Knowledge and Attitude of Patients Towards the Privacy and Confidentiality of Their Health Information Attending the Medical Outpatient (MOP)

INTRODUCTION

1.1      Background to the Study

People generally assume all communications between them and their doctor or other health professionals will remain private ,and the law generally reflects this expectations .If it were not so, some people might feel reluctant to seek medical treatment, patients may be less honest in describing their ailments , patients may give inaccurate or incomplete information in their medical histories, ask their physician not to record embarrassing information in their health records, also they may change physicians frequently, or pay out of pocket in an effort to protect their privacy ,if they are not assured of confidentiality (Pritts et al,2009).Therefore, as patients, we’ve come to expect confidential communication in these relationships. 

Privacy is viewed as the right of the individual client or patient to be let alone and to make decisions about how personal information is shared. Confidentiality is recognized by law as privileged communication between two parties in a professional relationship, such as with a patient and a physician, a nurse or other clinical professional (Brodnik, Rinehart-Thompson, Reynolds, 2012).

The privacy of personal information and of health in particular continues to be a vexing issue in the world. As more and more information is computerized, individuals express concern about their privacy, and that they are losing control over their personal health information. To help allay the public concerns, federal rules governing the use and disclosure of personal information were promulgated under HIPAA (Health Insurance Portability and Accountability Act) USA privacy rule 2000.

The idea of patient confidentiality was mutated over the last few years to accommodate the factors that infringe upon its meaning :such as expanding healthcare information technologies, physical  environment that promote breaches of patients privacy and healthcare workers who are unaware of how their routine behavior infringes on patients right to privacy (Top Health Info Mgt. May 17,2010).

The right to personal privacy is an important principle within many cultures. Within the healthcare sector there is a need to constantly balance patients’ requirements for personal privacy against the potential benefits that may add to society as a whole from the more widespread use of their personal information. Privacy and confidentiality are not only basic rights of the patients but also serve to further a trustful, frank and open relationship with the health worker, thus improving patient care. It has also been noted that patients often over- or underestimate their ethical rights in health care system. Every patient wants to be treated as an individual, and has the right to courtesy, respect, privacy and confidentiality and to receive full information about their condition, investigations provided and treatments offered. Patients share personal information with health workers. Health care providers have a duty as professionals to respect the patient's trust and keep this information private. This requires the health workers to respect the patient's privacy by restricting access of others to that information, furthermore, creating a trusting environment by respecting patient privacy and encourage the patient to be as honest as possible during the course of the visit.(Journal General Internal Medicine,2012)

When considering sensitive health information requiring special layers of confidentiality, such as with mental health treatment, state statutes provide guidance for health information management professionals. In Illinois, for example, the Mental Health and Developmental Disabilities Confidentiality Act offers detailed requirements for access, use and disclosure of confidential patient information including for legal proceedings (MHDDCA, 2007).

Patient privacy and confidentiality in health care is essential. The right of privacy protects a patient from unwanted intrusions into his/her life and into information about his/her health, illness, and treatment. The protection of confidentiality ensures the patient that information obtained during treatment will be shared only with those who are providing health care, unless consent is given for others to receive the patient’s information or an exception to the protection of confidentiality applies. (American Journal Of Nursing, 2011)

1.2    Statement of Problem

In utilizing health care services, it is important that patients share personal information with health workers. Health care providers have a duty as professionals to respect the patient’s trust and keep the information private. However, patients’ awareness of their rights to privacy and confidentiality is often low. Previous qualitative research has shown that a significant number of patients are not ready to give some of their personal information needed for their treatment. They can even give inaccurate or incomplete information in their medical histories because they believe that the healthcare providers might divulge such information to unauthorized third parties. Even when the health care providers do not disclose such information, it is likely that in teaching hospitals like University College Hospitals (UCH) where consultations are conducted with several medical personnel in the same room and also the presence of medical students can bring about difficulty in keeping privacy.

 In view of these observations, this study was conducted to explore the degree to which the ethical practices of privacy and confidentiality are understood as applied by patients attending the medical outpatient (MOP)  of  University College  Hospital (UCH)..

Objective of the Study

The general objective is to determine the knowledge and attitude of patients towards the privacy and confidentiality of their health information attending the medical outpatient  (MOP) of  University College  Hospital (UCH)..

The specific objectives include:

To assess the level of knowledge of patients towards privacy and confidentiality of health information.

To determine the attitude of patients towards privacy and confidentiality of health information.

To assess the attitude of patients on sharing of health information to medical and nursing students.

To determine the level of trust of patients on their health care providers. 

1.4 Research Questions 

Do patients have adequate knowledge about the privacy and confidentiality of their health information?

What are the attitudes of patients towards the privacy and confidentiality of health information?

What are the attitudes of patients towards sharing of health information to medical and nursing students?

 Do patients trust their health care providers on the privacy and confidentiality of their health information?

1.5   Research Hypothesis

HYPOTHESIS 1

H0: There is no significant relationship between patients’ level of education and their knowledge towards privacy and confidentiality of health information.

H1: There is a significant relationship between patients’ level of education and their knowledge towards privacy and confidentiality of health information.

HYPOTHESIS 2  

H0: There is no significant relationship between patients’ occupation and their attitude towards privacy and confidentiality of health information.

H1: There is a significant relationship between patients’ occupation and their attitude towards privacy and confidentiality of health information.

HYPOTHESIS 3

H0: There is no significant relationship between knowledge of patients’ towards privacy and confidentiality of health information and their attitude towards it.

H1: There is a significant relationship between knowledge of patients’ towards privacy and confidentiality of health information and their attitude towards it.

1.6   Scope of the Study

This study was carried out among patients attending the Medical Outpatient (MOP) in  University College Hospital (UCH) Ibadan Oyo State.

1.7     Significance of the Study

The findings of this research work will be useful in the evaluation of the knowledge and attitude of patients towards the privacy and confidentiality of their health information. The result of this study will also be useful in enlightening the patients about the importance of sharing their information with the health care providers.  

Furthermore the findings of this research will help various medical institutions adopt controls and policies concerning the appropriate use, access to and dissemination of patients’ health information.

Also, the results of this study will help to promote the practice of confidentiality of health information among health care professionals in Nigeria. It will further allow health organizations to devise educational mechanisms such as distributing information notices about patient confidentiality to ensure the use of ethical practices in regard to clinical information in the health care system.