Abstract
Background: 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. Methods: 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. Results: 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. Conclusions: 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.