title: Concern for privacy in relation to age during physical examination of children: an exploratory study.
abstract: OBJECTIVE
  To explore whether physicians behave differently regarding ethics and respect for privacy depending on children's age. We explored whether physician behaviours contributed to child uneasiness.
  
  
  METHODS
  Observational study of 21 children (0-12 years; 18 boys; mean age 3.2) undergoing evaluation for inguinal hernia. Specific physician-initiated verbal and nonverbal behaviours were coded from digital video discs of the consultations.
  
  
  RESULTS
  Physician intrusiveness (i.e. approaching the child suddenly or in an uninvited way) during the physical examination was related to concurrent child uneasiness (r = 0.42, p < 0.06) and lasted through the postexamination phase of the consultation (r = 0.52, p < 0.01). Child mood during the examination strongly predicted postexamination mood (r = 0.69, p < 0.0001). Neither the total number of physician-initiated positive behaviours or privacy-related behaviours was associated with child age. Negative physician behaviours were strongly related to negative mood in the child (r = 0.72, p < 0.0001) at the close of the consultation.
  
  
  CONCLUSIONS
  Although physicians were more likely to provide information to older than younger children, their behaviours regarding privacy did not differ by child age. We found that intrusiveness was rather common and related to child uneasiness that has implications for the ethical practice and a child's willingness to be examined.
authors.affiliation: Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Mats G
authors.initials: MG
authors.lastname: Hansson
authors.forename: Ulrik
authors.initials: U
authors.lastname: Kihlbom
authors.forename: Torsten
authors.initials: T
authors.lastname: Tuvemo
authors.forename: Alina
authors.initials: A
authors.lastname: Rodriguez
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D010372:Pediatrics / Q000941:ethics; D010808:Physical Examination / Q000941:ethics* / Q000523:psychology; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000523:psychology; D018907:Privacy / Q000523:psychology*; D011368:Professional-Family Relations; D002666:Psychology, Child; D013315:Stress, Psychological; D014741:Video Recording