Ou Kai Qi, Wong Zhen Ning, Wong Zhen Yu
Queens Medical Centre, Nottingham, England, United Kingdom.
Manipal University College Malaysia, Jalan Batu Hampar Bukit Baru, Melaka, Malaysia.
Ir J Med Sci. 2024 Dec;193(6):2955-2963. doi: 10.1007/s11845-024-03803-5. Epub 2024 Sep 12.
The General Medical Council (GMC) has made it mandatory to have a chaperone present during intimate examinations, including breast exams, highlighting the importance of medicolegal protection for both patients and clinicians.
The use of chaperones during breast examinations is logical, especially in an increasingly litigious society. This review aims to summarize current information regarding patients' and clinicians' perspectives on chaperone use in breast examination.
A PRISMA-compliant search was conducted in electronic databases from inception until April 2023 for qualitative literature on patients' and clinicians' perspectives on chaperone use in breast examination. The inclusion criteria focused on studies related to breast examinations, excluding other intimate examinations. An inductive thematic analysis was performed in three domains: physician-associated factors, patient-associated factors, and chaperone documentation.
Ten studies were included after screening 939 articles. For breast examination, the presence of male and older surgeons, nurse availability, rural settings, and patients' psychiatric comorbidities increased the likelihood of chaperone use during consultations. Medico-legal concerns were prominent for male physicians, while female physicians highlighted the need for technical support. Logistical issues were a common hindrance. The gender of physicians was important for patients, but there was conflicting evidence regarding patient preferences for chaperones and their purpose. Poor documentation was generally observed despite quality improvement projects.
This study emphasizes the vital role of chaperones in clinical practice, urging a precise definition and targeted resolution for implementation challenges. Patient preferences highlight the need for a personalized approach, and increased awareness among healthcare professionals is essential.
英国医学总会（GMC）规定，在包括乳房检查在内的私密检查过程中必须有陪诊人员在场，这凸显了为患者和临床医生提供法医学保护的重要性。
在乳房检查中使用陪诊人员是合理的，尤其是在一个诉讼日益增多的社会。本综述旨在总结有关患者和临床医生对乳房检查中使用陪诊人员的看法的现有信息。
从数据库建立至2023年4月，在电子数据库中进行了一项符合PRISMA标准的搜索，以查找关于患者和临床医生对乳房检查中使用陪诊人员看法的定性文献。纳入标准聚焦于与乳房检查相关的研究，排除其他私密检查。在三个领域进行了归纳主题分析：医生相关因素、患者相关因素和陪诊人员记录。
在筛选了939篇文章后，纳入了10项研究。对于乳房检查，男性和年长的外科医生在场、护士是否可用、农村地区以及患者的精神疾病合并症增加了会诊期间使用陪诊人员的可能性。男性医生对法医学问题较为关注，而女性医生则强调需要技术支持。后勤问题是一个常见的障碍。医生的性别对患者很重要，但关于患者对陪诊人员及其目的的偏好存在相互矛盾的证据。尽管有质量改进项目，但总体上记录不佳。
本研究强调了陪诊人员在临床实践中的重要作用，敦促对实施挑战进行精确界定并针对性解决。患者的偏好凸显了个性化方法的必要性，提高医疗保健专业人员的认识至关重要。
