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专业人员在向成年精神疾病患者家属发布信息方面的职责。

Professionals' responsibilities in releasing information to families of adults with mental illness.

作者信息

Marshall Tina, Solomon Phyllis

机构信息

Department of Psychiatry, University of Maryland, Baltimore, MD 21227, USA.

出版信息

Psychiatr Serv. 2003 Dec;54(12):1622-8. doi: 10.1176/appi.ps.54.12.1622.

Abstract

OBJECTIVE

Statutes, ethical standards, and local confidentiality guidelines have been developed to guide providers' decisions about releasing information from mental health records. However, confidentiality policies often do not specifically discuss the release of confidential information to the families of persons with mental illness. This study examined how providers and family members interpret and implement confidentiality policies about the release of information to families.

METHOD

S: Self-administered surveys were completed by 59 providers from outpatient, partial hospitalization, and case management programs in Pennsylvania. In-depth interviews were also conducted with a subsample of eight providers. In addition, 68 families of persons with mental illness receiving services from these providers completed self-administered surveys.

RESULTS

Ninety-five percent of the providers interpreted confidentiality policies conservatively, believing that they could not share confidential information without the consent of the client, However, 54 percent were confused about the types of information that are confidential. Implementation of confidentiality policies varied among the providers. Regression analysis indicated that providers' perceptions of confidentiality as a barrier to collaboration were significantly associated with their attitudes toward collaboration between the providers, consumers, and family members. Few families understood the requirements of confidentiality policies or the types of information that are confidential.

CONCLUSION

S: Confidentiality policies may be posing a barrier to collaboration between providers, consumers, and family members, which has been recommended by various experts for the treatment of mental illness. Clear guidelines for the release of confidential information to families are needed.

摘要

目的

已制定法规、道德标准和地方保密指南,以指导医疗服务提供者就发布心理健康记录中的信息做出决策。然而,保密政策往往未具体讨论向精神病患者家属发布机密信息的问题。本研究考察了医疗服务提供者和家庭成员如何解读和实施有关向家属发布信息的保密政策。

方法

来自宾夕法尼亚州门诊、部分住院治疗和病例管理项目的59名医疗服务提供者完成了自填式调查问卷。还对一个由8名医疗服务提供者组成的子样本进行了深入访谈。此外,接受这些医疗服务提供者服务的68名精神病患者家属完成了自填式调查问卷。

结果

95%的医疗服务提供者对保密政策的解读较为保守,认为未经客户同意就不能分享机密信息。然而,54%的人对哪些信息属于机密信息感到困惑。不同医疗服务提供者在保密政策的实施方面存在差异。回归分析表明,医疗服务提供者将保密视为合作障碍的看法与他们对医疗服务提供者、消费者和家庭成员之间合作的态度显著相关。很少有家属了解保密政策的要求或哪些信息属于机密信息。

结论

保密政策可能对医疗服务提供者、消费者和家庭成员之间的合作构成障碍,而这是治疗精神疾病的多位专家所推荐的。需要制定向家属发布机密信息的明确指南。

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