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艾滋病毒/艾滋病患者信息的安全与保密措施:越南艾滋病毒门诊工作人员的全国性调查。

Practices in security and confidentiality of HIV/AIDS patients' information: A national survey among staff at HIV outpatient clinics in Vietnam.

作者信息

Khac Hai Nguyen, Lawpoolsri Saranath, Jittamala Podjanee, Thi Thu Huong Phan, Kaewkungwal Jaranit

机构信息

Hanoi Medical University, Hanoi, Vietnam.

Mahidol University, Department of Tropical Hygiene, Bangkok, Thailand.

出版信息

PLoS One. 2017 Nov 14;12(11):e0188160. doi: 10.1371/journal.pone.0188160. eCollection 2017.

Abstract

INTRODUCTION

Breach of confidentiality or invasion of privacy from the collection and use of medical records, particularly those of patients with HIV/AIDS or other diseases sensitive to stigmatization, should be prevented by all related stakeholders in healthcare settings. The main focus of this study was to assess practices regarding security and confidentiality of HIV-related information among staff at HIV outpatient clinics (HIV-OPCs) in Vietnam.

METHODS

A descriptive cross-sectional study was conducted at all 312 HIV-OPCs across the country using an online survey technique.

RESULTS

In general, the staff practices for securing and protecting patient information were at acceptable levels. Most staff had proper measures and practices for maintaining data security; however, the protection of patient confidentiality, particularly for data access, sharing, and transfer still required improvement. Most HIV-OPC staff had good or moderate knowledge and positive perceptions towards security and confidentiality issues. Staff who were not trained in the practice of security measures differed significantly from those who were trained (OR: 3.74; 95%CI: 1.44-9.67); staff needing improved knowledge levels differed significantly from those with good (OR: 5.20; 95%CI: 2.39-11.32) and moderate knowledge levels (OR: 5.10; 95%CI: 2.36-11.00); and staff needing improved perception levels differed significantly from those with good (i.e., with 100% proper practices) and moderate perception levels (OR: 5.67; 95%CI: 2.93-10.95). Staff who were not trained in the protection of data confidentiality differed significantly from those who were trained (OR: 2.18; 95%CI: 1.29-3.65).

CONCLUSIONS

Training is an important factor to help raise the levels of proper practices regarding confidentiality and security, to improve knowledge and raise awareness about change among staff. The operation and management of HIV treatment and care in Vietnam are currently transitioning from separate healthcare clinics (HIV-OPC) into units integrated into general hospitals/healthcare facilities. The findings of this study highlight topics that could be used for improving management and operation of information system and revising guidelines and regulations on protection measures/strategies for data security and confidentiality of HIV/AIDS patients by Vietnam health authorities or other countries facing similar situations. Secure infrastructure and secure measures for data access and use are very important, worthwhile investments. The provision of continuous training and active enforcement and monitoring of the practices of healthcare personnel might lead to an improved understanding and acknowledegement of the importance of national policies/guidelines regarding HIV-related patient information.

摘要

引言

医疗环境中的所有相关利益攸关方都应防止在收集和使用医疗记录时违反保密规定或侵犯隐私,尤其是涉及艾滋病毒/艾滋病患者或其他易受污名化疾病患者的记录。本研究的主要重点是评估越南艾滋病毒门诊(HIV-OPC)工作人员在艾滋病毒相关信息安全和保密方面的做法。

方法

采用在线调查技术,在全国所有312家艾滋病毒门诊进行了描述性横断面研究。

结果

总体而言,工作人员在保护患者信息方面的做法处于可接受水平。大多数工作人员有适当的措施和做法来维护数据安全;然而,在保护患者隐私方面,特别是在数据访问、共享和传输方面,仍需改进。大多数艾滋病毒门诊工作人员对安全和保密问题有良好或中等程度的了解,并持积极态度。未接受安全措施培训的工作人员与接受过培训的工作人员有显著差异(比值比:3.74;95%置信区间:1.44-9.67);知识水平有待提高的工作人员与知识水平良好(比值比:5.20;95%置信区间:2.39-11.32)和中等的工作人员有显著差异(比值比:5.10;95%置信区间:2.36-11.00);认知水平有待提高的工作人员与认知水平良好(即100%做法正确)和中等的工作人员有显著差异(比值比:5.67;95%置信区间:2.93-10.95)。未接受数据保密保护培训的工作人员与接受过培训的工作人员有显著差异(比值比:2.18;95%置信区间:1.29-3.65)。

结论

培训是帮助提高保密和安全方面正确做法水平、增进工作人员知识并提高其对变革的认识的重要因素。越南的艾滋病毒治疗和护理运营与管理目前正从独立的医疗诊所(艾滋病毒门诊)过渡到纳入综合医院/医疗机构的科室。本研究结果突出了一些主题,可用于改善信息系统的管理和运营,以及越南卫生当局或其他面临类似情况的国家修订关于艾滋病毒/艾滋病患者数据安全和保密保护措施/策略的指南和法规。安全的基础设施以及数据访问和使用的安全措施是非常重要且值得的投资。持续提供培训以及积极执行和监督医护人员的做法可能会增进对国家关于艾滋病毒相关患者信息政策/指南重要性的理解和认可。

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