The when and how of the gynaecological examination: a survey among Norwegian general practitioners

Autor: Eivind Meland, Bjørn Bjorvatn, Gunnar Tschudi Bondevik, Yngvild Skåtun Hannestad, Stefán Hjörleifsson, Guri Rortveit
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Referral
Attitude of Health Personnel
General Practice
education
Norwegian
Intrauterine device
Logistic regression
Asymptomatic
03 medical and health sciences
0302 clinical medicine
General Practitioners
Surveys and Questionnaires
medicine
Humans
030212 general & internal medicine
Practice Patterns
Physicians'
Physical Examination
Referral and Consultation
bimanual palpation
Norway
business.industry
physician gender
030503 health policy & services
lcsh:Public aspects of medicine
Public Health
Environmental and Occupational Health
Gender Identity
lcsh:RA1-1270
Middle Aged
Patient Acceptance of Health Care
language.human_language
gynaecological examination
Gynaecological examination
Cross-Sectional Studies
Logistic Models
Gynecology
Family medicine
language
Global Positioning System
Female
medicine.symptom
0305 other medical science
business
Research Article
practice variation
Zdroj: Scandinavian Journal of Primary Health Care, Vol 37, Iss 2, Pp 264-270 (2019)
Scandinavian Journal of Primary Health Care
ISSN: 1502-7724
0281-3432
Popis: Introduction: Little is known about the indications general practitioners (GPs) perceive as relevant for performing gynaecological examinations (GEs), how GPs master the GE and associated procedures, and how they handle the sensitive nature of GEs. Methods: In 2015, 70 medical students at the University of Bergen distributed a questionnaire to all 175 GPs in the practices they visited. The questions covered practical routines related to GEs, insertion of intrauterine device, frequency of GEs in different clinical settings and use of assisting personnel. Statistical analyses included chi-square tests and multiple logistic regressions adjusting for age, gender, specialization and localization. Results: Ninety male and 61 female GPs (87% of invited GPs) responded to the questionnaire. A minority (8%) usually had other staff present during GEs. Compared with female colleagues, male GPs performed bimanual palpation significantly less often in connection with routine Pap smear (AOR 0.3 (95% CI 0.1-0.6)). Twenty-eight percent of the GPs stated that they often/always omitted the GE if the patient was anxious about GE and 35% when the patient asked for referral to a gynaecologist. Omission was more frequent among male GPs. When the GP decided to refer to a gynaecologist based on the patient’s symptoms, more male than female GPs omitted GE (AOR 2.5 (95% CI 1.1-5.4)). Conclusion: Male gender of the GP may be associated with barriers to medical evaluation of pelvic symptoms in women, potentially leading to substandard care. Possibly, however, male GPs’ reluctance to perform the GE may also limit unnecessary bimanual palpation in asymptomatic women. publishedVersion
Databáze: OpenAIRE
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