The biopsychosocial-spiritual impact upon health information managers from exposure to sensitive information within patient records: A qualitative study.

BACKGROUND: Health Information Managers (HIMs) routinely work with patient records containing detailed accounts of illness, trauma and death. While the biopsychosocial-spiritual (BPSS) impacts of trauma exposure have been widely documented among clinicians, little is known about the wellbeing of non-patient-facing health professionals who are repeatedly exposed to sensitive patient information.

OBJECTIVE: To explore the BPSS impacts experienced by HIMs following exposure to information contained within patient records.

METHOD: A qualitative study informed by grounded theory methodology was undertaken. Semi-structured interviews were conducted with 30 HIMs employed across a range of Victorian healthcare organisations in Australia. Participants were purposively recruited to represent diverse career stages and workplace settings. Interview data were analysed using reflexive thematic analysis, guided by the BPSS framework.

RESULTS: All participants described impacts in at least one BPSS domain, with many reporting experiences across multiple domains. All participants experienced psychological impacts such as empathy, emotional distress, personal resonance, health anxiety, intrusive thoughts, emotional fatigue, desensitisation and positive psychological responses. Three-quarters of respondents experienced spiritual impacts such as existential reflection, moral and ethical appraisal, compassion, helplessness and gratitude. Biological impacts affected over 50% of participants and included somatic (physical) expressions of emotion, sleep disturbances and physical fatigue. Social impacts were least prevalent, affecting only 10% of participants, and included health advocacy within personal networks and social withdrawal.

CONCLUSION: Findings demonstrated that repeated exposure to patient information alone, despite the absence of direct patient contact, was sufficient to influence participants' wellbeing across multiple domains. These findings challenge assumptions that non-patient-facing health professionals, including HIMs, are unaffected by the emotional consequences of patient care and highlight the importance of recognising occupational wellbeing risks associated with indirect exposure to trauma-related material.Implications for health information management practice:Recognition of BPSS impacts should inform workplace wellbeing initiatives and professional support for the HIM workforce. The findings also highlight the need to consider how education and ongoing professional development can better prepare HIMs to recognise and manage the potential wellbeing impacts associated with working with sensitive patient information.