Theoretical Approach and Scale Construction of Patient Privacy Protection Behavior of Doctors in Public Medical Institutions in China: Pilot Development Study

Abstract

Background Considering the high incidence of medical privacy disclosure, it is of vital importance to study doctors’ privacy protection behavior and its influencing factors. Objective We aim to develop a scale for doctors’ protection of patients’ privacy in Chinese public medical institutions, following construction of a theoretical model framework through grounded theory, and subsequently to validate the scale to measure this protection behavior. Methods Combined with the theoretical paradigm of protection motivation theory (PMT) and semistructured interview data, the grounded theory research method, followed by the Delphi expert and group discussion methods, a theoretical framework and initial scale for doctors in Chinese public medical institutions to protect patients' privacy was formed. The adjusted scale was collected online using a WeChat electronic survey measured using a 5-point Likert scale. Exploratory and confirmatory factor analysis (EFA and CFA) and tests to analyze reliability and validity were performed on the sample data. SPSS 19.0 and Amos 26.0 statistical analysis software were used for EFA and CFA of the sample data, respectively. Results According to the internal logic of PMT, we developed a novel theoretical framework of a “storyline,” which was a process from being unaware of patients' privacy to having privacy protection behavior, that affected doctors' cognitive intermediary and changed the development of doctors' awareness, finally affecting actual privacy protection behavior in Chinese public medical institutions. Ultimately, we created a scale to measure 18 variables in the theoretical model, comprising 63 measurement items, with a total of 208 doctors participating in the scaling survey, who were predominantly educated to the master’s degree level (n=151, 72.6%). The department distribution was relatively balanced. Prior to EFA, the Kaiser-Meyer-Olkin (KMO) value was 0.702, indicating that the study was suitable for factor analysis. The minimum value of Cronbach α for each study variable was .754, which met the internal consistency requirements of the scale. The standard factor loading value of each potential measurement item in CFA had scores greater than 0.5, which signified that all the items in the scale could effectively converge to the corresponding potential variables. Conclusions The theoretical framework and scale to assess doctors' patient protection behavior in public medical institutions in China fills a significant gap in the literature and can be used to further the current knowledge of physicians’ thought processes and adoption decisions.

Dilemmas and prospects of artificial intelligence technology in the data management of medical informatization in China: A new perspective on SPRAY-type AI applications

“…30 Our team also promotes better patient privacy protection by constructing a theoretical framework for doctor-patient confidentiality. 31…”

“…Our team previously conducted an exploratory study on the intrinsic mechanism of doctors’ patient-protective behavior in Chinese public medical institutions and constructed a theoretical model framework for such behavior. 31 At the technical level, the privacy algorithm creates bridges between data elements and data values by employing multiple secure computing, blockchain technology, homomorphic encryption, and zero knowledge protocols, including anonymity, access control models, special processing and control, and role control models based on privacy expansion, encryption, and correlation technologies for datasets. We also require the adoption of decentralized storage solutions to safeguard data security.…”