A qualitative exploration of obtaining informed consent in medical consultations with Burma-born women
Anna Power A B , Amita Tuteja A , Lester Mascarenhas A C and Meredith Temple-Smith A *A Department of General Practice, University of Melbourne, Parkville, Vic. 3010, Australia.
B The Royal Australian College of General Practitioners, East Melbourne, Vic. 3002, Australia.
C Utopia Refugee and Asylum Seeker Health, Hoppers Crossing, Vic. 3029, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22138
Submitted: 30 June 2022 Accepted: 7 November 2022 Published online: 29 November 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
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.
Keywords: Asia, asylum seeker, cross-cultural, ethics, migrant, Myanmar, refugee, women’s health.
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