Universitair Kinderziekenhuis Brussel, Vrije Universiteit Brussel, UZ Brussel, Brussels, Belgium.
Eur J Pediatr. 2011 Sep;170(9):1159-63. doi: 10.1007/s00431-011-1427-4. Epub 2011 Feb 22.
Confidentiality is a major issue in adolescent healthcare, and its perceived absence may be the main barrier for an adolescent to seek medical care. Little is known about the right on informative privacy and confidentiality for adolescents in Belgium, although these rights are unambiguously foreseen in the law on patients' rights since 2002. There are no data available regarding the introduction of a private moment with the physician during a consultation, about the nature and the quantity of information made available to parents by the paediatricians regarding the health situation of adolescents and about the existence of procedures with regard to these matters. The purpose of this study is to map out the current interpretation and the attitude of the paediatrician with regard to the right to confidentiality and informative privacy. The answers of 117 Flemish paediatricians to an anonymous questionnaire were analyzed. An unaccompanied medical visit is not frequent in Belgium (only 1%). Only 35.1% of the paediatricians systematically offer the possibility to have a private conversation with an adolescent. Almost 80% of the paediatricians render, as a rule, all information to the parents. Parents are informed about sensible information regarding psychosocial aspects, including data concerning sexual behaviour, in not less than 83.2% of the consultations by adolescents. Only in 2.9% no information is given to the parents. The paediatricians employ only for 13% the procedures regarding confidentiality for minors. This study reveals that Flemish paediatricians have a paternalistic attitude concerning the right on confidentiality and informative privacy, which is not in line with the Belgian legislation. Paediatricians offer only seldom the possibility for a private conversation to the adolescent. The small incidence of unaccompanied medical consultations contributes to this. Proper application of the legal context, the handling of the watertight procedures and the necessary communication in this respect is indispensable for the confidence and will lower the barrier for adolescents to use the healthcare system.
保密性是青少年保健的一个主要问题，而青少年认为缺乏保密性可能是他们寻求医疗保健的主要障碍。尽管比利时的患者权利法自 2002 年以来明确规定了青少年享有信息隐私和保密性的权利，但对于青少年在比利时获得这些权利的情况知之甚少。目前尚不清楚在咨询期间是否引入了与医生私下交流的机会，也不清楚儿科医生向青少年家长提供了多少关于青少年健康状况的信息，以及是否存在与这些问题相关的程序。本研究旨在描述儿科医生对保密性和信息隐私权利的当前解释和态度。我们分析了 117 名佛兰芒儿科医生对匿名问卷的回答。在比利时，独自看医生的情况并不常见（仅为 1%）。只有 35.1%的儿科医生系统地为青少年提供私下交流的机会。几乎 80%的儿科医生通常会向家长提供所有信息。在 83.2%的青少年就诊时，家长都会收到有关心理社会方面的敏感信息，包括性行为方面的数据。只有 2.9%的情况下不会向家长提供任何信息。儿科医生仅对 13%的未成年人使用保密性程序。这项研究表明，佛兰芒儿科医生在保密性和信息隐私权利方面持家长式态度，这与比利时的立法不符。儿科医生很少为青少年提供私下交流的机会。这在一定程度上是因为独自就诊的情况较少。适当应用法律背景、处理密不透风的程序以及在这方面进行必要的沟通，对于增强青少年对医疗保健系统的信心和降低他们使用该系统的障碍至关重要。
