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在乳房检查中使用导医:英国顾问乳房外科医生的态度和实践。

Use of a chaperone during breast examination: the attitude and practice of consultant breast surgeons in the United Kingdom.

机构信息

The Breast Unit, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, CF72 8XR.

出版信息

Scott Med J. 2010 Feb;55(1):24-6. doi: 10.1258/RSMSMJ.55.1.24.

Abstract

BACKGROUND

Professional guidelines and clinical practice regarding use of chaperones vary substantially in different health care settings. Although there are several studies in primary care practice, no such studies are available in a breast care setting. We have undertaken a questionnaire survey of practicing consultant breast surgeons in the U.K. regarding the use of a chaperone during breast examination.

METHOD

A self-completion questionnaire, with 18 items was developed, piloted, modified and mailed to 400 consultant breast surgeons across the U.K.

RESULT

302/400 questionnaires were returned (76%). Sixty-five per cent had a policy on the use of chaperone. Although 73% always offer a chaperone, the majority never documented the offer (74%) or identity (73%). Overall use of chaperone was significantly higher among male (82%), compared to female surgeons (38%, p < 0.001). The majority said that patient embarrassment (54%) and the availability of a nurse (57%) strongly influence chaperone use unlike patient's age, marital status, ethnicity, anxiety, instinct. Seventy per cent of respondents believed that the presence of a chaperone was important for medico-legal protection of doctor and patient (55%).

CONCLUSION

Our study shows that the majority of consultant breast surgeons in the UK use a chaperone. The overall use of a chaperone in secondary breast care setting is higher compared to previous studies in primary care. Documentation of the offer and identity of the chaperone is very poor.

摘要

背景

在不同的医疗保健环境中,关于使用陪同人员的专业指南和临床实践存在很大差异。尽管在初级保健实践中有几项研究,但在乳腺保健环境中尚无此类研究。我们对英国的执业顾问乳腺外科医生进行了一项关于在乳房检查期间使用陪同人员的问卷调查。

方法

我们开发了一份包含 18 个项目的自我完成式问卷,进行了试点、修改,并邮寄给了英国的 400 名顾问乳腺外科医生。

结果

在 400 份问卷中,有 302 份(76%)被退回。65%的医生有关于使用陪同人员的政策。尽管 73%的医生总是提供陪同人员,但大多数医生从未记录过提供陪同人员的情况(74%)或身份(73%)。与女性外科医生(38%,p < 0.001)相比,男性外科医生(82%)更经常使用陪同人员。大多数医生表示,患者的尴尬(54%)和护士的可用性(57%)强烈影响着陪同人员的使用,而不是患者的年龄、婚姻状况、种族、焦虑、本能。70%的受访者认为,陪同人员的存在对于医生和患者的医疗法律保护很重要(55%)。

结论

我们的研究表明,英国大多数顾问乳腺外科医生都使用陪同人员。与初级保健中的先前研究相比,二级乳腺保健环境中陪同人员的总体使用频率更高。对陪同人员的提供和身份的记录非常差。

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