Part 2)
Lockwood, P. 2013. Out of the comfort zone (Part 2).
AFROC analysis of reporting radiographer’s performance in CT head interpretation
Lockwood, P. and Piper, K. 2015. AFROC analysis of reporting radiographer’s performance in CT head interpretation. Radiography. 21 (3), pp. e90-e95. https://doi.org/10.1016/j.radi.2015.04.001
Out of the comfort zone (Part 1)
Lockwood, P. 2013. Out of the comfort zone (Part 1).
Origins of the Reporting Radiographer
Lockwood, P. 2013. Origins of the Reporting Radiographer.
Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging
Lockwood, P. and Breen, W. 2013. Patient safety and quality improvement: Iatrogenic venous air embolism in diagnostic imaging.
CT head reporting by radiographers: Findings of an accredited postgraduate programme
Lockwood, P. and Piper, K. 2013. CT head reporting by radiographers: Findings of an accredited postgraduate programme.
CT skull base & calvarium normal variant pitfalls
Lockwood, P. 2013. CT skull base & calvarium normal variant pitfalls.
CT head reporting by radiographers: results of an accredited postgraduate programme
Lockwood, P., Piper, K. and Pittock, L. 2015. CT head reporting by radiographers: results of an accredited postgraduate programme. Radiography. 21 (3), pp. e85-e89. https://doi.org/10.1016/j.radi.2014.12.001