18635: Patient Psychological Safety: A Qualitative Study of Patient Experiences (session 25467)

There is a nascent and growing interest in understanding patients’ experiences with psychological safety. Recent studies reveal that many patients describe a need for patient psychological safety (PPS) to form connections with their care providers—and these connections are associated with better health outcomes. Therefore, it is critical to examine barriers that may limit PPS and hinder patient – provider relationships. This study qualitatively explored how and why patients express a lack of PPS in health care encounters, identified barriers to PPS and connecting, and documented patients’ emotional responses to such experiences. Utilizing a patient narrative approach and thematic analysis, this research analyzed a diverse sample of open-ended responses (n=724). Four key themes emerged as barriers to PPS and connection: violations of patient dignity, provider distrust of patient accounts, disregard of patient input, and inadequate information or feedback to patients. Patients described feeling unseen, unbelieved, uninvolved, and unsupported when these barriers were present. These experiences often resulted in emotional distress, frustration, diminished confidence in providers, and reluctance to engage in care, all of which are likely contributors to lack of PPS. The study offers new patient experience insights, highlighting how providers’ words, non-verbal signals, and other actions—even if inadvertent—might interfere with patients’ perceptions of PPS and interpersonal connection.

view paper (if available)