1. A qualitative exploration of obtaining informed consent in medical consultations with Burma-born women.
- Author
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Power, Anna, Tuteja, Amita, Mascarenhas, Lester, and Temple-Smith, Meredith
- Subjects
HEALTH education ,HEALTH services accessibility ,NONVERBAL communication ,CONFIDENCE ,ATTITUDES of medical personnel ,RESEARCH methodology ,CONVERSATION ,WOMEN ,INTERVIEWING ,CULTURAL pluralism ,PATIENT-centered care ,COMMUNITY support ,INFORMED consent (Medical law) ,PRIMARY health care ,QUALITATIVE research ,HEALTH literacy ,MEDICAL referrals ,REFUGEES ,SOUND recordings ,DECISION making ,DESCRIPTIVE statistics ,RESEARCH funding ,JUDGMENT sampling ,STATISTICAL sampling ,THEMATIC analysis ,HEALTH facility translating services ,TRUST - Abstract
Background: Conciliatory attitudes, respect for medical professionals and avoidance of being direct can make health consultations with Burma-born patients difficult to navigate. Coupled with linguistic barriers, this may make the sensitive nature of many women's health consultations challenging. Little is known about current practices for obtaining informed consent in this context. The objectives of this study were to explore current practices, barriers and strategies to obtaining informed consent in medical consultations with women born in Burma. Methods: Purposive and snowball sampling was used to recruit health practitioners (n = 15, 2 male, 13 female) of different ages, years of professional experience, and country of origin, from clinics in Victoria that see a high volume of Burma-born patients. Thirty to sixty minute semi-structured interviews were conducted with four general practitioners, eight nurses and three interpreters, and de-identified audio recordings were transcribed for inductive thematic analysis. Results: Five key themes were generated: (1) cultural cognisance; (2) influence of community; (3) skilful navigation of communication; (4) favourable consultation attributes; and (5) individual tailoring of consent conversations. Differing cultural expectations, and linguistic and educational barriers, were highlighted as challenges to obtaining informed consent, whereas thoughtful utilisation of non-verbal communication, and intentional customisation of consent conversations were identified as facilitators. Conclusion: The findings of this study provide practical ways to optimise the informed consent process within the Australian primary healthcare context, and reinforce that accepted Western-based practices for obtaining informed consent are not a 'one-size-fits-all' process. The increasing cultural and linguistic diversity of Australian society necessitates a better understanding of the practise of cross-cultural medicine. The findings from this study suggest that accepted Western culture-based practices for obtaining informed consent cannot be universally upheld as ideals. Practical insights from this paper help to inform Australian clinicians on how to optimise cross-cultural informed consent with women born in Burma. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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