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Conversations about FGM in primary care : a realist review on how, why, and under what circumstances FGM is discussed in general practice consultations
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Dixon, Sharon, Ziebland, Sue, Papoutsi, Chrysanthi, Griffiths, Frances, Duddy, Claire and Harrison, Gabrielle (2021) Conversations about FGM in primary care : a realist review on how, why, and under what circumstances FGM is discussed in general practice consultations. BMJ Open, 11 (3). e039809. doi:10.1136/bmjopen-2020-039809 ISSN 2044-6055.
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Official URL: https://doi.org/10.1136/bmjopen-2020-039809
Abstract
Objectives Little is known about the management of female genital mutilation (FGM) in primary care. There have been significant recent statutory changes relevant to general practitioners (GPs) in England, including a mandatory reporting duty. We undertook a realist synthesis to explore what influences how and when GPs discuss FGM with their patients.
Setting Primary care in England.
Data sources Realist literature synthesis searching 10 databases with terms: GPs, primary care, obstetrics, gynaecology, midwifery and FGM (UK and worldwide). Citation chasing was used, and relevant grey literature was included, including searching FGM advocacy organisation websites for relevant data. Other potentially relevant literature fields were searched for evidence to inform programme theory development. We included all study designs and papers that presented evidence about factors potentially relevant to considering how, why and in what circumstances GPs feel able to discuss FGM with their patients.
Primary outcome measure This realist review developed programme theory, tested against existing evidence, on what influences GPs actions and reactions to FGM in primary care consultations and where, when and why these influences are activated.
Results 124 documents were included in the synthesis. Our analysis found that GPs need knowledge and training to help them support their patients with FGM, including who may be affected, what needs they may have and how to talk sensitively about FGM. Access to specialist services and guidance may help them with this role. Reporting requirements may complicate these conversations.
Conclusions There is a pressing need to develop (and evaluate) training to help GPs meet FGM-affected communities’ health needs and to promote the accessibility of primary care. Education and resources should be developed in partnership with community members. The impact of the mandatory reporting requirement and the Enhanced Dataset on healthcare interactions in primary care warrants evaluation.
| Item Type: | Journal Article | |||||||||
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| Subjects: | G Geography. Anthropology. Recreation > GN Anthropology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Female circumcision -- Great Britain, Clitoris -- Surgery -- Great Britain, Primary care (Medicine) -- Great Britain, Physicians (General practice) -- Great Britain | |||||||||
| Journal or Publication Title: | BMJ Open | |||||||||
| Publisher: | BMJ | |||||||||
| ISSN: | 2044-6055 | |||||||||
| Official Date: | 22 March 2021 | |||||||||
| Dates: |
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| Volume: | 11 | |||||||||
| Number: | 3 | |||||||||
| Article Number: | e039809 | |||||||||
| DOI: | 10.1136/bmjopen-2020-039809 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | Published | |||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||
| Date of first compliant deposit: | 12 April 2021 | |||||||||
| Date of first compliant Open Access: | 12 April 2021 | |||||||||
| RIOXX Funder/Project Grant: |
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| Is Part Of: | 1 | |||||||||
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