P-199: Confidentiality and youth voice in diabetes care: adolescents with type 1 diabetes in individual and group consultations
L B Johansen, S T Hansen, L Munch, M van Manen, M BeckAbstract
Introduction
Adolescents with type 1 diabetes (T1D) are encouraged to actively participate in clinical consultations; however, many report limited opportunities for meaningful dialogue. Confidentiality is considered essential for fostering trust and supporting adolescents’ engagement, yet little is known about how it is experienced within routine clinical consultations.
Objectives
To explore how adolescents with T1D experience and understand confidentiality in consultations, and how these experiences shape their sense of safety to speak openly.
Methods
A qualitative study using Interpretive Description was conducted in pediatric outpatient clinics in Region Zealand, Denmark. Semi-structured interviews were carried out with adolescents aged 13–19 years with T1D. Data was analyzed iteratively using inductive coding and constant comparison to identify patterns relevant to adolescents’ experiences of confidentiality in clinical consultations.
Results
Preliminary analysis indicates that confidentiality is relational and context-dependent. Trust appeared to be influenced by healthcare professionals’ communication style, parental presence, and clarity regarding boundaries of information sharing. Opportunities for private dialogue were valued but did not ensure openness in themselves; rather, feeling recognized and taken seriously was central. Glucose data further contributed to a sense of being ‘known’, sometimes in ways that felt exposing. These dynamics highlight how adolescents may navigate uncertainty and selectively withhold information.
Conclusions
This study nuances existing understandings of confidentiality by highlighting its relational and context-dependent character. Beyond structural elements such as time alone, confidentiality appears to be shaped by communication practices and the role of data in a form of implicit transparency, where aspects of adolescents’ lives are already visible. Addressing these dynamics may support more meaningful adolescent participation in clinical consultations.