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      Exploring discrimination towards pharmacists in practice settings

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          Abstract

          Background:

          Discrimination towards pharmacists, as a public-facing health professional group, is reported but not well-studied.

          Objectives:

          The aims of this study were to identify accounts of discrimination in pharmacy practice and to explore the nature and impacts of and discrimination experienced by pharmacists.

          Methods:

          A cross-sectional survey was emailed to practice-based preceptors associated with the School of Pharmacy at the University of Otago. The survey included demographic questions, in addition to questions asking about the frequency and sources of different types of discrimination and abuse encountered in practice. Survey respondents could also provide their contact information for follow-up interviews. Interviews occurred after completion of the survey to better understand the nature of discrimination in pharmacy practice. A thematic analysis of interview transcripts was conducted to identify pertinent themes.

          Results:

          A total of 43 participants completed the survey. A total of 29 (67.4%) respondents reported experiencing discrimination in pharmacy practice. The most common types of discrimination experienced included discrimination based on gender, appearance, or past, present, or expected pregnancy. Verbal abuse and sexual harassment were also frequently reported. Most discrimination was sourced from patients, colleagues, or supervisors/leaders. Discrimination specific to pregnancy was largely sourced from supervisors/leaders. Verbal abuse was sources primarily from patients, patient’s family, supervisors/leaders, and other healthcare professionals. Patients were the primary source of sexual harassment. Three themes were identified from the interview phase: Discrimination occurs for a variety of reasons from different sources with different behaviors, the impact on a person is individualized/personal, and preventative strategies can be broad and encompass multiple layers of society.

          Conclusions:

          Findings of this study support the notion that training programs must adjust to adequately train pharmacists with effective coping strategies, prevention mechanisms, and resilience building strategies. Pharmacist employers should also be accountable to creating zero tolerance workplaces and providing route maps for how pharmacists report and navigate situations when faced with discrimination. Doing so may result in a better equipped workforce that is able to navigate the pressures encountered through discrimination in practice.

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          Most cited references16

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          Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training

          Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. A cross-sectional national survey of general surgery residents administered with the 2018 American Board of Surgery In-Training Examination assessed mistreatment, burnout (evaluated with the use of the modified Maslach Burnout Inventory), and suicidal thoughts during the past year. We used multivariable logistic-regression models to assess the association of mistreatment with burnout and suicidal thoughts. The survey asked residents to report their gender. Among 7409 residents (99.3% of the eligible residents) from all 262 surgical residency programs, 31.9% reported discrimination based on their self-identified gender, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse (or both), and 10.3% reported sexual harassment. Rates of all mistreatment measures were higher among women; 65.1% of the women reported gender discrimination and 19.9% reported sexual harassment. Patients and patients’ families were the most frequent sources of gender discrimination (as reported by 43.6% of residents) and racial discrimination (47.4%), whereas attending surgeons were the most frequent sources of sexual harassment (27.2%) and abuse (51.9%). Proportion of residents reporting mistreatment varied considerably among residency programs (e.g., ranging from 0 to 66.7% for verbal abuse). Weekly burnout symptoms were reported by 38.5% of residents, and 4.5% reported having had suicidal thoughts during the past year. Residents who reported exposure to discrimination, abuse, or harassment at least a few times per month were more likely than residents with no reported mistreatment exposures to have symptoms of burnout (odds ratio, 2.94; 95% confidence interval [CI], 2.58 to 3.36) and suicidal thoughts (odds ratio, 3.07; 95% CI, 2.25 to 4.19). Although models that were not adjusted for mistreatment showed that women were more likely than men to report burnout symptoms (42.4% vs. 35.9%; odds ratio, 1.33; 95% CI, 1.20 to 1.48), the difference was no longer evident after the models were adjusted for mistreatment (odds ratio, 0.90; 95% CI, 0.80 to 1.00). Mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
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            Using thematic analysis in psychology

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              Dealing with Racist Patients

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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Jul-Sep 2020
                24 August 2020
                : 18
                : 3
                : 1966
                Affiliations
                School of Pharmacy, University of Otago . Dunedin ( New Zealand ). chuvi433@ 123456student.otago.ac.nz
                School of Pharmacy, University of Otago . Dunedin ( New Zealand ). yere1452@ 123456student.otago.ac.nz
                BSP, ACPR, PharmD, PhD. Associate Professor and Associate Dean (Undergraduate). School of Pharmacy, University of Otago , Dunedin ( New Zealand ). kyle.wilby@ 123456otago.ac.nz
                Author notes
                [*]

                Both authors contributed equally and should be considered first authors

                Author information
                https://orcid.org/0000-0002-3131-2985
                https://orcid.org/0000-0003-0539-6158
                https://orcid.org/0000-0002-1670-2512
                Article
                pharmpract-18-1966
                10.18549/PharmPract.2020.3.1966
                7427610
                c43fb623-96d0-428b-877e-15a8bca9f57f
                Copyright: © Pharmacy Practice and the Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 May 2020
                : 02 August 2020
                Categories
                Original Research

                pharmacists,pharmacies,workforce,workplace,sexual harassment,social discrimination,education, pharmacy,resilience, psychological,surveys and questionnaires,qualitative research,new zealand

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