Carlisle J, Shickle D, Cork M, McDonagh A
Public Health, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
J Med Ethics. 2006 Mar;32(3):133-7. doi: 10.1136/jme.2004.011262.
Young people who are concerned that consultations may not remain confidential are reluctant to consult their doctors, especially about sensitive issues. This study sought to identify issues and concerns of adolescents, and their parents, in relation to confidentiality and teenagers' personal health information.
Recruitment was conducted in paediatric dermatology and general surgery outpatient clinics, and on general surgery paediatric wards. Interviews were conducted in subjects' own homes.
Semistructured interviews were used for this exploratory qualitative study. Interviews were carried out with 11 young women and nine young men aged 14-17. Parents of 18 of the young people were interviewed separately. Transcripts of tape recorded interviews provided the basis for a framework analysis.
Young women were more concerned than young men, and older teenagers more concerned than younger teenagers, about people other than their general practitioner (GP) having access to their health information. Young people with little experience of the healthcare system were less happy than those with greater knowledge of the National Health Service (NHS) for non-medical staff to access their health information. As they grow older, adolescents become increasingly concerned that their health information should remain confidential.
Young people's willingness to be open in consultations could be enhanced by doctors taking time to explain to them that their discussion is completely confidential. Alternatively, if for any reason confidentiality cannot be assured, doctors should explain why.
担心会诊可能无法保密的年轻人不愿咨询医生,尤其是涉及敏感问题时。本研究旨在确定青少年及其父母在保密和青少年个人健康信息方面的问题及担忧。
在儿科皮肤科和普通外科门诊以及普通外科儿科病房进行招募。访谈在受试者家中进行。
本探索性定性研究采用半结构化访谈。对11名14至17岁的年轻女性和9名年轻男性进行了访谈。分别对其中18名年轻人的父母进行了访谈。录音访谈的文字记录为框架分析提供了基础。
年轻女性比年轻男性更担心其健康信息会被全科医生(GP)以外的人获取,年龄较大的青少年比年龄较小的青少年更担心这一点。对医疗系统经验较少的年轻人比那些对国民健康服务(NHS)了解较多的年轻人更不愿意非医务人员获取他们的健康信息。随着年龄增长,青少年越来越担心其健康信息应保密。
医生花时间向年轻人解释他们的讨论是完全保密的,可能会增强年轻人在会诊中坦诚交流的意愿。或者,如果由于任何原因无法保证保密,医生应解释原因。