Good therapeutic connections and patient psychological safety: A qualitative survey study.

Abstract

Background: Therapeutic connections (TCs) between patients and care providers are important for achieving desired patient outcomes. For patients, TC is associated with greater health self-efficacy, better health status, mental health status, and higher satisfaction with providers.

Purpose: The aim of the study was to examine patients' descriptions of what signals to them they have a TC with their care provider.

Methodology: We conducted an online survey of patients with a recent health care visit ( n = 1,766). This study analyzed the results of an open-ended question that asked how patients know they have a good TC with their care provider. Data were analyzed using framework analysis to determine the extent to which patient responses indicated TC dimensions. A thematic content analysis identified emergent themes.

Results: Of the TC dimensions, words associated with Shared Deliberation were mentioned by 60% of respondents. Other dimension mentions ranged between 14% (Shared Mind) and 2% (Bond). Thematic content analysis revealed that patient psychological safety seems to be required for many patients to feel connected.

Conclusion: A majority of patients indicated that good TCs happen when they feel seen and heard by providers. However, it appears that prior to feeling a strong TC, patients need to feel safe to be fully welcome into the encounter.

Practice implications: Health care organizations need to give care providers the uninterrupted time and space they need to fully connect with patients. Training about how to create a psychologically safe environment for patients should be tailored for practicing providers, leaders, and students in health care fields.