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.

Patient's informational privacy in prehospital emergency care: Paramedics' perspective

BACKGROUND

As a fundamental human right in healthcare, informational privacy creates the foundation for patient's safety and the quality of care. However, its realization can be a challenge in prehospital emergency care, considering the nature of the work.

OBJECTIVES

To describe patient's informational privacy, its realization, and the factors related to the realization in prehospital emergency care from the perspective of paramedics.

RESEARCH DESIGN

A descriptive questionnaire study was conducted. The data were analyzed with inductive content analysis.

PARTICIPANTS AND RESEARCH CONTEXT

The participants (n = 26) were paramedics in one of the 22 rescue departments in Finland.

ETHICAL CONSIDERATIONS

The study received ethical approval from the ethics committee of the University of Turku (Finland). Permission for the study was given by the collaborating rescue department.

FINDINGS

Paramedics described patient's informational privacy as patients' right to their own health records, as protection of the patient's health records, and as comprehensive respect of the patient's privacy by the persons involved in the patient's care. In general, informational privacy was described as being realized regarding confidentiality, reporting, and maintaining the patient's health records. However, it was also described as being dependent on the context, and some areas in need of improvement were identified. Promoting and preventing factors related to the realization were also identified. The promoting factors were paramedics' professional activity, environment, training, and guidelines. The preventing factors were the nature of the work, paramedics' attitudes, and the lack of knowledge concerning informational privacy among paramedics, the collaborating authority, patients, and relatives.

DISCUSSION AND CONCLUSION

Paramedics had a multidimensional understanding of informational privacy and the factors related to its realization. However, its realization varies, and more research and education are therefore needed to enhance the realization and to provide equal and high-quality care for all the patients in prehospital emergency care.

Does Disclosure About the Common Factors Affect Laypersons' Opinions About How Cognitive Behavioral Psychotherapy Works?

Background: Written and online information about cognitive-behavioral therapy (CBT) prioritizes the role of specific techniques (e.g., cognitive restructuring) and typically omits discussion of “common factors” (e.g., the working alliance, or therapist empathy). However, according to extensive psychotherapy process research the common factors may be important mediators of client improvement.

Objectives: This study aimed to assess lay opinions about the role of specific and common factors in CBT for depression. We also aimed to determine how different client disclosure processes might affect lay opinions about the relative importance of specific and common factors in CBT.

Methods: We conducted a web-based experiment involving a sample of US participants who had never undergone psychotherapy. All participants were presented with similar vignettes describing an individual suffering from depression whose doctor recommends CBT. Participants were randomized to read one of six vignettes created in a 2 × 3 factorial design that crossed client gender with type of informed consent (Standard CBT Disclosure vs. Common Factors and CBT Disclosure vs. No Disclosure).

Results: Disclosure type had a significant effect on participants' ratings of Common and Specific factors in psychotherapy. As compared to the CBT disclosure, participants allocated to the Common Factors disclosure rated Empathy and Positive Regard as significantly more important to treatment outcome, and rated the Specific factors of CBT as significantly less important to outcome. There were no significant differences between No Disclosure and Standard CBT Disclosure, and these participants rated Specific factors of CBT and the Working Alliance as more important components in treatment, and Empathy and Positive Regard as less important.

Conclusions: The content of information disclosures influences lay opinions about the importance of specific and common factors in CBT. Further research should investigate ethically acceptable disclosures to CBT and other forms of psychotherapy, including whether disclosure practices affect treatment outcome.

Is privacy privacy?

This position paper observes how different technical and normative conceptions of privacy have evolved in parallel and describes the practical challenges that these divergent approaches pose. Notably, past technologies relied on intuitive, heuristic understandings of privacy that have since been shown not to satisfy expectations for privacy protection. With computations ubiquitously integrated in almost every aspect of our lives, it is increasingly important to ensure that privacy technologies provide protection that is in line with relevant social norms and normative expectations. Similarly, it is also important to examine social norms and normative expectations with respect to the evolving scientific study of privacy. To this end, we argue for a rigorous analysis of the mapping from normative to technical concepts of privacy and vice versa. We review the landscape of normative and technical definitions of privacy and discuss specific examples of gaps between definitions that are relevant in the context of privacy in statistical computation. We then identify opportunities for overcoming their differences in the design of new approaches to protecting privacy in accordance with both technical and normative standards.This article is part of a discussion meeting issue 'The growing ubiquity of algorithms in society: implications, impacts and innovations'.

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.