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Initial Development of a Scale to Measure Patient Psychological Safety.

Paul J Hershberger1, Timothy N Crawford2, Angie Castle2

  • 1From the Department of Family Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH (PJH, KC, AC); Department of Population and Public Health Sciences and Department of Family Medicine, Wright State University Boonshoft School of Medicine, Dayton, OH (TNC); Wright State University Boonshoft School of Medicine, Dayton, OH (SKH, RBPA, KCC, JMB, DGF, SGY, KC). paul.hershberger@wright.edu).

Journal of the American Board of Family Medicine : JABFM
|February 20, 2025
PubMed
Summary

Patient psychological safety, a crucial factor for patient forthrightness and adherence, was assessed using the Patient Psychological Safety Scale (PPSS). Lower relationship comfort was linked to patients not disclosing disagreements with clinician recommendations.

Keywords:
Behavioral SciencesFactor AnalysisPatient Care TeamPatient SafetyPatient-Centered CarePrimary Health CarePsychological SafetyScalesSurveys and Questionnaires

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Area of Science:

  • Healthcare research
  • Patient experience
  • Psychological safety measurement

Background:

  • Psychological safety enhances team performance and patient outcomes.
  • Patient psychological safety, though overlooked, impacts patient honesty and adherence.
  • The initial Patient Psychological Safety Scale (PPSS) was developed to measure patient psychological safety.

Purpose of the Study:

  • To develop and validate a scale measuring patients' experience of psychological safety.
  • To explore the relationship between patient psychological safety and nondisclosure of information.

Main Methods:

  • A 13-item Patient Psychological Safety Scale (PPSS) was created from team-based measures.
  • Criterion validity was assessed using 8 items on nondisclosure.
  • 100 patients from primary care settings completed the PPSS and nondisclosure surveys.

Main Results:

  • Exploratory factor analysis identified two factors for a refined 9-item PPSS, showing good fit.
  • The refined PPSS demonstrated strong internal reliability and validity for 'relationship comfort' (α = 0.95) and 'belonging' (α = 0.88).
  • Lower relationship comfort correlated significantly with patients not disclosing disagreement with medical advice (P = .001).

Conclusions:

  • Patient psychological safety is a potentially significant factor influencing clinical outcomes.
  • The validated Patient Psychological Safety Scale (PPSS) offers a foundation for future research on patient psychological safety.