Cheng T L, Savageau J A, Sattler A L, DeWitt T G
Department of Pediatrics, University of Massachusetts Medical Center, Worcester 01655.
JAMA. 1993 Mar 17;269(11):1404-7. doi: 10.1001/jama.269.11.1404.
To assess adolescent knowledge, perceptions, and attitudes about health care confidentiality.
Anonymous self-report survey with 64 items addressing confidentiality issues in health care.
Rural, suburban, and urban high schools in central Massachusetts.
Students in ninth through 12th grades from three schools.
A total of 1295 students (87%) completed the survey: 58% had health concerns that they wished to keep private from their parents, and 69% from friends and classmates; 25% reported that they would forgo health care in some situations if their parents might find out. There were differences in response by gender, race, and school. About one third were aware of a right to confidentiality for specific health issues. Of those with a regular source of care, 86% would go to their regular physician for a physical illness, while only 57% would go there for questions about pregnancy, the acquired immunodeficiency syndrome, or substance abuse that they wished to keep private. Sixty-eight percent had concerns about the privacy of a school health center.
A majority of adolescents have concerns they wish to keep confidential and a striking percentage report they would not seek health services because of these concerns. Interventions to address confidentiality issues are thus crucial to effective adolescent health care.
评估青少年对医疗保密的知识、认知和态度。
一项包含64个关于医疗保密问题条目的匿名自填式调查。
马萨诸塞州中部的农村、郊区和城市高中。
来自三所学校的九年级至十二年级学生。
共有1295名学生（87%）完成了调查：58%的学生有希望对父母保密的健康问题，69%的学生希望对朋友和同学保密；25%的学生表示，如果父母可能会发现，他们在某些情况下会放弃医疗保健。在性别、种族和学校方面，回答存在差异。约三分之一的学生知道特定健康问题的保密权利。在有固定医疗来源的学生中，86%会因身体疾病去看他们的常规医生，而只有57%会因他们希望保密的怀孕、获得性免疫缺陷综合征或药物滥用问题去看医生。68%的学生担心学校健康中心的隐私问题。
大多数青少年有希望保密的问题，且有相当比例的学生表示因为这些担忧不会寻求医疗服务。因此，解决保密问题的干预措施对于有效的青少年医疗保健至关重要。
