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

Abstract

While 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.1-7 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. To summarise validated and reliable instruments used to measure role stress and strain among community pharmacists and evaluate compatibility in testing a theoretically-derived framework. In 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. After review, 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 facet-specific dimensions in psychological and social strain instruments. Strain instruments measuring individual evaluation of work were compatible with a social exchange approach. Twenty-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 develop additional role stress and strain instruments, and to discover pharmacist role benefits and their influence.