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dc.date.accessioned2017-08-16T12:47:04Z
dc.date.available2017-08-16T12:47:04Z
dc.date.issued2017
dc.identifier.urihttp://hdl.handle.net/10852/57081
dc.description.abstractWorldwide, the role of the community pharmacist is changing from distribution of medicines towards being a patient-centered profession and putting the patient and not the medicine in the center. Ideally, pharmacists use their specialized health and pharmacotherapeutic knowledge along with communication skills. This professional development involves a complex interplay between community pharmacists, the regulatory framework, and the pharmacy undergraduate education among others. The overall aim of this thesis was to explore, in the Nordic setting, how community pharmacists, the regulatory framework, and the pharmacy undergraduate education have responded to the shift in focus towards the increased communicative role of the pharmacists. The specific aims of this thesis were 1) to explore Norwegian community pharmacists’ motivation and perceived responsibility regarding role development and involvement in patient-centered care; 2) to describe society’s expectations of community pharmacist-patient communication around medications as expressed by the states in the Nordic legislation, economic incentives, and authority control; 3) to map communication skills building in pharmacy curricula in order to find ways to potentially improve the training by 3a) exploring current practice and 3b) course leaders’ opinions regarding teaching of patient communication skills in Nordic pharmacy schools; 4) to describe Nordic pharmacy students’ opinions of their patient communication skills training, and the association between course leaders’ reports of patient communication skills training qualities and the students' perceptions of their training. Secondary was to determine what factors influence these associations; and 5) to explore Nordic pharmacy students’ attitudes to communication skills learning, as well as the associations with various student characteristics. In order to explore the study aims, focus groups and a document review were utilized to address Aims 1 and 2. For Aims 3-5, two questionnaire studies were undertaken. Paper I showed a gap between the pharmacists day-to-day work as ‘distributors’ and their ideal tasks of patient care in the pharmacy. The pharmacists discussed, e.g., the patients, doctors, pharmacy chains, or time constraints as reasons for not claiming a more active role in patient’s medicine use and their role development. Paper II identified a general, but not very detailed, legislation on communication on prescription medicines during dispensing. Communication on medicines was not directly supported with economic incentives or effective control thereof. In Paper III it was shown that the pharmacy practical experience is the main period for patient communication skills training, and the training is often placed late in the education. During the five years of education, the teacher-led training varied from 6 to 92 hours, and few schools used experiential training methods. Most course leaders identified a need for larger focus on communication skills training. Paper IV showed that students with more experiential training methods and >20 hours of training were significantly more likely to report having received sufficient training (adjusted OR:4.20; 95% CI:2.03 to 8.69, p<0.001), and that the pharmacy school had contributed to their skills (adjusted OR:3.65; 95% CI:1.89 to 7.04, p<0.001) compared to students without such training. Paper V showed that Nordic pharmacy students in general had moderately positive attitudes towards learning communication skills and that such attitudes were associated with female gender (adjusted ß:0.42; 95% CI:0.20 to 0.63, p<0.001), newer types of pharmacy education (adjusted ß:0.81; 95% CI:0.63 to 0.98, p<0.001), students who thought their skills needed improvement (adjusted ß:0.50; 95% CI:0.30 to 0.71, p<0.001), and students who thought their communication skills were a result of their personality (adjusted ß: -0.24; 95% CI:- 0.44 to -0.04, p=0.017). The findings from this thesis imply that the pharmacists have positive beliefs towards the increased communicative role, the legislations are not hindering the role, but they are not supporting it either. Nordic pharmacy schools could have strengthened the role more. An overall conclusion is that the three factors need improvements and alignment if pharmacists’ communicative role is going to reach full potential in practice.en_US
dc.language.isoenen_US
dc.relation.haspartPaper I: Svensberg K, Sporrong SK, Håkonsen H, Toverud EL. 'Because of the circumstances, we cannot develop our role': Norwegian community pharmacists' perceived responsibility in role development. The International Journal of Pharmacy Practice. 2014;23(4):256-65. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1111/ijpp.12154
dc.relation.haspartPaper II: Svensberg K, Sporrong SK, Björnsdóttir I. A review of countries' pharmacist-patient communication legal requirements on prescription medications and alignment with practice: Comparison of Nordic countries. Research in Social & Administrative Pharmacy. 2015;11(6):784-802. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1016/j.sapharm.2015.01.002
dc.relation.haspartPaper III: Svensberg K, Björnsdóttir I, Wallman A, Sporrong SK. Strategies for Enhancing Communication Skills Training: Lessons from 11 Nordic Pharmacy Schools. The American Journal of Pharmaceutical Education (Accepted for publication), the American Journal of Pharmaceutical Education. To be published. The paper is not available in DUO awaiting publishing.
dc.relation.haspartPaper IV: Svensberg K, Sporrong SK, Lupattelli A, Olsson E, Wallman A, Björnsdóttir I. Nordic Pharmacy Students' Opinions of their Patient Communication Skills Training. The American Journal of Pharmaceutical Education (Accepted for publication), the American Journal of Pharmaceutical Education. To be published. The paper is not available in DUO awaiting publishing.
dc.relation.haspartPaper V: Svensberg K, Brandlistuen RE, Björnsdóttir I, Sporrong SK. Factors Associated with Pharmacy Students’ Attitudes towards Learning Communication Skills - a Study among Nordic Pharmacy Students. Research in Social & Administrative Pharmacy (2017) Available online 28 March 2017. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1016/j.sapharm.2017.03.055
dc.relation.urihttps://doi.org/10.1111/ijpp.12154
dc.relation.urihttps://doi.org/10.1016/j.sapharm.2015.01.002
dc.relation.urihttps://doi.org/10.1016/j.sapharm.2017.03.055
dc.titleFacilitators and Barriers to Pharmacists' Patient Communication: The Pharmacist Profession, the Regulatory Framework, and the Pharmacy Undergraduate Educationen_US
dc.typeDoctoral thesisen_US
dc.creator.authorSvensberg, Karin
dc.identifier.urnURN:NBN:no-59874
dc.type.documentDoktoravhandlingen_US
dc.identifier.fulltextFulltext https://www.duo.uio.no/bitstream/handle/10852/57081/1/PhD-Svensberg-DUO.pdf


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