de Oliveira Djenane Ramalho, Shoemaker Sarah J
School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
J Am Pharm Assoc (2003). 2006 Jan-Feb;46(1):56-64; quiz 64-6. doi: 10.1331/154434506775268724.
To present the benefits of openness for achieving patient centeredness by pharmacists, provide patient narratives from two qualitative research studies that demonstrated how patients have experienced pharmacists' traditional approach, and describe a tool with six component strategies for pharmacists to use in direct patient care.
(1) Ethnographic study and (2) hermeneutic phenomenological study.
(1) Pharmaceutical care practices and (2) university.
(1) Patients, practitioners, and student pharmacists, and (2) university faculty and staff taking long-term medications for chronic diseases.
(1) Participant observation, in-depth interviews, focus groups, and analysis of documents, and (2) unstructured, in-depth interviews.
(1) Observations and participant comments and (2) patient comments.
Pharmacists' primary reliance on pharmacology and pharmacotherapy--without consideration of the patient as an individual--can devalue patients' personal understanding of their own situation and negatively affect care. This "natural attitude" of pharmacists, created through their preparation and education, involves their understanding of medications, focus on the product, use of counseling as the major approach with patients, and emphasis on medication adherence as a goal. Pharmacists as professionals must recognize how their natural attitude negatively affects care and work to become more patient-centered practitioners by the development of skills such as openness. Pharmacists can achieve openness by applying six strategies with patients (listen, acknowledge, wonder) and themselves and professional colleagues (recognize, question, reflect).
Patients want to be heard and seen as individuals with unique experiences and responses to medications. If pharmacists are intent on working with patients to ensure that their medication-related needs are met, they should grasp what it means to be patient-centered, and the six strategies for achieving openness should be applied in the daily practice of pharmacy.
阐述药师保持开放态度对实现以患者为中心的益处，呈现两项定性研究中的患者叙述，这些叙述展示了患者对药师传统方法的体验，并描述一种包含六种组成策略的工具，供药师在直接的患者护理中使用。
（1）人种学研究和（2）诠释现象学研究。
（1）药学服务实践和（2）大学。
（1）患者、从业者和药学专业学生，以及（2）长期服用慢性病药物的大学教职员工。
（1）参与观察、深入访谈、焦点小组讨论和文件分析，以及（2）非结构化的深入访谈。
（1）观察结果和参与者评论，以及（2）患者评论。
药师主要依赖药理学和药物治疗——而不将患者视为个体——可能会贬低患者对自身情况的个人理解，并对护理产生负面影响。药师通过其培训和教育形成的这种“自然态度”，包括他们对药物的理解、对产品的关注、将咨询作为与患者沟通的主要方式，以及将药物依从性作为目标。作为专业人员，药师必须认识到他们的自然态度如何对护理产生负面影响，并通过培养开放等技能努力成为更以患者为中心的从业者。药师可以通过对患者（倾听、承认、好奇）以及对自己和专业同事（认识、质疑、反思）应用六种策略来实现开放。
患者希望被倾听，并被视为具有独特经历和对药物反应的个体。如果药师有意与患者合作以确保满足他们与药物相关的需求，他们应该理解以患者为中心的含义，并在日常药学实践中应用实现开放的六种策略。
