Chaperones for intimate examinations: cross sectional survey of attitu
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《英国医生杂志》
1 Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, London NW3 2PF, 2 Department of General Practice and Primary Care, Guy's, King's, and St Thomas' School of Medicine, King's College, London SE11 6SP, 3 Department of Obstetrics and Gynaecology, Guy's, King's and St Thomas' School of Medicine
Correspondence to: J Rosenthal j.rosenthal@pcps.ucl.ac.uk
Introduction
The use of chaperones by male doctors has substantially increased since the 1980s and '90s and a continuing low level of use by female doctors despite one third of practices having a policy. Record keeping about the offer and use of chaperones is poor, and significant barriers to the use of appropriate chaperones in general practice still undoubtedly exist. The recommendations of the royal colleges and other bodies are, therefore, difficult to implement fully. Their advice may be appropriate in most secondary care settings, but such recommendations may be difficult to translate into primary care practice. We suggest that more flexible guidance is needed for general practice, which must recognise the realities of current staffing and space arrangements, and take greater account of the wider context of the relationship between patients, their doctors, and the practice.5 Further research is needed into patients' views and wishes. We also need to gain more understanding of the circumstances in which problems might arise in this delicate area.
What is already known on this topic
Attitudes and behaviour of medical professionals are often at odds with the recommendations of the royal colleges and other bodies regarding the universal use of chaperones for intimate examinations
What this study adds
Use of chaperones by male doctors since the 1980s and '90s has substantially increased, but use by female doctors remains low
More flexible guidance is needed for general practice as well as further research into patients' views and wishes on the use of chaperones
This article was posted on bmj.com on 3 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38315.646053.F7
Contributors: RJ, JRo, and JRy had the original idea for the study. Data were collected by SH and SC. JB analysed the data and drafted a report. All authors wrote the paper. RJ is guarantor.
Funding: SH and SC were funded by the London Deanery GP Department as academic senior registrars in general practice.
Competing interests: None declared.
Ethical approval: South East Multicentre Research Ethics Committee.
References
The Royal College of Obstetricians and Gynaecologists. Gynaecological examinations, guidelines for specialist practice. London: RCOG, 2002.
Jones RH. The use of chaperones by general practitioners. J R Coll Gen Pract 1983;33: 25-7.
Speelman A, Savage J, Verburgh M. Use of chaperones by general practitioners. BMJ 1993;307: 986-7.
Stern V. Gynaecological examination post-Ledward: a private matter. Lancet 2001;358: 1896-8.
Whitford DL, Karim M, Thompson G. Attitudes of patients towards the use of chaperones in primary care. Br J Gen Pract 2001;51: 381-3.
((Joe Rosenthal, senior lecturer in genera)
Correspondence to: J Rosenthal j.rosenthal@pcps.ucl.ac.uk
Introduction
The use of chaperones by male doctors has substantially increased since the 1980s and '90s and a continuing low level of use by female doctors despite one third of practices having a policy. Record keeping about the offer and use of chaperones is poor, and significant barriers to the use of appropriate chaperones in general practice still undoubtedly exist. The recommendations of the royal colleges and other bodies are, therefore, difficult to implement fully. Their advice may be appropriate in most secondary care settings, but such recommendations may be difficult to translate into primary care practice. We suggest that more flexible guidance is needed for general practice, which must recognise the realities of current staffing and space arrangements, and take greater account of the wider context of the relationship between patients, their doctors, and the practice.5 Further research is needed into patients' views and wishes. We also need to gain more understanding of the circumstances in which problems might arise in this delicate area.
What is already known on this topic
Attitudes and behaviour of medical professionals are often at odds with the recommendations of the royal colleges and other bodies regarding the universal use of chaperones for intimate examinations
What this study adds
Use of chaperones by male doctors since the 1980s and '90s has substantially increased, but use by female doctors remains low
More flexible guidance is needed for general practice as well as further research into patients' views and wishes on the use of chaperones
This article was posted on bmj.com on 3 December 2004: http://bmj.com/cgi/doi/10.1136/bmj.38315.646053.F7
Contributors: RJ, JRo, and JRy had the original idea for the study. Data were collected by SH and SC. JB analysed the data and drafted a report. All authors wrote the paper. RJ is guarantor.
Funding: SH and SC were funded by the London Deanery GP Department as academic senior registrars in general practice.
Competing interests: None declared.
Ethical approval: South East Multicentre Research Ethics Committee.
References
The Royal College of Obstetricians and Gynaecologists. Gynaecological examinations, guidelines for specialist practice. London: RCOG, 2002.
Jones RH. The use of chaperones by general practitioners. J R Coll Gen Pract 1983;33: 25-7.
Speelman A, Savage J, Verburgh M. Use of chaperones by general practitioners. BMJ 1993;307: 986-7.
Stern V. Gynaecological examination post-Ledward: a private matter. Lancet 2001;358: 1896-8.
Whitford DL, Karim M, Thompson G. Attitudes of patients towards the use of chaperones in primary care. Br J Gen Pract 2001;51: 381-3.
((Joe Rosenthal, senior lecturer in genera)