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Physicians’ Attitudes toward Adolescent Confidentiality Services: Scale Development and Validation


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Figure 1

Inflection on the scree plot justifying the 4-factor solution.
Inflection on the scree plot justifying the 4-factor solution.

Respondents’ evaluations of the The Attitudes toward Adolescent Confidentiality Scale items.

ItemMean score ± Standard deviationMin-MaxSkewnessKurtosis
A1- Adolescent won’t share sensitive information regarding sexual and reproductive health with physician if they fear that parents might find out.3.65±1.071–5−0.594−0.244
A2- With confidentiality guaranteed adolescent patients will more likely seek medical help, speak openly about risky behaviors and continue with the treatment of reproductive health issues.4.24±0.971–5−1.6662.693
A3- Confidentiality is important for establishing a relationship of trust between the physician and the adolescent patient.4.65±0.761–5−2.94110.091
A4- By respecting confidentiality a physician shows respect for the adolescent patient’s person.4.63±0.791–5−3.00810.275
A5-Confidentiality is the ethical duty of every physician.4.74±0.721–5−3.61214.267
A6- A 15-year-old adolescent is capable of independent decision-making.2.47±0981–50.202−0.226
A7- A 15-year-old adolescent is capable of independently consenting to a medical procedure.2.31±1.011–50.319−0.650
A8- Adolescents are not able to adequately predict the long-term consequences of their decisions.1.93±0.821–50.7820.737
A9- Adolescents don’t possess adequate competence for decision-making.3.05±0.891–50.0250.119
A10- Parents are legally responsible for their children until the age of majority, therefore they have a right to be informed about all facts regarding their child’s health.1.84±0.971–50.9050.090
A11- Adolescents communicate poorly with their parents about sexuality and reproductive health problems.3.64±0.791–5−0.3840.212
A12- Parents have difficulty accepting their adolescent children’s emerging sexuality.3.45±0.871–5−0.3910.126
A13- Adolescents should be provided confidential counseling on sexual and reproductive health.4.47±0.801–5−1.8624.241
A14- Adolescents should be provided confidential contraceptive pill prescriptions.3.80±1.221–5−0.795−0.368
A15-Adolescents should be provided confidential diagnostics of STDs.3.74±1.291–5−0.677−0.823
A16-Adolescents should be provided confidential treatment of STDs.3.59±1.331–5−0.555−0.962
A17-Adolescents should be provided confidential pregnancy testing and prenatal care.2.78±1.501–50.245−1.315
A18- Adolescents should be provided confidential abortion service.2.33±1.361–50.679−0.733
A19- Adolescents should be provided confidential treatment of ovarian cysts.2.80±1.461–50.244−1.297

Correlations among 4 subscale scores.

123
2.24**
3.42**.17*
4.20*.35**.07

Factor loadings after varimax rotation and Kronbach alphas for the final 19-item scale.

Scale itemsFactor IFactor IIFactor IIIFactor IVKronbach alpha if item was deleted
A1- Adolescent won’t share sensitive information regarding sexual and reproductive health with physician if they fear that parents might find out.0.6920.836
A2- With confidentiality guaranteed adolescent patients will more likely seek medical help, speak openly about risky behaviors and continue with the treatment of reproductive health issues.0.6160.838
A3- Confidentiality is important for establishing a relationship of trust between the physician and the adolescent patient.0.8430.833
A4- By respecting confidentiality a physician shows respect for the adolescent patient’s person.0.9040.831
A5-Confidentiality is the ethical duty of every physician.0.8220.833
A6- A 15-year-old adolescent is capable of independent decision-making.0.7290.826
A7- A 15-year-old adolescent is capable of independently consenting to a medical procedure.0.7220.828
A8- Adolescents are not able to adequately predict the long-term consequences of their decisions.0.4610.842
A9- Adolescents don’t possess adequate competence for decision-making.0.5310.843
A10- Parents are legally responsible for their children until the age of majority, therefore they have a right to be informed about all facts regarding their child’s health.0.5460.839
A11- Adolescents communicate poorly with their parents about sexuality and reproductive health problems.0.6820.839
A12- Parents have difficulty accepting their adolescent children’s emerging sexuality.0.6730.841
A13- Adolescents should be provided confidential counseling on sexual and reproductive health.0.3440.836
A14- Adolescents should be provided confidential contraceptive pill prescriptions.0.5600.825
A15-Adolescents should be provided confidential diagnostics of STDs.0.8820.819
A16-Adolescents should be provided confidential treatment of STDs.0.9090.816
A17-Adolescents should be provided confidential pregnancy testing and prenatal care.0.8190.814
A18- Adolescents should be provided confidential abortion service.0.7450.818
A19- Adolescents should be provided confidential treatment of ovarian cysts.0.6490.830
A20- The family should be involved in making important decisions regarding the health of all its members.*0.0020.2280.2880.287

Characteristics of 4 subscales.

SubscaleNumber of itemsMean ±SD (Range)TertileCronbach alpha
1. Confidentiality in specific situations723.51±6.725 (7–35)Middle0.863
2. Importance of confidentiality418.26±2.664 (4–20)Third0.830
3. Adolescent maturity511.59±2.993 (5–25)First0.639
4. Communication with parents310.74±2.038 (3–15)Middle0.584
eISSN:
1854-2476
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Hygiene and Environmental Medicine