3: An Assessment of Adolescents’ Knowledge of Confidentiality in Health Care

Abstract

Purpose: To gain a better understanding of adolescents’ knowledge about their ability to receive confidential health care without the knowledge and consent of their parents or guardians. Methods: In primary care and subspecialty pediatric clinics, subjects ages twelve through seventeen were given an anonymous survey to complete. The questionnaire determined if the respondents were aware that adolescents could receive health care in a confidential manner. The questionnaire also determined the specific areas of health care respondents believed could be kept confidential. Questions were designed to determine adolescents’ knowledge about the circumstances where health care providers could break patient confidentiality. The study was approved by the hospital IRB. Results: A total of 47 adolescents completed the survey (48.9% male, 51.1% female). The survey completion appeared fairly evenly spread among the ages of 12 to 17. The majority of adolescents (74.5%) surveyed reported that they had never discussed confidentiality with their doctor. A majority of adolescents (66.0%) were aware that confidential health care is available. However, among those who believed that a healthcare provider could provide confidential care, there was no clear pattern as to which areas of care could be provided in a confidential manner. Those respondents who self-identified as being sexually active were statistically more likely to be aware of the availability of confidential health care as compared to those respondents who self-identified as not being sexually active (100% vs. 51.6%, p 0.05). Among those respondents who were aware that health care could be obtained in a confidential manner, most were aware that under certain circumstances, the health care provider could break the patient’s confidentiality. However, only 42.6% of respondents believed that their health care providers followed the laws relating to confidentiality. Conclusions: Adolescents have a wide range of correct and incorrect knowledge regarding confidentiality in health care. Given the importance of confidentiality to the delivery of appropriate health care to adolescents, education is needed to convey the message that confidentiality in adolescents’ health care is available. Not only do adolescents need to know that confidential health care is available, but clinicians who deliver care to adolescents need to be encouraged to discuss confidentiality with their adolescent patients and their parents or guardians. Sources of Support: None.