Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Division of Young Adult and Adolescent Medicine, Department of Pediatrics, University of San Francisco School of Medicine, San Francisco, California.
J Adolesc Health. 2023 Oct;73(4):650-654. doi: 10.1016/j.jadohealth.2023.03.016. Epub 2023 Jun 27.
This study aims to analyze parent responses to current strict Oklahoma confidentiality and consent laws in an outpatient subspecialty setting.
A consent for treatment form including an explanation of the benefits of qualified confidential care for adolescents was given to parents of patients under 18 years of age. The form asked parents to waive the right to access confidential portions of the medical record, be present for the physical exam, be present for risk behavior discussions, and consent for hormonal contraception including a subdermal implant. Demographic information was collected using patient medical records. Data were analyzed using frequencies, chi-square, and t tests.
Of the 507 parent forms, 95% of total parents gave permission for providers to have confidential conversations with the patients, 86% allowed providers to examine the patient alone, 84% of parents allowed providers to prescribe contraception, and 66% gave permission for subdermal implant. New patient status, race, ethnicity, assigned sex at birth, and insurance type did not correlate with parents' willingness to provide permissions. There was a statistically significant difference between patient gender identity and percentage of parents who granted permission for a confidential physical exam. Groups more likely to discuss questions about confidential care with the health care provider included parents of new patients, Native American and Black patients, and cisgender female patients.
Despite laws that limit adolescent ability to access confidential care in Oklahoma, the majority of parents who were provided an explanatory document allowed their children the right to access this care.
本研究旨在分析在门诊亚专科环境下，家长对俄克拉荷马州当前严格的保密性和同意法的反应。
向 18 岁以下患者的家长提供一份治疗同意书，其中包括对青少年合格保密护理益处的说明。该表格要求家长放弃访问病历机密部分的权利、允许医生单独为患者进行体检、允许医生进行风险行为讨论、并同意为包括皮下埋植在内的激素避孕措施提供同意。使用患者病历收集人口统计学信息。使用频率、卡方和 t 检验分析数据。
在 507 份家长表格中，95%的家长允许医生与患者进行保密对话，86%的家长允许医生单独为患者进行体检，84%的家长允许医生为患者开避孕药，66%的家长允许皮下埋植。新患者状况、种族、民族、出生时的性别和保险类型与家长提供许可的意愿无关。患者的性别认同与允许医生进行保密体检的家长比例之间存在统计学显著差异。更有可能与医疗保健提供者讨论有关保密护理问题的群体包括新患者的父母、美国原住民和黑人患者以及顺性别女性患者。
尽管俄克拉荷马州的法律限制了青少年获得保密护理的能力，但大多数收到解释性文件的家长都允许他们的孩子获得这种护理的权利。
