Smith Janie D, White Col, Roufeil Louise, Veitch Craig, Pont Lisa, Patel Bhavini, Battye Kristine, Luetsch Karen, Mitchell Chris
RhED Consulting Pty Ltd, Ocean Shores, New South Wales, Australia.
Rural Remote Health. 2013 Apr-Jun;13(2):2214. Epub 2013 May 20.
As for many health professionals, distance presents an enormous challenge to pharmacists working in rural and remote Australia. Previous studies have identified issues relating to the size of the rural and remote pharmacist workforce, and a number of national initiatives have been implemented to promote the recruitment and retention of pharmacists in rural and remote locations. The aim of this study was to explore and describe the current rural and remote pharmacy workforce, and to identify barriers and drivers influencing rural and remote pharmacy practice.
A mixed-methods approach was used, which comprised a qualitative national consultation and a quantitative rural and remote pharmacist workforce survey. Semi-structured interviews (n=83) and focus groups (n=15, 143 participants) were conducted throughout Australia in 2009 with stakeholders with an interest in rural and remote pharmacy, practising rural/remote pharmacists and pharmacy educators, and as well as with peak pharmacy organizations, to explore the issues associated with rural/remote practice. Based on the findings of the qualitative work a 45-item survey was developed to further explore the relevance of the issues identified in the qualitative consultation. All registered Australian pharmacists practising in non-urban locations (RRMA 3-7, n=3,300) were identified and invited to participate in the study, with a response rate of 23.4%.
The main themes identified from the qualitative consultation were the impact of national increases in the pharmacist workforce on rural/remote practice; the role of the regional pharmacy schools in contributing to the rural/remote workforce; and the perceptions of differences in pharmacist roles in rural/remote practice. The survey indicated that pharmacists practising in rural and remote locations were older than the national average (55.8 years versus 40 years). Differences in their professional role were seen in different pharmacy sectors, with hospital pharmacists spending significantly more time on the delivery of professional services and education and teaching, but less time on medication supply than community pharmacists. Rural/remote pharmacists were generally found to be satisfied with their current role. The main 'satisfiers' reported were task variety, customer appreciation, use of advanced skills, appropriate remuneration, happiness in their work location, sound relationships with other pharmacists, a happy team and relationships with other health professionals.
This study described the distribution, roles and factors affecting rural and remote pharmacy practice. While the results presented provide an extensive overview of the rural/remote workforce, a comparable national study comparing rural/remote and urban pharmacists would further contribute to this discussion. Knowledge on why pharmacists chose to work in a particular geographical location, or why pharmacists chose to leave a location would further enrich our knowledge on what drives and sustains the rural/remote pharmacist workforce.
对于许多医疗专业人员而言,距离给在澳大利亚农村和偏远地区工作的药剂师带来了巨大挑战。此前的研究已明确了与农村和偏远地区药剂师劳动力规模相关的问题,并且已实施了多项全国性举措来促进农村和偏远地区药剂师的招聘与留用。本研究的目的是探索并描述当前农村和偏远地区的药房劳动力情况,并确定影响农村和偏远地区药房实践的障碍与驱动因素。
采用了混合方法,包括一次定性的全国性咨询以及一次定量的农村和偏远地区药剂师劳动力调查。2009年在澳大利亚各地与对农村和偏远地区药房感兴趣的利益相关者、执业的农村/偏远地区药剂师和药房教育工作者,以及顶级药房组织进行了半结构化访谈(n = 83)和焦点小组讨论(n = 15,143名参与者),以探讨与农村/偏远地区实践相关的问题。基于定性研究的结果,制定了一份包含45个项目的调查问卷,以进一步探究定性咨询中所确定问题的相关性。确定了所有在非城市地区执业的澳大利亚注册药剂师(RRMA 3 - 7,n = 3300)并邀请他们参与研究,回复率为23.4%。
定性咨询确定的主要主题包括全国药剂师劳动力增加对农村/偏远地区实践的影响;地区药房学校对农村/偏远地区劳动力的贡献作用;以及对农村/偏远地区实践中药剂师角色差异的看法。调查表明,在农村和偏远地区执业的药剂师年龄高于全国平均水平(55.8岁对40岁)。在不同的药房领域可以看到他们专业角色的差异,医院药剂师在提供专业服务以及教育和教学方面花费的时间显著更多,但在药品供应方面花费的时间比社区药剂师少。总体而言,农村/偏远地区的药剂师对其当前角色感到满意。报告的主要“满意度因素”包括任务多样性、客户赞赏、先进技能的运用、适当的薪酬、对工作地点的满意度、与其他药剂师的良好关系、愉快的团队氛围以及与其他医疗专业人员的关系。
本研究描述了影响农村和偏远地区药房实践的分布、角色和因素。虽然所呈现的结果对农村/偏远地区劳动力情况进行了广泛概述,但一项比较农村/偏远地区和城市药剂师的全国性可比研究将进一步推动这一讨论。了解药剂师选择在特定地理位置工作的原因,或者药剂师选择离开某个地点的原因,将进一步丰富我们对驱动和维持农村/偏远地区药剂师劳动力的因素的认识。