Patient Data Sharing and Confidentiality Practices of Researchers in Jordan

Clinical Research: A Review of Study Designs, Hypotheses, Errors, Sampling Types, Ethics, and Informed Consent

Recently, we have been noticing an increase in the emergence and re-emergence of microbial infectious diseases. In the previous 100 years, there were several incidences of pandemics caused by different microbial species like the influenza virus, human immunodeficiency virus (HIV), dengue virus, severe acute respiratory syndrome Coronavirus (SARS-CoV), middle east respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2 that were responsible for severe morbidity and mortality among humans. Moreover, non-communicable diseases, including malignancies, diabetes, heart, liver, kidney, and lung diseases, have been on the rise. The medical fraternity, people, and governments all need to improve their preparedness to effectively tackle health emergencies. Clinical research, therefore, assumes increased significance in the current world and may potentially be applied to manage human health-related problems. In the current review, we describe the critical aspects of clinical research that include research designs, types of study hypotheses, errors, types of sampling, ethical concerns, and informed consent.

Jordanian views regarding sharing of medical data for research: A cross-sectional study during COVID-19 pandemic

PURPOSE

In the current study, the views of Jordanian regarding sharing medical reports for research purposes were investigated during the COVID-19 pandemic. In addition, motivators and barriers regarding sharing of medical records were examined.

METHODS

This observational survey-based cross-sectional study was conducted using an electronic questionnaire during the COVID-19 pandemic (second half of 2020). The questionnaire link was disseminated through two social media platforms (WhatsApp and Facebook), targeting Jordanian adults (age >18 years).

RESULTS

In this study, 1,194 participants agreed to complete the study survey. Results showed that 58.3% of them (n = 696) reported to be willing to share their medical data. while 17.6% of the participants (n = 210) showed hesitancy to share their medical information. The most important motivators as perceived by the study participants were helping other patients who have similar health conditions (n = 995, 83.3%). Moreover, fearing from stigma (n = 753, 63.1%), and the lack of confidence in data security and privacy (n = 728, 61.0%) were among the main barriers preventing participants from sharing their information. Finally, results showed that participants with higher educational level (bachelor or higher) (OR = 0.299, P<0.001), or those living in center of Jordan (OR = 0.270, P<0.001) showed a lower tendency to share their medical data. While participants those who have shared data before showed a higher tendency to share their medical data (OR = 2.524, P<0.001).

CONCLUSION

In this study, many of the participants had a positive attitude towards sharing biomedical data for scientific research during the COVID-19 pandemic, many had doubts in the control over their data. Thus, policymakers and data users should address the concerns and values of patients and understand their preferences in favor of an ethically scrupulous use of data in research.

Knowledge, practices, and patterns of data confidentiality among pharmacists in a developing country

Background

Increased application of electronic health information systems led to the buildup of patient information and facilitated access to this data. Consequently, the confidentiality of this information became an ethical challenge to medical teams' members including pharmacists. However, no study has been conducted to assess pharmacists' knowledge or practices of data confidentiality. Thus, the aim of this study was to assess the current practices and knowledge of pharmacists concerning data confidentiality.

Methods

This was a cross sectional study that included clinical pharmacists in tertiary hospitals and health care centers in Jordan. Data was collected through phone or face to face interviews using a data collection sheet. All continuous data was presented as median ± interquartile range (IQR) and categorical data as frequency (%). One way Chi square was used to check significant differences among categorical groups. Predictors that may affect knowledge and behavior scores were screened using simple linear regression.

Results

A total of 388 pharmacists were interviewed with a mean age of 39.59 ± 8.32 years, with an average experience of 12.55 ± 7.30 years. Pharmacists relied on their personal experience to resolve ethical dilemmas (n = 274, 70.3%), and when they seek advice, their work colleagues (n = 180, 46.4%) %), followed by the head of departments (144 n; 37.1%), were the main source of advice on ethical issues. The overall median knowledge score of pharmacists about data confidentiality was 2.0 out of 5.0 (IQR = 2.0). A considerable percentage of the pharmacists was willing to share information with family members without asking for permission from the patient (n = 98, 25.3%). Pharmacists had a median behavior score of 3.5 out of 4.0 (IQR = 0.4) regarding practices related to data confidentiality, where the majority of them handled medical information from the patient with great confidentiality (304 n, 78.4%), and 85.8% of them (n = 333) gave patient's sexual diseases-related medical information the highest confidentiality. However, based on univariate and multivariate linear regression analysis, none of the examined sociodemographic variables significantly predicted pharmacists' knowledge or behaviors (P > 0.05).

Conclusion

Pharmacists are aware of the importance of confidentiality issues of their patients. However, a number of gaps in their knowledge and practices of data confidentiality were identified. Training that targets these gaps in their knowledge, and rectifies incorrect practices is needed during university education and as part of their continuous medical education.

Data privacy and confidentiality from the perspectives of general public and health care providers in Jordan

OBJECTIVES

To assess knowledge, attitude, and beliefs about the right to privacy and confidentiality from the viewpoints of the general public (GP) and the health system (HS) professionals in Jordan.

METHODS

An online-based cross-sectional descriptive questionnaire was distributed across Jordan during May & June of 2020. A total number of 388 respondents filled in the online survey assessing their knowledge, attitude, and opinion about the right to privacy and confidentiality being practiced during the professional contact between the patients and their health care providers.

RESULTS

Amongst the respondents, 44 (11.3%) participants were health care professionals, and 344 (88.6%) participants were from the general public. Most of the respondents were females (69.6%) and the mean age was about 27 years. The main sources of knowledge about patients' right to privacy and confidentiality regulations were from school and media platforms. Only 18.1% of the GP respondents reported that they have been introduced to patients' right to privacy and confidentiality regulations by medical staff during professional contact. Almost about 97% of GP respondents and 93.2% of HS professionals valued patients' right to assure the level of their data privacy prior to receiving medical care. A significantly (P = .012) higher percentage (93%) of GP respondents believed that there should be no prioritisation of privacy based on the gender of the patient. Most of the GP respondents had concerns about electronic medical records being violated and their data being reached by unauthorised parties.

CONCLUSION

The general public and health system professionals in Jordan are familiar with the patients' right to privacy and confidentiality regulations. More efforts must be put in place to inform patients about their rights to privacy and confidentiality practices when they are in professional contact with their healthcare providers. In addition, rules, laws, and legal agreements must be effectively established and monitored to prevent privacy violations.

Physicians' Knowledge, Perceptions, and Attitudes Related to Patient Confidentiality and Data Sharing

BACKGROUND

The protection of patient confidentiality is an essential practice for the successful provision of healthcare. This study examines physicians' knowledge and attitudes related to data sharing and patient confidentiality.

METHODS

This is a descriptive, questionnaire-based study. Physicians were invited via e-mail to complete the study survey. The survey comprised three sections related to knowledge, attitudes, and demographic characteristics.

RESULTS

A total of 221 physicians, with varying levels of experience and from a range of specialty areas, completed the study survey. Ethical dilemmas were encountered annually by physicians specialized in family medicine and daily by physicians in internal medicine wards more often than those in other departments. The mean score for knowledge was 7.34 (out of 14; SD=2.92) and had a positive correlation with attitudes towards the protection of data confidentiality (r2=0.282, p<0.001). Undergraduate courses were the main source of knowledge related to ethical issues (167; 74.9%). Sex (B=-1.47, p=0.001), marriage (B=-1.198, p=0.021), and source of consultation (B=-.248, p=0.02) were all found to predict knowledge scores. Likewise, attitudes were predicted by experience (B= 0.279, p<0.001), sex (B= -2.797, p=0.002), marriage (B=1.91, p=0.02), and number of ethical dilemmas faced (B=1.695, p <0.001).

CONCLUSION

Physicians from different departments were found to lack sufficient knowledge about many aspects of patient confidentiality. While some of the physicians' practices complied with the law, other practices were identified as patient confidentiality breaches.

Awareness, Intention to Act and Action in the Exercising of Patients' Rights: A Case Study of Patients in Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia

Background and Objectives

In Cambodia, the patients' rights guideline was officially released in 2007 as a measure of the government policy to promote greater awareness and empower Cambodian people to exercise their rights as patients. The aim of this study was to identify the proportion of patients aware of the existence of patients' rights and compare the proportions of patients intending to exercise their rights and those actually exercising their rights among the aware and unaware groups.

Methods

Data were collected with a structured questionnaire, using face-to-face interview technique, from 142 randomly selected outpatients visiting the Khmer Soviet Friendship Hospital in Phnom Penh, Cambodia. Intention to exercise patients' rights was measured on a 5-point Likert scale (ranging from 1 "definitely not" to 5 "definitely yes").

Results

The proportion of Cambodian patients who were aware of the existence of patients' rights was 31.0% (95% CI: 23.5, 39.3). The average intention to act scores was 4.0±0.5 for the whole group, and 4.3±0.4 and 3.9±0.5 for those aware and unaware of the existence of patients' rights, respectively. The difference in the mean scores of intentions to act between the aware and unaware groups was statistically significant (mean difference =0.40, 95% CI: 0.22, 0.58, t₁₄₀=4.514, P< 0.001). Patients reported a total of 250 situations in which they believed they should take action to exercise their rights and 96 times that they took action (38.4%, 95% CI: 35.46, 41.34).

Conclusion

The proportion of Cambodian outpatients aware of the existence of patients' rights and the proportion of outpatients that exercised their rights were both low. Nevertheless, it appeared that raising awareness of the existence of patients' rights raised patient's intention to act, which corresponds to the hierarchy-of-effects behavioral model.

Knowledge and Practice of Patients' Data Sharing and Confidentiality Among Nurses in Jordan

BACKGROUND

The key patient rights entail respecting human decency, receiving healthcare services of high-quality, the right to information, the initial agreement of the patient to medical intervention, respecting privacy and personal life, and sustaining care and treatment. This study aims to survey the knowledge and practice of nurses in various healthcare industries toward sharing and confidentiality of patients' data.

METHODS

A descriptive cross-sectional design was employed through an online survey from May to June 2020. The authors sent a developed tool containing 19 statements reflecting the understanding of nurses' knowledge and practice of privacy and sharing of data required to safeguard patient privacy. A total of 800 nurses agreed to participate in the study out of 1000 nurses.

RESULTS

Roughly, all participants agreed that junior nurses should participate in a data sharing and confidentiality course before engaging in practice. Regarding institution policies for data sharing and protection, many nurses agreed that there are special recommendations and instructions from the institution in which they work to exchange patient information among nurses and the medical staff. The predictors of sharing practices and confidentiality among nurses include age, gender, marriage status, and attending a security course before practice. Young age, female, not attending a data sharing course, and single nurses are less engaging with data sharing and confidentiality of the patients for unauthorized patients.

CONCLUSION

A significant proportion of the staff had appropriate practices that ensured data security. However, practices that ensure patient confidentiality in the aspects of access, sharing, and transferring of patient data need improvement. Training is essential since it will have a beneficial relationship with knowledge, opinions, views, and actions. Thus, planning continuous training on policies and regulations about data safety and privacy may assist in improving healthcare setting practices.

Graduate students reported practices regarding the issue of informed consent and maintaining of data confidentiality in a developing country

Research involving human subjects requires strict adherence to ethical principles, including informed consent and assuring data confidentiality. Herein, a questionnaire was utilized to assess compliance of graduate students who conduct research involving human subjects in Jordan with proper practices related to informed consent and maintaining of data confidentiality. Among the 251 respondents, 55.4% were from health-related fields, 61.4% undertook research involving humans, and 48.6% did research requiring institutional review board approval. Only 37.1% of respondents reported exposure to research ethics education during their graduate study. Satisfactory adherence to informed consent practices was reported at rates of 56.0%-67.5%. Satisfactory adherence to practices related to data confidentiality and study participants' anonymity was reported at rates of 67.3%-74.7%. Sharing of data or samples with others was reported at a rate of 24.3%. The rates of adherence to proper informed consent practices and practices that maintain data confidentiality were less than ideal. Significant policy changes need to be implemented to address these issues.