Sağlık Hizmetlerinde Bilgi Mahremiyeti Endişesi Ve Korunma Davranışlarını Etkileyen Faktörler

Yıl 2023, Cilt: 12 Sayı: 4, 1498 - 1517, 26.12.2023

Cihan Unal , Cemal Sezer

https://doi.org/10.37989/gumussagbil.1362638

Öz

Bu çalışmanın temel amacı, bireylerin sağlık bilgi mahremiyeti endişesi düzeylerini, endişeye etki eden faktörleri ve bilgi mahremiyeti endişesi nedeniyle sergilenebilecek korunma davranışlarını ve bu davranışlara etki eden faktörleri belirlemektir. Diğer bir amaç bu çalışmada kullanılan ölçeği Türkçeye uyarlamaktır. Veriler Ankara ilinde toplam 692 katılımcıdan elde edilmiştir. Verilerin analizinde tanımlayıcı istatistiksel yöntemler ve lojistik regresyon analizi kullanılmıştır.
Araştırmanın bulgularında katılımcılar arasında, kişisel sağlık bilgilerinin gizliliği endişesi nedeniyle bilgi saklama eğilimi ve sağlık hizmetlerini ertelemek gibi korunma davranışları gözlemlenmiştir. Bilgi toplama endişesi, bireylerin kişisel sağlık bilgilerini daha az ifşa etmelerine ve bilgi saklama olasılığının artmasına yol açmaktadır. Ayrıca, bilgi toplama endişesi, bireylerin doktorlarına bilerek yanlış sağlık bilgisi verme davranışında bulunma, sağlık hizmetlerini erteleme veya almama olasılığını da artırmaktadır. Önceden sağlık bilgilerinin ihlal edildiğini düşünen bireyler, bilgi toplama endişesi, bilgi saklama, doktordan ve sağlık kurumundan bilgi saklama, doktordan hakkındaki bilgiyi kaydetmemesini isteme ve başka bir tanı yazılmasını isteme olasılıklarının arttığını göstermektedir. Çalışmada hasta-hekim iletişimi ve teknolojik mekanizmalara olan güvenin, sağlık bilgileriyle ilgili endişeler ve korunma davranışları üzerinde önemli bir rol oynadığı tespit edilmiştir. Hekimleri ile iyi iletişim kuran katılımcıların sağlık bilgilerinin ikincil kullanımı konusunda daha fazla endişe duydukları, ancak sağlık hizmetlerini ertelememe veya almama olasılıklarının daha düşük bulunmuştur. Ayrıca, bireylerin kendilerini internet ve bilgi teknolojilerini anlama ve kullanma konusunda yeterli hissetmeleri, sağlık bilgilerinin ikincil kullanımı endişesini arttırmaktadır. Bu durumun aksine sağlık hizmeti kalitesini yüksek değerlendiren katılımcıların bilgi toplama endişesi olasılıklarının daha düşük olduğu görülmüştür. Bu araştırmanın sonuçlarına göre, sağlık hizmetlerinde bilgi mahremiyeti politikalarının güçlendirilmesi ve iletişim stratejilerinin geliştirilmesi gerekmektedir.

Anahtar Kelimeler

Sağlık Bilgi Mahremiyeti Endişesi, Mahremiyet Odaklı Korunma Davranışları, Mahremiyet Endişesini Etkileyen Faktörler, Korunma Davranışlarını Etkileyen Faktörler

Information Privacy Concern in Health Services and Factors Affecting Protective Behaviors*

Öz

The primary objective of this study is to determine the levels of individuals' concern about health information privacy, the factors influencing this concern, and the protective behaviors that may be displayed due to concerns about information privacy, along with the factors influencing these behaviors. Another aim is to adapt the measurement tool in Turkish, used in this study. Data was collected from 692 participants in the province of Ankara. Descriptive statistical methods and logistic regression analysis were used in the analysis of the data.
The study's findings indicate protective behaviors such as the tendency to withhold information and postpone health services due to concerns about the confidentiality of personal health information among participants. Information collection concern leads individuals to disclose less of their personal health information, increasing the likelihood of information withholding. Moreover, information collection concern increases the behavior of intentionally providing incorrect health information to their doctors and also increases the likelihood of delaying or not obtaining health services. Individuals who believe their health information has been violated before show an increased likelihood of information collection concern, information withholding, withholding information from doctors and health institutions, requesting doctors not to record information about them, and requesting another diagnosis to be written. Trust in patient-doctor communication and technological mechanisms has been found to play a significant role in concerns related to health information and protective behaviors. Participants who have good communication with their doctors are more concerned about the secondary use of their health information, but their likelihood of delaying or not obtaining health services is lower. Additionally, individuals feeling competent in understanding and using the internet and information technologies increases their concern about the secondary use of health information. Contrarily, participants who rated the quality of health service highly have been found to have lower probabilities of information collection concern. The findings of this study emphasize the need to strengthen information privacy policies in health services and develop communication strategies.

Anahtar Kelimeler

Health Information Privacy Concern, Privacy-Oriented Protective Responses, Factors Influencing Privacy Concern, Factors Influencing Protective Responses

Kaynakça

• 1. Dülger, M. V. (2015). “Sağlık Hukukunda Kişisel Verilerin Korunması ve Hasta Mahremiyeti”. İstanbul Medipol Üniversitesi Hukuk Fakültesi Dergisi, 1 (2). https://doi.org/10.2139/ssrn.2564595
• 2. Perera, G, Holbrook, A, Thabane, L, Foster, G. ve Willison, D. J. (2011). “Views on health information sharing and privacy from primary care practices using electronic medical records”. International Journal of Medical İnformatics, 80 (2), 94–101. https://doi.org/10.1016/j.ijmedinf.2010.11.005
• 3. Smith, J. H, Dinev, T. and Xu, H. (2011). “Information Privacy Research: An Interdisciplinary Review”. MIS Quarterly, 989–1015.
• 4. Li, H, Gupta, A, Zhang, J. and Sarathy, R. (2014). “Examining the decision to use standalone personal health record systems as a trust-enabled fair social contract”. Decision Support Systems, 57, 376–386. https://doi.org/10.1016/j.dss.2012.10.043
• 5. King, T, Brankovic, L. and Gillard, P. (2012). “Perspectives of Australian adults about protecting the privacy of their health information in statistical databases”. International Journal of Medical Informatics, 81 (4), 279–289. https://doi.org/10.1016/j.ijmedinf.2012.01.005
• 6. Campos-Castillo, C. and Anthony, D. L. (2015). “The double-edged sword of electronic health records: İmplications for patient disclosure”. Journal of the American Medical Informatics Association: JAMIA, 22 (e1), e130-40. https://doi.org/10.1136/amiajnl-2014-002804
• 7. Walker, D. M, Johnson, T, Ford, E. W. and Huerta, T. R. (2017). “Trust Me, I'm a Doctor: Examining Changes in How Privacy Concerns Affect Patient Withholding Behavior”. Journal of Medical Internet Research, 19 (1), e2. https://doi.org/10.2196/jmir.6296
• 8. Alan F. Westin (2005). “Public Attitudes Toward Electronic Health Records”. AHIP Cover, 12 (2), 1–7.
• 9. Ben-Assuli, O. (2015). “Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments”. Health Policy (Amsterdam, Netherlands), 119 (3), 287–297. https://doi.org/10.1016/j.healthpol.2014.11.014
• 10. Bishop, L. S, Holmes, B. J, Kelley, C. M. and Forrester, R. I. (2005). “California Healthcare Foundation. National Consumer Health Privacy Survey 2005”. http://www.chcf.org/publications/2005/11/ adresinden erişildi. https://doi.org/10.1787/450154556467
• 11. Chhanabhai, P. and Holt, A. (2007). “Consumers Are Ready to Accept the Transition to Online and Electronic Records If They Can Be Assured of the Security Measures”. Medscape General Medicine, 9 (1), 1–15.
• 12. Kuo, K.‑M, Ma, C.‑C. and Alexander, J. W. (2014). “How do patients respond to violation of their information privacy?”. Health İnformation Management : Journal of the Health Information Management Association of Australia, 43 (2), 23–33. https://doi.org/10.1177/183335831404300204
• 13. Li, T. and Slee, T. (2014). “The effects of information privacy concerns on digitizing personal health records”. Journal of the Association for Information Science and Technology, 65 (8), 1541–1554. https://doi.org/10.1002/asi.23068
• 14. Son and Kim (2008). “Internet Users' Information Privacy-Protective Responses: A Taxonomy and a Nomological Model”. MIS Quarterly, 32 (3), 503. https://doi.org/10.2307/25148854
• 15. TÜİK (2022). TÜİK Kurumsal. 04 06 2023 tarihinde https://data.tuik.gov.tr/Bulten/Index?p=49685 adresinden erişildi.
• 16. Yazıcıoğlu, Y. ve Erdoğan, S. (2004). “SPSS uygulamalı bilimsel araştırma yöntemleri”. Ankara: Detay Yayıncılık
• 17. Altunışık, R, Coşkun, R, Bayraktaroğlu, S. ve Yıldırım, E. (2007). “Sosyal Bilimlerde Araştırma Yöntemleri: SPSS Uygulamalı” (5.baskı). Sakarya: Sakarya Yayıncılık.
• 18. Angst, C. M. and Agarwal, R. (2009). “Adoption of Electronic Health Records in the Presence of Privacy Concerns: The Elaboration Likelihood Model and Individual Persuasion”. MIS quarterly, 33 (2), 338–370.
• 19. Smith, J. H, Milberg, S. J. and Burke, S. J. (1996). “Information Privacy: Measuring Individuals' Concerns about Organizational Practices”. MIS quarterly 20 (2), 167–196.
• 20. Anderson, C. L. and Agarwal, R. (2011). “The Digitization of Healthcare: Boundary Risks, Emotion, and Consumer Willingness to Disclose Personal Health Information”. Information Systems Research, 22 (3), 469–490. https://doi.org/10.1287/isre.1100.0335
• 21. Campbell, A. j. (1997). “Relationship marketing in consumer markets: A comparison of managerial and consumer attitudes about information privacy”. Journal of Direct Marketing, 11 (3), 45–57. https://doi.org/10.1002/(SICI)1522-7138(199722)11:3<44::AID-DIR7>3.0.CO;2-X
• 22. Dimitropoulos, L, Patel, V, Scheffler, S. and Posnack, S. (2011). “Public Attitudes Toward Health Information Exchange: Perceived Benefits and Concerns”. The American Journal of Managed Care, 17 (12 Spec), SP111-6.
• 23. Dinev, T, Albano, V, Xu, H, D’Atri, A. and Hart, P. (2016). “Individuals’ attitudes towards electronic health records: A privacy calculus perspective”. Advances in healthcare informatics and analytics, 19-50.
• 24. Ermakova, T, Fabian, B, Kelkel, S, Wolff, T. and Zarnekow, R. (2015). “Antecedents of Health Information Privacy Concerns”. Procedia Computer Science, 63, 376–383. https://doi.org/10.1016/j.procs.2015.08.356
• 25. Patel, V, Beckjord, E, Moser, R. P, Hughes, P. and Hesse, B. W. (2015). “The role of health care experience and consumer information efficacy in shaping privacy and security perceptions of medical records: National consumer survey results”. JMIR Medical Informatics, 3 (2), e14. https://doi.org/10.2196/medinform.3238
• 26. Vodicka, E, Mejilla, R, Leveille, S. G, Ralston, J. D, Darer, J. D, Delbanco, T, . . . Elmore, J. G. (2013). “Online access to doctors' notes: Patient concerns about privacy”. Journal of Medical Internet Research, 15 (9), e208. https://doi.org/10.2196/jmir.2670
• 27. Alpar, R. ve Karabulut, E. (2017). “Uygulamalı Çok Değişkenli İstatistiksel Yöntemler (5.Baskı)”. Ankara: Detay Yayıncılık.
• 28. Coşkun, S, Kartal, M, Coşkun, A. ve Bircan, H. (2004). “Lojistik regresyon analizinin incelenmesi ve diş hekimliğinde bir uygulaması”. Cumhuriyet Üniversitesi Diş Hekimliği Fakültesi Dergisi, 7 (1), 42–50.
• 29. Çokluk, Ö. (2010). “Lojistik regresyon analizi: Kavram ve uygulama”. Kuram ve Uygulamada Eğitim Bilimleri, 10 (3), 1357–1407.
• 30. Karagöz, Y. (2016). “SPSS 23 ve AMOS 23 uygulamalı istatistiksel analizler”. Ankara: Nobel Yayın Dağıtım.
• 31. Meydan, C. M. ve Şeşen, H. (2011). “Yapısal eşitlik modellemesi AMOS uygulamaları (2.Baskı)”. Ankara: Detay Yayıncılık.
• 32. Fontaine, P, Ross, S. E, Zink, T. and Schilling, L. M. (2010). “Systematic review of health information exchange in primary care practices”. Journal of the American Board of Family Medicine : JABFM, 23 (5), 655–670. https://doi.org/10.3122/jabfm.2010.05.090192
• 33. Garcia-Sanchez, R. (2008). “The patient's perspective of computerised records: A questionnaire survey in primary care”. Informatics in Primary Care, 16 (2), 93–99. https://doi.org/10.14236/jhi.v16i2.680
• 34. Gaylin, D. S, Moiduddin, A, Mohamoud, S, Lundeen, K. and Kelly, J. A. (2011). “Public attitudes about health information technology, and its relationship to health care quality, costs, and privacy”. Health Services Research, 46 (3), 920–938. https://doi.org/10.1111/j.1475-6773.2010.01233.x
• 35. Pyper, C, Amery, J, Watson, M. and Crook, C. (2004). “Patients' experiences when accessing their on-line electronic patient records in primary care”. The British Journal of General Practice, 54(498), 38–43.
• 36. Dew, K, Morgan, S, Dowell, A, McLeod, D, Bushnell, J. and Collings, S. (2007). “'It puts things out of your control': Fear of consequences as a barrier to patient disclosure of mental health issues to general practitioners”. Sociology of Health & İllness, 29 (7), 1059–1074. https://doi.org/10.1111/j.1467-9566.2007.01022.x
• 37. Lafky, D. B. and Horan, T. A. (2011). “Personal health records: Consumer attitudes toward privacy and security of their personal health information”. Health Informatics Journal, 17 (1), 63–71. https://doi.org/10.1177/1460458211399403
• 38. Agaku, I. T, Adisa, A. O, Ayo-Yusuf, O. A. and Connolly, G. N. (2014). “Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers information are related to withholding of health information from healthcare providers”. Journal of the American Medical Informatics Association: JAMIA, 21 (2), 374–378. https://doi.org/10.1136/amiajnl-2013-002079
• 39. Ancker, J. S, Silver, M, Miller, M. C. and Kaushal, R. (2013). “Consumer experience with and attitudes toward health information technology: A nationwide survey”. Journal of the American Medical Informatics Association: JAMIA, 20 (1), 152–156. https://doi.org/10.1136/amiajnl-2012-001062
• 40. Verhaeghe, M. and Bracke, P. (2011). “Stigma and Trust Among Mental Health Service Users”. Archives of psychiatric nursing, 25 (4), 294–302.