How does national culture affect citizens' rights of access to personal health information and informed consent?

Two widely discussed and debated aspects of health law literature are ‘informed’ consent to medical treatment and the right of access to personal health information. Both are tied to the larger subject of patients’ rights, including the right to privacy. This article looks at the issue of informed consent internationally, and goes further to explain some of the inequalities across the world with respect to informed consent and patients’ rights legislation via an analysis of the take-up of key legislative attributes in patient consent. Specifically, the effect that national culture, as defined by the GLOBE variables, has on the rate and pattern of adoption of these consent elements is analysed using binary logistic regression to provide evidence of the existence or otherwise of a cultural predicate of the legislative approach. The article concludes by outlining the challenges presented by these differences

Adoption of information technology based patient education in psychiatric nursing

The overall goal of the study was to describe adoption of information technology (IT)-based patient education (PE) developed for patients and nurses use in psychiatric nursing. The data were collected in three phases during the period 2000-2006 in a variety of psychiatric settings in Finland. Firstly, the development process of IT-based PE for patients with schizophrenia spectrum psychosis was described. Secondly, nurses’ adoption of IT-based PE and the variables explaining adoption were demonstrated. Moreover, use of daily IT-based PE in clinical practice and factors associated with use were identified and described. And thirdly, nurses’ experiences of the IT-based PE after one year clinical use were evaluated. IT-based PE program was developed in several stages based on users’ needs and it included information and multimedia applications. Altogether, almost 500 IT-based PE sessions were carried out by the nurses on the study wards and revealed nurses’ activity in educating patients using IT to vary and depend on the hospital in which they worked. Almost 80% of all the possible IT-based PE sessions involved 93 patients and 83 nurses. Less than 2% of the IT-based PE sessions were interrupted and less than 10% suffered disturbances due to the patients or external causes. Moreover, the patients whose education took more days had poorer mental status than those whose education was carried out over a shorter period. After a year’s experience, advantages and disadvantages were described by the nurses for both patients and nurses of the IT-based PE. IT-based PE can be used even on closed acute psychiatric wards with patients with serious mental health disorders. However, technology adoption requires time, and therefore, it must fit in with clinical practice. Collaboration between users and developers is needed when developing user-centered methods in the area of mental health services. Moreover, it is important to understand factors that affect IT adoption in healthcare settings. IT-based PE is one option in interactive and co-operative health care practice between patients and nurses. Therefore the staff should begin to refer patients to established, credible and well-maintained Internet sites that provide information on common psychological problems. Even if every nurse should be trained and engaged to carry out IT-based PE, by targeting the training especially for the most active nurses aids them to support the less active ones. Adoption should also be understood from a perspective that includes aspects related to the context where it is implemented and examine how and in what circumstances it works.Siirretty Doriast

Privacy and data protection in eHealth in Africa - an assessment of the regulatory frameworks that govern privacy and data protection in the effective implementation of electronic health care in Africa: is there a need for reform and greater regional collaboration in regulatory policymaking?

This thesis examines and evaluates the legal protection of privacy and personal data in South Africa and across Africa in the electronic health care industry, that is, where medical services are provided to individuals by way of networked technological platforms including mobile telephones. This thesis presents a critical understanding of, and pragmatic solution to, the questions that lie at the intersection of the following: an individual's right to privacy and data protection, cultural disparities when defining privacy, the emergence of electronic health care, the sensitivity of health related data, the need for health care in areas, where lack of resources and lack of accessibility are often commonplace, and the introduction of networked technologies within the health care system as a solution. Firstly, eHealth services and applications are described. Secondly, notions of privacy and data protection are considered. Thirdly, the prevailing legal determinants that form the basis of African and South African data protection regulatory measures are ascertained. Fourthly, selected illustrations are presented of the practical implementation of eHealth services and certain recent influencers within the digital environment, which may inform the future eHealth privacy regulatory framework. Finally, criticisms of the Malabo Convention are presented and recommendations advanced. As there is limited guidance with regard to policymaking decisions concerning privacy and data protection in the implementation of eHealth in developing countries, possibilities for reform are suggested. These will allow a more careful balance between, on the one hand, the normative commitment to providing accessible health care using electronic means and, on the other, the rights to privacy and data protection of the user, which require safeguarding within an African context. In proposing a solution, it is argued that adequate privacy regulation of electronic health must (1) be sensitive to societal and cultural differences in what is considered private, (2) be responsive to rapid technological transformation in healthcare industries, and (3) build user confidence in data protection in this context, to enable nascent electronic health initiatives to reach their potential in Africa. It is proposed that the adoption of an accepted social imperative protected by a powerful triumvirate of ethical constraints, effective legal provisions and regulations, and operational necessities, is possible. Greater regulatory collaboration across the continent is called for based on harmonised domestic and international laws, national policies, and industry codes of conduct that are sensitive to local conditions and challenges

The Role of Mobile Phones in Health Education for Rural Communities in Ghana: An Exploratory Study in Digital Technologies

The use of wireless, mobile, and handheld digital devices is growing in every sector, including education and health. The increase in mobile (handheld) phone usage has gradually drawn most healthcare practitioners’ and patients’ attention to its capability as a promoter of health education. It has helped with reduction in social and economic impact of preventive and curative and unexplained non-curable illnesses, especially among rural communities in sub-Saharan African countries such as Ghana. Activity theory—an object-driven activity— was employed as the conceptual framework to answer the following research questions: What views do people have about information that relates to their health? What are the existing media used for obtaining information related to their health? What are the types of health-related activities that people perform on and with their mobile phones? What are the factors that influence employing a mobile phone in activities related to their health? And, what are some of the impacts of employing the device for activities related to their health in remote and isolated communities in sub-Saharan Africa? To help find responses to these questions, the study utilizes sequential mixed-methods approaches to sample 92 participants’ views about the role and potential of mobile phones to promote health literacy and access to information about health in order to improve the healthcare delivery system among people living in rural communities. Findings from the study show that health-related activities performed on and with mobile phones include: (i) inquiring about health concerns from friends, family, or healthcare personnel; (ii) practising teleconsultation, and telehealth with health helplines that address specific health issues such as pregnancy and cholera outbreak; (iii) clarifying any health symptom before travelling to healthcare centres; and (iv) scrutinizing counterfeit medications entering the country. Implementation of mobile phones in mobile health (mHealth) is revealed to be influenced by demographic and socio-economic status, as well as cultural practices and traditional beliefs in accessing and seeking medical assistance. Findings from this research add to literature on ways of addressing health inequities in remote communities through conducting capacity-building projects. Also, the findings contribute to educators’ understanding in identifying various forms of learning, seeking information, and pedagogies for which activity theory is particularly appropriate. Further, the results assist development agencies and policy-makers’ understanding on ways of promoting adult education and means of addressing issues related to patients’ privacy and confidentiality