A qualitative study of women’s views on medical confidentiality

Abstract

Context:The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality.Objective:To identify and describe patient views of medical confidentiality and to assess provisionally the range of these views.Design:Qualitative study using indepth, open ended face-to-face interviews.Setting:Southeastern Pennsylvania and southern New Jersey, USA.Participants:A total of 85 women interviewed at two clinical sites and three community/research centres.Main outcome measures:Subjects’ understanding of medical confidentiality, beliefs about the handling of confidential information and concerns influencing disclosure of information to doctors.Results:The subjects defined medical confidentiality as the expectation that something done or said would be kept “private” but differed on what information was confidential and the basis and methods for protecting information. Some considered all medical information as confidential and thought confidentiality protections functioned to limit its circulation to medical uses and reimbursement needs. Others defined only sensitive or potentially stigmatising information as confidential. Many of these also defined medical confidentiality as a strict limit prohibiting information release, although some noted that specific permission or urgent need could override this limit.Conclusions:Patients share a basic understanding of confidentiality as protection of information, but some might have expectations that are likely not met by current practice nor anticipated by doctors. Doctors should recognise that patients might have their own medical confidentiality models. They should address divergences from current practice and provide support to those who face emotional or practical obstacles to self-revelation.

The evaluation of physicians’ and patients’ opinion on confidence and confidentiality

“…Pacientų pasitikėjimas gydytojais ir apskritai medicinos darbuotojais yra abipusių sėkmingų santykių prielaida (3)(4)(5)(6). Pacientų pasitikėjimas medicinos darbuotojais turi įtakos jų pasitenkinimui gydymu ir gydymo rezultatais (7).…”

“…nuo pasitikėjimo, tarpusavio pagarbos ir konfidencialumo užtikrinimo mokslinėje literatūroje skiriama pakankamai daug dėmesio. Daugumoje straipsnių konfidencialumo problema nagrinėjama pirminės sveikatos priežiūros lygmeniu (3)(4)(5)(6)(7)(8)18) ir sprendžiant problemas, susijusias su įvairiomis ligomis: psichikos, AIDS (19), užkrečiamomis ar kitomis ligomis (20), taip pat suteikiant paliatyviąją pagalbą (23). Nemažas dėmesys skiriamas paauglių problemoms (21,22).…”

“…Visų tyrimų, nagrinėjančių gydytojo ir paciento santykius, taip pat konfidencialumą, duomenis būtų sunku palyginti su šio tyrimo duomenimis, nes anketos buvo pritaikytos įvairioms ligoms tirti. Užsienio literatūroje nagrinėjant bendravimo, pasitikėjimo, konfidencialumo užtikrinimo problemą, gana dažnai taikytas interviu, o ne anketinė apklausa (5,19,23). Literatūros duomenimis, konfidencialumo problema yra mažai nagrinėta.…”

Development of a Revised Health Care System Distrust Scale

“…The technique of Multilevel Consensus Coding was used to identify themes and refine the conceptual model. 31 Each transcript was read by at least 3 of the study investigators, each of whom identified major themes and subthemes. Investigator meetings were used to review these themes and subthemes and resolve differences in coding or interpretation.…”

What is in a cause? Exploring the relationship between genetic cause and felt stigma

“…If this group could not resolve the problem, the passage was omitted from analysis. This method, termed multilevel consensus coding, was developed by the authors, has been applied in multiple settings, 40,41 and meets accepted standards of validity in qualitative research. 42,43 This article reports data from the section of the interview that focused on respondents' understanding of the cause of their condition.…”