title: Confidentiality as a barrier to support seeking among physicians: the influence of psychosocial work factors in four European hospitals (the HOUPE study).
abstract: BACKGROUND
  Concerns about protecting patient's privacy can interfere with proper stress adaptation which is associated with physician's health. It is important to investigate relevant organizational confounders to this phenomenon to enable interventions that can ameliorate the subjective burden of patient confidentiality.
  
  
  OBJECTIVE
  This study investigates factors in the psychosocial work environment that can explain patient confidentiality's prominence in social support seeking among physicians, and if these factors covary differently with support seeking according to country.
  
  
  METHODS
  University hospital physicians in four European cities (N=2095) in Sweden, Norway, Iceland and Italy participated in a cross-sectional survey.
  
  
  METHODS
  Questionnaire comprised items on psychosocial work environment, basic socio-demographics, presence of formal and informal meetings at work, and measurement of confidentiality as a barrier for support.
  
  
  RESULTS
  High role conflict, availability of formal or informal meetings, lack of control over decisions, and lack of control over work pace were predictors of confidentiality as a barrier to support. There were differences between countries in how these factors covaried with confidentiality as a barrier to support. High role conflict was the strongest predictor of confidentiality as a barrier to support across all samples.
  
  
  CONCLUSIONS
  Psychosocial work factors predicted confidentiality as a barrier to support seeking among physicians. It is important to create routines and an organizational framework that ensures both the patient's right to privacy and physician's ability to cope with emotional demanding situations from work.
authors.affiliation: Department of Research and Development, Division of Psychiatry [AFFU], St Olavs University Hospital, Trondheim, Norway Department of Neuroscience, Faculty of Medicine, NTNU, Trondheim, Norway.
authors.forename: Lise Tevik
authors.initials: LT
authors.lastname: Løvseth
authors.affiliation: The Research Institute of the Norwegian Medical Association, Oslo, Norway Institute of Health Management and Health Economics, University of Oslo, Norwayy.
authors.forename: Olaf Gjerløw
authors.initials: OG
authors.lastname: Aasland
authors.affiliation: Department of Psychology, Stockholm University, Stockholm Sweden Center for Gender Medicine, Karolinska Institute, Stockholm, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Fridner
authors.affiliation: Center for Gender Medicine, Karolinska Institute, Stockholm, Sweden Department of Cardiology, Karolinska University Hospital, Stockholm, Swedenn.
authors.forename: Karin
authors.initials: K
authors.lastname: Schenck-Gustafsson
authors.affiliation: The Directorate of Health, Seltjarnarnes, Iceland.
authors.forename: Lilja Sigrun
authors.initials: LS
authors.lastname: Jónsdóttir
authors.affiliation: Faculty of Social Science, University of Iceland, Reykjavík, Iceland.
authors.forename: Torgerdur
authors.initials: T
authors.lastname: Einarsdóttir
authors.affiliation: Department of Neurological and Psychiatric Science, Clinic of Psychiatry, University of Padova, Padua, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Marini
authors.affiliation: Department of Oncological Gynecology, University of Padova, Padua, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Minucci
authors.affiliation: Department of Psychiatrics, University of Padova, Padua, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pavan
authors.affiliation: Department of Research and Development, Division of Psychiatry [AFFU], St Olavs University Hospital, Trondheim, Norway Department of Neuroscience, Faculty of Medicine, NTNU, Trondheim, Norway.
authors.forename: K Gunnar
authors.initials: KG
authors.lastname: Götestam
authors.affiliation: Department of Research and Development, Division of Psychiatry [AFFU], St Olavs University Hospital, Trondheim, Norway Department of Neuroscience, Faculty of Medicine, NTNU, Trondheim, Norway.
authors.forename: Olav Morten
authors.initials: OM
authors.lastname: Linaker
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003219:Confidentiality / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007055:Iceland; D007558:Italy; D008297:Male; D008875:Middle Aged; D009664:Norway; D010820:Physicians / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Professional secrecy; doctor; role conflict; social support; work environment