Assessment of Knowledge and Practices of Patient Privacy and Confidentiality among Undergraduate Nursing Students in Karachi, Pakistan

Abstract

Background: Patient privacy and confidentiality are fundamental ethical, legal, and professional obligations in nursing practice. Nursing students are expected to uphold these principles during clinical training; however, inadequate knowledge and poor adherence to confidentiality practices may compromise patient trust and the quality of healthcare delivery. Objective: This study aimed to assess the knowledge and self-reported practices regarding patient privacy and confidentiality among undergraduate nursing students in Karachi, Pakistan, and to examine the relationship between knowledge and practice. Methods: A descriptive cross-sectional study was conducted among 181 undergraduate nursing students in Karachi, Pakistan. Data were collected using a structured, self-administered questionnaire adapted from a previously validated instrument after obtaining permission from the original authors (1). comprising 20 items, including 10 knowledge (awareness) items and 10 practice items, along with participants' demographic characteristics. Data were entered and analyzed using IBM SPSS Statistics version 26. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were used to summarize participants' characteristics and questionnaire responses. Internal consistency of the questionnaire was assessed using Cronbach's alpha. Composite knowledge, practice, and total scores were calculated, and Pearson's correlation coefficient was used to examine the relationship between knowledge and practice scores. An independent-samples Welch's t-test was performed to compare total scores by gender. Statistical significance was set at p < 0.05. Results: Results: A total of 181 undergraduate nursing students participated in the study. The mean awareness score was 17.04 ± 3.33, and the mean practice score was 17.44 ± 3.99. Most participants demonstrated poor awareness and poor self-reported practices regarding patient privacy and confidentiality, with 95.6% classified as having poor practice. A statistically significant moderate positive correlation was observed between awareness and practice (r = 0.44, p < 0.001). No significant difference in total scores was found between male and female participants (p = 0.058). The overall questionnaire demonstrated good internal consistency (Cronbach's α = 0.795). Conclusion: Undergraduate nursing students demonstrated inadequate knowledge and poor self-reported practices regarding patient privacy and confidentiality. Although better knowledge was associated with improved practice, the findings suggest that knowledge alone is insufficient to ensure ethical behavior. Integrating comprehensive ethics education, confidentiality training, and simulation based learning, and reinforced clinical supervision into undergraduate nursing curricula is recommended to strengthen students' competence in protecting patient privacy and confidentiality. Keywords: Patient confidentiality; Patient privacy; Nursing ethics.