جودة الرعاية الصحية وسلامة المرضى (2-10)

BMJ Qual Saf doi:10.1136/bmjqs.2011.051912
Original research
Psychosocial influences on safety climate: evidence from community pharmacies
Denham L Phipps, Darren M Ashcroft
+ Author Affiliations

School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester, UK
Correspondence to
Dr Denham Phipps, School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK; denham.phipps@manchester.ac.uk
Accepted 10 June 2011
Published Online First 5 July 2011
Abstract
Objective

To examine the relationship between psychosocial job characteristics and safety climate.

Design Cross-sectional survey.

Setting Community pharmacies in Great Britain.

Participants A random sample of community pharmacists registered in Great Britain (n=860).

Survey instruments Effort–reward imbalance (ERI) indicator and Job Content Questionnaire (JCQ).

Main outcome measures

Pharmacy Safety Climate Questionnaire (PSCQ).

Results

The profile of scores from the ERI indicated a relatively high risk of adverse psychological effects. The profile of scores from the JCQ indicated both high demand on pharmacists and a high level of psychological and social resources to meet these demands. Path analysis confirmed a model in which the ERI and JCQ measures, as well as the type of pharmacy and pharmacist role, predicted responses to the PSCQ (χ2(36)=111.38, p<0.001; Tucker–Lewis index=0.96; comparative fit index=0.98; root mean square error of approximation=0.05). Two general factors (effort vs reward and control vs demand) accounted for the effect of job characteristics on safety climate ratings; each had differential effects on the PSCQ scales.

Conclusions

The safety climate in community pharmacies is influenced by perceptions of job characteristics, such as the level of job demands and the resources available to meet these demands. Hence, any efforts to improve safety should take into consideration the effect of the psychosocial work environment on safety climate. In addition, there is a need to address the presence of work-related stressors, which have the potential to cause direct or indirect harm to staff and service users. The findings of the current study provide a basis for future research to improve the safety climate and well-being, both in the pharmacy profession and in other healthcare settings.