ORIGINAL ARTICLE Patients' perception of privacy during emergency department care in hospitals in Aragón,

JULIÁN MOZOTA DUARTE 1,4,5 , J AVIER MOLINER LAHOZ 1,5 , A LBERTO GARCÍA NOAÍN 1,5 , MARÍA JESÚS MORENO MIRALLAS 2,5 , R AÚL WENSCESLAO FERNÁNDEZ MOROS 3,5 , MARÍA JOSÉ RABANAQUE HERNÁNDEZ 4,5 , EN REPRESENTACIÓN DE LOS INVESTIGADORES DEL PROYECTO 1Hospital Clínico Universitario Lozano Blesa, , Spain. 2Hospital Royo Villanova, Zaragoza, Spain. 3Hospital Ernest Lluch,, Zaragoza, Spain. 4Facultad de Medicina de Zaragoza, Spain. 5Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain.

CORRESPONDENCE : Objective: To analyze patients' perception of respect for their privacy in hospital Julián Mozota Duarte emergency departments in . Servicio de Urgencias Methods: In a prospective survey patients were asked to evaluate respect for their Hospital Clínico Universitario privacy while they were treated in hospital emergency departments. Assessments were Lozano Blesa expressed on a 5-point Likert scale. The study population was a stratified random sample Avda. San Juan Bosco, 15 of patients discharged from each of the participating hospital emergency departments. 50009 Zaragoza, Spain Results: A total of 3949 patient questionnaires were analyzed. The mean score for E-mail: [email protected] auditory privacy was 3.93 (range, 1-5; 95% CI, 3.89-3.96). The mean score for visual privacy was 4.32 (95% CI, 4.29-4.35). The overall privacy score was a mean of 4.17 RECEIVED : (95% CI, 4.15-4.21). The mean scores for men were higher for auditory privacy (3.97 vs 29-4-2013 3.90 for women, P<.05), visual privacy (4.35 vs 4.30, P<.05), and overall privacy (4.21 vs 4.16, P<.05). Private and small hospitals received better scores on all aspects of privacy ACCEPTED : (P<.01). 30-5-2013 Conclusions: Privacy is adequately respected in hospital emergency departments according to 64% to 92% of patients. Auditory privacy is the aspect that receives the lowest ratings. Although CONFLICT OF INTEREST : these scores can be considered positive, we must attempt to achieve a higher level that will be The authors declare no conflict perceived as fully respectful given that privacy is a basic patient right. [Emergencias 2013;25:445- of interest in relation with the present article. 450]

ACKNOWLEDGEMENTS : Keywords: Emergency medicine. Privacy. Confidentiality. Survey. To “Agencia de Evaluación de Tecnologías Sanitarias del Instituto de Salud Carlos III” (PI09/90787). The present study was awarded the prize for the best presentation at the II National congress on patient safety, accident and emergency medicine, held at Toledo 2011.

Introduction General Law on Health 2 which states that patients have the right "to respect for their personality, hu - Since ancient times, doctors have been obliged man dignity and privacy" and "the confidentiality to respect patient privacy and confidentiality. The of the information related to their process". The Hippocratic oath includes the following text: Law of patient autonomy 3 recognizes that "respect “What I may see or hear in the course of the for the autonomy of their will and their privacy treatment or even outside of the treatment in re - will govern all activities designed to obtain, use, gard to the life of men, which on no account one archive, keep or transmit clinical information and must spread abroad, I will keep to myself, holding documentation". such things shameful to be spoken about” 1. More The terms privacy and confidentiality in Span - recently, Spanish legislation reflects this, as in the ish (privacidad and confidencialidad) are frequent -

Emergencias 2013; 25: 445-450 445 J. Mozota Duarte et al.

ly used interchangeably or with overlapping sa, Hospital Ernest Lluch, University Hospital meaning 4,5 . According to the Real Academia Es - Miguel Servet, Hospital Royo Villanova, Hospital pañola, confidencialidad is closely linked to the San Jorge, Hospital Obispo Polanco, Hospital de private nature of personal information. Barbastro, Hospital Jaca, Clínica MAZ Zaragoza With regard to patient privacy, medical profes - and Clínica Quiron Zaragoza. The reasons for ex - sionals do not always share the same concepts, clusion of patients were: inability to understand or meaning and priorities as their patients. Issues fill out the survey, rejection of the invitation to concerning the self-image of the patient, how participate or a disabling medical condition. tests are performed or what information is includ - The necessary sample size was calculated using ed in their medical history may be perceived as vi - the formula for a known proportion of a particular olations of privacy by the patient without the characteristic in the population, from the most health professional being aware of it 6. Many unfavourable (p = q = 0.5), with a confidence in - physicians show knowledge gaps about the law terval (CI) of 95% and an accuracy of 5%, and governing their relationship with patients, espe - taking into account that the minimum number of cially in regard to patient autonomy and the re - emergencies attended by each participating hos - spect for their right to information 7. Patient per - pital was 35,000 per year. With these considera - ception of privacy has evolved with cultural tions, the number of surveys required per hospital change and is related to expectations of quality of was 384. The expected total sample was therefore attention that they receive. 3,840 questionnaires. The different dimensions of patient privacy To select the patients we performed random have scarcely been studied in hospital emergency stratified sampling of the patients discharged from departments (EDs). In a study 8 performed in each participating ED, whose destination was ei - Chicago, up to 36% of patients reported over - ther home or hospital admission. The stratification hearing conversations containing information variables were: time shift, holiday and ED area about other patients. In Spain, a study performed (first attendance area or observation room). The in 2001 9 found that overall patient satisfaction invitation to complete the questionnaire was was not related with structural improvements in made to consecutively discharged patients to dis - the ED. Others 10 have studied patient assessment charged patients as from a particular time for of the quality of service offered in the ED, espe - each shift, chosen at random, until reaching the cially the information delivered and the attention quota corresponding to that day. The variables received, waiting times, and the physical facilities. studied were the following: The nature of ED activity may pose threats to pa - – Explanatory variables: a) patient data: age, tient privacy and clinical safety 11 because of the sex; (b) ED episode data: day of the week, time, high number of patients and their companions, destination after ED discharge; (c) Hospital data: overcrowding, the speed of care, the priority of public or private, number of beds (small: less than the clinical problem, the presence of many health 200 beds; medium: 200-500 beds; and large: professionals in limited space and time, and the more than 500 beds), rural or urban. lack of spaces suitable for information delivery. – Response variables: the questionnaire com - The aim of the present study was to assess the prised 11 closed questions with 5 possible an - degree of respect for patient privacy in the EDs of swers on a Likert scale, exploring three aspects: hospitals in Aragon, and identify the characteris - auditory privacy (4 questions), visual privacy (4 tics of the various services associated with a cer - questions) and overall privacy (3 questions). The tain perception. questionnaire used was translated from the origi - nal by Barlas et al. 12 . A pilot study was previously conducted in one Method of the EDs to assess the completion of the ques - tionnaire, the adequacy of the language used and We performed a prospective study based on to identify potential problems to be rectified be - information obtained from patients using a ques - fore the definitive study. tionnaire on respect for privacy. The study was ED-discharged patients were invited to com - approved by the clinical research ethics commit - plete the self-administered questionnaire; those tee of the Clínica de Aragon. Patients over 18 discharged from the observation area had spent years of age discharged from the ED during the up to 48 hours there, and were awaiting final des - period May-June 2010 in 10 different hospitals of tination (home or admission to a ward). The Aragon: Hospital Clínico Universitario Lozano Ble - questionnaire was delivered by a health profes -

446 Emergencias 2013; 25: 445-450 PATIENTS ' PERCEPTION OF PRIVACY DURING EMERGENCY DEPARTMENT CARE IN HOSPITALS IN ARAGÓN , S PAIN

sional not involved in that patient’s care or dis - CI 4.15-4.21). Assessment of the respect shown charge but who remained available for clarifica - by ED professionals for their privacy was "quite a tion of doubts. The physical space in which the lot" or "a lot" in 89% of cases. The percentage of questionnaire is completed was consultation/ favourable opinions dropped to 80% when asked room/courtroom that reported high or entry to about their perception of privacy of patients in the patient. To reduce variability in survey admin - the ED (Table 1). istration, a meeting with researchers from each Cronbach’s alpha coefficient for the three cate - Center was held to explain the protocol in detail. gories of privacy (auditory, visual, and overall), Each investigator conducted meetings at their were higher than 0.88, so scores for each of these hospital with staff who collaborated in survey ad - categories were used in the analysis. ministration. When comparing the results according to pa - For data analysis, a descriptive study of the tient gender (Table 2) we found higher score in questionnaire was performed using percentages males vs women in auditory privacy (3.97 vs for each level of response. For quantitative analy - 3.90, p < 0.05), visual privacy (4.35 vs 4.30, sis, the answers to the 11 questions in each ques - p<0.05) and overall privacy (4.21 vs 4.16, p < tionnaire were considered discrete quantitative 0.05). Regarding patient age, stratified in quar - variables, where 1 was the most negative and 5 tiles, those aged below 34 years showed lower the most positive score. Questions were grouped scores for auditory privacy than other age groups to explore patient perception of auditory (ques - (3.83 vs 4.01 vs 3.91 vs. 3.97, p < 0.01). No dif - tions 1-4), visual (questions 5 to 8) or overall pri - ferences between age groups were observed for vacy (questions 9-11) and mean scores were ob - the other variables assessed. The patients who tained for each dimension. In this way we were discharged from the first attending area obtained three response variables, with continu - showed better scores for both visual and auditory, ous quantitative variables having a range of 1-5. as well as overall privacy, than those who had Cronbach's alpha coefficient was calculated to been in the observation room (p <0.01). Patients measure reliability, i.e. the agreement between re - discharged home showed better perception of pri - sponses to questions measuring the same variable. vacy than those requiring hospital admission Values above 0.70 were considered to guarantee (p < 0.01). There were no differences between reliability. Comparison of the means were per - patients attended in weekend versus weekday formed using Kruskall Wallis or Mann-Whitney test shifts, but the best scores corresponded to morn - to assess the association of perceived privacy with ing shifts and the worst for night shifts (p < 0.01). the explanatory variables. Private centers obtained better scores than public hospitals, for all levels of privacy studied (p < 0.01). Better scores were obtained in patients Results attended in small hospitals (less than 200 beds) than the medium size (between 200-500 beds) In the 10 participating hospitals, we collected and large hospitals (p < 0.01). And patients at - 3,949 completed questionnaires (51% males, tended in rural hospitals showed better scores mean age 51 years). Two thirds (74.7%) were than those attended in urban ocenters (p < 0.01). completed in the first attention area and 25.3% in the observation room; 76.1% of patients were discharged home and 23.9% were admitted to Discussion hospital. Mean score for auditory privacy was 3.93 In general, perception of respect for privacy in (95% CI: 3.96-3.89). Nearly a quarter of the pa - the ED of hospitals of Aragon was positive; 64- tients reported overhearing private conversations 88% considered their auditory privacy was ade - between other patients and staff, and more than quate, 78-92% their visual privacy and 78-88% 20% felt that other patients might have heard overall privacy. Although these figures can be their private conversations with staff (Table 1). considered positive, it must not be forgotten that Mean rating of visual privacy was 4.32 (95% CI 100% is the target rate and anything below that 4.29-4.35). One in every seven people reported indicates how far we have to go to ensure the having seen other patients while they were being right to privacy for all patients, as pointed out by attended, and one in ten felt they had been seen Figueras-Sabater 13 . More favourable views on re - by other patients while being attended. spect for privacy was found in men, perhaps Mean score for overall privacy was 4.17 (95% younger patients, those not admitted and those

Emergencias 2013; 25: 445-450 447 J. Mozota Duarte et al.

Table 1. Patient responses to questions on auditory and visual privacy in hospital emergency departments Question Response (%) Definitely Probably Not sure Probably Definitely not not Auditory privacy 1. Would you say that other patients could hear your conversation with the doctor or nurse? 9.8 12.8 13.6 28.2 35.5 2. Have you had the feeling that your personal information could be heard by other people? 7.5 13.2 14.1 28.7 36.5 3. Have you ever heard the conversations of other patients with the doctor or nurse? 14.5 9.9 8.9 18.5 48.3 4. Have you changed/omitted information given to your doctor or nurse because you felt it could be heard by other people? 1.6 2.9 6.5 16.1 72.8 Visual privacy 5. Have you had the feeling that unauthorized persons have been able to see you while you were receiving assistance? 3.9 6.7 12.2 29.1 48 6. Have you had the feeling that people not attending you have been able to see intimate parts of your body while you were receiving attention? 2.5 5.5 10.4 23.7 58 7. Have you seen other patients while they were being examined? 7.3 6.5 6.2 16.9 63.2 8. Have you rejected physical examination by your doctor because you had the feeling the process could be seen by unauthorized persons? 0.8 1.9 4.9 15.0 77.3 Zero Poor Fair Good Excellent Overall privacy 9. During this visit, how would you rate staff respect for your privacy? 0.9 3.4 6.9 38.6 50.2 10. What is your overall impression of personal privacy in this emergency department? 3.6 4 13.3 38.3 40.8 11. During this visit, to what extent have your expectations of privacy been met? 3.5 4 12.4 38.2 42 attended in smaller size and/or rural hospitals, ceived privacy. Almost all (90%) of the participat - and private hospitals. ing EDs have partition walls in the main attending A quarter (25%) of the ED patients studied area and curtains in the observation area, and the had overheard conversations between other pa - results were as expected, but other factors may al - tients and health personnel, which is consistent so help explain this finding: patients assigned to with the findings of a Chicago hospital study be - the observation room remain longer in the ED, fore and after structural reforms to expand the which increases interactions with ED staff and surface area and create rooms separated by parti - therefore the possibility of perceived privacy viola - tions instead of curtains (36% and 14%, respec - tion. Barlas et to al 12 surveying patients at a New tively) 8,14 . A curious study performed in the eleva - York ED and comparing the areas of care with tors of a Canadian hospital detected that more curtain or wall separation of patients found that, than 10% of the occupants had overheard infor - in the areas with curtains, the perception of hear - mation compromising patient privacy from health ing and seeing other patients and listening to professionals 15 . staff was greater than in the areas of partitions. The transmission of private information in cor - Other studies have shown both aspects: that ridors or in the presence of other patients or fami - longer stays in the ED and curtained areas were ly members constitutes a violation of auditory pri - related to perceived privacy violation 18,19 . In a vacy. In our study 25% of the patients reported study performed in intensive care units, perceived overhearing private conversations with the doctor privacy was related to adequate physical space al - or nurse. These data are consistent with those of lowing solitude, respect for dignity and self-care, a survey of professionals in which more than 40% rule flexibility, nurse professionalism and family reported giving information "almost always" or support 20 . Although solutions to this problem in "always" in the corridor or in front of the room - EDs are no simple matter, especially at times of mate 16 . In a study by Barlas et al 12 , 85% of pa - overcrowding, a recently published study has tients considered that staff respected their privacy, shown the benefits of multifactorial intervention, similar to our percentage (88.8%), as well as the consisting of re-organisation of space, control of 86.4% reported by Rebull et al 17 in a telephone access and training of staff and consultants, result - survey performed in Catalan EDs. ing in improved perception of privacy and satis - In the present study we assessed whether ade - faction in patients treated in the ED 21 . quate separation of patients (partitions and doors Following completion of the work, we believe vs curtains) in the ED was the main factor in per - it necessary to carry out further studies related to

448 Emergencias 2013; 25: 445-450 PATIENTS ' PERCEPTION OF PRIVACY DURING EMERGENCY DEPARTMENT CARE IN HOSPITALS IN ARAGÓN , S PAIN

Table 2. Variables related to patient perception of auditory limitations, we believe the information obtained is and visual privacy in the emergency department (ED) useful and relevant for respect to the right to pri - Variables N (%) Visual Overall Privacy vacy in the ED and to plan actions that will im - Auditory privacy privacy prove that right. Sex Male 1,977 (50.1) 3.97* 4.35* 4.21* Female 1,898 (49) 3.90 4.30 4.16 Addendum Age (years) Յ 34 1,013 (25.7) 3.83** 4.30 4.12 The other project researchers were: José Maria Abad Diez, Faculty of 35-49 961 (24.3) 4.01 4.33 4.22 Medicine of Zaragoza; Rafael Boldova Aguar, Hospital Miguel Servet; Mª 50-69 919 (23.3) 3.91 4.33 4.15 José Borruel Aguilar, Hospital Obispo Polanco; Maria Pilar Coloma, Clíni - Ն 70 904 (22.9) 3.97 4.32 4.21 ca MAZ; Eduardo Hernando Ardanaz, Hospital de Jaca; Fernando Pedro Survey area Moliner, Clínica Quiron; Itziar Ortega Castrillo, Hospital de Barbastro First ED attention 2,790 (70.7) 4.08** 4.42** 4.26** and Juan José Sanz Petrona, Hospital San Jorge. Observation 952 (24.1) 3.50 4.06 3.95 Destination Discharge home 2,793 (70.7) 4.06** 4.37** 4.23** References Admission 879 (22.3) 3.64 4.11 3.95 Day of attention 1 Código de deontología médica. Guía de ética médica. : Or - Weekday 3,066 (71.7) 3.92 4.32 4.17 ganización Médica Colegial de España; 2011. Weekend 820 (19.2) 3.94 4.30 4.19 2 Ley 14/1986, de 25 de abril, General de Sanidad. Boletín Oficial del Shift Estado, núm. 102 de 29 de abril de 1986, pág 15207-15224. (Con - Morning 1,785 (45.2) 4.00** 4.37** 4.23** sultado 19 Marzo 2013). Disponible en: http://www.boe.es/boe/ Afternoon 1,426 (36.1) 3.88 4.28 4.14 dias/1986/04/29/pdfs/A15207-15224.pdf. Night 629 (15.9) 3.81 4.25 4.11 3 Ley 41/2002, de 14 de noviembre (BOE 15-11-2002), básica regula - dora de la autonomía del paciente y de derechos y obligaciones en Type of Hospital materia de información y documentación clínica.. Boletín Oficial del Public 3,113 (78.8) 3.83** 4.29 4.11** Estado, núm. 274 de 15 de noviembre de 2002, pág 40126-40132. Private 836 (21.2) 4.32 4.45 4.42 (Consultado 19 Marzo 2013). Disponible en: http://www.boe.es/ Size of Hospital boe/dias/2002-11-15/pdfs/A40126-40132.pdf. Small 2,116 (49.5) 4.08** 4.43** 4.33** 4 Moskop JC, Marco CA, Larkin GL, Geiderman JM, Derse AR. From Hippocra - Medium 1,301 (30.4) 3.39 3.90 3.70 tes to HIPAA: Privacy and Confidentiality in Emergency Medicine. Part I: Large 862 (20.1) 3.55 3.98 3.88 Conceptual, Moral, and Legal Foundations. Ann Emerg Med. 2005;45:53-9. Site of Hospital 5 Geiderman JM. Moskop JC, Derse AR. Privacy and confidentiality in emergency medicine: obligations and challenges. Emerg Med Clin Rural 1,207 (30.6) 4.01** 4.48** 4.34** North Am. 2006;24:633-56. Urban 2,742 (69.4) 3.90 4.25 4.11 6 Soldevilla-Cantueso MA, Solano D, Luna-Medina E. La intimidad desde una Total sample 3,949 (100) 3.93 4.32 4.17 perspectiva global: pacientes y profesionales. Rev Calid Asist. 2008;23:52-6. Mean rating (range 1-5). *p < 0.05; **p < 0.01 (Mann-Whitney U test 7 Mira JJ, Lorenzo S, Vitaller J, Guilabert M. Derechos de los pacientes. for 2 independent groups, Kruskall Wallis for k independent groups). Algo más que una cuestión de actitud. Gac Sanit. 2010;24:247-50. 8 Olsen JC, Sabin BR. Emergency department patient perceptions of privacy and confidentiality. J Emerg Med. 2003;25:329-33. ethical conflicts and respect for the rights of pa - 9 Lopez-Madurga ET, Mozota J, Moliner FJ, Cuartero R, Martínez-Vidal JA, Guerrero JL. Estrenamos servicio de urgencias, ¿mejora la satisfac - tients in the ED. This topic generates interest ción de los pacientes? Rev Calid Asist. 2001;16:164-8. among professionals: 36% of ED staff report hav - 10 López-Madurga E, Mozota J, González I, Sánchez Y, Enríquez N, Mo - liner J. Satisfacción de los pacientes atendidos en el servicio de ur - ing had ethical conflicts related with confidentiali - gencias de un hospital de agudos. Emergencias. 1999;11:184-90. ty or professional silence 22 at some point or other 11 Tomás S, Chanovas M, Roqueta F, Alcaraz J, Toranzo T y grupo de trabajo EVADUR-SEMES. EVADUR: eventos adversos ligados a la asistencia en los ser - in their professional life and this constituted the vicios de urgencias de hospitales españoles. Emergencias. 2010;22:415-28. second most important source of ethical prob - 12 Barlas D, Sama AE, Ward MF, Lesser ML. Comparison of the auditory and visual privacy of emergency department treatment areas with cur - lems, after end-of-life issues. tains versus those with solid walls. Ann Emerg Med. 2001;38:135-9. The study has certain limitations. First, ED pa - 13 Figueras-Sabater R. Derechos de los pacientes y calidad asistencial. Rev Calid Asist. 2005;20:318-26. tient response rate was not evaluated since we 14 Olsen JC, Cutcliffe B, O’Brien BC. Emergency department design and patient were unable to record the number of patients perceptions of privacy and confidentiality. J Emerg Med. 2008;35:317-20. 15 Vigod SN, Bell CM, Bohnen JM. Privacy of patients’ information in who declined to participate in the survey. Second, hospital lifts: observational study. BMJ. 2003;327:1024-5. patients admitted to hospital may be over-repre - 16 Iraburu M, y Grupo de Trabajo del EMIC. Estudio multicéntrico de inves - tigación sobre la confidencialidad. Med Clin (Barc). 2007;128:575-8. sented (22% in the sample versus 14% in the 17 Rebull J, Castellà M, de Pablo A, Vázquez R, Portoles M, Chanovas general ED population). Third, we did not include MR. Satisfacción de los usuarios de un servicio de urgencias: compa - ración de resultados. Rev Calid Asist. 2003;18:286-90. an assessment of respondent characteristics such 18 Lin YK, Lin CJ. Factors predicting patients’ perception of privacy and as educational level, nationality, frequent ED at - satisfaction for emergency care. Emerg Med J. 2011;28:604-8. 19 Karro J, Dent AW, Farish S. Patient perceptions of privacy infringements tendance, spontaneous or referred visits, which in an emergency department. Emerg Med Australas. 2005;17:117-23. could influence their perception of privacy. Finally, 20 Amorós Cerdá SM, Arévalo Rubert MJ, Maqueda Palau M, Pérez Juan E. Percepción de la intimidad en pacientes hospitalizados en una the proportion of ED patients from small hospitals Unidad de Cuidados Intensivos. Enferm Intensiva. 2008;19:193-203. in our sample was overly high, due to the type of 21 Lin YK. Building an ethical environment improves patient privacy and satisfaction in the crowded emergency department: a quasi-ex - proportional sampling used for the study and the perimental study. BMC Med Ethics. 2013;14:8. convenience of obtaining participants representa - 22 Lucas FJ, Galán MA, Roldán R. La actividad asistencial en el servicio de urgencias hospitalario genera conflictos éticos a sus profesionales. tive of different levels of hospital. Despite these Emergencias. 2011;23:283-92.

Emergencias 2013; 25: 445-450 449 J. Mozota Duarte et al.

Percepción de intimidad de los pacientes atendidos en los servicios de urgencias hospitalarios de Aragón

Mozota Duarte J, Moliner Lahoz J, García Noaín A, Moreno Mirallas MJ, Fernández Moros RW, Rabanaque Hernández MJ Objetivo: Analizar el respeto a la intimidad de los pacientes en el ámbito de los servicios de urgencias hospitalarios (SUH) de Aragón. Método: Estudio prospectivo llevado a cabo mediante la cumplimentación de un cuestionario por parte de los pacien - tes sobre la valoración del respeto a la intimidad durante su asistencia en los SUH de diferentes hospitales de Aragón, con respuestas de cinco opciones graduales de escala Likert. Se realizó un muestreo estratificado aleatorio de los pa - cientes dados de alta de cada uno de los servicios incluidos. Resultados: Se analizaron 3.949 cuestionarios de pacientes. La intimidad auditiva fue valorada con una puntuación media de 3,93 (mínimo 1, máximo 5), (IC95%: 3,89-3,96). En cuanto a la privacidad visual, la puntuación media fue de 4,32 (IC 95% 4,29-4,35). La intimidad global obtuvo una puntuación media de 4,17 (IC 95% 4,15-4,21). Se halló mayor puntación en los varones vs mujeres en la intimidad auditiva (3,97 vs 3,90, p < 0,05), en la intimidad visual (4,35 vs 4,30, p < 0,05) y en la intimidad global (4,21 vs 4,16, p < 0,05). Los centros privados y los de tamaño pequeño obtuvieron mejores puntuaciones en todos los ámbitos de la intimidad estudiados (p < 0,01). Conclusiones: La percepción de los pacientes sobre el respeto a la intimidad en los SUH es valorada como adecuada entre un 64-92%, y la peor puntuada fue la intimidad auditiva. Aunque las valoraciones pueden considerarse positivas, dado que evaluamos un derecho, ha de intentar alcanzarse el 100% en la percepción de respeto de la intimidad por parte de todos los pacientes. [Emergencias 2013;25:445-450]

Palabras clave: Servicio de Urgencias. Intimidad. Confidencialidad. Encuesta.

450 Emergencias 2013; 25: 445-450