Sharif Pooneh Salari, Javadi Mohammadreza, Asghari Fariba
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran;
J Med Ethics Hist Med. 2011 May 2;4:5. Print 2011.
Alterations in pharmacy practice from prescription dispensing to more patient-centered relationship intensifies the necessity of clinical decision-making. Pharmacists' knowledge as well as ethical reasoning affects their clinical decision-making. Unfortunately in Iran pharmacy ethics did not develop along with medical ethics and special considerations are of major importance. The study was designed to evaluate pharmacists' attitude toward some principles of bioethics. A cross-sectional survey was performed on a sample of Iranian pharmacists attended in continuous education programs in 2010. Based on the pharmacists' attitude toward common ethical problems, 9 Likert-type scale scenarios were designed. A thousand pharmacists were surveyed and 505 questionnaires were filled. For the whole questionnaire the strongly disagree answer was the most ethical answer. On a scale from 1-5 on which 5=strongly disagree, the total score of pharmacists ethical attitude was 17.69 ± 3.57. For easier analysis we considered the score of 1 for agree and strongly agree answers, score of 2 for neutral answers and score of 3 for disagree and strongly disagree answers. The total score in confidentiality for all participants was 4.15 ± 1.45 out of 9, in autonomy 6.25 ± 1.85 out of 9, in non-maleficence 5.14 ± 1.17 out of 6 and in justice was 2.27 ± 0.89 out of 3, however there was no significant difference between men and women in the total score and the score of each theme. The older participants (> 40 years) significantly had lower total score (P< 0.05) as well as the score of each theme (P< 0.05), except for non-maleficence. The work experience showed impact on the pharmacists' attitude toward autonomy and the participants with more than 5 years work experience significantly obtained lower score in this theme. Compiling ethical guidelines and improving pharmacy ethics curriculum is highly critical to provide the best pharmaceutical care and to make clinical decisions in critical situations. Therefore further quantitative and qualitative investigations into finding pitfalls and challenges in this issue are highly recommended.
药学实践从处方调配转向更以患者为中心的关系,这强化了临床决策的必要性。药剂师的知识以及伦理推理会影响他们的临床决策。遗憾的是,在伊朗,药学伦理并未与医学伦理同步发展,特殊考量至关重要。本研究旨在评估药剂师对一些生物伦理原则的态度。2010年,对参加继续教育项目的伊朗药剂师样本进行了一项横断面调查。基于药剂师对常见伦理问题的态度,设计了9个李克特量表情景。对1000名药剂师进行了调查,共收回505份问卷。对于整个问卷,强烈反对的回答被视为最符合伦理的回答。在1至5分的量表中(5分表示强烈反对),药剂师伦理态度的总分是17.69±3.57。为便于分析,我们将同意和强烈同意的回答计为1分,中立回答计为2分,不同意和强烈不同意的回答计为3分。所有参与者在保密方面的总分在9分中为4.15±1.45,在自主性方面为6.25±1.85,在不伤害原则方面为6分中的5.14±1.17,在公正方面为3分中的2.27±0.89,然而,男性和女性在总分及各主题得分上没有显著差异。年龄较大的参与者(>40岁)总分显著较低(P<0.05),各主题得分也显著较低(P<0.05),不伤害原则主题除外。工作经验对药剂师的自主性态度有影响,工作经验超过5年的参与者在该主题上得分显著较低。编制伦理准则并改进药学伦理课程对于提供最佳药学服务以及在危急情况下做出临床决策至关重要。因此,强烈建议进一步开展定量和定性研究,以找出该问题中的缺陷和挑战。