THE OBSERVANCE OF DIFFERENT ASPECTS OF PATIENT PRIVACY: ANALYSIS OF ELDERLY VIEWS

Introduction: Privacy is one of the basic human rights which has always been emphasized from the far past and has been proposed in all social systems and schools of law over time. Privacy is also closely related to normative values in the healthcare environment. People normally tend to have it respected, protected and under control. Patient privacy, as part of the patient rights with respect to the dignity of the person, is nowadays considered as the cornerstone of treatment and patient care. The importance of preserving the privacy and dignity of the patient is continuously increasing as a principle of medical ethics. Observance of personal privacy is also an important variable in determining the level of satisfaction and patients' perception of care services quality. Most studies in this field, however, have been carried out in ICU and on non-elderly age groups. The aim of this study was to determine the elderly's attitudes towards respect to their privacy during nursing cares. Methods: In this descriptive cross-sectional study, the study population included all hospitalized elderly patients in medical-surgical wards of the governmental hospitals in the city of Ferdows. The sample size was calculated based on the Cochran formula (95% confidence level and maximum sampling errors of 5%) as 100, and convenient sampling was employed as the sampling method. Data compilation instrument was a questionnaire consisting of two parts. The first part of the questionnaire consisted of seven questions regarding such demographic data as age, sex, marital status, education level, occupation, place of residence, and duration of hospitalization. The second part contained 30 questions on different aspects of human realm (18 questions) and personal space (12 questions). The questionnaire prepared by Heidari (1999) was chosen and its validity and reliability were verified. Content validity was used to evaluate the validity, and split-half method was adopted to assess the reliability of the method. The correlation coefficient between the two halves of the test was r = 0.8 and the reliability of the test using the Spearman-Brown formula was 0.88. The answers to the questions with positive aspects were scored with three points for "all cases", two points for "often", one point for "sometimes", and zero point for "never" or "no". The answers to the questions with negative aspects had negative scores, respectively. The total scores for all of the questions in each questionnaire were calculated in the “total” column and the “percentage” column. Privacy observance was classified into three levels of poor, medium and fine. Scores between zero and 33.33% were classified as poor, scores from 33.34% to 66.66% were labelled as medium, and scores from 66.67% to 100% were viewed as fine. All ethical considerations were observed at various stages of research. To do that, the following measures were taken: informed consent was obtained; the questionnaires were anonymous: the information remained confidential; data collection was undertaken by people of the same sex with people answering the questionnaires; the nature and objectives of the research were explained and were justified to the participants; taking part in the study was free and voluntary. Using interviews, questionnaires were completed at the surgical wards of Shahid Chamran Hospital in the city of Ferdows in the morning, afternoon and night shifts. The data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (t-test, ANOVA test, Mann-Whitney, Spearman tests) running SPSS statistical software (version 18). Ethical considerations: informed consent was obtained, after explaining about study aim, anonymously and confidentiality of the information, verbal consent of the participants was obtained. Data collection was done by persons with similar sex. Results: The mean and standard deviation for the age of the patients in the study was 73.69 ± 8.71 years (age range of 60 to 95) with men composing 53 percent of them. Of the sample, 77% (n = 77) were married. In terms of education, 96 percent of the participants had degrees lower than diploma and only 4% had higher education. The mean and standard deviation for duration of hospitalization was 4.83 ± 3.27 days. A total of 69 percent of the patients had a history of hospitalization. The results of the study in terms of human realm showed that most of the patients with a mean score of 16.95 ± 5.73 (74%) had mentioned respect for human realm as poor, and regarded observance for the personal space as poor with a mean score of 11.55 ± 2.15 (99%). The lowest observed issues for the patients in terms of personal privacy were asking very personal questions (100%), disrespecting the patients’ personal stuff (99%), and staff’s sitting on the patients’ bed (99 percent). Using independent t-tests, a significant difference was found between the gender and the human realm with the total score of observed privacy. In other cases, no statistically significant relationship was found between age, marital status, and place of residence with the total score of observed privacy. Discussion and Conclusion: The present study revealed that observing the privacy of elderly patients is at a low level. This may reflect the weakness of health systems in the observance of privacy of the patients, especially that of the elderly. The need for privacy is one of the patient's basic needs, any disruption in estimation of which may lead to many problems as patients’ increased anxiety and stress, distrust towards the medical staff, aggressiveness, hiding the medical history and physical examination refusal. Therefore, the need to educate the nurses and other medical personnel about observing the patients’ privacy and to enhance the supervising functions of the managers and the staffs in the field seems necessary. Familiarity with how the nurses should observe the elderly patient's privacy can contribute to professional development of the staff and respecting the patients’ rights and satisfaction. Being sensitive towards the patient's privacy, nurses can also respectfully fulfil the patients’ expectations. Moreover, addressing the shortage of manpower in different hospital wards can be helpful; obviating this shortage, the necessary background to improve the quality of care would be delivered. It is recommended that some further research investigate the impact of facilitating and debilitating factors on the observance of the patients’ privacy, and the impact of holding workshops on the performance of the nurses in observance of the patients' privacy. Please cite this article as: Yazdanparast E, Davoudi M, Ghorbani SH, Abbaspoor M. The observance of different aspects of patient privacy: Analysis of elderly views. Med Ethics J 2016; 10(36): 73-80.