Protection of privacy and confidentiality as a patient right: physicians' and nurses' viewpoints
Conclusion: The practice of patient's rights among physician and nurses are in a the importance of a strong relationship between patients and their health care. its benefits both in relation to patients and health care organisations. It also considers the contribution of nurses to PCC and in the enhancement of service delivery. compromise a patient's rights to self-determination and autonomy. Patient autonomy can be seen as a subcategory of the right of every individual to self-determination, and as such is Advocacy: implications for nursing practice.
This cross-sectional study was conducted in In this study nurses were randomly selected.
Two-part questionnaire was used for data collection. The validity and reliability of questionnaire was determined and then it was distributed between subjects. The data were analyzed by SPSS version 15 using descriptive and inferential statistics. Nurses, Patients rights, Teaching hospital Introduction Despite of presentation of medical ethics as a new science in academic teaching, the ethical concepts have been alongside the medicine, and its antiquity back to the medicine history.
For instance, literatures such as Hippocratic Oath letter, liturgy of Ibn Maymun, and Shirazi ethics ordinance are the old literatures in which the principles such as the necessity of patient preference defender on the physician and observing the principle of confidentiality have been emphasized.
Human being is a creature with physical, mental and spiritual dimensions which has rights during the health and illness. Patient rights are the very expectations he has from the health care services and must encompass his physical, mental, spiritual and social needs which are manifested as criteria, standards, rules and laws 45. In this charter patient satisfaction is considered as one of the characteristics of hospital effectiveness 9.
Today, the issues related to the quality of health care services, attention to the patients as customers and accomplishing their satisfaction are the main priorities and are of high importance. One of the important factors in patient satisfaction is regarding their demands and observing their rights and providing care along with respect 6.
Awareness of the patients rights and observing them accomplishes more satisfaction of the patient, physician and other medical team and hospital staff and will lead to the spread of good morals among patients and medical team; so eventually the moral status of all the individuals such as patients and medical team will be upgraded, but otherwise provided not observing these rights, it would lead to distrust to health care team. If there is no trust between medical staff and patients, it would lead to damages and losses for the patient and the medical team.
It is very important for me to replace whatever has been taken from a patient, even if it is a tablet. Nevertheless, some factors, such as the lack of competency and recourses 10burn out, professional suffering, and lack of dedication to nursing 11 hinder achievement of these goals.
On the other hands, these factors place the clients at risk, which increases the importance of patient advocacy. Considering these barriers, in the present study, patient advocacy in nursing consisted of two themes of empathy with the patient and protecting the patient.
These findings have some similarities and differences to other studies that have been conducted in this field. Patients experience different degrees of vulnerability Therefore, protection is a key element of patient advocacy. Regarding children, this protection includes protection against child abuse 33 The nurses participating in this study also suggested that protection forms the predominant part of patient advocacy in nursing.
In nursing, however, many internal and external risks threaten a patient's health care environment. The participants of this study had committed themselves to protecting the patients. Their study was a great study that supports the present study results in patient protection. Patients often complain about the lack of appropriate verbal communication with the nurses. They choose nurses who establish a close relationship with them as their advocates Empathy is the ability to define the unique situation of others 36and also an inseparable part of the nurse-patient relationship Considering these results, which support our findings, it can be stated that empathy is an implicit component of patient advocacy.
Empathy is a personal matter which takes on a more professional aspect in nursing. Patient advocacy is a developed and distinct form of communication between nurses and patients which has been illustrated in the comments of the study participants. From the perspective of the participants, patients require by their side individuals with whom they can share their problems, individuals who understand them and help them.
Nurses, like other individuals in these situations, want to gain closeness to others and collaborate with them. Since nurses have been trained for these situations, they try to approach patients in different situations in order to defend their rights with more power and a better understanding of the patient. A common concern is then formed among patients and nurses. A feeling of empathy is formed between nurses and patients as part of patient advocacy. Previous studies have not provided any support regarding empathy and its relationship with patient advocacy, but the common elements of empathy, communication, and advocacy cannot be denied.What is a PCNA (Patient Care Nursing Assistant)
For example, a study in reported that individuals with higher capacity for empathy can more easily understand and accept the perspectives of others Tomaschewski Barlem et al. The study by Jafari Manesh et al. The findings of Negarandeh et al.
In the Iranian culture, almost everything, including ethics and values, is influenced by religion. Thus, personal value in this culture refers to religious beliefs. Protection of the vulnerable and doing all that is in your power for others is ordered in Islam. However, the data presented in the current text did not indicate this subject explicitly. It seems that empathy in patient advocacy in nursing is a relatively new issue that is largely dependent on the social context of the Iranian society, including religious background, and perhaps more specific studies can confirm or repudiate this matter.
Conclusion Patient advocacy is a social issue which can be evaluated from personal and professional aspects. In this study, patient advocacy in nursing included the two themes of empathy with patients and protecting patients.
Protection of patients in previous studies has been repeatedly defined as an important component of patient advocacy. Nevertheless, empathy with the patient is a relatively new idea and it seems that a more thorough study on this topic can help the better understanding of this relationship.
It is suggested that further studies be conducted on the relationship between empathy and patient advocacy. Future studies may be performed on the effect of religion on patient advocacy, especially in religious societies.
Acknowledgment This study was registered by the Kerman University of Medical Sciences with ethical code: Our sincere appreciation goes to all the nurses who participated in this study.
Nurses’ commitment to respecting patient dignity
Conflict of Interest statement No conflict of interest has been declared by the author s. The lived experience of nursing advocacy. The voice of Florence Nightingale on advocacy. Online J Issues Nurs. Kalaitzidis E, Jewell P.
Nurses awareness of patients rights in a teaching hospital
The concept of advocacy in nursing: Health Care Manag Frederick ;34 4: Nursing and justice as a basic human need. This is probably related to the fact that the number of male physicians involved in this study was higher than the number of female physicians. With the increasing interest in patient rights in the world and in Turkey, a regulation [ 1920 ] and some instructions [ 30 ] were adopted in Turkey. Departments related to patient rights were established in hospitals in parallel with the putting into practice of the directives.
The departments of patient rights are of much importance in terms of determining whether the services provided have reached the desired results and whether the needs of patients and their relatives have been met. In our study, 70 of the nurses This shows that they are aware of the patient rights department at higher rates than the other studies conducted in Turkey that we have been able to reach [ 3132 ]. Physicians and nurses, as health care professionals, have primary responsibilities with regard to the protection of patient rights.
Nurses seem to have more responsibilities since they spend more time with patients than physicians do, and patients mostly tend to feel closer to nurses [ 34 ].
In the present study, there is a significant relationship between being informed about the presence of a patient rights unit and knowing patient rights. The majority of nurses who said that there was no patient rights unit in the hospital reported that they partially knew patient rights. This suggests that they were not informed enough about patient rights and the protection of such rights.
Furthermore, over half of the nurses that knew patient rights also knew the presence of a patient rights unit in the hospital. People that are informed about the privacy of others are expected to respect the privacy during and after a medical intervention. The source of this expectation is the relationship based on the confidence between patients and health care professionals [ 35 ]. The confidence derives from patients' belief that health care professionals do not share the information about patients they obtain during the provision of health services with others.
Patients' right to the protection of privacy, included in the "confidentiality of private life"-one of the fundamental human rights, is one of the most important points to be considered in the provision of health care services. Privacy, a concept with no specific definition, is affected by various perceptions.
Patients', nurses' and physicians' knowledge and awareness of various aspects of this concept are likely to affect how they perceive privacy aspect of their practices.
Furthermore, patients, nurses and physicians may have different perceptions of privacy because of differences in cultural and educational background as well as socialization processes [ 36 ]. Virginia Henderson has stated that the objective of the care professions is to make them independent in terms of meeting the fundamental needs of individuals.
She argued that these fundamental needs are comprised of the physiological, psychological, sociological, spiritual and intellectual fields, and defined 14 principal needs [ 37 ]. When the right to privacy is evaluated within the general framework, it is included in all of these fundamental needs as an important element.
The right to privacy of patients is not a new concept in nursing. The first principle taught to nurses is the need to protect the privacy of patients during their practices. However, this privacy is thought to be limited only to the use of curtains and screens. Curtains, screens and sheets only make the patient invisible and privacy consists of much more than this.
As a fundamental need, privacy is the principal component of the right to autonomy. Nursing is a patient-centered profession, which involves interventions that require being close to physical, psychological, social and personal information related to individuals. Among the responsibilities of nurses are to help patients get adapted to the hospital environment, to protect an individual's health as their proxy when required, to make them have control in their personal sphere, to ensure their comfort and to protect and maintain the protection of privacy and confidentiality of their physical, psychological, social and cognitive information related to patients in this new environment [ 36 ].
Despite the efforts of experts in the field of health to emphasize the privacy of privacy, there are not enough studies in this area, especially in the field of nursing [ 3839 ]. The concept of privacy has been referred to for many years together with the regulations and new practices in the Turkish health system in the area of patient rights, but there have been no specific research on patient privacy.
In certain studies where the views of health workers on patient rights have been questioned-both in Turkey and throughout the world [ 132225283840 ], while health workers have stated that patient privacy is important, and that it is supported at a high rate, in certain national studies [ 4142 ], it has been stated that the treatment of the patient takes priority over their privacy.
In the present study, with the statement that "patients have the right to demand the protection of privacy in the provision of care and treatment", Almost all of the health workers in our study were in agreement with the need for the protection of the privacy of patients. This clearly shows that they believe that the protection of the privacy of patients is just as important as their treatment.
There is a statistically significant relationship between physicians' years of experience and their agreement with patients' right to demand the protection of privacy.
The physicians working for 1 to 5 years agree more with patients' right to demand the protection of privacy in the provision of care and treatment compared to the other physicians. Private life is known and shared by an individual's immediate vicinity in personal and professional life.
Private law considers private life confidential and protects its confidentiality. Physicians are required to keep such information confidential, complying with the principle of respect for confidentiality, which is an important medical ethics rule.
Nurses awareness of patients rights in a teaching hospital
Physicians and nurses necessarily and naturally witness patients' bodies, moral defects and disabilities. They have to keep confidential the information related to their patients they obtain when fulfilling their profession.
Disclosure of confidential information and observation is a violation of not only a patient's but also their relatives' personal rights, and physicians are required not to disclose confidential information related to their patients [ 43 ]. Information related to patients cannot be obtained and disclosed without their consent, and digital patient records can only be used by related people.
Information related to patients cannot be exchanged in public spheres and in the presence of unrelated people [ 44 ]. Guaranteeing the respect for confidentiality of patients' private life enable them to provide more accurate information to health care professionals.
This guarantee not only reinforces the confidence between patients and physicians but also contributes to the improvement of treatment practices. Besides, the physician contributes to the formation of a strong partnership and effective cooperation between nurses and patients as the administrators of the treatment. The Ethical Codes of Nursing of the International Council of Nursing recommends that nurses keep personal information confidential, and use their common sense at the point where they need to share this information ICN, The principle of care referred to in the Nightingale Oath is confidentiality.
The principle of confidentiality can only be questioned when faced with a circumstance where it is necessary to prevent damage to innocent individuals [ 46 ].
In certain studies conducted in Turkey and throughout the world [ 2847 - 49 ] while it is stated that the confidentiality of the information belonging to patients is supported at a high rate, in a study which includes health workers in Britain, it was determined that the rate of participation and the level of awareness of health workers on the matter of confidentiality was low [ 13 ].