Respecting the privacy of hospitalized patients: An integrative review

The ethical pathway of individuals with stroke-A follow-up study

AIM

To analyse the ethical pathway as perceived by individuals with stroke (IwS) in the first three post-stroke months. In the novel concept of ethical pathway, dignity, privacy, and autonomy are considered as dimensions of the ethical pathway while the pathway illustrates their potential change in the post-stroke time. Furthermore, the focus of interest was on whether the perceived realisation of values is associated with the life situational factors of symptoms diminishing functioning, social environment, and self-empowerment.

METHODOLOGICAL DESIGN AND JUSTIFICATION

A follow-up study with a descriptive correlational design was used to capture the changes in the perceived realisation of values.

ETHICAL ISSUES AND APPROVAL

The study followed the ethical principles of research involving human participants. The study was approved by the ethics committee of the university and one of the university hospitals following national standards. Permission to conduct the study was obtained from the university hospitals.

RESEARCH METHODS AND INSTRUMENT

Data were collected from IwS after the onset of stroke and 3 months post-stroke with the Ethical Pathway of Individuals with Stroke instrument and background questions and were analysed statistically.

RESULTS

Thirty-six participants completed the questionnaire at both measurement points. Wide variety in the ethical pathway was detected. IwS' perceived dignity decreased and autonomy increased. Privacy did not change significantly. Of the life situational factors, IwS perceived less symptoms diminishing functioning and stronger self-empowerment while social environment was perceived as rather stable. Only one association was detected between the dimensions of the ethical pathway and life situational factors: autonomy had a low negative correlation with social environment of health care professionals.

CONCLUSIONS AND STUDY LIMITATIONS

The results provide preliminary evidence of the dynamic nature of the ethical pathway. The ethical pathway was incompletely realised for most participants and requires special attention and improvement in health care. The sample size is small and the results are therefore not generalisable.

A Qualitative Research Survey on Cardiologist's Ethical Stance in Cases of Moral Dilemmas in Cardiology Clinics

This study sought to determine cardiologists' degrees of ethical awareness and preferred courses of action for ethical dilemmas frequently encountered in clinical settings. For this evaluation, an online survey was created and sent to cardiologists affiliated with various academic posts in Ankara, Turkey. The survey included ten cases with various ethical considerations selected from our book, "Clinic Ethics with Cases from Cardiology." Four possible action choices were defined for each case. Participants were asked to choose one or more of these preferences. In addition, a fictional change was made in each case's context without changing the original ethical issue, and participants were asked whether an attitude different from the first chosen one was preferred. The participation ratio was 49/185 (26%), consent ratio 47/185 (25,4%), and completion ratio 44/185 (23,7%). Nine of the ten scenario changes did not change participants' preferred action. For most questions, action preferences were concentrated between the two options. Although legal regulations did not reduce ethical dilemmas, they clarified physicians' action preferences. Similarly, as an obscure moral issue gained prominence, physicians were forced to draw clearer lines in their actions. External factors such as healthcare emergencies can change physicians' ethical dilemma-solving attitudes.

Analysis of patients' privacy and associated factors in the perioperative period

Background

Healthcare professionals recognize how to protect patient privacy in order to effectively reduce the occurrence of conflict between the two parties. Therefore, understanding the protection of patient privacy during the perioperative period and the relevant factors affecting privacy is essential to improving healthcare delivery.

Methods

This was a cross-sectional survey of a convenience sample of 400 perioperative patients. General demographic information, the perioperative privacy scale (PPS), and the Amsterdam preoperative anxiety and information scale (APAIS) were used for the survey. And factors affecting patient privacy were investigated by ANOVA or t-test analysis, Pearson correlation analysis, and linear regression models.

Results

This study found that perioperative patient privacy satisfaction scores were (53.51 ± 12.54). The results of the univariate analysis showed that factors affecting privacy satisfaction included gender, age, and the number of surgeries (p < 0.05). Preoperative anxiety and Information Needs Scale was negatively associated with the perioperative patient privacy satisfaction (r = -0.807, p < 0.01). Further analysis was performed using linear regression models to finally obtain five factors affecting perioperative patient privacy: gender, age, anesthesia modality, the number of surgeries, and the Amsterdam preoperative anxiety and information.

Conclusion

Healthcare professionals working in healthcare facilities need to be aware of the sensitivity of different populations to privacy when protecting patient privacy. Patients' preoperative anxiety and information need status affect privacy satisfaction. This will mean that healthcare professionals will be able to identify key privacy concerns early and take appropriate action.

Healthcare professionals and pregnant and post-natal women's perceptions of interprofessional collaboration in a maternity care facility: A qualitative study from Botswana

OBJECTIVE

To explore the perceptions of healthcare professionals and pregnant and post-natal women regarding interprofessional collaboration in a maternity care setting in Botswana, a low-to-middle-income country in Sub-Sahara Africa.

DESIGN

A descriptive qualitative design using in-depth interviews with forty participants, including healthcare professionals and women in maternity wards. Data were transcribed and thematically analysed.

SETTING

Antenatal, delivery and post-natal maternity wards in a referral hospital that provides basic and specialist care in Botswana.

PARTICIPANTS

We interviewed 13 pregnant and post-natal women and 27 healthcare professionals in the maternity care wards.

FINDINGS

Participants perceived several interrelated factors that influenced the delivery of interprofessional collaborative care. Interpersonal factors such as poor communication, disrespectful behaviours and inadequate teamwork practices prevented interprofessional collaboration. Other barriers to collaboration included lack of understanding of each other's roles and responsibilities, ineffective coordination of resources, hierarchical power struggles and poor collaborative leadership.

KEY CONCLUSIONS

Effective interprofessional collaboration remains elusive in this maternity care setting. Healthcare systems in low-to-middle-income countries may benefit from interventions for healthcare professionals to learn and practice interprofessional collaborative care.

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.

Mobile health apps use among Jordanian outpatients: A descriptive study

Our purpose in this descriptive cross-sectional study was to examine the prevalence of mobile health (mHealth) apps use, factors associated with downloading mHealth apps, and to describe characteristics of mHealth apps use among Jordanian patients in government-sponsored outpatient clinics. A total of 182 (41.6%) of the 438 outpatients who completed questionnaires downloaded mHealth apps. Common reasons for downloading mHealth apps included tracking physical activity, losing weight, learning exercises, as well as monitoring, and controlling diet. More than two thirds of the users (70%) stopped using the apps they downloaded due to loss of interest, lack of anticipated support, too time consuming, or better apps available. The most common personal reasons for never downloading mHealth apps were lack of interest, in good health, and the most common technical reasons included a limited data plan, lack of trust, cost, and complexity of the apps. We also found that gender, age, weight, and educational level influenced the decision whether to download mHealth apps or not. We have shown the potential in mHealth apps use among Jordanian patients is promising, and health care systems must adopt this technology as well as work through population needs and preferences to supply it.

Evaluating the Effective Factors of Hospital Rooms on Patients' Recovery Using the Data Mining Method

OBJECTIVES

This study aims to investigate the effective environmental factors of hospital rooms in patients' recovery through data mining techniques.

BACKGROUND

Previous studies have shown the positive effect of the interior environment of the hospitals on patients' recovery. The methods of these studies were mainly based on the evidence and patients' perception while hospital environments are associated with a large amount of data that make them an appropriate case for data mining studies. But data mining studies in hospitals mainly focused on medical and management purposes rather than evaluating the interior environment condition.

METHODS

We analyzed the hospital information system data of a hospital using Python programming language and some of its libraries. Preprocessing and eliminating the outliers, labeling and clustering of diseases, data visualization and analysis, final evaluation, and concluding were done using the knowledge discovery in databases process.

RESULTS

Pearson coefficient value for rooms' area was .5 and, respectively, for the distance from the ward entrance and nursing station were .75 and .70. The χ² values for the variables of room types, location, and occupation were 24.62, 18.98, and 21.53, respectively, and for the beds' location was 0.12.

CONCLUSIONS

The results confirmed the correlation of the length of stay with the room types, location, and occupation, distance from the nursing station and ward entrance and also showed a moderate correlation with the rooms' area. However, no evidence was found about the relationship between the beds' location in rooms and patients' length of hospital stay.

Patient's Dignity: Viewpoints of Patients and Nurses in Hospitals

Much of the available research on perceptions of patient dignity either is qualitative in type or explores them in specific patient groups, such as elderly patients, cancer patients, terminally-ill patients, and adolescent patients. The present study addresses nurses' and adult patients' views on patient dignity. A total of 400 individuals (200 nurses and 200 patients) from 39 internal and surgical units from four hospitals affiliated to Shiraz University of Medical Sciences participated in the study. The collected data were analyzed using descriptive, t-test, one-way ANOVA, and Pearson's correlation coefficient using SPSS v. 23.0. A significant difference between nurses' and patients' points of view was identified in relation to four domains: the importance of privacy (p < 0.001); attention to patient autonomy (p < 0.001); respect for patients (p < 0.001); and communication between nurses and patients (p < 0.001). In order to maintain patients' dignity in practice, nurses must become better acquainted with patients' expectations. The questionnaire assessing respect for patient's dignity developed in the present study is a reliable and valid instrument for this purpose.

The challenges of male nurses in the care of female patients in Iran

BACKGROUND

Nurses professional duty mean that nurses must care for patients without gender discrimination. Meanwhile, the intrinsic differences between men and women and the need for personal contact with the patients during care procedures can create challenges for male nurses in the process of caring for a female patient.

AIMS

The present study aims to understand the challenges of male nurses in the care of female patients in Iran.

METHODS

A descriptive qualitative study was conducted with 20 male nurses selected by purposive sampling. Data were collected through unstructured and semi-structured interviews as well as observations and were analysed using conventional content analysis, based on the Graneheim and Lundman model.

FINDINGS

The findings revealed two main themes, including 'religious-cultural restrictions' and 'inappropriate organizational context'.

DISCUSSION/CONCLUSION

Male nurses are faced with a combination of religious-cultural and organizational challenges in providing patient care without discrimination in clinical settings. In addition to negatively affecting the quality of nursing care and satisfaction for female patients, these problems also create a stressful work environment for male nurses.

IMPLICATIONS FOR HEALTH PRACTICE AND POLICY

These problems can be alleviated in clinical settings by trying to ensure same-gender nurses and patients, especially when performing personal care. In addition to the efforts made by nurses to present a positive and real image of themselves in caring for female patients, health policy-makers should also attempt to improve society's attitude towards male nurses caring for female patients through the media.