Jeremić Stojković Vida, Cvjetković Smiljana, Matejić Bojana
University of Belgrade, School of Medicine, Department of Humanities, Pasterova 2, 11000 Belgrade, Serbia.
University of Belgrade, Faculty of Medicine, dr Subotića starijeg 8, 11000 Belgrade, Serbia.
Zdr Varst. 2020 Apr 6;59(2):99-107. doi: 10.2478/sjph-2020-0013. eCollection 2020 Jun.
Confidentiality is one of the oldest ethical principles in healthcare. However, confidentiality in adolescent healthcare is not a universally-accepted doctrine among scholars. The ethical acceptability of confidential services in adolescents' healthcare is based on perceptions of adolescent maturity and an appreciation of its importance to adolescents' access and utilization of healthcare services. Despite legal policies that promote adolescents' rights, physicians' attitudes toward adolescent confidentiality can be a determining factor in their ultimate decision to protect adolescents' confidentiality.
A new Attitude towards Adolescent Confidentiality Scale was developed based on the results of a qualitative interview study. This new instrument was administered to a sample of 152 physicians working at school pediatric and gynecology departments in 13 primary healthcare institutions in Belgrade. Principal component analysis was applied to determine the main components of the scale. Reliability was assessed by calculating Cronbach alpha and mean inter-item correlations.
Psychometric analysis of the final 19-item version of the scale showed a high level of reliability (Cronbach alpha of 0.83). Principal component analysis showed four components, which present subscales of the instrument: Confidentiality in clinical situation, Iimportance of confidentiality, Adolescent maturity, and Communication with parents.
The instrument showed satisfactory levels of reliability and validity. The results of the scale dissemination may be a valuable tool for needs assessment for future educational interventions and training programs that will raise physicians' awareness of the importance of adolescent confidentiality.
保密是医疗保健领域最古老的伦理原则之一。然而，青少年医疗保健中的保密并非学者们普遍接受的信条。青少年医疗保健中保密服务的伦理可接受性基于对青少年成熟度的认知以及对其对于青少年获得和利用医疗保健服务重要性的认识。尽管有促进青少年权利的法律政策，但医生对青少年保密的态度可能是他们最终决定是否保护青少年保密的决定性因素。
基于定性访谈研究的结果开发了一种新的青少年保密态度量表。该新工具被应用于在贝尔格莱德13家初级医疗机构的学校儿科和妇科工作的152名医生样本。应用主成分分析来确定该量表的主要成分。通过计算克朗巴哈系数和平均项目间相关性来评估信度。
对该量表最终的19个项目版本进行的心理测量分析显示出较高的信度水平（克朗巴哈系数为0.83）。主成分分析显示有四个成分，它们构成了该工具的子量表：临床情境中的保密、保密的重要性、青少年成熟度以及与父母的沟通。
该工具显示出令人满意的信度和效度水平。该量表传播的结果可能是未来教育干预和培训项目需求评估的宝贵工具，这些项目将提高医生对青少年保密重要性的认识。
