Patients' Attitude Towards the Use of a Chaperone in Breast Examination

Abstract

INTRODUCTION The aim of this study was to assess the attitude and the preferences of patients towards the use of a chaper one during breast examination. PATIENTS AND METHODS A two-part questionnaire was circulated among 204 consecutive new patients, attending both symptomatic breast and screened assessment clinics. RESULTS A total of 200 questionnaires were fully completed and returned. Although 104 (52%) patients felt that they did not need a chaperone during breast examination, 65 (33%) preferred to have one. Amongst these 65 patients, the majority (52%) wanted a chaperone in the presence of both a male and female doctor whereas 19 (29%) wanted a chaperone in the presence of a male doctor. When patients were asked which person would be the best chaperone for them, 63 patients (32%) preferred their spouse to act as a chaperone, whereas 57 (29%) preferred a clinic nurse. However, the majority of teenagers and young adults (10–30 years) preferred their parents to act as a chaperone. On asking the reason for preferring a chaperone during breast examination, 69% felt a chaperone helped them to feel more at ease, 28% felt they get more support, 23% get less embarrassed and 10% felt safer. The majority (54%) preferred the nurse to offer a chaperone instead of the doctor (22%). Patients generally said they were comfortable in asking for a chaperone (68%). Overall, 68% of patients considered the offer of a chaperone as a sign of respect and the majority felt the attitude (32%) and gender (20%) of the clinician are the two most important factors influencing the chaperone use. Most patients were of the opinion that the presence of a chaperone does not have a negative effect on the doctor-patient relationship (75%), patient confidentiality (74%) and do not cause embarrassment (68%). Following their assessment in clinic, the patients' views on the use of a chaperone were not significantly changed. CONCLUSIONS There is a wide variety of opinion among patients about the desirability of a chaperone during breast examination. However, the majority consider the offer of a chaperone as a sign of respect and many patients commented that the presence of a chaperone is important for medicolegal protection of both patient and clinician. In recent years, there has been an increasing call from medicolegal societies and medical insurance companies for greater use of chaperones during intimate examinations. We feel that recommendations regarding the use of a chaperone should now be incorporated into the British Association of Surgical Oncology guidelines.

The importance of a medical chaperone: a quality improvement study exploring the use of a note stamp in a tertiary breast surgery unit

“…This information will be important to female clinicians who have traditionally less frequently offered a chaperone during breast examinations. 6 8 11 12 This study, as others, 12 – 14 demonstrates that women are more likely to decline the offer of a chaperone when the examining clinician is female; 61.45% declined a chaperone offered by a female clinician compared to 3.82% declining if the clinician was male. The reverse of this is that nearly 40% of women will still choose a chaperone even with a female clinician.…”

“… 9 10 Studies have also shown that many patients see the offer of a chaperone as a sign of respect from their doctor and helps build a good patient–doctor relationship. 5 6 …”

Chaperones and intimate physical examinations: what do male and female patients want?

“…The majority of reports about patients' perceptions of a medical chaperone have focused on female patients [3][4][5][6][7] ; those of male patients are less well studied. [8][9][10] A potential discrepancy may exist between the two groups.…”

Male nurses and the protection of female patient dignity

“…Inoue et al (2006) reported that female patients experience stress when undergoing intimate care provided by male nurses. Although the presence of a chaperone is viewed as a sign of respect and protection (Sinha et al 2009), Inoue et al (2006) revealed that female patients would much prefer a female nurse to provide care. However, on some occasions this may not be an option.…”