Privacy: a review of the literature

The role of the physical environment in stroke recovery: Evidence-based design principles from a mixed-methods multiple case study

Hospital design can impact patient outcomes, but there is very little healthcare design evidence specific to stroke rehabilitation facilities. Our aim was to explore, from the patient perspective, the role of the physical environment in factors crucial to stroke recovery, namely, stroke survivor activity (physical, cognitive, social), sleep, emotional well-being, and safety. We conducted a mixed-methods multiple-case study at two inpatient rehabilitation facilities in Victoria, Australia, (n = 20 at Case 1, n = 16 at Case 2) using "walk-through" semi-structured interviews, behavioural mapping, questionnaires, and retrospective audit. Four interrelated themes emerged: 1) entrapment and escape; 2) power, dependency, and identity in an institutional environment; 3) the rehabilitation facility is a shared space; and 4) the environment should be legible and patient-centred. Quantitative data revealed patterns in patient activity; stroke survivors spent over 75% of their time in bedrooms and were often inactive. Convergent mixed methods analysis was used to generate a new conceptual model of the role of the physical environment in stroke survivors' behaviour and well-being, highlighting the importance of variety and interest, privacy without isolation, and patient-centred design. This model can be used by designers, healthcare providers, and policy makers to inform the design of rehabilitation environments.

Toward an open access genomics database of South Africans: ethical considerations

Genomics research holds the potential to improve healthcare. Yet, a very low percentage of the genomic data used in genomics research internationally relates to persons of African origin. Establishing a large-scale, open access genomics database of South Africans may contribute to solving this problem. However, this raises various ethics concerns, including privacy expectations and informed consent. The concept of open consent offers a potential solution to these concerns by (a) being explicit about the research participant's data being in the public domain and the associated privacy risks, and (b) setting a higher-than-usual benchmark for informed consent by making use of the objective assessment of prospective research participants' understanding. Furthermore, in the South African context-where local culture is infused with Ubuntu and its relational view of personhood-community engagement is vital for establishing and maintaining an open access genomics database of South Africans. The South African National Health Research Ethics Council is called upon to provide guidelines for genomics researchers-based on open consent and community engagement-on how to plan and implement open access genomics projects.

Navigating the Role of LGBTQ+ Identity in Self-Disclosure and Strategies Used for Uncertainty Reduction in Online Dating

Online dating platforms pose novel challenges for personal privacy, self-disclosure, and uncertainty management. Emerging evidence suggests that LGBTQ+ users may be especially impacted by issues like personal privacy and misrepresentation online. LGBTQ+ identity disclosure is often fraught with pressures related to stigma, fear of accidental disclosure to unintended, undesired audiences, and the possibility of facing harassment and violence. How these identity concerns may manifest in uncertainty reduction strategies in online dating contexts has not yet been examined. To understand this relationship, we replicated and extended precious work examining self-disclosure concerns and uncertainty reduction strategies when online dating with a focus on LGBTQ+ users. Participants were surveyed on the amount of personal information they disclosed, the uncertainty reduction strategies they used, and concerns about disclosure. We found that use of uncertainty reduction strategies was predicted by concerns of personal security, misrepresentation of communication partners, and the possibility of being recognized. We also found that using these strategies predicted the frequency of specific self-disclosure in online dating situations. These findings support the value in continuing to understand the ways in which online information sharing and relationship development are influenced by social identity.

Privacy awareness among healthcare professionals in intensive care unit: A multicenter, cross-sectional study

This multicenter, cross-sectional study aimed to determine and examine the privacy awareness and patient rights education of healthcare professionals working in intensive care units (ICUs). The primary purpose of this study was to determine the privacy awareness of healthcare professionals working in the ICU. In addition, the secondary aim was to examine the relationship between patient rights education and awareness scores, as well as to question the need for privacy awareness education. The study population consisted of ICU physicians, nurses, and allied health personnel working in university hospitals, training and research hospitals, state hospitals, and private hospitals in Turkey. The data were collected through a questionnaire prepared by the researchers, including a question set about sociodemographics, a question about patient rights education, and the privacy awareness scale (PAS) scores using online Google Forms. In the results of the study conducted among 569 participants, the mean total PAS score was 38.31 ± 2.54. The PAS score was significantly different according to the occupation. The PAS scores of the nurses were higher than physicians and allied health personnel. The PAS scores differed according to whether the participants had received patient rights education. This study found that nurses were the group with the highest PAS scores among healthcare professionals. In addition, the PAS scores of nurses working in private and training and research hospitals were higher than those of other hospital employees. On the other hand, the lowest scores belonged to university hospitals and receiving patient rights education increased the PAS score of the nurses. This study showed that all enrolled healthcare professionals required in-service training to gain privacy awareness.

Privacy and housing: research perspectives based on a systematic literature review

Grounded in psychological and social constructs, the need for privacy is reflected in human socio-spatial behaviour and in our own home. To discuss housing privacy, this article presents a systematic literature review (SLR) that identified theoretical and methodological aspects relevant to the topic. The research was based on consolidated protocols to identify, select and evaluate articles published between 2000 and 2021 in three databases (Web of Science, Google Scholar and Scielo), with 71 eligible articles identified for synthesis. The results showed a concentration of studies in the American, European and Islamic context, and the increase in this production since 2018. This was guided by the inadequacy of architectural and urban planning projects, by new forms of social interaction and, recently, by the COVID-19 pandemic. From a theoretical point of view, the SLR demonstrated the importance of investigating privacy in housing from a comprehensive perspective, observing its different dimensions (physical, social and psychological) and characterizing the issues involved and the context under analysis. Methodologically, the main instruments identified were: (i) to behavioural analysis, questionnaires, interviews and observations; (ii) to built environment evaluation, in addition to the previous ones, space syntax analysis, architectural design and photographs analysis; (iii) for the general characterization of users, the data collection regarding the socio-demographic and cultural context and the meanings attributed to spatial organizations; (iv) to characterize the participants of the investigations, the analysis of personality traits, the ways to personalize the space, user satisfaction/preferences and the influence of social interactions on these perceptions.

Development of the Perioperative Privacy Scale: A Validity and Reliability Study

PURPOSE

This study aims to develop the Perioperative Privacy Scale and test its validity and reliability.

DESIGN

This is a methodological study.

METHODS

This study was conducted with 298 patients who were hospitalized in surgical clinics in a university hospital, met the inclusion criteria, and agreed to participate in the study. The data were collected using a personal information form and the Perioperative Privacy Scale developed by the researchers. This methodological study was conducted between August 2019 and March 2020. The items of the scale were determined after a literature review and qualitative interviews with the patients. The draft version created to test the scale's content and face validity was reviewed by 11 experts (faculty members). Six items were omitted from the 37-item pool and revisions were made based on the experts' opinions and recommendations. Data analysis was conducted using the content validity index specially for content validity, and exploratory and confirmatory factor analyses for construct validity. Reliability was assessed using Cronbach's Alpha, Spearman Brown, and Guttman's coefficients.

FINDINGS

The content validity index of the 16-item scale was 0.87. The scale explained 63.37% of the total variance and consists of 3 subscales. The scale's Kaiser-Meyer-Olkin value was 0.89, Bartlett's test was χ² = 3834.2 (P < .05), and Anti-Image Correlation was between 0.74 and 0.97. The goodness of fit values showed that the scale was acceptable. Items and subscales were related with the scale and a three-factor structure was confirmed. Spearman-Brown was 0.87, Guttman Split-Half was 0.87, and Cronbach Alpha was 0.92 for the entire scale.

CONCLUSIONS

The Perioperative Privacy Scale is a short scale consisting of 16 items. It can be used in descriptive and experimental studies to assess the thoughts of inpatients in surgical clinics regarding privacy.

The SHAPES Smart Mirror Approach for Independent Living, Healthy and Active Ageing

The benefits that technology can provide in terms of health and support for independent living are in many cases not enough to break the barriers that prevent older adults from accepting and embracing technology. This work proposes a hardware and software platform based on a smart mirror, which is equipped with a set of digital solutions whose main focus is to overcome older adults’ reluctance to use technology at home and wearable devices on the move. The system has been developed in the context of two use cases: the support of independent living for older individuals with neurodegenerative diseases and the promotion of physical rehabilitation activities at home. Aspects such as reliability, usability, consumption of computational resources, performance and accuracy of the proposed platform and digital solutions have been evaluated in the initial stages of the pilots within the SHAPES project, an EU-funded innovation action. It can be concluded that the SHAPES smart mirror has the potential to contribute as a technological breakthrough to overcome the barriers that prevent older adults from engaging in the use of assistive technologies.

Donor-centred care: the facilitating and constraining factors experienced by gamete donors in a public bank

The provision of care that is responsive to the preferences, needs and values of gamete donors is key to improving their recruitment and ensuring the functioning of gamete banks. This qualitative study aimed to explore gamete donors' experiences about the facilitating and constraining human and system factors to donor-centred healthcare delivery in gamete banks. It is based on 20 semi-structured interviews with oocyte and sperm donors, recruited at the Portuguese Public Bank of Gametes, conducted from November 2017 to February 2019. Deductive content analysis was performed using the software NVivo12, following the patient-centred infertility care model. Interviewees identified facilitating factors mostly related with the human dimension of care (i.e. careful and available attitude and behaviours of health professionals, as well as their good communication skills and emotional support). Constraining factors were predominantly identified at the system level (i.e. insufficient information provision, poor coordination, and integration). Lack of privacy emerged simultaneously as a human and a system constraining factor (i.e. physical discomfort during medical-technical acts or gamete collection). There is room for improving clinical practice and the organisation of healthcare services within a context where the competence and attitude of, and relationship with, the staff are highly valued.

Cultural Viewpoints of Nursing Students on Patient Privacy: A Qualitative Study

The purpose of this study was to determine the feelings, thoughts, perceptions and cultural standpoint of nursing students concerning patient privacy. This study was conducted as a qualitative descriptive design. The homogeneous sampling method, purposive sampling method for qualitative research samples, was used to determine the study group. Data were collected from 17 nursing students at a state university in Turkey. Individual semi-structured interviews were conducted, and content analysis was used to analyze data. Three main themes emerged from the data: perception of privacy, factors affecting patient privacy and suggested solutions. Four sub-categories emerged: religion, gender, culture and reassuring communication. The perceptions of many of the students relating to the concept of privacy coincided with the concepts of confidentiality and all kinds of information concerning the patient. It was seen that the most effective intervention among the students' solution proposals to ensure privacy was the necessity to make physical improvements in hospitals.

The informational privacy of patients in prehospital emergency care-Integrative literature review

AIMS AND OBJECTIVES

To explore the informational privacy of patients in prehospital emergency care based on the existing literature.

BACKGROUND

Informational privacy, a central value in health care, is strongly connected to patients' safety and quality of care. However, its realisation faces challenges in the unique context of prehospital emergency care.

DESIGN

Integrative literature review.

METHODS

Systematic searches of the CINAHL, MEDLINE and Cochrane library databases (n = 1588) and a manual search of the reference lists of the included articles (n = 0) were conducted in August 2019. In the article selection, specified inclusion and exclusion criteria were used. Two Joanna Briggs Institute quality appraisal tools were used. Ultimately, 11 studies were included. Analysis was conducted by using content analysis. Overall, process of the review was guided by PRISMA checklist.

RESULTS

The number of primary research studies related to informational privacy in prehospital emergency care is limited and mainly focused on privacy and confidentiality. The informational privacy was described from three aspects (a) information control by patients, (b) information protection by healthcare professional and (c) concepts related to informational privacy. The realisation of patients' informational privacy varied. Factors related to the realisation were related to the paramedics, the prehospital emergency care work and the patients.

CONCLUSION

More research specifically focused on informational privacy in prehospital emergency care is needed. Paramedics' understanding of informational privacy and its protection is essential to enhance the realisation of patients' informational privacy. Therefore, a response is required to their need for more education concerning informational privacy.

RELEVANCE TO CLINICAL PRACTICE

Paramedics' attention should be drawn to the identified factors related to the realisation of informational privacy and its use in clinical practice in order to continue to provide high-quality prehospital emergency care.

Uncovered and disrespected. A qualitative study of Jordanian women's experience of privacy in birth

BACKGROUND

Privacy is related to a person's sense of self and the need to be respected and it is a key factor that contributes to women's satisfaction with their birth experiences.

AIM

To examine the meaning of privacy for Jordanian women during labour and birth.

METHOD

A qualitative interpretive design was used. Data were collected through face-to-face semi-structured interviews with 27 Jordanian women. Of these women, 20 were living in Jordan while seven were living in Australia (with birthing experience in both Jordan and Australia). Thematic analysis was used to analyse the data.

RESULTS

The phrase 'there is no privacy' captured women's experience of birth in Jordanian public hospitals and in some private hospital settings. Women in public hospitals in Jordan had to share a room during their labour with no screening. This experience meant that they were, "lying there for everyone to see", "not even covered by a sheet" and with doctors and others coming in and out of their room. This experience contrasted with birth experienced in Australia.

CONCLUSIONS

This study explicates the meaning of privacy to Jordanian women and demonstrates the impact of the lack of privacy during labour and birth. Seeking a birth in a private hospital in Jordan was one of the strategies that women used to gain privacy, although this was not always achieved. Some strategies were identified to facilitate privacy, such as being covered by a sheet; however, even simple practices are difficult to change in a patriarchal, medically dominated maternity system.

Impacts of Nursing Unit Design on Visibility and Proximity and Its Influences on Communication, Privacy, and Efficiency

OBJECTIVES

This study examines the role of visibility and proximity on nurse communication patterns, perception of privacy, and efficiency in double-corridor nursing units.

BACKGROUND

Nurses are extremely important for the quality of healthcare. The literature suggests that visibility and proximity have a substantial impact on the delivery of care and staff experience. However, few studies have empirically examined nursing units in China.

METHOD

Questionnaire surveys, observations, and simulations of medication administration tasks were employed.

RESULTS

Visibility and proximity influenced communication patterns, perceptions of privacy, and efficiency. The type of wall in the medication room could impact nurses' perception of privacy and efficiency. A partial glass wall in the medication room could achieve balance between privacy and visibility. A medication room that is adjacent to and is easily accessed from the nurse station (NS) could provide efficient communication and efficient work. The partition type between the NS and the doctor's office and the layout of the medication room could impact communication patterns. The relative position of the NS, medication room, and disposal room could influence the flow of medication administration tasks, and a geographically contiguous spatial layout could enhance work efficiency.

CONCLUSIONS

The findings contribute to the body of knowledge on the impact of visibility and proximity on nurses' communication patterns, perception of privacy, and efficiency. Recommendations to improve the design of double-corridor nursing units are also provided.

Trading company for privacy: A study of patients’ experiences

Ethical considerations

The study was conducted according to the principles of Declaration of Helsinki, and was approved by the Norwegian Social Science Data Services.

Objective

To describe patients’ experiences of staying in multiple- and single-bed rooms.

Patients and methods

This qualitative study employed a descriptive and exploratory approach, and systematic text condensation was used to analyze the material. Data were collected in a hospital trust in Norway. A total of 39 in-depth interviews were performed with patients discharged from the medical, surgical, and maternity departments.

Results

Patients had ambiguous views on whether multiple-bed rooms or single-bed rooms were to be preferred. Main results include how patients cherished “the importance of others” but at the same time valued “the importance of privacy.” Being hospitalized in multiple-bed rooms was for many patients a very positive experience in terms of social interaction. Patients in single-bed rooms reported being more dependent on nurses to maintain social contact and obtain safety.

Conclusion

This research provides new knowledge on how the need for privacy can be in contradiction with the need for socializing with other patients. When hospitalized, the physical structure of a hospital impacts with whom patients interact and to what extent they depend on the nursing staff to have their social needs met.

Factors related to privacy of Somali refugees in health care

BACKGROUND

Privacy is one of the key principles in health care and requires understanding of the cultural aspects of patients' privacy. In Western cultures privacy is focused on the individual, however, in some non-Western cultures, privacy is linked to the collectivism of the community or religion.

OBJECTIVES

The objective of this study is to describe the factors related to the realisation of privacy of Somali refugees in health care by describing the factors related to the patient, healthcare professional and interpreter.

RESEARCH DESIGN

The data were collected from Somali refugees (N = 29) using a qualitative questionnaire and were analysed by deductive content analysis based on factors related to the patient, healthcare professional and interpreter.

ETHICAL CONSIDERATION

Ethical approval was obtained from the University of Turku, and research permissions were obtained from all participating institutions.

FINDINGS

Factors related to the patient were as follows: privacy was realised when the patient had self-determination; was able to act according to Somali culture; had knowledge and understanding of treatment; and trusted the healthcare professional. Factors related to the healthcare professional were as follows: the healthcare professional was expected to be of the same gender as the patient, act professionally, focus on the health issues, and to have knowledge and understanding of the Somali culture. Factors related to the interpreter were as follows: the presence and Somali background of the interpreter decreased privacy; the interpreter was expected to be of the same gender as the patient; to have competence and to behave professionally.

DISCUSSION

Gender congruence, professionalism and caring attitude and common understanding between the Somali patient and Finnish provider increase the privacy of Somali patients.

CONCLUSION

Somali patients' privacy can be improved by increasing healthcare professionals' understanding of Somali culture, acknowledging the importance of gender concordance in relation to healthcare professionals and interpreters, and the effect of the presence of the interpreter on patients' privacy.

Cancer patients’ perspectives on dignity in care

Background:

Since “dignity” is one of the fundamental rights of every patient, consideration for patients’ dignity is essential. Unfortunately, in many cases, especially in cancer patients, dignity is not fully respected. Dignity is an abstract concept, and there are only a few comprehensive studies on the dignity of cancer patients in Iran.

Research objective:

This study aimed to evaluate the perception of Iranian cancer patients on human dignity.

Research design:

A qualitative research approach was used as the study design. The data were collected through individual semi-structured interviews and analyzed using the qualitative content analysis method.

Participants and research context:

 This study was conducted on cancer patients in internal medicine wards in Iran. The data were gathered through semi-structured interviews from May 2017 to February 2018.

Ethical considerations:

The study protocol was approved by the Research Ethics Committee of medical universities located in Southwest of Iran. The ethical principles were carefully followed throughout the study.

Findings:

Based on the results of the interviews, 3 main themes and 11 categories were determined. The main themes were identified as the “personal space and privacy,” “respect for human values,” and “moral support.”

Discussion:

The results of the present study showed the necessity of care for cancer patients in a respectful manner. The key elements in such care were the preservation of their personal space and privacy, respect for their values, and the provision of adequate moral support. These measures will have a positive effect on the perception of such patients on human dignity.

Conclusion:

Considering the special care required by cancer patients, the Iranian healthcare and hygiene managers should design and implement a care plan that includes the ethical principles related to human dignity.

Visitors’ use of corridors in internal medicine wards

Purpose

This paper aims to analyze visitors’ waiting behavior in corridors of an internal medicine ward in relation to concepts of territoriality and privacy.

Design/methodology/approach

Waiting activities, visitors’ room numbers and duration of activities were recorded on a floor plan. Results were tallied according to behavioral and architectural zones in which the activity took place.

Findings

Locations that are near patient rooms that provide visual and auditory access are largely used as territorial areas for non-privacy-required activities. Ends of corridors, secondary corridors and staircases were mainly used for activities that required some level of privacy such as grieving.

Research limitations/implications

As is true with post-occupancy evaluations in other single buildings, this research may not be generalizable to all internal medicine wards. Future research could measure whether responding to visitors’ spatial needs could result in lower density and sense of crowding in the corridors, as well as reduce stress and task interruptions and increase efficiency of patient-check rounds.

Practical implications

The findings indicate that internal medicine wards should include waiting areas near the patient rooms for visitors to be able to keep visual and auditory connection with their patients, as well as areas that provide privacy. This may help lower density, sense of crowding, distraction of medical staff, stress and burn-out and errors, as well as increase the efficiency of patient checks.

Originality/value

The ways in which architectural design of internal medicine corridors can support visitors’ activities and environmental needs such as territoriality and privacy is an issue that is rarely examined. This paper also adds an example from a non-Western culture, to a literature that is dominated by examples from Western cultures.

Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study

Background

Emergency care providers regularly deal with ethical dilemmas that must be addressed. In comparison with in-hospital nurses, emergency medical service (EMS) personnel are faced with more problems such as distance to resources including personnel, medico-technical aids, and information; the unpredictable atmosphere at the scene; arriving at the crime scene and providing emergency care for accident victims and patients at home. As a result of stressfulness, unpredictability, and often the life threatening nature of tasks that ambulance professionals have to deal with every day, ethical decision-making (EDM) has become an inevitable challenge.

Methods

The content analysis approach was used to conduct the present qualitative study in Iran. The participants consisted of 14 EMS personnel selected through purposive sampling, which continued until the data became saturated. Data were collected using semi-structured interviews and analyzed concurrently with their collection through the constant comparison method.

Results

The process of data analysis resulted in the emergence of 3 main categories “respecting client’s values”, “performing tasks within the professional manner”, “personal characteristic”, and the emergence of eight (8) sub-categories signifying participants’ experiences with regard to EDM.

Conclusion

According to the results, when EMS personnel are faced with ethical dilemmas, they consider the client’s values and professional dignity, and perform the assigned tasks within the framework of the regulation. The findings also suggest that pre-hospital care providers assess legal consequences before making any decision. Further studies should be conducted regarding the experiences of the subordinates and other related parties.

Privacy of Clinical Research Subjects: An Integrative Literature Review

With changes in clinical research practice, the importance of a study-subject's privacy and the confidentiality of their personal data is growing. However, the body of research is fragmented, and a synthesis of work in this area is lacking. Accordingly, an integrative review was performed, guided by Whittemore and Knafl's work. Data from PubMed, Scopus, and CINAHL searches from January 2012 to February 2017 were analyzed via the constant comparison method. From 16 empirical and theoretical studies, six topical aspects were identified: the evolving nature of health data in clinical research, sharing of health data, the challenges of anonymizing data, collaboration among stakeholders, the complexity of regulation, and ethics-related tension between social benefits and privacy. Study subjects' privacy is an increasingly important ethics principle for clinical research, and privacy protection is rendered even more challenging by changing research practice.

Privacy and Well-Being in Aged Care Facilities with a Crowded Living Environment: Case Study of Hong Kong Care and Attention Homes

This study aims to understand the relationship between bedroom privacy and well-being of the elderly in aged care facilities with a compact living situation. A majority of studies on this topic were carried out in a low-density population context. The crowded living situation might compromise the well-being of residents. This study proposed five architectural parameters to measure bedroom privacy in aged care facilities: total open surface per unit, openness/solid ratio per bed, height of partition wall, number of people per unit, and personal control over bedroom privacy. SF-12 v.2 Health Survey was used to collect information on physical and mental health status. The study surveyed nine Care & Attention homes and their 213 residents in Hong Kong. The total open surface per unit and the openness/solid ratio per bed were positively associated with the physical health of residents. The height of partition walls was associated negatively with their physical and mental health conditions, and the number of people per unit was negatively associated with their physical health. More than half of respondents preferred a single unit with high partition walls; however, 40% of respondents preferred low partition walls. The provision of privacy for the elderly should be balanced with their needs for social interactions; total open surface per unit, openness/solid ratio per bed and height of partition wall should be taken into consideration. The study provides evidence and design guidelines for improving privacy in aged care facilities with a compact living environment.

Influence of Color in a Lactation Room on Users' Affective Impressions and Preferences

OBJECTIVE

The present study aims to examine the influence of environmental color hue in a lactation room at a health center on users' affective response and preference.

BACKGROUND

Hospital design plays an important role in the emotional experience of patients. In this regard, many studies have attempted to find relationships between design variables and healthcare facilities users' response. Color has been frequently examined because it is always present in the environment and can be easily changed. However, most of the studies dealing with color-emotion relationships acquire users' affective response by questionnaires developed by experts which could lead to inaccurate results since nonexperts may misunderstand concepts set by experts and use nonimmersive images to simulate the environments to assess.

METHODS

To overcome these limitations, a Kansei Engineering-based approach was proposed. In the first phase, users' specific affective factors for lactation rooms were determined using Semantic Differential. In the second phase, the influence of nine different color hues on users' affective factors was obtained. An immersive display system was used to visualize the room altering hues in an isolated and controlled way.

RESULTS

(1) Six user's affective factors connected to the lactation rooms were discovered: safety, elegance, coziness, spaciousness, simplicity, and luminosity, of which coziness has the most impact on the assessment of the room. (2) Warm colors like orange and yellow tend to score highly for coziness which puts them in leading positions when users' assess lactation rooms.

CONCLUSIONS

Results provide recommendations for designers and show the advantages of using semantic differential and immersive displays to analyze user's affective response to environments.

Is privacy a problem during bedside handovers? A practice-oriented discussion paper

Bedside handover is the delivery of the nurse-to-nurse handover at the patient’s bedside. Although increasingly used in nursing, nurses report many barriers for delivering the bedside handover. Among these barriers is the possibility of breaching the patient’s privacy. By referring to this concept, nurses add a legal and ethical dimension to the delivery of the bedside handover, making implementation of the method difficult or even impossible. In this discussion article, the concept of privacy during handovers is being discussed by use of observations, interviews with nurses, and interviews with patients. These findings are combined with international literature from a narrative review on the topic. We provide a practice-oriented answer in which two mutually exclusive possibilities are discussed. If bedside handover does pose problems concerning privacy, this situation is not unique in healthcare and measures can be taken during the bedside handover to safeguard the patient. If bedside handover does not pose problems concerning privacy, privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward patient participation. Therefore, a possible breach of privacy—whether a justified argument or not—is not a reason for not delivering the bedside handover.

Evaluating the Privacy Policies of Mobile Personal Health Records for Pregnancy Monitoring

A mobile personal health record (mPHR) for pregnancy monitoring allows the pregnant woman to track and manage her personal health data. However, owing to the privacy and security issues that may threaten the exchange of this sensitive data, a privacy policy should be established. The aim of this study is to evaluate the privacy policies of 19 mPHRs for pregnancy monitoring (12 for iOS and 7 for Android) using a template covering the characteristics of privacy, security, and standards and regulations. The findings of this study show that none of the privacy policies evaluated entirely comply with the characteristics studied. The developers of mPHRs for pregnancy monitoring are, therefore, requested to improve and pay more attention to the structure and the content of the privacy policies of their apps.

Respecting the privacy of hospitalized patients: An integrative review

BACKGROUND

Privacy is a complicated and obscure concept, which has special meanings in the healthcare environment; therefore, it is essential for healthcare providers to fully understand this concept. However, there is no universally accepted definition for this concept in the texts, and it has been interpreted differently, based on its application.

AIM

To analyze and provide a clear and scientific definition for respect of privacy of hospitalized patients and identify the common aspects of this concept.

RESEARCH DESIGN

This study was conducted using the Whittemore and Knafl's modified framework as a conceptual analysis method. Ethical consideration: This study was approved by the Research Council of the University of Social Welfare and Rehabilitation Sciences. We have respected the ethical requirements required regarding the sources and authorship. Research context and data sources: Using integrative review, a search was performed using national and international databases, including CINAHL, Scopus, Medline, Web of Science, and ISI (with no date restriction). The keywords employed during the search process were "privacy of patients," "confidentiality," "and patients' rights." In total, 1345 articles were retrieved from the databases. After the elimination of repetitive studies and with regard to the study objectives, 124 articles, 3 books, and 4 theses were entered into the study. The data were analyzed using the conventional content analysis approach.

FINDINGS

The results were extracted in the form of four, seven, and two themes related to attributes such as physical, informational, social, and psychological and the antecedents and consequences of respecting patient privacy, respectively.

CONCLUSION

Respect for hospitalized patient privacy contains multiple dimensions. Factors affecting the achievement of this concept include individual backgrounds, nature of the disease, and rule of paternalism. The fulfillment of patient privacy leads to such consequences as protection and improvement of human dignity as well as improved communication between the patient and the health team.

Informational Privacy in the Recovery Room-Patients' Perspective

PURPOSE

To describe patients' perceptions of informational privacy and factors promoting it in the recovery room.

DESIGN

A descriptive semistructured qualitative interview study.

METHODS

The study was conducted in 2013, and the data were analyzed with inductive content analysis. Adult surgical recovery room patients (n = 17) were recruited with purposive sampling at the Department of Ear, Nose and Throat diseases in a university hospital in Finland.

FINDINGS

Informational privacy was described as control of patients' health information maintained by the health care professionals and the patients. Informational privacy was especially important in relation to other patients. Health care professionals and patients' attitude, behavior, and knowledge of informational privacy, barriers of hearing and seeing, societal rules, and the electronic patient data system promoted informational privacy.

CONCLUSIONS

Informational privacy in relation to other patients could be improved in the recovery room, for example, by developing patient health information transmission and architectural solutions.

Patients' Dignity and Its Relationship with Contextual Variables: A Cross-Sectional Study

Introduction: Dignity is considered as fundamental human needs and recognized as one of the central concepts in nursing science. The aim of this study was to assess the extent to which patients’ dignity is respected and to evalutae its relationship with contextual variables.

Methods: This cross-sectional study was conducted on 256 hospitalized patients in the two teaching hospitals affiliated to Zanjan University of medical sciences, Iran. Data were collected by a questionnaire consist of two sections: (a) demographic characteristics, and (b) patient dignity including 32 questions. Data were analyzed by SPSS (ver.13) software using independent t-test, ANOVA and Pearson correlation.

Results: The result showed that the mean (standard deviation) of total score of patient’s dignity was 108.17 (25.28). According to the result, the majority of the respondents (76.2%) were not aware of patient’s rights. There was a significant difference in mean scores of total dignity between single and married persons, living in city or village, and hospitalization in Moosavi and Valiasr hospital.

Conclusion: Health care systems should take the provision of the patients' dignity into account through using a comprehensive educational program for informing of patient, family members, and health professionals about patients’ dignity.

Smart Health Caring Home: A Systematic Review of Smart Home Care for Elders and Chronic Disease Patients

As access to health care is important to people's health especially for vulnerable groups that need nursing for a long period of time, new studies in the human sciences argue that the health of the population depend less on the quality of the health care, or on the amount of spending that goes into health care, and more heavily on the quality of everyday life. Smart home applications are designed to "sense" and monitor the health conditions of its residents through the use of a wide range of technological components (motion sensors, video cameras, wearable devices etc.), and web-based services that support their wish to stay at home. In this work, we provide a review of the main technological, psychosocial/ethical and economic challenges that the implementation of a Smart Health Caring Home raises.

Examination of an Electronic Patient Record Display Method to Protect Patient Information Privacy

Electronic patient records facilitate the provision of safe, high-quality medical care. However, because personnel can view almost all stored information, this study designed a display method using a mosaic blur (pixelation) to temporarily conceal information patients do not want shared. This study developed an electronic patient records display method for patient information that balanced the patient's desire for personal information protection against the need for information sharing among medical personnel. First, medical personnel were interviewed about the degree of information required for both individual duties and team-based care. Subsequently, they tested a mock display method that partially concealed information using a mosaic blur, and they were interviewed about the effectiveness of the display method that ensures patient privacy. Participants better understood patients' demand for confidentiality, suggesting increased awareness of patients' privacy protection. However, participants also indicated that temporary concealment of certain information was problematic. Other issues included the inconvenience of removing the mosaic blur to obtain required information and risk of insufficient information for medical care. Despite several issues with using a display method that temporarily conceals information according to patient privacy needs, medical personnel could accept this display method if information essential to medical safety remains accessible.

Privacy in occupational health practice: Promoting and impeding factors

Aim: This article describes the views of occupational health professionals, employees, and employers on factors that are thought to promote and impede privacy in occupational health practice. Methods: The data were collected through theme interviews with 44 subjects and were analysed by content analysis. Results: Both promoting and impeding factors organized around two content areas: ``caregiving'' (patient—caregiver relationship) and ``tripartite cooperation'' (cooperation between occupational health professionals, employees, and employer). The content areas illustrated the two different roles Finnish occupational health professionals have toward their two groups of clients: employees and employers. ``Adequate behaviour'' (respect, good communication, presence) and ``Adequate knowledge base'' (instinct, work experience, ethical thinking, knowledge of legislation) promoted privacy in caring relationship, whereas ``Inadequate behaviour'' (untrustworthy, busy, distant, ``friend'') impeded its realization. In tripartite cooperation, the promoting factors had to do with ``Common good'' (impartiality, regular contacts, community spirit, fair play) and ``Individual good'' (informed consent, advocacy). The main category, ``Confusions in loyalties'', emerged from three subcategories (confusions in confidentiality, confusions in duties, and confusions in roles) illustrating the impeding factors in tripartite cooperation. Conclusions: Questions of privacy are crystallized in occupational health professionals' diverse duties and roles towards employees and employers. In occupational health practice, privacy cannot be seen only as a privilege of employees, but must also be viewed as an instrumental value serving the interests of employers and whole work community. Confusions in loyalties need more discussion and research before privacy can be optimally realized. Lapses in confidentiality should never happen.

Somali asylum seekers’ perceptions of privacy in healthcare

Background:

Privacy has been recognized as a basic human right and a part of quality of care. However, little is known about the privacy of Somali asylum seekers in healthcare, even though they are one of the largest asylum seeker groups in the world.

Objectives:

The aim of the study was to describe the content and importance of privacy and its importance in healthcare from the perspective of Somali asylum seekers.

Research design:

The data of this explorative qualitative study were collected by four focus group interviews with 18 Somali asylum seekers with the help of an interpreter. The data were analysed by inductive content analysis.

Ethical considerations:

Research permissions were obtained from the director of the reception centre and from the Department of Social Services. Ethical approval was obtained from the Ethics Committee of Turku University.

Findings:

The content of privacy includes visual privacy, physical privacy and informational privacy. All contents can be shared with healthcare professionals. The importance of privacy includes respect, dignity and freedom.

Discussion:

Privacy is strongly connected to the collectivism of Somali culture and religion. Unlike the Western cultures, privacy is not important only for the individual; most of all, it is seen to support collectivism.

Conclusion:

Even though all contents of privacy can be shared with healthcare professionals, it is important to recognize the cultural aspect of privacy especially when using interpreters with Somali background.

User Evaluation of Neonatology Ward Design

Objective:

The object of this article is to identify the set of affective and emotional factors behind users’ assessments of a space in a neonatology unit and to propose design guidelines based on these.

Background:

The importance of the neonatology service and the variety of users place great demands on the space at all levels. Despite the repercussions, the emotional aspects of the environment have received less attention.

Methods:

To avoid incurring limitations in the user mental scheme, this study uses two complementary methodologies: focus group and semantic differential. The (qualitative) focus group methodology provides exploratory information and concepts. The (quantitative) semantic differential methodology then uses these concepts to extract the conceptual structures that users employ in their assessment of the space. Of the total 175 subjects, 31 took part in focus groups and 144 in semantic differential.

Results:

Five independent concepts were identified: privacy, functionality and professional nature, spaciousness, lighting, and cleanliness. In relation to the importance of the overall positive assessment of the space, the perception of privacy and sensations of dominance and pleasure are fundamental. Six relevant design aspects were also identified: provide spacious surroundings, facilitate sufficient separation between the different posts or cots, use different colors from those usually found in health-care centers, as some aversion was found to white and especially green, design areas with childhood themes, use warm artificial light, and choose user-friendly equipment.

Conclusions:

Results provide design recommendations of interest and show the possibilities offered by combining both systems to analyze user response.

Nurses’ and patients’ perceptions of privacy protection behaviours and information provision

Background:

With increased attention to patient privacy and autonomy, privacy protection and information provision for patients are becoming increasingly important.

Objectives:

The aim of this study was to identify and analyse nurses’ and patients’ perceptions of the importance and performance of protecting patients’ privacy and providing them with relevant information.

Research design:

This study is a descriptive cross-sectional investigation. Participants and research context: Participants were 168 patients hospitalised in medical and surgical wards and 176 nurses who cared for them.

Ethical consideration:

This study was approved by the Chung-Ang University Bioethics Committee, and informed written consent was collected from all participants.

Findings:

Nurses’ recognition of the importance of protecting patients’ privacy and providing adequate information was higher compared to their actual performance, and the nurses’ level of performance was higher in comparison with the patients’ recognition of its importance.

Discussion:

Although a holistic approach to patient privacy protection and information provision is needed, the medical field has not embraced this model of care.

Conclusions:

These findings provide empirical data to create an ethical environment for the future, as considerable attention has been devoted to patients’ rights and medical institutions’ liability for providing explanations to patients.

An Exploratory and Comparative Evaluation on the Spatial Perception of Two Densities of Multioccupancy Hospital Rooms

OBJECTIVE

The objective of this article was to explore interior spatial qualifications on patient perception of two densities of multioccupancy hospital rooms.

BACKGROUND

The research setting of this study was the three- and six-person capacity hospital rooms used for treatment of patients at a large hospital in a major metropolitan city in Turkey.

METHOD

The subjects used in the study were randomly selected from among patients treated in the surgical medical sciences' departments of the hospital. Accordingly, a research questionnaire was applied to a total of 101 subjects.

RESULTS

Results have shown that the three-person rooms were assessed more positively for privacy, functional, and perceptual qualifications compared to the six-person rooms. An increase in the number of persons and interior units of rooms affects negatively the auditory privacy and privacy areas of other patients.

CONCLUSION

Consequently, although these rooms with different spatial sizes were very similar for concentration of persons and commodities, six-person rooms were perceived to be more crowded than three-person rooms.

Patients' perception of dignity in an Italian general hospital: a cross-sectional analysis

BACKGROUND

Dignity is related to a patient's respect, privacy, information and autonomy. Maintaining dignity is defined as ethical goal of care. Although the importance of dignity has been widely recognized, there is limited research that investigates if dignity is really maintained in clinical practice and few studies have been conducted in acute hospital settings with adults across the age range. The aim of the study was to explore inpatients' perception of dignity in an hospital setting.

METHODS

This descriptive cross-sectional study was carried out in 10 medical and surgical wards of a General Hospital in Modena (Italy). We collected a purposive sample of 100 patients by selecting 10 participants from each ward who met following criteria: hospitalized for more than three days, at least 18 years old, not mentally ill, willing to participate and able to speak Italian. We developed a 15-item anonymous questionnaire divided into three sections: "physical privacy", "information and autonomy", "nurse-patients respectful interaction".

RESULTS

The percentages of positive (preserved dignity perception) were more frequent than negative (not preserved dignity perception) and no answers with a statistically significantly difference among the three sections (Pearson chi2 = 150.41, p < 0.0001). The frequency of positive or negative answers was statistically significantly related to the preservation of dignity according to the following questions (p < 0.005, multivariate logistic regression): "privacy to use the bathroom" and "respectful interaction", as protective factors and "maintaining of body privacy", "involvement in the care process", "correct communication" as risk factors.

CONCLUSIONS

Dignity was quite but not completely maintained according to the standards expected by patients. According to patients' views, privacy of the body during medical procedures and respectful nurse-patient interactions were preserved more than information and verbal communication. Listening to patients' views on the specific factors they consider useful to maintaining their dignity can help in this process. Recognizing and focusing on these factors will help professionals to establish practical measures for preserving and promoting patients' dignity and providing more dignified care. Dignity should be extensively and systematically pursued as other important clinical goals.

The development of the patient privacy scale in nursing

BACKGROUND

The developments in technology and communication channels, increasing workload, and carelessness cause problems regarding patient privacy and confidentiality in nursing services.

RESEARCH OBJECTIVES

The study was conducted to develop a patient privacy scale to identify whether nurses observe or violate patient privacy at workplace.

RESEARCH DESIGN

This research was a methodological and descriptive study.

PARTICIPANTS AND RESEARCH CONTEXT

Participants were 354 nurses working at private hospitals and hospitals affiliated with the Ministry of Health in Istanbul/Turkey. Data were collected with a questionnaire about the demographic characteristics of nurses and their opinions about patient privacy and with patient privacy scale.

ETHICAL CONSIDERATIONS

After getting permission from the top management of hospitals, information about the study was given to nurses. Those willing to participate were informed that participation was voluntary and invited to give written consent before data collection.

FINDINGS

The content validity index of scale was 0.91, Cronbach's alpha was 0.93, Spearman-Brown and Guttman coefficients were 0.85, the upper and lower 27% test was -29.65, and item-total correlation values ranged from 0.47 to 0.71. The scale had five subscales. In addition, 49% of the nurses stated that patient privacy was always observed in their services/units. They appraised with a mean score of 4.51 ± 0.49 for the total scale, 4.39 ± 0.61 for confidentiality of personal information and private life, 4.39 ± 0.70 for sexual privacy, 4.56 ± 0.57 for the privacy of those unable to protect themselves, 4.60 ± 0.59 for physical privacy, and 4.60 ± 0.52 for ensuring a favorable environment.

DISCUSSION

The findings of this study were in contrast with the results of some international studies which determined the violation of the patient privacy.

CONCLUSION

The patient privacy scale is a valid and reliable tool to collect data on whether nurses observe or violate patient privacy, and the nurses generally reported observing or paying attention to patient privacy in all hospitals and especially private hospitals.

Surgical patients' and nurses' opinions and expectations about privacy in care

The purpose of this study was to determine the opinions and expectations of patients and nurses about privacy during a hospital admission for surgery. The study explored what enables and maintains privacy from the perspective of Turkish surgical patients and nurses. The study included 102 adult patients having surgery and 47 nurses caring for them. Data were collected via semistructured questionnaire by face-to-face interviews. The results showed that patients were mostly satisfied by the respect shown to their privacy by the nurses but were less confident of the confidentiality of their personal data. It was found that patients have expectations regarding nursing approaches and attitudes about acknowledging and respecting patient autonomy and confidentiality. It is remarkable that while nurses focused on the physical dimension of privacy, patients focused on informational and psychosocial dimensions of privacy, as well as its physical dimension.

[Patients' perception about privacy in the hospital]

This qualitative study aimed to describe the hospitalized patient's perception on privacy, using the content analysis. Thirty-four patients, who have been at least three days hospitalized, participated in the study. The analysis of the information was based on the theoretical reference framework of privacy, and evidenced three thematic categories: dignity and respect, autonomy, personal and territorial space. The subjects pointed out behavioral factors, which contribute or not for the protection and maintenance of the privacy in the hospital, highlighting respect as the most important aspect, followed by personal control over situations that violate privacy. Patients believe that privacy is linked to dignity and respect, depends on the demarcation of the personal/territorial space and the autonomy's security; and that these concepts and attitudes are connected and essential to protect privacy in the hospital context.

A Study on Protecting Patients' Privacy of Obstetric and Gynecologic Nurses

PURPOSE

This study aims to determine obstetric and gynecologic (OBGY) nurses' perception and performance propecting patients' privacy, and to contribute to develop educational program and improve the quality of nursing care.

METHODS

206 OBGY nurses in 6 hospitals using an electronic medical record or an order communicating system were chosen by convenience sampling and agreed to participate in the study. The questionnaire, explored 4 domains of privacy: direct nursing, linked business, patient information management, communication with relatives.

RESULTS

Perception and performance of protecting patient privacy averaged 4.29 (of 5) and 3.55 (of 5), respectively. Most nurses (94.2%) recognized the importance of protecting patient privacy, 80.1% received patient privacy education. There was a distinct difference between the perception and performance of protecting patient privacy of nurses. Performance of protecting patient privacy had a positive correlation with perception.

CONCLUSION

Proper performance of protecting privacy protection requires improving perception of each nurse on the patient privacy, and various efforts should be made to minimize the affect from external factors such as hospital environment. It is needed to educate nurses for patient privacy. It is also needed for medical organizations to improve their policies and facilities to ease the performance for privacy protection.

Smart wearable systems: current status and future challenges

OBJECTIVE

Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research.

METHODS

Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered.

RESULTS

We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS.

CONCLUSION

We conclude by identifying the future challenges facing SWS for HM.

"Not all my friends need to know": a qualitative study of teenage patients, privacy, and social media

Background

The literature describes teenagers as active users of social media, who seem to care about privacy, but who also reveal a considerable amount of personal information. There have been no studies of how they manage personal health information on social media.

Objective

To understand how chronically ill teenage patients manage their privacy on social media sites.

Design

A qualitative study based on a content analysis of semistructured interviews with 20 hospital patients (12–18 years).

Results

Most teenage patients do not disclose their personal health information on social media, even though the study found a pervasive use of Facebook. Facebook is a place to be a “regular”, rather than a sick teenager. It is a place where teenage patients stay up-to-date about their social life—it is not seen as a place to discuss their diagnosis and treatment. The majority of teenage patients don't use social media to come into contact with others with similar conditions and they don't use the internet to find health information about their diagnosis.

Conclusions

Social media play an important role in the social life of teenage patients. They enable young patients to be “regular” teenagers. Teenage patients' online privacy behavior is an expression of their need for self-definition and self-protection.

Uncovering the features of negotiation in developing the patient-nurse relationship

This article describes a study that set out to explore the interaction between patients and nurses in community practice settings, in order to understand the social meanings and understandings brought to the interaction and at play within it.

METHOD

The study used a grounded theory methodology with traditional procedures. Driven by constant comparative analysis, data were collected by non-participant observation and informal and semi-structured interviews in four community health centres. Eighteen patients and 18 registered practice nurses participated.

RESULTS

Negotiation was found to be a fundamental process in patient- nurse interaction. Navigation, socio-cultural characteristics and power and control were found to be key properties of negotiation. The negotiation processes for developing understanding required patients and nurses to draw upon social meanings and understandings generated from within and beyond their current interaction.

CONCLUSION

Social meanings and understandings created within and beyond the health-care setting influence negotiation. The developmental nature of negotiation in interaction is an important dimension of the patient- nurse relationship in community practice.