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

IF 1.7 3区医学 Q3 HEALTH POLICY & SERVICES

Health Care Management Review Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI:10.1097/HMR.0000000000000412

Cheryl Rathert, Derick R Simmons, Jessica N Mittler, Kimberly Enard, Joanna Veazey Brooks

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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.

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良好的治疗联系与患者心理安全：定性调查研究。

背景：患者与医疗服务提供者之间的治疗联系（TC）对于实现预期的患者疗效非常重要。对患者而言，治疗性联系与更高的健康自我效能感、更好的健康状况、心理健康状况以及对医疗服务提供者的更高满意度相关联：我们对近期就诊的患者（n = 1,766）进行了在线调查。本研究分析了一个开放式问题的结果，该问题询问患者如何知道他们与医疗服务提供者之间有良好的沟通。研究采用框架分析法对数据进行了分析，以确定患者的回答在多大程度上表明了医患关系的各个方面。主题内容分析确定了新出现的主题：在医患沟通维度中，60% 的受访者提到了与 "共同商议 "相关的词语。其他维度的提及率介于 14%（共享心智）和 2%（纽带）之间。主题内容分析表明，患者心理安全似乎是许多患者感受到联系的必要条件：大多数患者表示，当他们感到被医疗服务提供者看到和听到时，就会产生良好的沟通。然而，在感受到强烈的沟通之前，患者似乎需要有安全感，才能完全融入到沟通中：实践启示：医疗机构需要为医疗服务提供者提供不间断的时间和空间，让他们与患者充分沟通。应为医疗保健领域的从业人员、领导者和学生提供有关如何为患者创造心理安全环境的培训。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Care Management Review HEALTH POLICY & SERVICES-

CiteScore

4.70

自引率

8.00%

发文量

期刊介绍： Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.