1034: Racial/Ethnic Group Differences in Patient Psychological Safety: Qualitative Patient Narrative Study (13437)

The existence of racial and ethnic disparities in health outcomes is well-established. In addition to historical discrimination and social determinants, disparities can result from lower-quality health care relationships historically marginalized groups may experience with health care providers and systems. The extent to which patients can connect with and be understood by care providers is thought to play a key role in their subsequent diagnoses, treatments, and finding the right care plans for them. Recent research has found that many patients express the need for psychological safety (PPS) in order to feel connected. Thus, we were interested in exploring whether there exist racial/ethnic differences in experiences of PPS, as a lack of safety could reduce patients’ abilities to connect with providers. This study used a patient narrative approach in a large sample of patients from across the U.S. (n=1766) to examine what patients say about PPS, and to explore the extent to which their descriptions may vary by race and/or ethnicity. Patient comments were coded to fit into one of four sequential psychological safety stages. Analysis found that nearly all patients described some level of PPS in order to feel connected, with greater proportions of Black and Hispanic/Latino patients expressing the need for inclusion safety, that is, the need to be welcome and respected as a human being. In contrast, White patients were more likely to express the need for contributor safety, or the need to have influence on their care. While our data are limited and preliminary, the finding of racial/ethnic differences in PPS in terms of connecting with providers is worthy of timely future research.

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