약국약사의 커뮤니티 재구성과 환자중심성 : 의약분업 20년, 약사 전문주의 변화 = Capturing the Patient-centeredness and New Communities in the Perceived Roles of Community Pharmacists

다국어 초록 (Multilingual Abstract)

Twenty years have passed since the separating drug prescribing and dispensing was implemented in Korea. The separation fundamentally changed the ground of the professionality of community pharmacists. This study explored, after experiencing the structural transition in pharmacies, the changes in pharmacists’ perception of their professional roles and also examined whether the perceived roles captured concepts related to patient-centeredness. In addition, this study searched the possibility of cooperation with doctors in the context. Data from in-depth interview with 13 experienced community pharmacists was analysed using thematic content analysis. Following five themes were emerged: ‘Factors influencing change in professionality’, ‘Perceived changes in role of community pharmacists’, ‘Perception of patients’, ‘Relationship with doctors’, ‘Conditions for better service’. Participants perceived that the pharmacist’s roles were connecting the prescriptions and patients and providing patient-specific information. Pharmacists have captured the patient as a person and the new communities as the object of their professional roles. These results confirmed that changes in the roles of pharmacists were primarily related to patient-centered care. However, it seems that the possibility of cooperation with doctors is still low. Understanding pharmacists’ perception about their roles may provide insight into recent and historical changes in pharmacy practice. Furthermore, this study raises the need to expand opportunities for cooperation with doctors.

목차 (Table of Contents)

• 서 론(Introduction) 연구 방법(Research Methods) 결 과(Results) 고 찰(Discussion) 결 론(Conclusion) 참고문헌

참고문헌 (Reference)

1 박경용, "접골사(接骨士)의 구술생애사를 통해 본 접골 의료문화" 실천민속학회 21 : 297-332, 2013

2 박경용, "전통 침구의 단절과 침구사의 존립 양상 - 원로 침구사의 경험과 인식을 중심으로 -" 한국학연구원 (37) : 291-318, 2008

3 정형선, "의약분업이 의원 및 약국의 영업이익에 미친 영향" 한국보건행정학회 14 (14): 44-64, 2004

4 변진옥, "의약분업과 약국약사 전문주의의 재구성" 서울대학교 보건대학원 2011

5 변진옥, "의약분업 이후 약국약사의 전문주의 - 전문직 체계론을 활용하여 -" 한국보건사회학회 (51) : 81-109, 2019

6 김대업, "의약분업 시행 이후 개국 약사의 의식구조에 관한 연구" 성균관대학교 임상약학대학원 2005

7 변진옥, "약국약사들의 사회적 역할 실천에 대한 근거이론적 접근" 한국보건사회학회 (35) : 107-144, 2014

8 이창우, "문헌고찰을 통해 본 의약분업정책 10년의 성과 평가" 한국보건행정학회 23 (23): 188-195, 2013

9 이수연, "국가와 의사집단 그리고 전문주의" 한국사회복지연구회 21 : 137-160, 2003

10 趙南春, "개설약사와 병원약사의 건강생활 및 직무만족도와 관련요인 연구" 慶山大學校 大學院 1999

11 Mercer, K., "“My pharmacist”: Creating and maintaining relationship between physicians and pharmacists in primary care settings" 16 : 1-, 2020

12 Irvine D. H., "Time for hard decisions on patient-centred professionalism" 181 : 5-, 2004

13 Holloway, I., "The status of method: flexibility, consistency and coherence" 3 : 3-, 2003

14 Jang, S .M., "The separation of prescribing and dispensing: policy evaluation and improvement plans" Korea Institute for Health and Social Affairs 2002

15 Ha, Y. C., "The Role of the State in Health Policy-Making: The Case of 1993 Korean Herbal Pharmacy Disputes" 14 : 2-, 2005

16 Kim, H., "The Limits and Alternatives of medical professionalism against the commercialization of health care system" 31 : 2013

17 Bryman, A., "Social research method" Oxford University Press 2008

18 Ward, J., "Shared decision making in chronic medication use: Scenarios depicting exemplary care" 16 : 2020

19 Kim, H. N., "Review on pilot operation of Safe Pharmacy" 11 : 2-, 2013

20 Rathbone, A. P., "Qualitative study to conceptualise a model of interprofessional collaboration between pharmacists and general practitioners to support patients’ adherence to medication" 6 : 3-, 2016

21 Padgett, D. K., "Qualitative methods in social work research" Sage publications 2016

22 Lee, C. Y., "Performance evaluation for the separation of prescribing and dispensing dispensing of drugs" Korea Institute for Health and Social Affairs 2008

23 Mead, N., "Patient-centredness: a conceptual framework and review of empirical literature" 51 : 2000

24 Elvey, R., "Patient-centred professionalism in pharmacy: values and behaviours" 29 : 3-, 2015

25 H, H.A., "Patient centred professionalism" 4 : 2012

26 Cho, B., "National medical control and medical specialization :The historical background of the conflict structure of the Korean medical system" 24 : 8-, 1992

27 Choi, H G., "Medical Conflict and Medical Policy in Korea" History of Knowledge Industry 2007

28 Flick, U., "Managing quality in qualitative research" Sage publications 2008

29 Bradley, F., "Integration and differentiation: a conceptual model of general practitioner and community pharmacist collaboration" 8 : 1-, 2012

30 Mc Namara, K. P., "Implementing screening interventions in community pharmacy to promote interprofessional coordination of primary care-a mixed methods evaluation" 16 : 2-, 2020

31 Joint Ministry of Health and Welfare related ministries, "Focusing on Community Care for the Elderly 「Basic Plan for Integrating Community Care (draft)」" 2018

32 Kang, E. J., "Factors related to pharmacist’s professionalism" Seoul National University 1997

33 Doucette, W. R., "Factors affecting collaborative care between pharmacists and physicians" 1 : 4-, 2005

34 Snyder, M. E., "Exploring successful community pharmacist-physician collaborative working relationships using mixed methods" 6 : 4-, 2010

35 Nahai, F., "Embracing patient-centered professionalism" 31 : 7-, 2011

36 Jang, S. M., "Comparative analysis of drug misuse after the separation of prescribing and dispensing practice" Korea Institute for Health and Social Affairs 2001

37 Dey, R, M., "Bosnic-Anticevich S. Collaboration in chronic care: unpacking the relationship of pharmacists and general medical practitioners in primary care" 19 : 1-, 2011

38 Lee, M., "Analysis of pharamacists’ professionalism and job satisfaction after the separation of prescribing and dispensing practice" Chung-Ang University 2000

39 Cho. J. G., "Analysis of implementation evaluation and improvement measures for the division of medicine" Korea Institute for Health and Social Affairs 2001

40 Ryu, S., "An Analysis of the Changes in Community Pharmacy Operation after the Implementation of the Separation Policy of Drug Prescription and Dispensing" 7 : 4-, 2002

41 Cho, J. K., "A study on the health behavior for prescription dispensing" Korea Institute for Health and Social Affairs 2002

42 Lee, S. Y., "A Study on the Pharmacists knowledge, Attitudes and Treatment of Herbl Drugs Pharmacists in Seoul and Gyeonggi area" Seoul National University 2000

43 Kwon, K. H., "A Study on Pharmacist Manpower Project ‘VISION 2030’" Dongguk University Industry-Academic Cooperation FoundationMinistry of Health and Welfare 2013