Salter Charlotte, Holland Richard, Harvey Ian, Henwood Karen
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ.
BMJ. 2007 May 26;334(7603):1101. doi: 10.1136/bmj.39171.577106.55. Epub 2007 Apr 20.
To explore the advice giving role of pharmacists during consultation for medication review with patients aged 80 or more.
Discourse analysis.
Participants' homes.
Subsample of consultations within a large randomised trial of home medication review among patients aged 80 or more who had been admitted to hospital.
Extent to which advice given by pharmacists was accepted and acknowledged by patients.
Pharmacists found many opportunities to offer advice, information, and instruction. These advice giving modes were rarely initiated by the patients and were given despite a no problem response and deliberate displays of competence and knowledge by patients. Advice was often resisted or rejected and created interactional difficulties and awkward moments during the consultations.
The advice giving role of pharmacists during consultations with patients aged 80 or more has the potential to undermine and threaten the patients' assumed competence, integrity, and self governance. Caution is needed in assuming that commonsense interventions necessarily lead to health gain.
探讨药剂师在为80岁及以上患者进行用药复查咨询时的建议提供角色。
话语分析。
参与者家中。
在一项针对80岁及以上入院患者的大型家庭用药复查随机试验中的咨询子样本。
药剂师提供的建议被患者接受和认可的程度。
药剂师发现了许多提供建议、信息和指导的机会。这些建议提供模式很少由患者发起，并且尽管患者给出了没问题的回应以及刻意展示出能力和知识，仍会给出建议。建议常常遭到抵制或拒绝，并在咨询过程中造成互动困难和尴尬时刻。
药剂师在与80岁及以上患者咨询时的建议提供角色有可能破坏并威胁患者假定的能力、完整性和自我管理能力。在假设常识性干预必然会带来健康益处时需要谨慎。
