Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England

<p><strong>Background:</strong> Female genital mutilation (FGM) includes all procedures that intentionally harm or alter female genitalia for non-medical reasons. In 2015, reporting duties were introduced, applicable to GPs working in England including a mandatory reporting duty an...

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Hlavní autoři: Dixon, S, Hinton, L, Ziebland, S
Médium: Journal article
Jazyk:English
Vydáno: Royal College of General Practitioners 2020
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author Dixon, S
Hinton, L
Ziebland, S
author_facet Dixon, S
Hinton, L
Ziebland, S
author_sort Dixon, S
collection OXFORD
description <p><strong>Background:</strong> Female genital mutilation (FGM) includes all procedures that intentionally harm or alter female genitalia for non-medical reasons. In 2015, reporting duties were introduced, applicable to GPs working in England including a mandatory reporting duty and FGM Enhanced Dataset. Our patient and public involvement work identified the exploration of potential impacts of these duties as a research priority.</p> <p><strong>Aim:</strong> To explore the perspectives of GPs working in England on potential challenges and resource needs when supporting women and families affected by FGM.</p> <p><strong>Design and setting:</strong> Qualitative study with GPs working in English primary care.</p> <p><strong>Method:</strong> Semi-structured interviews focused around a fictional scenario of managing FGM in primary care. The authors spoke to 17 GPs from five English cities, including those who saw women who have experienced FGM often, rarely, or never. Interviews were audio recorded and transcribed verbatim for thematic analysis. Lipsky’s theory of street-level bureaucracy was drawn on to support analysis.</p> <p><strong>Results:</strong> Managing women with FGM was experienced as complex. Challenges included knowing how and when to speak about FGM, balancing care of women and their family’s potential care and safeguarding needs, and managing the mandated reporting and recording requirements. GPs described strategies to manage these tensions that helped them balance maintaining patient–doctor relationships with reporting requirements. This was facilitated by access to FGM holistic services.</p> <p><strong>Conclusion:</strong> FGM reporting requirements complicate consultations. The potential consequences on trust between women affected by FGM and their GP are clear. The tensions that GPs experience in supporting women affected by FGM can be understood through the theoretical lens of street-level bureaucracy. This is likely to be relevant to other areas of proposed mandated reporting.</p>
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spelling oxford-uuid:e8085c6d-c49e-417c-848e-361ebd858c2f2022-03-27T10:43:42ZSupporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in EnglandJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e8085c6d-c49e-417c-848e-361ebd858c2fEnglishSymplectic ElementsRoyal College of General Practitioners2020Dixon, SHinton, LZiebland, S<p><strong>Background:</strong> Female genital mutilation (FGM) includes all procedures that intentionally harm or alter female genitalia for non-medical reasons. In 2015, reporting duties were introduced, applicable to GPs working in England including a mandatory reporting duty and FGM Enhanced Dataset. Our patient and public involvement work identified the exploration of potential impacts of these duties as a research priority.</p> <p><strong>Aim:</strong> To explore the perspectives of GPs working in England on potential challenges and resource needs when supporting women and families affected by FGM.</p> <p><strong>Design and setting:</strong> Qualitative study with GPs working in English primary care.</p> <p><strong>Method:</strong> Semi-structured interviews focused around a fictional scenario of managing FGM in primary care. The authors spoke to 17 GPs from five English cities, including those who saw women who have experienced FGM often, rarely, or never. Interviews were audio recorded and transcribed verbatim for thematic analysis. Lipsky’s theory of street-level bureaucracy was drawn on to support analysis.</p> <p><strong>Results:</strong> Managing women with FGM was experienced as complex. Challenges included knowing how and when to speak about FGM, balancing care of women and their family’s potential care and safeguarding needs, and managing the mandated reporting and recording requirements. GPs described strategies to manage these tensions that helped them balance maintaining patient–doctor relationships with reporting requirements. This was facilitated by access to FGM holistic services.</p> <p><strong>Conclusion:</strong> FGM reporting requirements complicate consultations. The potential consequences on trust between women affected by FGM and their GP are clear. The tensions that GPs experience in supporting women affected by FGM can be understood through the theoretical lens of street-level bureaucracy. This is likely to be relevant to other areas of proposed mandated reporting.</p>
spellingShingle Dixon, S
Hinton, L
Ziebland, S
Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title_full Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title_fullStr Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title_full_unstemmed Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title_short Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England
title_sort supporting patients with female genital mutilation in primary care a qualitative study exploring the perspectives of gps working in england
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AT hintonl supportingpatientswithfemalegenitalmutilationinprimarycareaqualitativestudyexploringtheperspectivesofgpsworkinginengland
AT zieblands supportingpatientswithfemalegenitalmutilationinprimarycareaqualitativestudyexploringtheperspectivesofgpsworkinginengland