With the establishment of the Republic Act No. 11036, more popularly known as the Mental Health Act, improvement in the mental, neurologic, and psychosocial health took a step forward in the Philippines. This law, which was signed on June 2018, gave specific provisions in different aspects of delivery of mental health services to Filipinos. This law proved very useful in the dilemma faced in the following case where a potential problem in confidentiality was encountered.
Mental Health Services ; Confidentiality ; Mental Health ; Philippines

PURPOSE: The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). METHODS: The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). RESULTS: Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. CONCLUSION: Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.
Checklist ; Child ; Child Abuse ; Clinical Competence ; Confidentiality ; Disclosure ; Domestic Violence* ; Education, Medical, Undergraduate ; Humans ; Negotiating ; Students, Medical

PURPOSE: This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality.METHOD: This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups.RESULTS: The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units.CONCLUSION: Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.
Confidentiality ; Critical Care ; Delivery of Health Care ; Education ; Ethics ; Intensive Care Units ; Mental Competency ; Methods ; Surveys and Questionnaires

The purpose of this article is to introduce smoking cessation services in the community to which physicians can refer their patients. There are three types of services: smoking cessation clinics at public health centers, regional smoking cessation centers, and quitlines. Smoking cessation clinics were established in 2005 at public health centers to reduce the smoking rate. Tailored counseling, nicotine replacement therapy, and drug treatment can improve the success rate of smoking cessation in clinical settings, and behavioral therapy can promote smoking cessation in the community. Quitlines have been launched and operated throughout the world as effective cessation services that guarantee confidentiality, accessibility, convenience, and cost-effectiveness. Tailored information and intervention programs for smoking prevention and smoking cessation have been offered through the telephone, multimedia messaging services, social networking services, and chatting in Korea. Referrals from other national cessation programs for maintaining cessation are also available. Since 2015, regional smoking cessation centers have administered two types of camps. The target group of intensive-care smoking cessation camps includes heavy smokers, who should receive inpatient care at the regional smoking cessation center for 5 days. The general support smoking cessation camps target smokers who wish to quit or who have unsuccessfully quit, and provide education and consulting programs over 1 to 2 days. These three types of services provide different services and programs to smokers in the community. If physicians refer to their patients to these services, they may prove to be excellent resources for increasing smoking cessation.
Confidentiality ; Counseling ; Education ; Humans ; Inpatients ; Korea ; Multimedia ; Nicotine ; Primary Health Care ; Public Health ; Referral and Consultation ; Smoke ; Smoking Cessation ; Smoking ; Social Work ; Telephone

No abstract available.
Confidentiality* ; Informatics*

BACKGROUND: Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. METHODS: An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents. The questionnaire was also distributed to 52 specialists and 46 residents who attended the annual meeting of the Korean Association of Occupational and Environmental Clinics in October 2015, and to 240 specialists by uploading the questionnaire to the online community ‘oem-doctors’ in February 2016. The responses to each question (perception of general ethical conflicts, recognition of various ethical codes for OPs, core professional values in ethics of occupational medicine, and a mock case study) were compared between specialists and residents by the chi-squared test and Fisher’s exact test. RESULTS: Responses were received from 80 specialists and 71 residents. Most participants had experienced ethical conflicts at work and felt the need for systematic education and training. OPs suffered the most ethical conflicts in decisions regarding occupational health examination and evaluation for work relatedness. Over 60% of total participants were unaware of the ethical codes of other countries. Participants thought ‘consideration of worker’s health and safety’ (26.0%) and ‘neutrality’ (24.7%) as the prominent ethical values in professionality ofoccupational medicine. In mock cases, participants chose beneficence and justice for fitness for work and confidential information acquired while on duty, and beneficence and respect for autonomy in pre-placement examinations. CONCLUSIONS: This study evaluated the current perception of and attitude toward ethical issues among the Korean OPs. These findings will facilitate the development of a code of ethics and the ethical decision-making program forthe Korean OPs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40557-017-0182-z) contains supplementary material, which is available to authorized users.
Beneficence ; Codes of Ethics ; Confidentiality ; Education ; Electronic Mail ; Environmental Medicine ; Ethics* ; Occupational Health ; Occupational Medicine ; Social Justice ; Specialization

PURPOSE: The aim of this study was to elucidate clinical nurses' ethics germane to information literacy and perception of patient data privacy and thus help nurses to develop more positive and consolidated ethical values. METHODS: For this study a descriptive survey design was used. Participants were 142 nurses who worked in a hospital and completed self-report questionnaires. Data were collected from August 1 to 5, 2016 and were analyzed using independent t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and stepwise multiple regression with SPSS 22.0. RESULTS: Ethical value had a positive correlation with information needs (r=.25, p=.002) in information literacy as well as in direct patient care (r=.27, p=.001), shift work (r=.20, p=.016), patient information management (r=.39, p<.001), and communication (r=.24, p=.004) in perception of patient data privacy. Patient information management, educational background, and age were significant variables predicting the level of ethical values and accounted for 21% of the variance. CONCLUSION: Ethical values education with particular emphasize on managing patient information should be encouraged for nurses who are younger and have a lower education level. Findings indicate a need for education programs to guide clinical nurses to utilize appropriate information when solving ethical challenges in every day nursing practice.
Confidentiality* ; Education ; Ethics ; Humans ; Information Literacy* ; Information Management ; Nursing ; Patient Care

OBJECTIVES: Confidentiality of health information is an important aspect of the physician patient relationship. The use of digital medical records has made data much more accessible. To prevent data leakage, many countries have created regulations regarding medical data accessibility. These regulations require a unique user ID for each medical staff member, and this must be protected by a password, which should be kept undisclosed by all means. METHODS: We performed a four-question Google Forms-based survey of medical staff. In the survey, each participant was asked if he/she ever obtained the password of another medical staff member. Then, we asked how many times such an episode occurred and the reason for it. RESULTS: A total of 299 surveys were gathered. The responses showed that 220 (73.6%) participants reported that they had obtained the password of another medical staff member. Only 171 (57.2%) estimated how many time it happened, with an average estimation of 4.75 episodes. All the residents that took part in the study (45, 15%) had obtained the password of another medical staff member, while only 57.5% (38/66) of the nurses reported this. CONCLUSIONS: The use of unique user IDs and passwords to defend the privacy of medical data is a common requirement in medical organizations. Unfortunately, the use of passwords is doomed because medical staff members share their passwords with one another. Strict regulations requiring each staff member to have it's a unique user ID might lead to password sharing and to a decrease in data safety.
Confidentiality ; Electronic Health Records* ; Health Insurance Portability and Accountability Act ; Health Records, Personal ; Humans ; Legislation, Medical ; Medical Records ; Medical Staff ; Physician-Patient Relations ; Prevalence* ; Privacy ; Social Control, Formal

PURPOSE: This study aims to identify perception, performance, and the related factors of performance in regards to patients' medical information protection among allied health college students. METHODS: Four hundred twelve subjects from three colleges located in Jeonbuk and Kyungbuk province consented to participate. Data was collected from November 28 to December 15, 2012. To assess perception and performance in regards to patients' medical information protection, a self-reporting questionnaire was used. Data was analyzed via SPSS 18.0 program. RESULTS: The score of perception and performance about patients' medical information protection were 4.07 and 3.56, respectively. All item's scores of performance were significantly lower than those of perception. The perception score was significantly different according to recognition of hospital ethics code (t=1.95, p=.052), and recognition of association ethics code (t=2.88, p=.004). The performance score was significantly different according to gender (t=-3.32, p=001), major (F=14.41, p<.001), clinical practicum hospitals (F=8.22, p<.001), and method of electronic medical record access (F=3.23, p=.023). The factors influencing performance were perception(beta=.46, p<.001), duration of clinical practice(beta=-.36, p<.001), and gender(beta=.09, p=.033). CONCLUSION: In order to improve performance in regards to patients' medical information protection of allied health college students, we should develop ethical education programs and standardize them through multidisciplinary collaboration.
Codes of Ethics ; Computer Security* ; Confidentiality ; Cooperative Behavior ; Education ; Electronic Health Records ; Ethics, Institutional ; Humans ; Jeollabuk-do ; Medical Records ; Students, Public Health

CONTEXT: Evolution of the scope and context of privacy and confidentiality brought about by use of information and communications technology in healthcare.

OBJECTIVE: To review the legal, professional and ethical landscape of health information privacy in the Philippines.

METHODOLOGY: Systematic review of literature and policy frameworks.

RESULTS: Philippine laws jurisprudence recognize and protect privacy of health information as a general rule; impose upon individual practitioners and institutions the obligation to uphold such right; and may apply in both the traditional and eHealth milieu. There is no existing policy framework that addresses issues relating to [a] access to health information by non-health professionals, [b] use of health information for non-health purposes, and [c] rules relating to collection, storage and utilization of electronically-derived or -stored information. A privacy culture, on either the provider's or client's side, is also lacking in the country.

CONCLUSION: Technological developments have outpaced policy and practice. There is a need to unify the patchwork of regulations governing the privacy of health information; advocate for a privacy culture among professionals and patients alike; fortify the evidence base on patient and provider perceptions of privacy; and develop and improve standards and systems to promote health information privacy at the individual and institutional levels.