Background: As patient’s basic rights, privacy and confidentiality are paramount elements to establish a trusting and open doctor-patient relationship. Sometimes, however, there are situations when healthcare providers face some dilemma and fail to provide this to all patents, like in a maternity setting. Therefore, this study is an attempt to design a valid and reliable tool to assess patient’s knowledge, experiences, concerns, and attitudes to regulations pertaining to confidentiality and disclosure of patient information in a maternity setting.

Methods: A comprehensive review of literature formed the basis for the design of the 28-item Self-Report Confidentiality Instrument which bridged the gap for the absence of a valid and reliable tool in a maternity setting. The said instrument comprised of four sections. The study was conducted in three phases: Inductive and deductive item generation process, theoretical analysis/ "content validity" or quantitative evaluation, and psychometric analysis/ "construct validity and reliability" or validation.

Results: The four dimensions and number of items for the scale are as follow: patient’s knowledge about confidentiality (9 items), experiences with disclosure and confidentiality (4 items), effects of confidentiality concern on seeking care (3 items), and attitudes toward regulations pertaining to patient confidentiality (8 items). The said instrument has both an English and Arabic translations. All the questions were confirmed as valid and reliable. The final version of the Confidentiality Self-Report Instrument (CSRI) had 24 items after deleting four items. Scale reliability was assessed by Cronbach’s Alpha, which is a measure of internal consistency and how closely a set of items are related as a group. The obtained result of the Cronbach’s Alpha value of 0.71 in this study is greater than widely considered to be an acceptable level of 0.70.