Secrets and their consequences in heathcare: a scoping review of worker experiences
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2025
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Stewart, K.
Evans, D.
Xu, Q.
Procter, N.
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Journal article
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Journal of Advanced Nursing, online, 2025; online(1):1-15
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Abstract
Aims: To explore current knowledge of the nature of secrets healthcare consumers reveal to healthcare workers and the impact on the healthcare worker experience resulting from these private disclosures.
Design: Scoping review.
Data Sources: Eight electronic databases were searched for studies published between 1980 and 2025 that met the inclusion criteria.
Review Methods: Arksey and O'Malley's five-step methodological framework for scoping reviews guided this review. Petronio's Communication Privacy Management theory also informed the inclusion criteria.
Results: A total of 11,812 records were identified, and 76 studies were included. Four types of secrets emerged: (1) Medical concerns, (2) Sexuality, (3) Abuse and (4) Life choices and decisions. Healthcare workers viewed the disclosure experience either as a privilege or a burden. Healthcare workers constructed strategies to avoid or facilitate disclosure and sought out trusted confidants for personal support throughout the experience. The review highlights the vulnerability of both the healthcare consumer and the healthcare worker, and the potential for negative health outcomes following a private disclosure.
Conclusion: Healthcare consumers make private disclosures to healthcare workers. Further research is needed to construct evidence-based clinical practice guidelines to support healthcare workers in facilitating and managing private disclosures.
Impact: Healthcare consumers may disclose secrets of sexuality, medical concerns, abuse, and life decisions and choices to healthcare workers. Limited studies report on the impact of these difficult conversations. The findings of this review can inform healthcare practice and further research.
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Copyright 2025 The author(s) (https://creativecommons.org/licenses/by/4.0/)
Access Condition Notes: This is an open access article