Hospitalized patient’s privacy is a structure with several dimensions including physical, informational, psychosocial and spiritual-religious and a wide range of antecedents and consequences [2]. Privacy has special meanings in health systems [3, 4]. Awareness of the principles and respect for patients' privacy is essential for health system staff, especially nurses, and is one of the professional rules of the field [5], as patients are physically, mentally, socially and economically vulnerable groups and are unable to control their privacy. Therefore, this is of particular importance [6].
There are other implications for patient privacy that remain unknown. Understanding the specific reason and the simple explanation does not allow for an understanding of complex phenomena; therefore, using qualitative research that utilizes different methods of gathering information and evaluating events of values ​​and norms from the perspective of the participants enables the in-depth examination of a clear and comprehensive understanding of this phenomenon. Thus, the safest way to assess the consequences of privacy in care is to directly examine patients' own perspective [18]. Investigating the patient experience of privacy implications can be effective in assessing and enhancing patient privacy and confidentiality in health care [4].

 

In this study, qualitative research method with conventional content analysis approach was used to describe the experiences of hospitalized patients regarding the consequences of privacy. The internal and surgical wards in Tehran public hospitals (Tajrish, Taleghani) were selected for the study. Purposeful sampling was used to select participants and sampling continued until data saturation. Participants included 20 patients (12 females and 8 males) admitted to internal and surgical wards. Inclusion criteria included 20- to 65-year-old hospitalized patients who had been hospitalized for at least 24 hours, had knowledge of place and time, were able to communicate, had a history of mental illness, and had the ability to express and remember experiences and were rich in information. Data were collected using open and semi-structured interviews and field notes. To gather information for the start of the interview, the researcher first obtained demographic information by introducing himself and expressing the purpose of the interview to communicate and gain the participants' trust. Then, by asking the basics, communicating well, and gaining the trust of the participants, they set the stage for a better and easier interview. Patients were given verbal consent to record the interviews. Interviews were conducted individually in a quiet environment at a time and place where participants felt comfortable.
For data analysis, the recorded verbatim interviews were first typed and analyzed using MAXQDA Version 10 software. The data analysis process was performed using the steps of Graneheim and Lundman (2004). The steps of analyzing interviews in the Granheim and Landman method include performing each interview immediately after each interview, reading the full text of the interview for its overall understanding, defining semantic units and basic codes, classifying similar primary codes into more comprehensive classes, and identifying the meaning behind the data [19].

Interviews were extracted from patients with 456 primary codes, 13 subcategories, and 4 classes, which illustrated the nature of participants' understanding of the consequences of inpatient privacy. Codes were merged based on similarities. These codes were then subdivided into classes. It was attempted to have the highest homogeneity within the classes and the highest heterogeneity between the classes, and no data to fall into two classes at the same time. The classes included protecting and promoting human dignity, adjusting to the existing status, developing health and satisfaction (Table 1).

Table 1. Main classes and subcategories of privacy consequences in Iranian hospitalized patients

Patients' experiences of the consequences of their privacy have led to the emergence of four themes of safeguarding and promoting human dignity, adjusting to the status quo, developing health and patient satisfaction that have been mentioned in some similar studies. One of the most important consequences of protecting patients' privacy is promoting human dignity. Most patients stated that understanding their feelings and values ​​during care is the basis of care and that they felt the empathy of staff with respect to patient privacy. Given that in Iran due to the lack of treatment staff, there is a need for companionship and a large proportion of nursing services, the extracted categories of this class emphasize on respect for the patient and family and their sense of empathy.

 

The results of this study showed outcomes of observance for patient’s privacy. With the treatment team's awareness of these consequences, the patients' expectations are respected, which leads to the provision of favorable health care and patient satisfaction.

 

This article is part of a first author's doctoral dissertation approved by contract number 3714 / t / 801/96 on February 23, 2016, at the University of Welfare and Rehabilitation Sciences, which supported this research. We are grateful to the public hospital officials in Tehran and the participating patients who assisted the research team in the implementation of this project, as well as the research assistant of Tehran University of Welfare and Rehabilitation Sciences, for financial support of the present project.

 

The authors declared no conflict of interest regarding the publication of this article.