Pharmacist Perceptions of Motivation and Well-being Using Self-Determination Theory: A Qualitative Study.

Abstract

Background: Many US hospitals and health systems have implemented well-being programs to address the clinician well-being and burnout crisis. Most community pharmacists experience at least one symptom of burnout, yet they have been overlooked for inclusion in well-being initiatives.

Objective: To explore community pharmacists' perceptions of how motivation and burnout impact patient care and how fulfillment of basic psychological needs (autonomy, competence, and relatedness) impacts motivation and well-being.

Methods: Focus groups were conducted with 20 community pharmacists. A semi-structured focus group guide was developed using Self-Determination Theory (SDT). Transcriptions from the focus groups were analyzed using deductive qualitative analysis with SDT as a framework and inductive analysis to code subthemes.

Results: Our findings revealed that pharmacists who feel burnout experience depersonalization toward patients which lowers the quality of patient-pharmacist interactions. Pharmacists who did not feel burnout expressed a sense of professional fulfillment, which motivated them to provide patient-centered care. Pharmacists indicated that unrealistic expectations from patients and corporate management, such as pressure from patients to fill prescriptions quickly and management expectations to meet prescription fill quotas, negatively impacted autonomy. Conversely, having access to clinical information, workflow optimization, and realistic job expectations supported autonomy. Poor relationships with patients and coworkers negatively impacted relatedness and contributed to communication barriers, workplace negativity, and emotional detachment from work. Relatedness was facilitated by building relationships and mutual respect with patients and coworkers and cultivating a positive work culture. Expectations for perfection and the need for multitasking when understaffed diminished competency. Adequate staffing and allocation of time to complete job duties served to support competency.

Conclusions: Community pharmacists are faced with situations that undermine autonomy, relatedness, and competency, which according to SDT need to be fulfilled to facilitate well-being.