Margareta Sanner

People's attitudes and reactions to organ donation

Abstract This article is based on the authors previous studies on peoples reactions to organ donation, including both questionnaire surveys and qualitative interviews. A model was developed where six anti-donation factors and two pro-donation factors influence the attitude toward organ donation. This model can be applied also to other procedures with the dead body such as autopsy, anatomical dissection, and burial. Two-thirds of the adult population recognise some discomfort concerning organ donation though they are positive to transplantation per se and want to obtain a transplant themselves if in need. The most common discomfort is “Illusion of lingering life,” which means that it is difficult to imagine a difference between the living and the dead body and that procedures with a corpse are perceived as conducted on a living body. However, for the majority, the discomfort is an initial reaction that dissolves when put against altruistic and fact-stressing arguments. Teenagers are less willing to donate organs and feel more discomfort than adults, especially concerning trespassing the borders of identity by becoming a part of another individual through a donated organ. The findings of these studies can help medical staff to approach relatives of a potential donor in an empathic way and also have implications for donation campaigns.

Comparing 4 classification systems for drug-related problems: processes and functions.

BACKGROUND Counseling patients on drug-related problems (DRPs) is a new enterprise for pharmacists. Accordingly, a variety of classification systems have been created to document DRPs. This aroused our interest in finding out how classification systems differ. OBJECTIVE The objective is to explore and describe the characteristics of 4 classification systems for DRPs to understand their similarities and differences with regard to processes and functions. METHODS Four established classification systems were selected; they were Strand, Granada-II, Pharmaceutical Care Network Europe v5.0, and Apoteket. To gain experience of the use of the systems, an existing database containing documented problems that were identified during patient counseling at community pharmacies was used. The entries in the database were classified using the 4 selected classification systems, one at a time. In the following analysis, focus was set on what issues were classified and how they were classified in each system. Based on similarities and differences, 8 themes were identified and characteristics of the 4 systems were listed according to these themes. Characteristics of each system were thoroughly scrutinized and interpreted. RESULTS The processes of selecting classification categories were different in all 4 systems, and as a result the contents of categories in systems were different. The systems had different characteristics and a decisive characteristic was whether the patients were involved in the classification of problems or not. Because of the different characteristics the systems had different functions. CONCLUSIONS To understand the usefulness of a classification system, both structure of categories and work process must be considered. The studied systems had different functions that revealed different aims embedded in the systems. To develop the counseling role of pharmacists, a limited number of classification systems would be beneficial. To get there, common aims and common systems must be developed.

Care ideologies reflected in 4 conceptions of pharmaceutical care

BACKGROUND Different ways to practice pharmaceutical care have been developed. One expression of this fact is the existence of many different classification systems to document drug-related problems (DRPs). Evidence suggests that classification systems have different characteristics and that these characteristics reflect different conceptions of pharmaceutical care. To increase the understanding of conceptions of pharmaceutical care, underlying values and beliefs (ideologies) can be explored. OBJECTIVE To explore various conceptions of pharmaceutical care to identify the care ideologies on which these conceptions are based. METHODS Representatives of 4 selected conceptions of pharmaceutical care were interviewed in face-to-face meetings. During the interviews, 4 basic questions were asked. Three were focused on pharmaceutical care and 1 on DRPs. Interview transcripts were analyzed by an inductive method inspired by grounded theory. The conceptions studied were Strand, Granada-II, PCNE v5.0, and Apoteket. RESULTS In Strand, patients are given a more active role in the pharmaceutical care process, as compared to Granada-II, PCNE v5.0, and Apoteket. Pharmacists in all the conceptions of pharmaceutical care assume they have special knowledge that patients benefit from. However, they use their knowledge in different ways in the various pharmaceutical care conceptions. In Strand, individual goals of drug therapy are established together with the patient, whereas in Granada-II, PCNE, and Apoteket goals are not explicitly discussed. The identified differences correspond to different care ideologies. CONCLUSIONS The pharmaceutical care conceptions are based on different care ideologies. The ideology is expressed in how therapy goals are set and patient needs defined. Strand is based on a patient-centered ideology; patient therapy goals and needs are defined by the patient together with the practitioners. Granada-II, PCNE, and Apoteket are based on an evidence-based medicine approach; patient therapy goals and needs are defined by the practitioners, based on available scientific knowledge.