Someone to Watch Over Me: Perspectives From Health Professionals Involved in Womens' Health on Intimate Examinations

AIMS: This study sought to determine contemporary practice and opinions regarding the use of third parties when performing intimate examinations. Specifically: What constitutes an 'intimate examination', the role and preferred terminology of third parties involved in intimate examinations, the nature of the consent and regulatory processes. METHODS: Prospective, cross-sectional, observational study with participants recruited using a convenience sampling approach. Following a scoping review, an anonymous, confidential online survey was developed and distributed to health professionals working within Western Australian outer metropolitan obstetrics and gynaecology units. Both qualitative and quantitative data were obtained. RESULTS: 141 health professionals participated; the majority were female (86%), with 56 respondents from a nursing/midwifery background, 53 from a medical background. Most respondents agreed on which components of physical examination could be viewed as 'intimate', expressed strong preferences for the third party to be called 'chaperone' and had similar opinions on what the role involved and the importance of using registered health professionals. Compared to doctors, nurse/midwife participants were significantly more likely to obtain written consent, report health professional norms, and chaperone availability influenced their use of chaperones, and were less likely to offer a chaperone for a breast examination. More than one third of respondents considered a medical student appropriate to act as chaperone. DISCUSSION: Although intimate examinations are an integral part of clinical practice, it remains under-researched. This study indicates that despite RANZCOG and MBA guidance, womens' health professionals prefer the term 'chaperone'. Respondents recognised the importance of consent and documentation, but it is concerning that a significant proportion of respondents consider it acceptable to use students in these roles.