Adamcik B A, Ransford H E, Oppenheimer P R, Brown J F, Eagan P A, Weissman F G
Soc Sci Med. 1986;23(11):1187-200. doi: 10.1016/0277-9536(86)90338-2.
This study assessed the legitimacy of expanded roles for pharmacists with different status audiences. Pharmacy is a profession in transition and is characterized by considerable ambiguity and uncertainty concerning its status as a health care profession. Significant changes have occurred within the profession of pharmacy in the past few decades which have led to loss of function, social power and status. The response of the profession has been a movement toward a patient-oriented, clinical role for pharmacists. Hypotheses concerning level of support for expanded roles were derived from two conflict-based models of professionalization: a power model which focuses on conflict between professions and the central role of power in defining occupational territory; and a process model which focuses on conflict of interest and diversity within a profession and the development of 'segments' which struggle for control of a profession's direction. Data were collected by self-administered questionnaires sent to California pharmacists, physicians and nurses. Respondents were asked to indicate level of support for 20 role activities for pharmacists working in two practice settings (community and hospital). Pharmacy faculty were the most supportive of the clinical role activities, followed by practicing pharmacists, nurses and physicians. Physicians and nurses were more antagonistic toward clinical activities in the community than hospital practice setting, and were most antagonistic toward role activities which require independent judgement or autonomous action relevant to patient care on the part of the pharmacist. Differences were also noted in support for clinical role activities within the pharmacists' group. The effect of experience in working with a clinical pharmacist on support for clinical role activities is also discussed.
本研究评估了不同地位受众对药剂师角色扩展的认可度。药学是一个处于转型期的专业，其作为医疗保健专业的地位存在相当大的模糊性和不确定性。在过去几十年里，药学专业发生了重大变化，导致其功能、社会权力和地位丧失。该专业的应对措施是朝着让药剂师承担以患者为导向的临床角色发展。关于对扩展角色支持程度的假设源自两种基于冲突的专业化模式：一种权力模式，侧重于专业之间的冲突以及权力在界定职业领域中的核心作用；另一种过程模式，侧重于专业内部的利益冲突和多样性以及为控制专业发展方向而斗争的“群体”的发展。数据通过向加利福尼亚州的药剂师、医生和护士发放自填式问卷收集。受访者被要求表明对在两种执业环境（社区和医院）工作的药剂师的20项角色活动的支持程度。药学教员对临床角色活动的支持度最高，其次是执业药剂师、护士和医生。医生和护士对社区临床活动的反对态度比对医院执业环境的更强烈，并且对要求药剂师在患者护理方面具备独立判断或自主行动的角色活动最为反对。在药剂师群体内部，对临床角色活动的支持也存在差异。还讨论了与临床药剂师合作的经验对支持临床角色活动的影响。
