Patient psychological safety is the degree to which patients feel able to ask questions, admit concerns, and participate in decisions about medications. According to the PLOS One study (El-Kotob et al., 2026), psychological safety shaped whether patients spoke up about medication concerns during clinical encounters, which has direct implications for medication safety and person-centered care. This post translates the PLOS One findings into actionable methods for qualitative researchers using AI-enabled tools to analyze interviews, transcripts, and open-ended survey data.
Key Takeaways
Patients’ willingness to raise medication concerns depends on patient psychological safety, according to the PLOS One study (El-Kotob et al., 2026) which explored medication conversations and psychological safety in primary and community care.
- The PLOS One study published on August 20, 2026 included 21 participants interviewed between May and August 2024, and found that respectful communication, clear information, and invitation to participate supported psychological safety.
- In the PLOS One dataset, 19 participants were aged 40 or older and 14 participants identified as White, supporting the study’s note on limited demographic diversity (El-Kotob et al., 2026).
- Participant quotes in the PLOS One study revealed common barriers: shame, dismissal, and uncertainty reduced willingness to speak up; for example participant P10 said, "I try to treat providers respectfully and behave in an intelligent way with them too. And they treat me as an equal."
- The PLOS One authors recommend multi-level changes (clinician communication, appointment length, training) to foster psychologically safe medication conversations (El-Kotob et al., 2026).
What Happened / How It Works
The PLOS One study analyzed patient narratives to explore how psychological safety shapes medication conversations during primary and community care encounters.
According to the PLOS One study (El-Kotob et al., 2026), researchers conducted semi-structured interviews and focus groups with adults who had taken at least one prescribed medication for three months or longer, with data collection occurring between 01/05/2024 and 31/08/2024.
According to the PLOS One study (El-Kotob et al., 2026), the analysis used the Patient Psychological Safety (PPS) framework with three deductive constructs: Patient Belonging, Patient Learning, and Patient Participating.
According to the PLOS One study (El-Kotob et al., 2026), the final sample included 21 participants and the authors reported that psychological safety emerged as central to whether patients asked questions, shared concerns, and joined decision-making.
Findings Snapshot
| Date / Period | Metric | Value | Implication |
|---|---|---|---|
| 01 May–31 Aug 2024 | Data collection window | Semi-structured interviews and focus groups | Convenient virtual methods captured sensitive medication narratives (PLOS One) |
| Aug 20, 2026 | Publication date | PLOS One article published | Peer-reviewed evidence available for qualitative methods and framework use |
| 2024 (sample) | Total participants | n = 21 | Small, information-rich sample for deductive PPS analysis (PLOS One) |
| 2024 (sample) | Age distribution | 19 participants ≥ 40 years | Findings may skew toward older adult medication experiences (PLOS One) |
| 2024 (sample) | Gender / Race | 14 identified as women; 14 White | Authors note limited diversity and recommend wider sampling (PLOS One) |
Implications for Qualitative Researchers
Qualitative researchers should treat patient psychological safety as a measurable analytic focus rather than a background theme.
According to the PLOS One study (El-Kotob et al., 2026), coding around the PPS constructs (Belonging, Learning, Participating) clarifies how communication patterns shape willingness to disclose medication problems.
Researchers should prioritize purposive sampling to capture diversity: the PLOS One authors warn that their sample (n = 21, largely older and White) limits transferability and recommend targeted recruitment for underrepresented groups.
When designing studies, researchers should document data collection dates and settings exactly as the PLOS One study did (e.g., May–August 2024), because temporal context and care-mode (virtual vs in-person) affect psychological safety.
How Evidano Helps
Problem: Long manual synthesis of interview data
Evidano is an AI-powered qualitative data analysis platform that helps researchers analyze interviews, open-ended surveys, and documents.
Evidano speeds synthesis by ingesting transcripts, applying deductive codebooks like the PPS framework, and producing thematic and frequency analyses that mirror the PLOS One approach.
Problem: Inconsistency and lost context during coding
According to the PLOS One study (El-Kotob et al., 2026), reflexivity and coder consensus were critical to reliable interpretation; Evidano supports reproducible coding workflows and team review to document coder decisions.
Evidano’s transcription and custom dictionary features reduce noise in medication names and clinical terms, improving code reliability across interviews.
Problem: Need to compare subgroups (e.g., age, race, gender)
According to the PLOS One study (El-Kotob et al., 2026), limited demographic diversity affected transferability; Evidano enables cross-segment analysis so researchers can compare themes across demographic axes and identify gaps.
Evidano integrates qualitative tags and quantitative frequency displays so researchers can test whether themes like 'dismissal' cluster with specific social identities.
Problem: Rapid reporting for policy or clinical teams
According to the PLOS One study (El-Kotob et al., 2026), actionable system-level recommendations (training, appointment length) are needed; Evidano generates shareable evidence tables and visualizations to inform stakeholders quickly.
Learn more about relevant features on the Evidano features page: Evidano features.
FAQ: patient psychological safety
What is patient psychological safety in medication conversations?
Patient psychological safety means patients feel accepted, able to ask questions, and safe to share opinions about medications.
According to the PLOS One study (El-Kotob et al., 2026), the Patient Psychological Safety (PPS) framework captures this concept with three domains: Belonging, Learning, and Participating.
How did the PLOS One study measure psychological safety?
The PLOS One study used a secondary deductive content analysis of 21 interviews and focus groups coded to the PPS framework.
According to the PLOS One study (El-Kotob et al., 2026), analysts used a data display matrix and team consensus meetings to align codes with PPS constructs and ensure reliability.
Can AI help analyze interviews about psychological safety?
Yes, AI-assisted qualitative platforms can accelerate coding, surface co-occurrence patterns, and quantify theme frequencies without replacing human interpretation.
According to the PLOS One study (El-Kotob et al., 2026), human reflexivity and multidisciplinary review were essential; Evidano combines AI coding with team review to preserve interpretive rigor and audit trails (see Evidano features).
How should researchers report quotes and participant context ethically?
Report verbatim quotes with participant codes and follow ethics approvals to avoid re-identification.
According to the PLOS One study (El-Kotob et al., 2026), identifiable raw data were restricted by ethics; researchers should redact PII and follow institutional review board guidance when sharing transcripts.
What sample size is appropriate for this topic?
Answer: Sample adequacy depends on information power, not a fixed n.
According to Malterud et al. (2016) and as applied in the PLOS One study (El-Kotob et al., 2026), smaller, focused samples (for example n = 21) can be sufficient when data are information-rich and analysis is narrowly scoped.
Conclusion & Next Steps
The PLOS One study (El-Kotob et al., 2026) shows that psychological safety is central to whether patients disclose medication concerns and participate in decisions, and that respectful communication, clear information, and invitation to participate support safer medication use.
Qualitative researchers can adopt the PPS framework, purposive sampling for diversity, and AI-assisted analysis to produce timely, reproducible evidence for clinicians and policymakers.
If you want to prototype a PPS codebook, run cross-segment analyses, or generate shareable evidence tables from interview transcripts, try an AI-enabled platform built for qualitative research.
Get started: Try Evidano for free.
Topics
- patient psychological safety
- psychological safety in medication conversations
- qualitative analysis patient safety
- AI qualitative research
- medication communication qualitative
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