Chaperone in breast examination: a comprehensive systematic review of patient and clinician perspectives, and documentation

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.