вторник, 16 сентября 2008 г.

Lithuanian KAP

Lithuanian general practitioners' knowledge of confidentiality laws in adolescent sexual and reproductive healthcare: A cross-sectional study

Jeffrey V. Lazarus

Division of Social Medicine and Global Health, Lund University, Sweden, Jeffrey.lazarus@med.lu.se

Lina Jaruseviciene

Department of Family Medicine, Kaunas Medical University, Lithuania

Jerker Liljestrand

Division of Social Medicine and Global Health, Lund University, Sweden

Background: In Lithuania, the legislation addressing confidentiality in adolescent healthcare is contradictory and vague. Previous studies have also revealed that medico-legal knowledge among physicians is poor, and attitudes play a correspondingly greater role than legal knowledge in ensuring the confidentiality of patients. Objective: To survey the knowledge of Lithuanian general practitioner (GPs) of legal issues surrounding confidentiality for minors in sexual and reproductive healthcare. Methods: A 41-item questionnaire was sent to a random sample of 607 GPs. Their legal knowledge was evaluated with respect to the provisions of the Lithuanian Law on the Rights of Patients and Compensation for Health Damage. The analysis included descriptive statistics and binary logistic regression to estimate odds ratios for the eight independent variables (age, gender, type, location, ownership, size, frequency of consultations, and existence of a written office policy). Results: The response rate was 73.5%. Of these respondents, 49.3% proved to be knowledgeable about legal standards protecting the confidentiality of adolescents in healthcare. Knowledgeability was found to be higher among GPs who had a written office policy that was based on the law. Respondents stated that the most important measure to improve confidentiality in adolescent healthcare would be the development of an explicit legal framework to address it. Conclusions: GPs' unfamiliarity with existing confidentiality regulations implies that there are ways to improve confidentiality in sexual and reproductive care beyond merely changing the law. This study suggests the need for a comprehensive strategy, including the development of professional guidelines and written office policies coupled with legal educational programmes directed at GPs.

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