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Prevalence, Influencing Factors and Attitudes Towards Patient-Led Covert Recording: A Cross-Sectional Study of Nurses in Western China

Nurs Open. 2026 Mar;13(3):e70482. doi: 10.1002/nop2.70482.

ABSTRACT

AIM: To investigate the prevalence of patient-led covert recording in Western China, nurses’ attitudes towards covert recording and explore the factors.

DESIGN: A descriptive cross-sectional study.

METHODS: This study was conducted in 33 cities in 6 provinces of China from November to December 2021. A convenience sampling strategy was used to get access to 2323 participants, and a self-designed questionnaire was used for evaluation.

RESULTS: This study included 2124 nurses; of this, 442 (20.8%) had the experience of patient-led covert recording. After being covertly recorded, they felt stressful (76.9%), nervous (61.3%) and angry (58.6%). A total of 1287 (60.6%) nurses didn’t accept covert recording under any condition. There were differences in age, education, professional titles, years of working, departments, and management measures launched by hospitals between the groups with or without the experience of being covertly recorded. Furthermore, the binary logistic regression analysis showed that nurses running outpatient clinics (OR = 0.635, 95% CI: 0.425-0.950, p < 0.05) were accompanied by higher prevalence of patient-led covert recording while the opposite was true when hospitals launched related management measures (OR = 1.632, 95% CI: 1.126-2.366, p < 0.05).

CONCLUSIONS: Patient-led covert recording might be a form of workplace violence which could be stressful. Thus, it deserves attention and consideration. Management measures and training on patient-led covert recording are urgently required to meet the needs of nurses.

PATIENT OR PUBLIC CONTRIBUTION: The findings of this study emphasise the significant role of patient and public contributions in healthcare dynamics. By revealing nurses’ stress and anxiety associated with covert recordings, it highlights the need for open dialogue about privacy and consent. Engaging patients in discussions about the ethical implications of such recordings can foster collaboration and trust in clinical settings. The findings suggest that implementing better management measures in hospitals could alleviate negative impacts and enhance communication between patients and healthcare providers.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2100048557.

PMID:41797636 | DOI:10.1002/nop2.70482

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