Introduction: Confidentiality is one of the oldest ethical principles in healthcare. However, confidentiality in adolescent healthcare is not a universally-accepted doctrine among scholars. The ethical acceptability of confidential services in adolescents' healthcare is based on perceptions of adolescent maturity and an appreciation of its importance to adolescents' access and utilization of healthcare services. Despite legal policies that promote adolescents' rights, physicians' attitudes toward adolescent confidentiality can be a determining factor in their ultimate decision to protect adolescents' confidentiality.
Method: A new Attitude towards Adolescent Confidentiality Scale was developed based on the results of a qualitative interview study. This new instrument was administered to a sample of 152 physicians working at school pediatric and gynecology departments in 13 primary healthcare institutions in Belgrade. Principal component analysis was applied to determine the main components of the scale. Reliability was assessed by calculating Cronbach alpha and mean inter-item correlations.
Results: Psychometric analysis of the final 19-item version of the scale showed a high level of reliability (Cronbach alpha of 0.83). Principal component analysis showed four components, which present subscales of the instrument: Confidentiality in clinical situation, Iimportance of confidentiality, Adolescent maturity, and Communication with parents.
Conclusions: The instrument showed satisfactory levels of reliability and validity. The results of the scale dissemination may be a valuable tool for needs assessment for future educational interventions and training programs that will raise physicians' awareness of the importance of adolescent confidentiality.
Uvod: Zaupnost je eno najstarejših etičnih načel v zdravstvenem varstvu. Vendar zaupnost pri zdravstvenem varstvu mladostnikov med strokovnjaki ni splošno sprejeta doktrina. Etična sprejemljivost zaupnih storitev pri zdravstvenem varstvu mladostnikov temelji na dojemanju zrelosti mladostnikov in priznavanju njene pomembnosti za dostop mladostnikov do storitev zdravstvenega varstva in njihovo uporabo. Kljub pravnim politikam, ki spodbujajo pravice mladostnikov, je lahko odnos zdravnikov do zaupnosti mladostnikov odločilni dejavnik pri končni odločitvi za zaščito zaupnosti mladostnikov.
Metoda: Na podlagi rezultatov kvalitativne raziskave z intervjuji smo oblikovali novo lestvico odnosa do zaupnosti mladostnikov. Novi instrument smo izvedli v vzorcu 152 zdravnikov, zaposlenih v pediatričnih in ginekoloških oddelkih v 13 ustanovah primarnega zdravstvenega varstva v Beogradu. Za določitev glavnih komponent lestvice smo opravili analizo glavnih komponent. Zanesljivost smo ocenili z izračunom koeficienta Cronbach alfa in povprečnih korelacij med postavkami.
Rezultati: Rezultati psihometrične analize končne različice lestvice z 19 spremenljivkami so pokazali visoko raven zanesljivosti (koeficient Cronbach alfa 0,83). Analiza glavnih komponent je pokazala štiri komponente, ki predstavljajo pomožne lestvice instrumenta: zaupnost v posebnih kliničnih stanjih, pomembnost zaupnosti pri zdravstvenem varstvu mladostnikov, zrelost mladostnikov in starševska odgovornost ter komunikacija in skrivnosti med mladostniki in starši.
Sklepi: Instrument je pokazal zadovoljive ravni zanesljivosti in veljavnosti. Rezultati razširjanja lestvice so lahko dragoceno orodje za oceno potreb pri prihodnjih izobraževalnih intervencijah in programih usposabljanja, ki bodo zdravnike ozaveščali o pomembnosti zaupnosti mladostnikov.
Keywords: adolescent; attitude of health personnel; confidentiality; primary healthcare; psychometrics; surveys and questionnaires.
© 2020 Vida Jeremić Stojković et al., published by Sciendo.