Academic journal article The Qualitative Report

Autoethnography as an Instrument for Professional (Trans) Formation in Pharmaceutical Care Practice

Academic journal article The Qualitative Report

Autoethnography as an Instrument for Professional (Trans) Formation in Pharmaceutical Care Practice

Article excerpt

Nowadays, it is essential that pharmacists participate in knowledge construction as members of multidisciplinary healthcare teams. Their recent inclusion in primary health care in Brazil through the Family Health Support Team in 2008 (Brazil, 2008) has been leading pharmacists to reflect on their own attitudes, behaviors, roles and the need for change: from a professional focused on medications to a professional focused on individuals. These teams provide support to the Family Health Strategy, the foundation of primary care that consists of a doctor, nurse, nursing assistant and community healthcare worker. The multidisciplinary teams are part of an important strategy created in 2008 by the Ministry of Health as an initiative to expand the range and effectiveness of Primary Health Care (PHC) at the municipal level. They function as a specialized, multidisciplinary backup support, taking responsibility for guaranteeing optimal health outcomes and for promoting comprehensive care. Moreover, they assist with interdisciplinary activity and knowledge sharing in health. Thus, the public health system is structured in Brazil in such a way that PHC coordinates care and allows for effective transitions of care (Brazil, 2006, 2008, 2009, 2012).

Pharmacists are among the professionals who frequently comprise the multidisciplinary healthcare teams, being present in about 40% of them (Nakamura &Leite, 2014). They are tasked with dividing their workload between managerial and patient care activities. The former includes the control of the Primary Care Units' medicine inventories. The patient care activities include group activities, individual consultations, and home visits completed individually or along with other professionals. According to PHC guidelines, it is important for patients with complex medication routines to receive some form of pharmacotherapeutic monitoring. However, these guidelines do not specify how this monitoring should be done nor is there any systematization of pharmacists' patient care activities (Brazil, 2009).

Therefore, searching to better adapt to this work reality, two years ago, I (Daniela - Dani) started a journey aiming to challenge what I had learned training for my traditional role as a pharmacist with regards to care. Under the supervision of professors Djenane, Clarice, and Simone, I started learning about pharmaceutical care practice. Following that experience, I was able to reflect on my social role and responsibilities as a health care professional. These professors were my guides in interpreting the data generated throughout the research process and actively influenced my view of the patient care world as represented in this work.

In general, in the health professions, when we refer to technical preparation, we refer to an education that focuses on biomedical knowledge and lacks focus on humanistic skills and attitudes. This means that educational programs usually prepare the professional to treat the body and the disease (with good performance in clinical skills), but not the person. By comparison, in Brazil, the most traditional pharmacy schools are not even preparing pharmacists with the technical knowledge needed to take care of patients, let alone deliver a person-centered education. Pharmacists neither learn to make decisions about drug therapy nor how to perform anamnesis, physical examinations or interpret clinical exams (Freitas, Ramalho-de-Oliveira, & Perini, 2006). This has been my preparation as a pharmacist. As such, my training relied mostly on technicalities associated with the production and quality control of drug products. Thus, acknowledging that professional training was mostly technical has a very different meaning in the pharmacy profession as compared to the other health careers. As a result, the nuances involved in taking direct patient-care responsibilities and the construction of a therapeutic relationship with the patient is overlooked in most pharmacy curricula (Angonesi & Sevalho, 2010; Freitas et al. …

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