Health Services Research Centre, Victoria University of Wellington, PO Box 600, Pipitea Campus, Wellington, New Zealand.
School of Nursing, Midwifery, and Health Practice, Victoria University of Wellington, PO Box 600, Newtown Campus, Wellington, New Zealand.
BMC Health Serv Res. 2021 Sep 3;21(1):911. doi: 10.1186/s12913-021-06931-1.
The introduction of new health professional roles, such as that of the nurse practitioner and pharmacist prescriber in primary health care can lead to changes in health service delivery. Consumers, having used these roles, often report high satisfaction. However, there is limited knowledge of how these individuals position nurse practitioner and pharmacist prescriber roles within existing practice structures.
Semi-structured interviews were conducted with 21 individuals receiving services from these practitioners in New Zealand primary health care. Interviews were recorded and transcribed verbatim for thematic analysis.
Participant views reflect established practice hierarchies, placing advanced practitioners 'below' general practitioners. Participants are unable to articulate what it was about these practitioners that meant they operated at lower tiers and often considered practitioners to act as 'their doctor'. They also highlight structural barriers impairing the ability of these providers to operate within their full scope of practice.
While seeing value in the services they receive, consumers are often unable to position nurse practitioner and pharmacist prescriber roles within health system contexts or to articulate how they value their practitioner's skills. Embedded structural barriers may be more visible to consumers than their interactions with the health system suggest. This may influence peoples' ability to receive intended or optimal health services. Consumer 'health professional literacy' around the functions of distinct health practitioners should be supported so that they may make informed service provision choices.
新的卫生专业人员角色的引入，如在初级卫生保健中担任护士从业者和药剂师处方者，可以导致卫生服务提供方式的变化。消费者在使用这些角色后，通常报告满意度很高。然而，对于这些个体如何在现有实践结构内定位护士从业者和药剂师处方者角色，我们知之甚少。
对 21 名在新西兰初级卫生保健中接受这些从业者服务的个人进行了半结构式访谈。访谈进行了录音，并逐字转录进行主题分析。
参与者的观点反映了既定的实践层次结构，将高级从业者置于全科医生之下。参与者无法说明是什么使这些从业者处于较低层次，并且经常认为从业者是“他们的医生”。他们还强调了结构性障碍，这些障碍削弱了这些提供者在其全部实践范围内运作的能力。
虽然消费者重视他们所接受的服务，但他们往往无法在卫生系统背景下定位护士从业者和药剂师处方者的角色，也无法说明他们如何重视从业者的技能。消费者比他们与卫生系统的互动所表明的更能看到嵌入的结构性障碍。这可能会影响人们获得预期或最佳卫生服务的能力。应该支持消费者对不同卫生从业者的职能的“健康专业素养”，以便他们能够做出明智的服务提供选择。
