School of Clinical Sciences, QUT, Brisbane, Australia.
Institute of Health and Biomedical Innovation, QUT, Brisbane, Australia.
Prehosp Disaster Med. 2020 Dec;35(6):612-618. doi: 10.1017/S1049023X20001077. Epub 2020 Sep 10.
Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems' infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations.
The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas.
Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods- manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team.
From the manual coding analysis, five key themes emerged - communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis - community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial support from the government and received most assistance from local council bodies and local branches of professional pharmacy organizations.
During disasters, community pharmacies help reduce the burden on public hospitals by maintaining medication supplies and treating patients with minor ailments. However, increased support and inclusion in disaster management planning is needed to continue this role.
人为引起的气候变化增加了全球范围内野火发生的可能性和严重程度。这对受灾社区的健康造成了负面影响,导致卫生系统基础设施受损和卫生服务中断。社区药店是患者与医疗保健系统之间的重要枢纽,在发生野火时可以提供持续的护理。然而,同行评议文献中关于野火对社区药店运营影响的内容很少。
本研究旨在探讨 2018/2019 年塔斯马尼亚夏季丛林大火对受影响地区社区药店运营的影响。
对在丛林大火期间在受影响地区工作的 4 名社区药剂师进行了半结构化电话访谈。访谈进行了录音,并逐字记录。使用两种方法(使用 NVivo 软件进行手动编码和 Leximancer 分析)对定性数据进行分析。两名研究人员独立分析数据以确保评估者之间的可靠性。通过研究团队之间的讨论解决了编码差异,并达成了一致。
从手动编码分析中,出现了五个关键主题 - 沟通与协作;支持;患者健康挑战;药剂师提供医疗保健的经验;以及未来规划。这些主题与 Leximancer 分析中出现的五个主题一致 - 社区;当地;城镇;患者;和工作。参与者描述了在野火中工作的困难,报告了多种挑战,包括沟通困难、运营障碍(如停电)、立法障碍、获取和储存药物供应的后勤问题、以及缺乏准备、支持和资金。他们强调政府缺乏运营和资金支持,主要得到地方议会机构和专业药房组织的地方分支机构的帮助。
在灾难期间,社区药店通过维持药物供应和治疗小病患者,有助于减轻公立医院的负担。然而,需要增加支持并将其纳入灾害管理规划,以继续发挥这一作用。