• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (8)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Patient-Physician Communication  • Alert me on articles by topic  Social Bookmarking   What's this?

Primary Care Patients’ Disclosure Deliberations

Pamela Sankar, PhD; Nora L. Jones, PhD

Arch Intern Med. 2005;165:2378-2383.

Background  Literature on patient disclosure has highlighted policy proposals, practitioner attitude and practices, and issues specific to already identified vulnerable populations (eg, human immunodeficiency virus–positive patients and adolescents). We investigated the topics and concerns that led less-studied primary care patients to deliberate disclosure to their physician and the range of actions taken following such deliberation.

Methods  This descriptive qualitative study used semistructured in-depth interviews with 85 self-selected female primary care patients recruited from 2 hospital-associated primary care practices and through advertisements in local newspapers.

Results  Topics that led subjects to deliberate over disclosure included sex, sexually transmitted diseases, reproductive health, drug use, mental health, and domestic circumstances. Concerns prompting this deliberation fell into 2 categories. The first, extraindividual concerns, included fear of information circulating to employers or insurance companies and the need to disclose for adequate treatment. The second, intrapersonal concerns, centered on feelings of comfort, embarrassment, or shame in the act of disclosing during the clinical encounter. While the majority of women did eventually disclose all or part of the information in question, a significant minority did not disclose. There were no significant demographic differences associated with patterns of disclosure.

Conclusions  Primary care patients have concerns that affect and sometimes limit disclosure. Physicians are encouraged to explore patients’ concerns about the uses and circulation of medical information, as well as anxiety over anticipated shame or embarrassment at the moment of information disclosure to physicians. This is especially important in primary care settings, where failure to disclose can mean lack of referral to needed specialized care.

Author Affiliations: Center for Bioethics, University of Pennsylvania, Philadelphia.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The ethics of unsolicited diagnosis of mental disorder in acquaintances: benefits and dangers
Mitchell
The Psychiatrist 2011;35:297-301.
ABSTRACT | FULL TEXT  

What Latina Patients Don't Tell Their Doctors: A Qualitative Study
Julliard et al.
Ann Fam Med 2008;6:543-549.
ABSTRACT | FULL TEXT  

Genitourinary medicine clinic and general practitioner contact: what do patients want?
Fernando and Clutterbuck
Sex. Transm. Infect. 2008;84:67-69.
ABSTRACT | FULL TEXT  

Letters from beyond: do patients attending Genitourinary Medicine clinics want their general practitioner to know?
Steedman and Clutterbuck
Sex. Transm. Infect. 2007;83:594-594.
FULL TEXT