Cultural Preferences for Chaperone Use during Breast Examinations: A Preliminary Study.
Authors: C. Checka, K. Bright, H. Toth, J. Chun, A. Guth
Journal: Cancer Research (2009)

Abstract Previous studies have demonstrated that use of chaperones by physicians occurs most consistently for pelvic and rectal exams than for breast examinations. Factors that may influence chaperone for breast examination include duration of doctor-patient relationship, gender of the examiner, and availability of an assistant. The purpose of this study is to characterize patient preferences, not previously reported, for chaperone use.A patient questionnaire was approved by the institutional IRB at NYU Langone Medical Center and Bellevue Hospital. It was translated into Chinese, Spanish, and Arabic. Responses were collected from 277 patients. Variables included age, marital status, highest level of education, income, family background, religion, primary language, and chaperone and examiner preferences. For the respondents who preferred a chaperone, education was categorized as some college or none, language was English or non-English-speaking, background was Caucasian or non-Caucasian, and religion was Christian or non-Christian. Descriptive analyses and Pearson's chi-square test was used to determine significance.Median age was 49 years, range 17-87 years. 28 (10%) respondents preferred to have a chaperone present. An equal proportion of respondents did not want a chaperone (N=95, 34%) or had no preference (N=95, 34%). An additional 19% (N=53) of patients indicated that they preferred to be asked about their wishes. 142 (52%) indicated that they preferred a female examiner, 2 (1%) preferred a male examiner, and 126 (46%) had no preference regarding the examiner's gender.Table 1. Respondent Characteristics (N=277)VariablesN (%)EDUCATION (N=256) Grade School10 (4%)High School44 (17%)College116 (45%)Graduate School86 (34%)FAMILY BACKGROUND (N = 251) Caucasian/European159 (64%)African-American18 (7%)Hispanic28 (11%)Middle-Eastern17 (7%)Asian28 (11%)Other1 (0%)RELIGION (N = 250) Christian137 (55%)Jewish, reform49 (20%)Jewish, orthodox16 (6%)Islam14 (5%)Buddhist5 (2%)Other22 (9%)LANGUAGE (N = 256) English198 (77%)Spanish15 (6%)Chinese9 (3%)Arabic12 (5%)Other22 (9%)CHAPERONE PREFERENCE (N = 277) Do not use95 (34%)Use28 (10%)No preference94 (34%)Like to be asked53 (19%)Unknown7 (3%)EXAMINER GENDER PREFERENCE (N = 273) Female142 (52%)Male2 (1%)No preference126 (46%)Unknown3 (1%) Of the 28 patients who did prefer a chaperone, there was a statistically significant difference, p=0.011, for family background that was non-Caucasian. There was no statistical finding for differences in education, religion, or language.Table 2. Characteristics of Respondents who Prefer a Chaperone (N = 28)VARIABLESP-VALUEEducation0.078Language0.409Family Background0.011*Religion0.161* Denotes Statistical SignificanceThe majority of women responding to our survey either did not want a chaperone present for a breast examination or had no preference. However, the majority of all respondents did prefer to have a female examiner. This may simply represent that these patients were comfortable with a woman performing the exam. Additional investigation will further evaluate possible cultural differences. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6080.