A Qualitative Study on the Relationship and Distinction Between Psychological Safety and Individual Trustworthiness in a Hospital Context

Vollständiger Abstract

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This study aimed to disentangle the concepts of psychological safety and individual trustworthiness, which are often used interchangeably in organizational behavior literature, and to examine their dynamic relationship in-depth within the high-risk context of a hospital. This qualitative study was conducted with 28 healthcare workers selected via purposive sampling from a city hospital in Turkey. Data were collected using semi-structured interviews between May and August 2025 and analyzed using thematic analysis. Participants' demographic characteristics are presented using descriptive statistics, and main themes are presented accordingly. Thematic analysis of the data revealed that participants clearly distinguished between these two concepts. Psychological safety was defined as an "environmental" characteristic (freedom of speech; absence of punishment), while trustworthiness was perceived as an individual "reputation" matter (keeping one's word; doing one's job well). Leader trustworthiness was found to be a strong prerequisite for psychological safety, while a safe environment provided a space for experiencing and building mutual trust. Psychological safety and individual trustworthiness are mutually reinforcing yet distinct phenomena. The findings offer practical implications, suggesting that leadership training should focus on the concrete behaviors that build trustworthiness and that performance systems should be redesigned to be more learning-oriented.