ASSESSMENT OF CONFIDENTIALITY OF PATIENTS’ RECORD AMONG HEALTH PROFESSIONALS (A CASE STUDY OF DELTA STATE UNIVERSITY TEACHING HOSPITAL)

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TOPIC: ASSESSMENT OF CONFIDENTIALITY OF PATIENTS’ RECORD AMONG HEALTH PROFESSIONALS (A CASE STUDY OF DELTA STATE UNIVERSITY TEACHING HOSPITAL)

TABLE OF CONTENTS

Title Page
Certification
Dedication
Acknowledgment
Abstract
Table of Contents
CHAPTER ONE: INTRODUCTION

1.1 Background to the Study
1.2 Statement of the Problem
1.3 Objectives of the Study
1.4 Research Questions
1.5 Research Hypotheses
1.6 Significance of the Study
1.7 Scope of the Study
1.8 Operational Definition of Terms

CHAPTER TWO: LITERATURE REVIEW

2.0 Introduction

2.1 Conceptual Framework

2.3 Empirical Studies

2.4 Appraisal of Literature

2.5 Summary

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design

3.2 Study Setting

3.3 Population of the Study

3.4 Sample Size Determination

3.5 Sampling Techniques

3.6 Instrument for Data Collection

3.7 Validity & Reliability of the Instrument

3.8 Method of Data Collection

3.9 Method of Data Analysis

3.10 Ethical Considerations

CHAPTER FOUR: DATA PRESENTATION, ANALYSIS, AND INTERPRETATION

4.1 Introduction

4.2 Demographic Presentation

4.3 Answering Research Questions

4.4 Testing Hypotheses

4,5 Summary of Analysis

CHAPTER FIVE: DISCUSSION, CONCLUSION, RECOMMENDATION

5.1 Discussion of Findings

5.2 Implication of Findings

5.3 Summary of the Study

5.4 Conclusion

5.5 Recommendations

5.6 Limitations of the Study

5.7 Suggestion for Further Studies

References

Appendix

ABSTRACT

This study examined the confidentiality of patients’ records among health professionals at Delta State University Teaching Hospital, focusing on awareness, attitudes, contributing factors to breaches, and institutional safeguards. Employing a descriptive survey design, the study sampled 200 healthcare professionals drawn from clinical and administrative departments using proportionate stratified sampling. Data were collected through a structured, self-administered questionnaire comprising five sections that assessed demographic characteristics, awareness levels, attitudes and practices, breach factors, and institutional measures. The reliability of the instrument was confirmed with a Cronbach’s alpha coefficient above 0.80. Data analysis employed descriptive statistics (mean and standard deviation) and inferential statistics including one-way ANOVA to test two hypotheses. Results revealed high awareness levels with mean scores ranging from 3.80 to 4.05, indicating general recognition of confidentiality as both a legal and ethical imperative. Attitudes and practices were also positive (mean = 3.93–4.07), reflecting conscientious handling of patient data. However, significant breach contributors were identified, including inadequate training (mean = 4.14), poor supervision (mean = 4.08), and infrastructural limitations (mean = 4.05). ANOVA results showed a significant relationship between awareness and attitude (F = 6.832, p = 0.013), as well as between institutional factors and frequency of breaches (F = 5.473, p = 0.026). These findings underscore the need for consistent staff training, improved infrastructure, and reinforced hospital protocols. Recommendations include routine confidentiality audits, updated digital security systems, and mandatory ethics workshops to ensure that health professionals remain compliant with confidentiality standards essential for patient trust and legal protection.

CHAPTER ONE

INTRODUCTION (Preview)

1.1 Background of the Study

In the evolving landscape of global healthcare, the delivery of timely, accurate, and patient-centered services is increasingly recognized as a cornerstone of sustainable development, economic resilience, and social cohesion. Health systems worldwide are not only expected to treat illness but also to manage patient information flows that enable preventive care, policy-making, and system accountability.  Scholars such as Popoola (2024) sees patients’ information as a multidimensional construct encompassing the systematic collection, organization, analysis, and application of data pertaining to individuals’ health status, medical history, clinical encounters, diagnostic results, treatment regimens, and health outcomes. It serves as the informational backbone of healthcare systems, enabling data-driven decisions across clinical, administrative, and policy domains. As defined by Bates et al. (2023), health information systems are instrumental in advancing evidence-based healthcare by integrating patient-level data across time and settings, thereby enhancing the accuracy, speed, and coordination of medical interventions.

Fundamentally, Health professionals bear an essential fiduciary responsibility to safeguard the health and personal information of patients. This responsibility is rooted in the broader duty of care that underpins clinical practice and therapeutic trust. Patient records are not merely clerical documentation but critical repositories of sensitive health information that support clinical decision-making, continuity of care, and medical research (Abdelrahman et al., 2021). These records, whether in electronic or paper-based formats, must be managed with a high degree of professionalism, integrity, and discretion.

As patients entrust healthcare providers with intimate details of their lives, health professionals are ethically bound to handle such data with confidentiality and respect. Confidentiality, as a professional and ethical concept, is defined as the obligation of individuals or institutions to protect personal information from unauthorized disclosure. According to Oyeleye and Nwachukwu (2022), confidentiality in the healthcare context involves a deliberate effort to restrict access to patient information, ensuring that it is only shared with authorized individuals directly involved in patient care. Confidentiality can be operationalized through procedural, administrative, and technological measures, such as secure storage, password protection, access controls, and information-sharing protocols. In contemporary healthcare systems, the challenge lies not only in maintaining privacy but in ensuring that patient information is used responsibly and judiciously in line with consent.

The principle of confidentiality is universally enshrined in medical ethics and codified in institutional and global health policy documents. The World Health Organization (WHO, 2023) upholds confidentiality as a fundamental component of patients' rights and ethical healthcare delivery. Similarly, national regulatory bodies such as the Medical and Dental Council of Nigeria (MDCN) and the Nursing and Midwifery Council of Nigeria (NMCN) stipulate confidentiality in their codes of professional conduct. These codes emphasize that any breach of patient confidentiality without lawful justification constitutes professional misconduct and could attract sanctions including license suspension or revocation (MDCN, 2022). Confidentiality is not just a moral expectation but a legal obligation under various healthcare legislation, including Nigeria’s National Health Act.

Maintaining confidentiality is vital to fostering trust between patients and healthcare providers. As observed by Igwe et al. (2021), when patients are confident that their medical histories and personal disclosures will be treated discreetly, they are more likely to be honest and cooperative during consultations. This enhances diagnostic accuracy, treatment efficacy, and long-term therapeutic relationships. Conversely, breaches of confidentiality—whether through negligence or intentional misconduct—can lead to psychological harm, stigmatization, erosion of trust, and potential legal liability. In the context of teaching hospitals, where multidisciplinary teams and student clinicians are involved, the risks and responsibilities surrounding confidentiality become more pronounced

Yusuf & Okafor, 2023) reckoned that the confidentiality of patient records is increasingly challenged by the integration of digital health technologies and electronic medical records (EMRs). While EMRs offer significant benefits for data access and care coordination, they also introduce complexities related to data protection, cyber-security, and unauthorized third-party access (Ensuring confidentiality in such environments requires robust institutional policies, continuous staff training, and advanced technological safeguards. Healthcare institutions must strike a balance between data accessibility for care provision and stringent protection of personal information. In light of these dynamics, confidentiality is no longer a passive obligation but an active process requiring vigilance and accountability at all levels of the health system. Against this backdrop, the present study aims to examine the confidentiality of patient records among health professionals at Delta State University Teaching Hospital (DELSUTH),

1.2 Statement of Problem

In recent years, there has been growing concern about the erosion of trust between patients and healthcare professionals due to breaches in confidentiality. Across several Nigerian healthcare institutions, patients have reported incidents where their private medical information was disclosed without consent, leading to embarrassment, stigmatization, and in some cases, social exclusion (Okeke & Nwankwo, 2022). Instances of healthcare workers discussing patients' conditions in public spaces, unauthorized access to sensitive records, or divulging patients’ health statuses to third parties—including family members and colleagues—without informed consent, have increasingly undermined the ethical fabric of patient-caregiver relationships (Onwuzurike et al., 2023). This growing breach of ethical conduct has fostered patient hesitancy in sharing accurate health information, especially in cases involving sensitive conditions such as HIV status, mental illness, reproductive health, or substance abuse. The implication is a diminished quality of care and poor treatment outcomes stemming from incomplete or inaccurate clinical data.

Multiple factors contribute to the problem of compromised confidentiality in Nigerian healthcare settings. These include inadequate professional training on ethical standards, overcrowding in clinical spaces, lack of private consultation areas, weak institutional enforcement mechanisms, and insufficient digital safeguards in record-keeping systems (Adebayo & Oladipo, 2021). Particularly in public hospitals, the integration of students, interns, and administrative staff in the patient care process often dilutes the ethical boundaries regarding access to medical information. In addition, lax attitudes toward professional conduct, and in some cases, a lack of awareness about the legal consequences of breaching confidentiality, have normalized this malpractice. This unethical culture has adverse effects not only on patient satisfaction but also on healthcare utilization. Research by Adepoju et al. (2024) indicates that patients who fear stigmatization or unauthorized disclosure of their information are more likely to avoid care, withhold critical symptoms, or seek alternative (often unsafe) medical options.

While several studies have investigated ethical compliance in healthcare broadly—such as those focusing on consent, malpractice, and professional misconduct—there remains a significant empirical gap in the specific area of confidentiality of patient records in Nigerian tertiary health institutions. Most existing literature concentrates on patient satisfaction or general medical ethics, without a focused examination of how confidentiality is practiced, breached, or protected within the multidisciplinary and complex operational contexts of teaching hospitals. The absence of localized data on confidentiality practices in institutions like Delta State University Teaching Hospital (DELSUTH) constrains policy reforms and training interventions. Against this backdrop, the current study investigates how health professionals at DELSUTH understand, implement, and potentially compromise the confidentiality of patient records. The goal is to bridge the gap in empirical evidence, inform institutional policies, and contribute to enhancing trust and ethical compliance within Nigeria’s tertiary healthcare system.

1.3 Objectives of the Study

The aim of the study is focused on assessment of confidentiality of patients’ records among health professionals at Delta State University Teaching Hospital. Specifically the study seeks to:

i.To assess the level of awareness of health professionals on the importance of maintaining confidentiality of patients' records in Delta State University Teaching Hospital.

ii.To examine the attitudes and practices of health professionals towards confidentiality of patients' records in Delta State University Teaching Hospital.

iii.To identify the factors that contribute to breaches of confidentiality of patients' records among health professionals in Delta State University Teaching Hospital.

Iv.To determine the measures in place to ensure confidentiality of patients' records in Delta State University Teaching Hospital and their effectiveness.

OTHER PARTS OF CHAPTER ONE INCLUDE:

1.4 Research Questions

1.5 Research Hypotheses

1.6 Significance of the Study

1.7 Scope of the Study

1.8 Operational Definition of Terms

CHAPTER TWO

LITERATURE REVIEW  (Preview)

This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the contributions of scholars who had previously conducted studies on similar research topics. The chapter intends to deepen the understanding of the study and address the perceived gaps in existing literature. This chapter, therefore, focuses on the concept of health service delivery, concept of health information,  patient’s record, concept of confidentiality, legal and institutional frameworks guiding confidentiality, etc. The chapter covers the following subheadings:

2.1 Conceptual Framework

2.2 Empirical Studies

2.3 Appraisal of Literature

2.4 Summary

CHAPTER THREE

RESEARCH METHODOLOGY  (Preview)

Research Design: The study adopted a descriptive survey research design.

Population of the Study: The population of the study comprises all categories of health professionals at Delta State University Teaching Hospital (DELSUTH), including doctors, nurses, health records officers, medical laboratory scientists, pharmacists, and administrative officers.

Sample Size Determination: The study adopted convenience sampling to select a sample size of 200 respondents.

Sampling Technique: The study employed a convenience sampling technique to select the individual respondents.

Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.

Methods of Data Analysis: The collected data were analyzed using frequencies, percentages, means, and standard deviations to summarize and present the demographic characteristics of the respondents and their responses. Inferential statistics, such as Analysis of Variance (ANOVA), was used to test the hypotheses at a 0.05 level of significance.

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

MAJOR FINDINGS (Preview)

The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that health professionals at Delta State University Teaching Hospital have a high level of awareness of the importance of maintaining confidentiality of patients’ records, as evidenced by mean scores ranging from 3.80 to 4.05, which are above the acceptance benchmark of 3.00. The corresponding hypothesis test further showed an F-value of 6.832 and a p-value of 0.013 (p < 0.05), leading to the rejection of the null hypothesis and indicating a significant relationship between awareness and attitudes towards maintaining confidentiality of patients’ records.

ii. The study found that health professionals at Delta State University Teaching Hospital demonstrate positive attitudes and practices towards maintaining confidentiality of patients’ records, as evidenced by mean scores ranging from 3.93 to 4.07, which are above the acceptance benchmark of 3.00. These findings indicate that respondents generally adhere to confidentiality practices, including secure record storage, restricted information sharing, and compliance with hospital policies.

iii. The study found that inadequate training, weak supervision and enforcement of hospital policies, staff negligence, lack of secure infrastructure, and workload pressure are major factors contributing to breaches of confidentiality of patients’ records, as evidenced by mean scores ranging from 4.03 to 4.14, which are above the acceptance benchmark of 3.00. The corresponding hypothesis test further showed an F-value of 5.473 and a p-value of 0.026 (p < 0.05), leading to the rejection of the null hypothesis and indicating a significant association between institutional factors and the frequency of confidentiality breaches.

iv. The study found that measures such as confidentiality agreements, secure storage of patient records, restricted access to authorized personnel, periodic staff training, and monitoring and disciplinary procedures are in place to ensure confidentiality of patients’ records at Delta State University Teaching Hospital, as evidenced by mean scores ranging from 3.95 to 4.09, which are above the acceptance benchmark of 3.00. These findings indicate that the hospital has established measures to protect patient information, although continued improvements in training, monitoring, and enforcement are necessary to strengthen their effectiveness.

CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

This chapter covers the following outline:

5.1 Discussion of Findings

5.2 Implication of Findings

5.3 Summary of the Study

5.4 Conclusion

5.5 Recommendations

5.6 Limitations of the Study

5.7 Suggestion for Further Studies