Roche Hannah, Morton Liza, Cogan Nicola
Psychology Department, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1XQ, UK.
Healthcare (Basel). 2025 Apr 16;13(8):914. doi: 10.3390/healthcare13080914.
This study explores barriers and facilitators to psychological safety during medical procedures among individuals diagnosed with chronic illnesses in childhood. Psychological safety in healthcare, detected via neuroception and the autonomic nervous system's responses to perceived safety or threat, is essential for the well-being and mental health of chronically ill patients, especially those with early diagnoses. Using Polyvagal Theory as a framework, semi-structured interviews were conducted with six participants (aged 20-64) who experienced chronic disease from a young age. The Neuroception of Psychological Safety Scale (NPSS) guided thematic exploration to understand participants' experiences. Thematic analysis identified key themes that reflect contributors and detractors to psychological safety during medical care. Four primary themes were developed: (1) knowledge empowerment through information and facilitated inquiry, (2) holistic acknowledgment of psychological and social impacts, (3) the role of parental involvement in healthcare interactions, and (4) the need for an individualised, patient-centred approach. Participants expressed a need for psychological support integrated with their medical treatment and the importance of autonomy and clear communication. Psychological safety is central to medical experiences for chronically ill individuals and requires a patient-centred, psychologically informed approach. Emphasising tailored support, family involvement, and comprehensive mental health consideration can foster more effective care and enhance patients' long-term well-being.
本研究探讨了童年时期被诊断患有慢性病的个体在医疗过程中心理安全的障碍和促进因素。通过神经感知以及自主神经系统对感知到的安全或威胁的反应来检测的医疗保健中的心理安全，对于慢性病患者，尤其是那些早期确诊的患者的幸福感和心理健康至关重要。以迷走神经理论为框架，对六名从小就患有慢性病的参与者（年龄在20至64岁之间）进行了半结构化访谈。心理安全神经感知量表（NPSS）指导了主题探索，以了解参与者的经历。主题分析确定了反映医疗护理期间心理安全的促成因素和阻碍因素的关键主题。形成了四个主要主题：（1）通过信息和便利的询问实现知识赋权，（2）对心理和社会影响的全面认可，（3）父母参与医疗互动的作用，以及（4）需要个性化的、以患者为中心的方法。参与者表示需要将心理支持与他们的医疗治疗相结合，以及自主权和清晰沟通的重要性。心理安全是慢性病患者医疗体验的核心，需要以患者为中心、有心理学依据的方法。强调量身定制的支持、家庭参与和全面的心理健康考虑可以促进更有效的护理，并提高患者的长期幸福感。
