A qualitative exploration of obtaining informed consent in medical consultations with Burma-born women

A qualitative exploration of obtaining informed consent in medical consultations with Burma-born women
Anna Power, Amita Tuteja, Lester Mascarenhas, Meredith Temple-Smith
Australian Journal of Primary Health, 7 November 2022
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 4 general practitioners, 8 nurses and 3 interpreters, and deidentified audio recordings were transcribed for inductive thematic analysis.
Results
Five key themes were generated (i) cultural cognisance; (ii) influence of community (iii) skilful navigation of communication; (iv) favourable consultation attributes; and (v) individual tailoring of consent conversations. Differing cultural expectations, and linguistic and educational barriers, were highlighted as challenges to obtaining informed consent, while 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’.

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