Abstract
ObjectivesThe Code of Ethics of pharmacy practitioners in Australia recognises the obligation to provide care to patients in a culturally safe and responsive manner. The aim of this exploratory study was to examine how Australian community pharmacists understand and experience the concept of ‘culture’ in their everyday practice environment.MethodsVoluntary, semi-structured interviews were conducted at community pharmacy placement sites in South-East Queensland, Australia. Pharmacists were asked to recall an incident that evoked their cultural awareness during the course of their practice. The question stated, verbatim: “We are preparing our students to be pharmacists in a highly multicultural community. Can you think of an incident where you learnt something about another person’s culture or it made you more aware of your own culture? Please briefly describe the incident.” Reportable responses were collected from 59 of the 92 visited pharmacists. These responses were audio-recorded and transcribed. The data were collated and analysed through iterative, reflexive, thematic analysis using constant comparison.Results and significanceThe responses provided a rich selection of lived experiences within Australian multicultural pharmacy practice, describing professional dilemmas, fears and the strategies employed to overcome practice challenges. Six main response categories were identified: (i) Language/communication challenges, (ii) Cultural attitudes and behaviours, (iii) Exposure to culture due to pharmacy location, (iv) Religion, gender, and age, (v) Prejudiced/perceived racist attitudes and discrimination towards ‘other’ cultures, (vi) Perceived ‘sameness’ of different cultures. The study has provided valuable insights into community pharmacists’ experiences of culture in their day-to-day professional practice, also highlighting the associated strategies used to maintain a high standard of practice. There is merit in ensuring that the pharmacy curriculum and professional development programs are designed to respond to the ethical obligation of pharmacists to practise in a culturally safe, responsive manner that acknowledges and incorporates the importance of culture, cultural differences and intercultural relations, while addressing culturally unique needs in a skilled and professional manner.
Highlights
Australia is culturally and linguistically diverse (CALD)
The researchers noted that this experience was congruent with the results of the recent systematic review reporting that the most common barriers to participation in pharmacy practice research are a lack of time and workload [40]
The rationale for asking the research question arose as a means of obtaining a succinct ‘snapshot’ of the pharmacy practice events that pharmacists associate with culture
Summary
Australia is culturally and linguistically diverse (CALD). It has been enriched by the contribution of people from many nations and its policies remain committed to maintaining a culturally diverse, tolerant and open society where the language needs of CALD populations are addressed [1]. The oldest continuing human culture on earth, Aboriginal and Torres Strait Islander peoples, have lived on the continent for more than 50,000 years and their history and culture have uniquely shaped the Australian nation [1,2]. The Code of Ethics of pharmacy practitioners in culturally diverse Australia [2] recognises the obligation to provide care to the healthcare consumer (here referred to interchangeably as patient, client or customer [6]) in a culturally safe and responsive manner that acknowledges and incorporates the importance of culture and cultural differences, the assessment of crosscultural relations, the expansion of cultural knowledge, and the adaptation of services to meet culturally unique needs [7]. Written in relation to health services for Indigenous people, but relevant more generally, it is argued that “developing and embedding cultural competence in health services requires a sustained focus on knowledge, awareness, behaviour, skills and attitudes at all levels of service, including at the operational or administrative service level, health practitioner level, practitioner-patient level and studenttraining level” [9]
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