Clinicians’ attitudes and utilization of a chaperone for intimate examinations within a Contraceptive and Reproductive Health Care Service

Clinicians’ attitudes and utilization of a chaperone for intimate

examinations within a Contraceptive and Reproductive Health Care Service

L. Murray

Abacus Clinics for Contraception & Reproductive Health Care, North

Liverpool Primary Care Trust, UK

Introduction: Abacus Liverpool has adopted a policy of always offering

a chaperone when conducting intimate examination regardless of the examiners

gender. This was in response to the Royal College of Obstetricians and

Gynaecologists (RCOG) and the General Medical Council guidelines.

Aims and Method: The aim was, via conducting an audit, to examine the

adherence to the chaperone policy one year after implementation and possible

reasons behind non-compliance. The audit was a questionnaire with a mix of open

and closed questions and was sent to all 65 members of the clinical staff

working within the clinics in Abacus Liverpool. The results are based upon 44

questionnaires returned, a response rate of 69%. Of the questionnaires returned

19 were Doctors and 25 were Nurses divided by gender as 2 males and 42 females.

Results: Only 8 staff always offered a chaperone when performing an

intimate examination. The majority of staff only sometimes offered a chaperone

for intimate examinations, and only 2 staff had never offered a chaperone. It is

note worthy when offered it was well documented. The reasons given for not

offering a chaperone were varied but the most common was time pressures and

staff shortages, 10 staff reported forgetting to offer a chaperone and 2 thought

it was an interruption to the client/practitioner relationship. In direct

contrast to this when asked if at all times a designated chaperone was made

available, 75 percent of staff thought that this would make no difference in the

offering of a chaperone. On the occasions where a chaperone has been required

most staff had no problem obtaining one with only 4 members of staff having

occasions where they could not obtain a chaperone at the time requested. Staff

estimated that only 6 percent of clients requested a chaperone when offered and

the clients’ own anxiety determined this. Two members of staff thought that

gender difference between client and clinician was an issue.

Conclusion: Complex and varied reasons were given by clinicians for

non-adherence to the chaperone policy. Clinicians within contraceptive and

reproductive health care work autonomously, and this may have an impact for

policy adherence. This audit did not clearly define this and the offering of a

chaperone for intimate examinations has shown to be a more subjective decision.

The time impact on a fully staffed and balanced clinic is questionable.

Consistent remainders of the policy may improve adherence. The unique nature of

contraception and reproductive health care is such that the sensitivity of the

consultation changes the influence of the chaperone and more investigation is

needed on this issue.

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