Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care - A randomized controlled trial
Influence of physician confidentiality assurances on adolescents' willingness to disclose information and seek future health care - A randomized controlled trial
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DOI：
10.1001/jama.278.12.1029
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发表时间：
1997-09-24
影响因子：
120.7
通讯作者：
Irwin, CE
中科院分区：
文献类型：
--
作者：
Ford, CA;Millstein, SG;Irwin, CE
背景。-青少年对临床环境中隐私的担忧降低了他们就敏感问题寻求医疗保健的意愿，并可能抑制他们与医生的沟通。目的。-调查医生的保密保证对青少年披露信息和寻求未来医疗保健的意愿的影响。设计。-随机对照试验。设置。-加利福尼亚州三所郊区公立高中，参与者。-562 名参与的青少年占 92% 或义务教育学生课程。干预。-在随机分配到 3 组中的一组后，青少年听了一次办公室就诊的标准化录音带，在此期间他们听到一位医生保证无条件保密，一位医生保证有条件保密，或一位医生不提及保密。主要结果测量--青少年愿意透露一般信息，愿意透露有关敏感话题的信息，有意的诚实，以及回访场景中描述的医生的可能性通过匿名书面形式进行评估调查问卷结果.-保密保证使愿意披露有关性、药物使用和心理健康敏感信息的青少年人数从 39% (68/175) 增加到 46.5% (178/383) (beta=.10, P=.02)，并将愿意寻求未来医疗保健的人数从 53% (93/175) 增加到 67% (259/386) （β=.17，P
Context.-Adolescents' concerns about privacy in clinical settings decrease their willingness to seek health care for sensitive problems and may inhibit their communication with physicians.Objective.-To investigate the influence of physicians' assurances of confidentiality on adolescents' willingness to disclose information and seek future health care.Design.-Randomized controlled trial.Setting.-Three suburban public high schools in California,Participants.-The 562 participating adolescents represented 92% or students in mandatory classes.Intervention.-After random assignment to 1 of 3 groups, the adolescents listened to a standardized audiotape depiction of an office visit during which they heard a physician who assured unconditional confidentiality, a physician who assured conditional confidentiality, or a physician who did not mention confidentiality.Main Outcome Measures.-Adolescents' willingness to disclose general information, willingness to disclose information about sensitive topics, intended honesty, and likelihood of return visits to the physician depicted in the scenario were assessed by anonymous written questionnaire.Results.-Assurances of confidentiality increased the number or adolescents willing to disclose sensitive information about sexuality, substance use, and mental health from 39% (68/175) to 46.5% (178/383) (beta=.10, P=.02) and increased the number willing to seek future health care from 53% (93/175) to 67% (259/386) (beta=.17, P