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首页> 美国卫生研究院文献>Journal of Medical Ethics >A qualitative study of womens views on medical confidentiality
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A qualitative study of womens views on medical confidentiality

机译：妇女对医疗保密性观点的定性研究

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>Context: The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality. >Objective: To identify and describe patient views of medical confidentiality and to assess provisionally the range of these views. >Design: Qualitative study using indepth, open ended face-to-face interviews. >Setting: Southeastern Pennsylvania and southern New Jersey, USA. >Participants: A total of 85 women interviewed at two clinical sites and three community/research centres. >Main outcome measures: Subjects' understanding of medical confidentiality, beliefs about the handling of confidential information and concerns influencing disclosure of information to doctors. >Results: The subjects defined medical confidentiality as the expectation that something done or said would be kept "private" but differed on what information was confidential and the basis and methods for protecting information. Some considered all medical information as confidential and thought confidentiality protections functioned to limit its circulation to medical uses and reimbursement needs. Others defined only sensitive or potentially stigmatising information as confidential. Many of these also defined medical confidentiality as a strict limit prohibiting information release, although some noted that specific permission or urgent need could override this limit. >Conclusions: Patients share a basic understanding of confidentiality as protection of information, but some might have expectations that are likely not met by current practice nor anticipated by doctors. Doctors should recognise that patients might have their own medical confidentiality models. They should address divergences from current practice and provide support to those who face emotional or practical obstacles to self-revelation.
机译：>背景：重新建立医疗机密保护的必要性被认为是建立患者信任度的重要目标，从而获得成功的健康结果。关于患者对医学机密性的理解和期望知之甚少。 >目的：识别并描述患者对医疗机密性的看法，并临时评估这些看法的范围。 >设计：使用深入的开放式面对面访谈进行定性研究。 >设置：：美国宾夕法尼亚州东南部和新泽西州南部。 >参与者：总共有85名妇女在两个临床站点和三个社区/研究中心接受了采访。 >主要结果指标：受试者对医学机密性的理解，对机密信息处理的信念以及对医生信息披露的影响。 >结果：受试者将医疗机密性定义为对所做的某些事情或所说的事情将被“私有”的期望，但是在哪些信息属于机密信息以及保护信息的基础和方法上有所不同。一些人认为所有医疗信息都是机密信息，并认为机密性保护的作用是将其信息流通限制于医疗用途和报销需求。其他人仅将敏感或可能带有污名的信息定义为机密。其中许多还把医疗机密性定义为禁止发布信息的严格限制，尽管有些人指出，特定的许可或紧急需求可能会超出此限制。 >结论：患者对保密作为信息保护有着基本的了解，但有些患者可能会有目前实践或医生未曾期望的期望。医生应认识到患者可能拥有自己的医学保密模型。他们应解决与当前做法的分歧，并为面临自我启示的情感或实际障碍的人们提供支持。

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