Jaruseviciene Lina, Zaborskis Apolinaras, Sauliune Skirmante, Jarusevicius Gediminas, Lazarus Jeffrey V
Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Institute of Health Systems Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
BMC Health Serv Res. 2015 Sep 4;15:360. doi: 10.1186/s12913-015-1027-5.
In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual and reproductive healthcare (SRH) by comparing data from surveys administered in 2005 and 2012.
For both surveys, the participants were random samples of the Lithuanian residents aged 16 to 74. A 23-item questionnaire was used in 2005 and complemented with 2 items in 2012. Linear regression analysis was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables.
The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005 to 73% in 2012. Regardless of their belief in the importance of confidentiality, in 2012 respondents more often indicated positive outcomes on the relations between the physician and the minor patient, such as increased trust of the adolescent in the physician and more frequent visits to physicians. However, study participants who believed that adolescents would find confidentiality important in 2012 were less optimistic about potential positive outcomes of further legal consolidation of adolescents' right to confidentiality than in 2005. Younger respondents were the most optimistic about potential outcomes if laws were enacted to further protect adolescent confidentiality.
This study uncovers the dynamics of public attitudes towards the socially and ethically sensitive issue of adolescent SRH. Our study suggests that legislation could be a factor prompting changes in public opinion, but not sufficient in and of itself for its social acceptance.
2010年，立陶宛通过新立法保障了16岁以上青少年在医疗保健方面的保密权。本研究旨在通过比较2005年和2012年进行的调查数据，探讨立陶宛居民对青少年性与生殖健康保健（SRH）中保密保护态度的变化。
两次调查的参与者均为16至74岁立陶宛居民的随机样本。2005年使用了一份包含23个条目的问卷，2012年在此基础上补充了2个条目。采用线性回归分析来估计在青少年就SRH问题咨询医生时，认为保密很重要的信念流行率的绝对差异。拟合对数二项回归模型以估计自变量的相对变化（流行率比）。
2005年的受访者总数为1054人（回复率83%），2012年为1002人（回复率80%）。报告认为青少年在就SRH问题看医生时会觉得保密很重要的受访者比例从2005年的62%显著增加到2012年的73%。无论他们是否相信保密的重要性，2012年的受访者更常指出医生与未成年患者之间关系的积极结果，如青少年对医生的信任增加以及看医生的频率更高。然而，2012年认为青少年会觉得保密很重要的研究参与者对进一步法律巩固青少年保密权的潜在积极结果不如2005年乐观。年轻受访者对如果制定法律进一步保护青少年保密的潜在结果最为乐观。
本研究揭示了公众对青少年SRH这一社会和伦理敏感问题态度的动态变化。我们的研究表明，立法可能是促使公众舆论发生变化的一个因素，但就其社会接受度而言，立法本身并不充分。
