Confidence, consent and chaperones for pubertal staging examinations: a national survey
Confidence, consent and chaperones for pubertal staging examinations: a national survey
OBJECTIVE: General Medical Council (GMC) guidance describes an intimate examination as one that may be embarrassing for the patient, for example, breast or genitalia examination. Documentation of consent and use of a trained impartial observer (chaperone) is recommended. Pubertal staging is often necessitated for assessment of growth and puberty. We assessed current practice of pubertal staging by paediatricians and paediatric endocrinology nurse specialists (PENS) in the UK.
METHODS: An electronic survey was distributed to paediatricians (consultants and trainees) and PENS across the UK. The survey enquired about training received, confidence in and typical practice for pubertal staging examinations.
RESULTS: 235 responses were received. Low confidence in pubertal staging was commonly reported by trainees and consultants without an endocrinology interest.Most respondents consider pubertal staging to be an intimate examination for male (94.9%) and female (93.1%) patients. Consent to examination is always documented by 38.2% of respondents. 62.0% and 54.8% report always using a chaperone for male and female pubertal staging, respectively. However, many respondents use a parent as the chaperone. Few document the name of the chaperone used. Patient objections and availability of chaperones were commonly perceived barriers to chaperone use.
CONCLUSION: Most clinicians consider pubertal staging an intimate examination, but documentation of consent and use of formal chaperones is not standard practice. The use of a parent as a chaperone was common but is not recommended by the GMC. Local chaperone policies should address these issues to protect patients and clinicians.
adolescent health, endocrinology, paediatrics
31-35
Moon, Rebecca Jane
16ba3d3f-010f-4b11-a9c2-635979a27f4a
Davies, Justin Huw
9f18fcad-f488-4c72-ac23-c154995443a9
Moon, Rebecca Jane
16ba3d3f-010f-4b11-a9c2-635979a27f4a
Davies, Justin Huw
9f18fcad-f488-4c72-ac23-c154995443a9
Moon, Rebecca Jane and Davies, Justin Huw
(2022)
Confidence, consent and chaperones for pubertal staging examinations: a national survey.
Archives of Disease in Childhood, 108 (1), , [324784].
(doi:10.1136/archdischild-2022-324784).
Abstract
OBJECTIVE: General Medical Council (GMC) guidance describes an intimate examination as one that may be embarrassing for the patient, for example, breast or genitalia examination. Documentation of consent and use of a trained impartial observer (chaperone) is recommended. Pubertal staging is often necessitated for assessment of growth and puberty. We assessed current practice of pubertal staging by paediatricians and paediatric endocrinology nurse specialists (PENS) in the UK.
METHODS: An electronic survey was distributed to paediatricians (consultants and trainees) and PENS across the UK. The survey enquired about training received, confidence in and typical practice for pubertal staging examinations.
RESULTS: 235 responses were received. Low confidence in pubertal staging was commonly reported by trainees and consultants without an endocrinology interest.Most respondents consider pubertal staging to be an intimate examination for male (94.9%) and female (93.1%) patients. Consent to examination is always documented by 38.2% of respondents. 62.0% and 54.8% report always using a chaperone for male and female pubertal staging, respectively. However, many respondents use a parent as the chaperone. Few document the name of the chaperone used. Patient objections and availability of chaperones were commonly perceived barriers to chaperone use.
CONCLUSION: Most clinicians consider pubertal staging an intimate examination, but documentation of consent and use of formal chaperones is not standard practice. The use of a parent as a chaperone was common but is not recommended by the GMC. Local chaperone policies should address these issues to protect patients and clinicians.
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Accepted/In Press date: 19 October 2022
e-pub ahead of print date: 3 November 2022
Additional Information:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.
Keywords:
adolescent health, endocrinology, paediatrics
Identifiers
Local EPrints ID: 473228
URI: http://eprints.soton.ac.uk/id/eprint/473228
ISSN: 0003-9888
PURE UUID: 71a86b9b-c52f-48ef-bd15-0b6d84a24939
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Date deposited: 12 Jan 2023 18:07
Last modified: 16 Mar 2024 23:30
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Author:
Rebecca Jane Moon
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