Instruments measuring community pharmacist role stress and strain measures: A systematic review

Abstract

BackgroundWhile macro and meso approaches to implementing public health initiatives in community pharmacies have been studied, the micro perspective of their pharmacist providers requires more inspection. Community pharmacists report increasing stress, overload and limited control over facets of their work. [1][2][3][4][5][6][7] Social exchange principles, e.g. role price, may help to typify pharmacist work decisions so problematic situations can be modified, thus protecting workforce health. To do so, the underlying pressures of the pharmacist role (i.e. role stresses) and indicators of systemically-caused strain (i.e. role strains) should be measurable. ObjectivesTo summarise validated and reliable instruments used to measure role stress and strain among community pharmacists, and evaluate compatibility in testing a theoretically-derived framework. MethodsIn April 2020, journal articles describing reliable and validated instruments measuring role stress and strain responses among community pharmacists were identified from an online search via Scopus, Web of Science and PubMed. English-language articles after 1990 were selected; duplicates were deleted. Inclusion and exclusion criteria were used to screen title/abstracts and full texts. Reference lists were manually searched. Resultant instruments were analysed for theoretical compatibility.Results 26 separate instruments were found: seven psychological strain instruments, 14 social strain response instruments, and five role stress instruments. Role stresses were often present as facetspecific dimensions in psychological and social strain instruments. Strain instruments measuring individual evaluation of work were compatible with a social exchange approach. ConclusionsTwenty-six reliable and validated instruments measuring role stress and role strain were found to measure negative role outcomes from the micro community pharmacist perspective. Structural measurement of role stress and resultant negative responses enable detailed examination into pharmacist roles, and insights into pharmacist behaviour. Further research is required to developadditional role stress and strain instruments, and to discover pharmacist role benefits and their influence.

Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study

“…In the busy world of community pharmacy, pharmacists and staff may be requested to provide a new service without being resourced to do so [40,[43][44][45][46]. This lack of resources can lead to worker strain and turnover [1,41], since each CPS has its own set of administrative tasks for claiming federal funding, protocols, guidelines and a body of assumed knowledge from its initial authors [47][48][49][50]. Negative consequences caused by underresourced CPS implementation and provision could be a major barrier to organisational sustainability and worker motivation to deliver them.…”

“…These conflicting expectations can only be balanced by pharmacy organisations aligning with one of these identities and providing congruent rewards [96,98,[121][122][123]. When the professional identity, rather than traditional supply roles, is rewarded for fulfilling health service provider tasks and expectations, it may allow pharmacists to implement patient-centred care and innovate in CPS implementation [1,41]. Conversely, rewarding product supply roles incentivises individual pharmacists to remain in more traditional forms of pharmacist work, and avoid CPS provision and implementation.…”

“…Pharmacies in Australia implementing CPS are likely to have done so due to a change in professional focus [29][30][31], and out of necessity. A limited and diminishing pool of federal funding for dispensing services [17] has affected pharmacy viability [40,41]. As a result, pharmacies often deliver multiple CPS which were hastily adopted.…”

“…As a result, pharmacies often deliver multiple CPS which were hastily adopted. These CPS are seen as complementary and supplementary to prescription dispensing services, and in practice are delivered at varying levels of quantity and quality [18,[40][41][42][43][44][45][46]. The perceived urgency caused by a decreased pharmacy profitability means pharmacies may not have expertise nor time to trial, resource and embed each new service sustainably.…”

A participatory research approach in community pharmacy research: The case for video-reflexive ethnography

“…As an example, a poor understanding of pharmacist work and outdated workload measurements (which were often gathered using quantitative data collection 27 ) may be a cause of current workforce issues. 16,[28][29][30][31][32][33] This may be because community pharmacist work is more complex than previously recognised. 16,30,34 Many processes are enacted by different pharmacy team members and may occur in swift or parallel succession, under the watchful eye of the pharmacist and general public whom they directly interact with.…”