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1.
Pediatrics ; 126(6): e1469-76, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21098148

ABSTRACT

OBJECTIVE: To understand adolescents' preferences for multidimensional aspects of privacy, including psychological, social, and physical, and confidentiality (informational privacy) in the health care setting. PATIENTS AND METHODS: Fifty-four adolescents with and without chronic illness participated in 12 focus groups composed of participants of the same age (11-14 or 15-19 years), gender, and health status. Health care preferences, including privacy and confidentiality, were discussed, and themes were determined. On the basis of a literature review, Burgoon's framework best represented participant feedback. The data were categorized as representations of informational, psychological, social, or physical privacy. RESULTS: Maintaining informational privacy (ie, keeping information confidential) was most salient to the adolescents. Younger adolescents were concerned with information being disclosed to others (ie, health care providers), whereas older adolescents worried more about information being disclosed to parents. Other privacy aspects (psychological, social, and physical) also were important. To protect psychological privacy, adolescents were cautious about revealing sensitive information for fear of being judged by providers. To protect social privacy, they were reluctant to talk with unfamiliar or multiple providers, and they did not want to discuss issues they perceived as unrelated to their health care. Adolescents who commented about physical privacy said that they thought about their physical safety during physical examinations, as well as their visibility to others, and said that they were more comfortable when examinations were performed by female rather than male providers. CONCLUSIONS: Adolescents value all aspects of privacy. Providers should address not only informational but also psychological, social, and physical privacy to improve the care of adolescent patients.


Subject(s)
Adolescent Health Services/standards , Confidentiality , Disclosure , Health Services Needs and Demand , Health Status , Adolescent , Child , Female , Humans , Male , Young Adult
2.
J Fam Pract ; 54(8): 679-87, 2005 Aug.
Article in English | MEDLINE | ID: mdl-16061053

ABSTRACT

OBJECTIVE: To explore how adolescents with and without chronic illness perceive patient-physician trust and to identify physician behaviors related to these perceptions that might be modified to promote adolescent health care. METHODS: Fifty-four adolescents recruited from the community (healthy subjects) and from hospital-based clinics (subjects with chronic illnesses) participated in 12 focus groups divided by age (11-14 or 15-19 years old), gender, and health status. Major themes related to preferred physician characteristics and trusting one's doctor were derived through a multistep, team-based qualitative analytic process. RESULTS: Adolescents hold varied perspectives of trust in their physicians. They describe elements of patient-physician trust similarly to the comprehensive model developed with adults, including fidelity, confidentiality, competency, honesty, and a global perspective intersecting several of the more specific domains. However, adolescents differ in the relative importance of these dimensions. Younger adolescents express more concern about confidentiality of their health information, and adolescents with chronic illnesses are more interested in involving parents in their care than are adolescents without chronic illnesses. Examples of specific behaviors to improve trust include asking for adolescent's opinion, keeping private information confidential, not withholding information, and engaging in small talk to show concern. CONCLUSION: Understanding the importance of trust and listening to recommendations about behaviors to improve it, in the words of the adolescents, may help physicians build positive relationships with their adolescent patients.


Subject(s)
Physician-Patient Relations , Psychology, Adolescent , Trust , Adolescent , Child , Chronic Disease , Family Practice , Female , Focus Groups , Humans , Male , Ohio
3.
Clin Pediatr (Phila) ; 43(1): 55-61, 2004.
Article in English | MEDLINE | ID: mdl-14968893

ABSTRACT

This study describes adolescent preferences about offices and waiting. Fifty-four adolescents participated in 12 discussion groups, which were audiotaped and transcribed. The transcripts were analyzed qualitatively. Two themes emerged about the health care environment: (1) making the interior design less childish, more teen-oriented, and more home-like; and (2) decreasing waiting time and enhancing waiting experience by providing teen diversions (e.g., magazines, tv, games). Teens preferred that artwork portray realistic images, that medical paraphernalia be hidden, and that colors be neutral. Modifying interior décor, constructing smaller subwaiting areas, and incorporating diversions that are teen-oriented may help promote positive health care experiences and utilization by adolescents.


Subject(s)
Attitude , Health Facility Environment , Interior Design and Furnishings , Patient Satisfaction , Physicians' Offices , Psychology, Adolescent , Adolescent , Adult , Appointments and Schedules , Child , Environment Design , Female , Focus Groups , Humans , Male
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