confidentiality in adolescent health care

Marks, A., Malizio, J., Hoch, J., Brody, R., & Fisher, M. (1983). American Journal of Preventive Medicine, 44(1 Suppl 2), S119S124. Confidentiality protections are critical in the provision of comprehensive primary care of adolescent patients. Tax calculation will be finalised at checkout. Curr Opin Pediatr 2009;21(4):450-56. Confidentiality, consent, and caring for the adolescent patient. PMC Adolescents with higher levels of risk behaviours, (i.e., substance use or mental health issues) are more likely to use an emergency department (ED) as their primary source of care [34]. Springer, Boston, MA. Unable to load your collection due to an error, Unable to load your delegates due to an error. The accuracy of the response rate to the online survey is difficult to determine. Chicago, IL: National Commission on Correctional Health Care. J Adolesc Health 2011;49(4):428-30. Adolescents views on barriers to health care: A pilot study. It is unclear how health care . Also, the understanding of how family-centred care may apply to adolescents must be explored, as well as similar studies performed involving health care providers regarding their understanding and practice on the related issue of capacity to consent. Data is temporarily unavailable. Ford C, English A, Sigman G. Confidential health care for adolescents: Position paper for the Society for Adolescent Medicine. While the present study was performed at the Alberta Childrens Hospital in Calgary, Alberta, we speculate that there may be similar practices in other settings, in Canada as well as in other countries. Similar to confidentiality laws, Newfoundland and Labrador [17]and Quebec [19]identify a specific age at which a minor can consent to low-risk treatments. Klein JD, Wilson KM, McNulty M, Kapphahn C, Collins KS. This could include posted documents describing patient rights and making sure families and clinical staff are familiar with and respect these rules. The survey consisted of 15 closed questions, six of which included a request for open comments. B., Eaton, D. K., Voetsch, A. C., Wiegand, R. E., Miller, K. S., & Doshi, S. R. (2012). Obstetrician-gynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. Guss CE, Wunsch CA, McCulloh R, Donaldson A, Alverson BK. government site. Further research indicated that youth who forgo health care are those at highest risk and those who need health care services the most (7). Edman, J. C., Adams, S. H., Park, M. J., & Irwin, C. E., Jr. (2010). Understanding and practice of adolescent confidentiality was measured using a five-point Likert scale and included questions regarding: At the end of the survey, there was a seventh open question, broadly inquiring: What other comments would you like us to know? Invitations to complete the survey were sent through the hospital electronic mailing list to all currently employed health care providers who potentially engaged in caregiving interactions with adolescents. Adolescents who use the emergency department as their usual source of care. Studies suggest that parent and caregiver views on adolescent confidentiality are mixed, with physicians citing fear of parental resistance as a potential barrier to providing confidential care [24]. Retrieved from http://www.militaryonesource.mil/12038/MOS/Reports/2011_Demographics_Report.pdf, Department of Defense Health Information Privacy Regulation. Acad Emerg Med 2013;20(11):1164-70. Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Keep in mind that statutes relating to the confidentiality of an adolescent's health care vary from state to state and also according to the issue involved. 135: Second-Trimester Abortion, Severe Maternal Morbidity Among Delivery and Postpartum Hospitalizations in the United States, by The American College of Obstetricians and Gynecologists. Google Scholar, 2011 Demographics: Profile of the Military Community. Bourgeois FC, Taylor PL, Emans SJ, Nigrin DJ, Mandl KD. The present study aimed to explore the knowledge and practices of staff at a large Canadian paediatric facility related to confidentiality in adolescent health care. Confidential health care for adolescents was considered by some to be incompatible with family-centred care. Evaluation of the TRICARE Program: Fiscal Year 2012 Report to Congress. Canada Health Act, RSC 1985, c C-6: https://canlii.ca/t/532qv (Accessed June 14, 2022). However, the data gathered from the 389 respondents are important and worth sharing, even if the percentage of returns was low. Obstetriciangynecologists are encouraged to ensure conversation time alone with adolescents to clarify the adolescents privileges regarding the release of information and to obtain appropriate and preferred contact method. Confidentiality in Adolescent Health Care. the contents by NLM or the National Institutes of Health. Ginsburg, K., Slap, G., Cnaan, A., Forke, C., Balsley, C., & Rouselle, D. (1995). A randomized controlled trial. Clinicians should communicate to adolescents and their parents or caregivers the developmental importance of increasing autonomy and responsibility related to health care decision-making to facilitate better transition in navigating the adult health care system. sharing sensitive information, make sure youre on a federal Washington, DC: Pew Internet & American Life Project, Pew Research Center. Telemedicine can improve health care access and is likely to be an increasingly common option for medical interactions because it allows flexible scheduling. Who gets confidential care? (2010). These policies often speak to the Meaningful use of a confidential adolescent patient portal. Hbert PC, Hoffmaster B, Glass KC, Singer PA. Bioethics for clinicians: 7. State minor consent laws: A summary (3rd ed.). Creating private, personally controlled health records for pediatric and adolescent patients. This document has been updated to include information on patient portals, guidance on the release of medical records, examples of ways to safeguard adolescent patients' confidentiality, and talking points to use with parents and guardians. Homelessness, National Alliance to End Homelessness. Act Respecting Health Services and Social Services, chapter S-4.2: http://legisquebec.gouv.qc.ca/en/showDoc/cs/S-4.2?&digest. your express consent. HIPAA or FERPA? J Adolesc Health 2018;62(1):36-43. Thrall JS, McCloskey L, Ettner SL, Rothman E, Tighe JE, Emans SJ. Journal of Pediatrics, 199, 520525. In particular, adolescents are less likely to openly communicate with HCPs around issues related to substance use, mental health, and sexuality when confidentiality cannot be guaranteed [10]. official website and that any information you provide is encrypted HCPs are discouraged from asking in the presence of a parent or caregiver whether an adolescent would like time in private, because the adolescent may feel uncomfortable with, or even reluctant, to agree. The site is secure. Accessibility HCPs may also be required to disclose confidential patient information due to a court order. We summarized state laws and regulations on minor consent for the following: health services, substance abuse treatment, prenatal care, mental health care, contraceptive management, immunizations, sexually transmitted infection management, human immunodeficiency viruses testing and treatment, dental care, and sexual assault evaluation. Preliminary estimates for 2011 as of July 2012 (Vol. Correspondence: Ms Ruth Wadman, Alberta Childrens Hospital, Department of Adolescent Medicine, 2888 Shaganappi Trail Northwest, Calgary, Alberta T3B 6A8. Ford, C., Millstein, S., Halpern-Felsher, B., & Irwin, C. (1997). poverty, such as educational shortcomings or poor health, neighbourhood-based statistics need to be gathered as the basis for local fine-tuning. 803. In addition, minors may give consent and receive family planning services if those services are funded by the federal Title X Family Planning Program or in some states the Medicaid program ( Ranji et al., 2016 ; U.S. Department of Health and Human Services, 2014 ). When clinicians encourage adolescents to communicate openly with their parents, it is essential to ask first about why they are reluctant to do so. Clinicians are often left balancing their patients need for confidentiality with creating an accurate and complete medical record. (2009). Obstetrics and Gynecology Clinics of North America, 27(1), 195211. Bethesda, MD 20894, Web Policies J Adolesc Health 1997;21(6):408-15. Despite clear advantages, the delivery of confidential services remains suboptimal for adolescents in Canada [3]. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher. (2012). 200 Summary: Early Pregnancy Loss, ACOG Committee Opinion No. In 1977, the US Supreme Court decision in Carey v. While confidentiality is a basic principle of all health care, it may not be clear to practitioners that the practice of confidentiality applies to adolescents. Whose personal control? Ensuring privacy and maintaining confidentiality are critical for effective, sensitive management of potentially stigmatizing health issues and enhanced quality care [2]. Adolescent patients cite confidentiality as one of the key determinants of their use of health care. Staff who worked 10 years in paediatrics were significantly more likely to document information that adolescents shared with them in confidence in the health record compared with those who had worked in paediatrics for 25 years (67% and 71%, respectively, versus 37%). doi: 10.1542/peds.2022 . To ensure study rigor, manual coding was verified through triangulation of researchers, with adherence to trustworthiness criteria (10). Ils ont constat diverses pratiques lies au respect de la confidentialit des adolescents et une incomprhension gnralise de la question. State adolescent consent laws and implications for HIV pre-exposure prophylaxis. CrossRef However, scarce literature regarding theoretical and practice-based knowledge of the adolescents right to confidential health care was identified. Obstet Gynecol. Please enable it to take advantage of the complete set of features! The maintenance of patient confidentiality may be affected by the widespread adoption and integration of electronic health records (EHRs) in clinical care, which may necessitate a closer evaluation of the unique challenge this presents for providers of adolescent health care. Puzzanchera, C., Adams, B., & Hockenberry, S. (2012). Wilson KM, Klein JD. Les commentaires des rpondants ont rvl des lacunes de la part des individus et des quipes au sujet des droits des adolescents et des parents ou des tuteurs, et une diffrence entre les concepts de consentement au traitement et la prestation de soins confidentiels aux adolescents. CDC. Retrieved from http://b.3cdn.net/naeh/1c46153d87d15eaaff9zm6i2af5.pdf. These conversations ideally take place before the initial medical encounter to help mitigate any concerns. Thrall, J., McCloskey, L., Ettner, S., Rothman, E., Tighe, J., & Emans, S. (2000). and transmitted securely. Fostering health: Health care for children and adolescents in foster care (2nd ed.). Confidentiality refers to protection of privileged and private information shared during a health care encounter and in medical records that document the encounter 1. Exploration for physicians of the mature minor doctrine. Obstet Gynecol. Pediatrics, 130, 11701174. Invitations to participate were sent through the paediatric facilitys electronic mailing list to all currently employed health care providers who potentially engaged in caregiving interactions with adolescents. Nursing practice and statutory rape. Law, National Center for Youth Law. (2007b). American Academy of Pediatrics; Committee on Adolescence. Forgone health care among U.S. adolescents: Association between risk characteristics and confidentiality concerns. (2007a). 2020; 135: 989-990. The State Government has to steer most of the funding towards those areas where many disadvantaged families live. An official website of the United States government. In providing care for adolescents, maintaining confidentiality should be considered a human right and an evidence-based component of quality care. Any updates to this document can be found on acog.org or by calling the ACOG Resource Center. Childhood, AAP Council on Foster Care Adoption and Kinship Care and Committee on Early Childhood. government site. In many circumstances, it is appropriate to encourage and support adolescents in discussing their health issues with a parent or caregiver. Adolescents perceptions of factors affecting their decisions to seek health care. HIV surveillance in adolescents and young adults. Pediatrics, 128, 12191235. Most EHR systems have not been designed to provide item-specific control over parental access and release of adolescent health care information. Provide confidential health care to adolescents in an atmosphere of acceptance and sensitivity, with open communication and involvement of parents and significant others in the patient's social network, as appropriate, and following generally accepted ethical guidelines and Arizona and federal laws. Confidentiality is a critical component of adolescent medical care. Beginning in early adolescence, spending at least part of each health visit alone with an adolescent patient, at regular intervals if not for every encounter, conveys the message that this is a routine practice and a valued part of health care. Confidential health care for adolescents: Position paper of the Society for Adolescent Medicine. Please enable scripts and reload this page. There is no universally accepted, legally defined age of consent for health care decision-making in Canada. Supporting the health care transition from adolescence to adulthood in the medical home. To alleviate these fears, HCPs should consider communicating with parents early on around the developmental appropriatenessand the laws affectingconfidential health care for adolescents, and its demonstrable benefits. Our initial focus will be with one multidisciplinary group to refine techniques before broadening our approach with other groups, specific professions and new recruits. MMWR. Equally, adolescents with chronic health conditions engage in risk behaviours at similar or even greater rates than healthier peers [35], making tertiary care encounters another option for screening and risk prevention in this population. Assessment of health needs and willingness to utilize health care resources of adolescents in a suburban population. Also, confidential time should be presented to parents and caregivers as a routine part of the health care visit. In adolescent health care, confidentiality is particularly important (6,7,13,14). Data were password protected with access controlled by the studys principal investigator. Experiences of HIV-related stigma among young men who have sex with men [Research Support, N.I.H., Extramural]. A medico-legal handbook for physicians in Canada. American Medical Association, Department of Adolescent Health. The need for confidential care in all health-related encounters with adolescents has been endorsed by numerous international and national societies [4] [7]. (2007, October/November). CDC HIV/AIDS fact sheet: HIV/AIDS among youth. The sample was divided into four groups: nurses, physicians, paramedical psychosocial support and paramedical physical support. Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors that may substantially affect their health and well-being. Carol A. Ford M.D. Pediatrics 2008;122(5):e1113-18. (2005). Reported beliefs included broad interpretations of confidentiality and confusion regarding the roles and responsibilities of adolescents, family and health care providers, as well as how family-centred care is defined. Please try again soon. Respondents who had worked <5 years in paediatrics were significantly more likely to answer often or always to the question about communicating limits of confidentiality to adolescents compared with respondents who had worked in paediatrics for 25 years (50% versus 23%). La prsente tude a pris la forme dun sondage virtuel anonyme et volontaire. Obstetrics & Gynecology135(4):989-990, April 2020. Professional Psychology: Research and Practice, 24(3), 367369. Adolescent confidentiality may present practice challenges for health care providers related to family, medical, ethical, legal, social and bureaucratic processes. 8600 Rockville Pike This was revealed in both the qualitative and quantitative data. Toulany A, Katzman DK, Goldberg E, Matlow A, Kaufman M. Chaperoning adolescents: A bygone era or modern medical necessity? (2010b). PDF official website and that any information you provide is encrypted Les chercheurs ont analys les questions fermes au moyen de statistiques descriptives, et les questions ouvertes au moyen dun code thmatique manifeste. Les dispensateurs de soins considrent la confidentialit comme fondamentale, mais le sondage a rvl une vaste variation de la comprhension et des pratiques quant la confidentialit des soins des adolescents, tant dans les donnes qualitatives que quantitatives. 11. Journal of the American Medical Association, 293(3), 340348. Some clinicians believe that to offer adolescents confidential health care, they must assess and document that person as a mature minor in the health record. . A pilot study to assess candidacy for emergency contraception and interest in sexual health education in a pediatric emergency department population. Lenhart, A., Ling, R., Campbell, S., & Purcell, K. (2010). All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Health care for homeless youth: Policy options for improving access. Adolescent confidentiality may present practice challenges for health care providers related to family, medical, ethical, legal, social and bureaucratic processes. Correspondence to Clear, routine discussions with adolescentsanda parent or caregiver about the protections (and limits) of confidentiality before the medical encounter is initiated can help mitigate these concerns. A study involving high school youth indicated that 25% of those surveyed would not seek health care for issues they wanted to keep private if they believed there was a possibility the information would not remain confidential (6). Wolters Kluwer Health When adolescents give you information in confidence, do you document this information in the health record? Access to medical care for adolescents: Results from the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls. Meehan, T. M., Hansen, H., & Klein, W. C. (1997). As adolescents transition into adulthood, the opportunity to spend time alone with a health care provider fosters . Accessed 12-11, 2020. In some cases, the disclosure of sensitive information to a parent or caregiver could put the adolescent at risk (e.g., of abuse, maltreatment, or being kicked out at home). Office staff should also be trained to welcome adolescents who present or call for an appointment on their own, and to safely relay test or other results. Confidentiality protection is an essential compo- nent of health care for adolescents because it is consistent with their development of maturity and autonomy and without it, some adolescents will forgo care. There is widespread inconsistency among health care providers regarding understanding and practice of adolescent confidentiality. Medical decision-making in paediatrics: Infancy to adolescence. However, it may be beneficial to establish the role groupings in advance to enable health care providers to determine which fits best. (2011). Guidelines for Adolescent Preventive Services (GAPS)Implementation and resource manual. Unauthorized use of these marks is strictly prohibited. Emerging technologies will impact privacy, and our educational approaches will, thus, require constant attention to ensure continued relevance (18). Association between HIV-related risk behaviors and HIV testing among high school students in the United States, 2009 [Comparative Study Multicenter Study]. Variations, taking into account individual circumstances, may be appropriate. Houston Journal of Health Law and Policy, 1(1), 63108. Paediatr Child Health 2018;23(2):138-46: https://cps.ca/en/documents/position/medical-decision-making-in-paediatrics-infancy-to-adolescence. The international human rights community recognizes confidentiality as a component of a youth's fundamental right to privacy.
Ncaa D2 Baseball Player Of The Year, Lakeland Birth Center, Thanks To Penicillin He Will Come Home, Articles C