Abstract
BackgroundIn Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents’ attitudes towards confidentiality protection in adolescent sexual and reproductive healthcare (SRH) by comparing data from surveys administered in 2005 and 2012.MethodsFor both surveys, the participants were random samples of the Lithuanian residents aged 16 to 74. A 23-item questionnaire was used in 2005 and complemented with 2 items in 2012. Linear regression analysis was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables.ResultsThe total number of respondents was 1054 (response rate 83 %) in 2005 and 1002 (response rate 80 %) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62 % in 2005 to 73 % in 2012. Regardless of their belief in the importance of confidentiality, in 2012 respondents more often indicated positive outcomes on the relations between the physician and the minor patient, such as increased trust of the adolescent in the physician and more frequent visits to physicians. However, study participants who believed that adolescents would find confidentiality important in 2012 were less optimistic about potential positive outcomes of further legal consolidation of adolescents’ right to confidentiality than in 2005. Younger respondents were the most optimistic about potential outcomes if laws were enacted to further protect adolescent confidentiality.ConclusionsThis study uncovers the dynamics of public attitudes towards the socially and ethically sensitive issue of adolescent SRH. Our study suggests that legislation could be a factor prompting changes in public opinion, but not sufficient in and of itself for its social acceptance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1027-5) contains supplementary material, which is available to authorized users.
Highlights
In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation
This resulted in 1054 study participants (83 % response rate)
Specific public education campaigns coupled with interventions targeted at adolescents’ parents or guardians in healthcare settings could be instrumental in eliminating fears that are potentially related to confidentiality in ASRH and in shaping a new understanding of parenthood
Summary
In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. A violation of confidentiality increases potential negative consequences because a lack of trust in the physician reduces the disclosure of information needed to make an appropriate medical decision. Regardless of these potential negative health consequences, a breach of confidentiality is primarily seen as a violation of personal autonomy and privacy. Studies in adolescent sexual and reproductive healthcare (ASRH) provide evidence supporting the importance of confidentiality. The existing body of research indicates that a lack of confidentiality decreases adolescents’ interest in seeing healthcare providers [3, 4], deteriorates physicianpatient communication [5] and negatively affects continuity of care [6, 7]. Confidentiality has been shown to be one of the leading reasons for adolescents to use preventive services [9] and is an important criterion of quality of care in general [10]
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