Original Article

Determination of Pharmacists’ Opinions about Collegial Solidarity

10.4274/tjps.galenos.2021.98271

  • Bilge SÖZEN ŞAHNE
  • Elif ULUTAŞ DENİZ
  • Onur KABAŞ
  • Nilay TARHAN
  • Miray ARSLAN
  • Özlem AKBAL DAĞISTAN

Received Date: 13.02.2021 Accepted Date: 19.03.2021 Turk J Pharm Sci 2021;18(6):770-775 PMID: 34979742

Objectives:

Colleague solidarity, which emphasizes trust, independent thinking skills, and sharing, enables the problems encountered in the health service delivery to be dealt with effectively. This study aims to identify the current situation regarding colleague solidarity among pharmacists, which is also included in Turkey’s pharmacy legislation.

Materials and Methods:

“Colleague Solidarity Scale Among Nurses” was used in this study conducted with the questionnaire technique. The scale comprises of 23 items and was scored using a 5-point Likert scale. In addition, there were three demographic questions and six questions to get information from participants related to collegial solidarity in the questionnaire.

Results:

As a result of the exploratory factor analysis (Kaiser-Meyer-Olkin: 0.837), three factors reported 51.029% of the total variance. The t-test indicated a significant difference between gender groups only in the negative opinions about solidarity (NOS) factor (p=0.000). Females exhibited more negative thoughts about solidarity. The ANOVA showed a significant difference in the academic solidarity (AS) factor (p=0.007) among the participants’ works in community pharmacies and universities. Pharmacists working in universities had higher means in the AS factor. Moreover, the number of working years made significant differences in the emotional solidarity factor (p=0.000) and NOS factor (p=0.002). Additionally, it was found that the average responses in all factors of the participants who thought that they supported their colleagues in need and that solidarity with their colleagues increased significantly during the COVID-19 pandemic period (p<0.05).

Conclusion:

The findings suggest that colleague solidarity among pharmacists should be addressed profoundly as an element specified in legislation and education processes. It is crucial to determine the level of colleague solidarity and improve it using this scale for different practice areas in pharmacy.

Keywords: Colleague, solidarity, pharmacist, communication, health services

INTRODUCTION

Solidarity is reflected in a wide range of integrated interests from policy to health and is defined comprehensively as “Networks of social relationships that involve mutual dependencies, responsibilities, and entitlements within a defined group of people or a community”.1

The word solidarity has been known since the early times. Historically, there have been many uses of the concept of solidarity, from Roman law to the French revolution.2 According to İbni Haldun, individuals develop strong solidarity by uniting for certain reasons. Solidarity helps individuals in overcoming several difficulties and achieving their desired goals. On account of this solidarity, individuals tend to protect and defend each other, take a common stand on economic, social, and political issues, and take joint actions. It is the society wherein they live, which has intense solidarity, that makes people who are considered superior and successful, not their personal talents.3

Particular concepts, such as intergenerational solidarity,4 social solidarity,5 and gender solidarity,6 can be found in the literature. Colleague solidarity is another important aspect related to solidarity. It includes supporting colleagues and sharing professional knowledge, technique, and skills. Additionally, it is related to developing professional knowledge and increasing professional skills.7

One of the important benefits of collegiality listed by Benshoff and Paisley8 is the effect of enhancing the skills that help each other professionally. Similarly, Carroll9 mentioned “the support and assistance of group members to each other helps group members to integrate with each other” in terms of solidarity.

It is said that colleague solidarity, which emphasizes trust, independent thinking skills, and sharing, enables the problems encountered in the health service delivery to be dealt with effectively. Furthermore, it is known to support a sense of belonging, open communication, cooperation, and support.10

Particularly in times of crisis, it can be seen that collaboration among colleagues is required, which makes it easier to overcome problems. Studies have shown that colleague solidarity affects factors, such as job satisfaction, job stress, and professional self-esteem. In addition, it is emphasized that colleague solidarity can be improved with applications in vocational education processes.11 In healthcare sector, colleague solidarity is as important as the solidarity among different occupational groups owing to its close link with colleague relations. It is known that colleague interactions increase opportunities to speak and reflect, ensuring that everyone involved is aware of their knowledge and experience. Besides colleague relations, it also works when issues, such as patient health, are considered more important than one’s personal ambitions.12 In this context, there are some studies with healthcare professionals, especially with nurses, about colleague solidarity.

Gül and Bahçecik13 performed a descriptive study with 297 nurses working in hospitals in İstanbul. An introductory information form, a colleague solidarity scale, and a job stress scale were used as data collection tools. This study reported high levels of collegiality and work stress among nurses.13

Furthermore, another study with nurses indicated that the more professional solidarity there is among nurses, the higher the job satisfaction. In addition, it was mentioned that generational differences should be considered to increase colleague solidarity and job satisfaction among working nurses.14

The professional solidarity of pharmacists in Turkey is based on the Turkish Pharmacists Deontology Regulation, as well as their professional practices.10 The statement, which is specifically related to solidarity, reads, “Pharmacists establish good relations with their colleagues; they help each other materially and spiritually”.15 Collaboration with colleagues is also included in the National Pharmacy Core Education Program.16

Apart from these, there are various studies related to colleague solidarity in the fields of nursing and teaching.17,18 However, collegiality among pharmacists has not yet been explored in both national and international literature. Therefore, within the scope of the planned study, the current situation regarding colleague solidarity among pharmacists, which is also included in the relevant legislation in our country, will be revealed.


MATERIALS AND METHODS


Measurement tool

In this study, the data were collected questionnaire. The questionnaire included the “Colleague solidarity scale among nurses,” developed by Uslusoy and Alpay.19 This scale comprises three factors, namely: (i) emotional solidarity (ES), (ii) academic solidarity (AS), and (iii) negative opinions about solidarity (NOS). The questionnaire contained 23 items and was scored using a 5-point Likert scale, ranging from (1) never to (5) always.

In addition, there were three demographic questions and six questions to obtain information from participants related to colleague solidarity in the questionnaire.


Sample size and data collection

The minimum sample size was calculated as 385; on 0.05 significance level, z: 1.96, d (sensitivity): 0.05, and p and q values being 0.5. To increase the reliability of the study results, we tried to reach the maximum number of individuals that could be reached. We were able to obtain data from 774 pharmacists working in community pharmacies, hospital pharmacies, public institutions, universities, and in the pharmaceutical industry in Turkey.

The current investigation was conducted between July 17, 2020 and September 12, 2020, after ethical approval was obtained from the Hacettepe University Ethical Committee, and Permit Number 35853172-050.06 was issued.


Statistical analysis

The first eight questions were analyzed using the descriptive statistics. Following this, the negative items on the scale were inverted. Subsequently, exploratory factor analysis (EFA) was performed to extract factors using IBM SPSS® Software version 22. After determining the factor structures, independent sample t-test and ANOVA tests were applied.


RESULTS

Table 1 presents the demographic characteristics of the participants (n=774). Table 2 displays the findings related to the importance of colleague solidarity to the participants.

Table 2 indicates that participants generally give positive answers to the questions about the importance they attach to colleague solidarity. When the participants were asked about the importance of colleague solidarity in problem solving, it was revealed that 40.2% of the participants found it important in improving the professional image, 29.2% in solving ethical problems, and 21.6% in improving the service quality. The participants were then asked about the subjects they communicate on, with their colleagues more frequently. It was found that 47.8% of the participants contacted their colleagues to learn about innovations in professional practices and 43.5% to find solutions to professional problems. Lastly, the participants were asked what could be effective in increasing colleague solidarity. Different answers were received. Upon evaluating the answers, it was found that approximately 70% of the participants emphasized that the scientific and social activities offered by the professional organizations could be effective. This was followed by the effective use of social media (25.6%).

As a result of EFA, a three-factor solution was obtained (Table 3) with the Kaiser-Meyer-Olkin measure 0.837. These three factors explained 51.029% of the total variance. This value proved the adequacy of the variance ratio.

The factors obtained from EFA were found to be the same as the factors in the scale developed by Uslusoy and Alpay.19 Unfortunately, eight items were removed owing to low factor loading (less than 0.50). According to the calculated Cronbach’s alpha internal consistency coefficients (Table 3), the factors of the scale demonstrated high reliability in the pharmacist population with this current form. Table 3 presents the mean values of the scale items. It can be seen that mean values are generally higher than 3.5. It was found that “Q5: I respect the personalities of my colleagues” had the highest mean response (4.726), and “Q20: I warn my colleagues regarding their lack of professional knowledge when I recognize it” had the lowest mean response (3.291).

Using the participants’ factor loadings, t-test and ANOVA were conducted to investigate participant differences basis gender, place of duty, and number of working years. The results of the t-test showed that there was a significant difference between gender groups only in the NOS factor (p=0.000). Females displayed more negative thoughts about solidarity. According to the ANOVA, the place of duty only made a significant difference in the AS factor (p=0.007). Since the group variances were homogeneous, the Tukey test was performed. Consequently, a statistically significant difference was found between the participants working in community pharmacies and universities. Pharmacists working in universities had higher means in the AS factor. Furthermore, the number of years they had been working showed significant differences in the ES factor (p=0.000) and the NOS factor (p=0.002). The Tukey test results revealed that these differences came from participants who had worked less than 5 years and others in the ES factors. Unlike this, in the NOS factor, differences came from participants who worked less than 5 years and 6-10 years, and 6-10 years and 16-20 years. In these two cases, it was determined that those with less working years had less negative views.

Moreover, the result of the t-test indicated that the participants who received support from their colleagues in their professional practices had statistically significantly higher mean answers in the ES (p=0.000) and the NOS (p=0.000) factors than those who did not. Additionally, it was found that the average responses in all factors of the participants who thought that they supported their colleagues in need and that solidarity with their colleagues increased during the coronavirus disease-2019 pandemic period were statistically significantly higher (p<0.05).


DISCUSSION

Solidarity is a concept emphasized in many international documents and is important in terms of sustainability.20,21 This concept, which is also crucial in the health sector,22,23 has been examined within the framework of colleague solidarity of pharmacists in the scope of this study.

Pharmacists are an essential part of the Turkish healthcare system. According to the latest reports of the Turkish Pharmacists‘ Association (TPA), approximately 57% of 39,377 pharmacists are female, and 43% are male.24 This rate is approximately half of the pharmacists participating in this study. In addition, the same report noted that approximately 73.79% of pharmacists in Turkey work as community pharmacists.24 Similarly, 75.2% of the pharmacists who took the questionnaire reported that they were working in community pharmacies.

When it comes to collegiality, helping colleagues in need is a key element.19 In the study, 93.2% of pharmacists who participated in the survey thought that they supported colleagues in need, and 40.2% found colleague solidarity beneficial in improving their professional image. Nearly 30% of the participants found it helpful in solving ethical problems. Similarly, Arslan et al.25 identified that support of colleagues in solving unethical issues is valuable for pharmacists.

Providing pharmacists with colleague solidarity is one of the aims of the TPA in Turkey.24 The pharmacists who participated in the study stated that the activities of the professional organization increased colleague solidarity. In this context, 70% of pharmacists indicated that scientific and social activities offered by the TPA could be effective in terms of collegial solidarity. Concordantly, in one of the latest publications of the TPA, it highlighted that communication channels needed to be strengthened between the pharmacists and the Association.26

When the responses of the pharmacists to the scale were examined, it was seen that the highest average was in the expression of respect for the personality of colleagues. This is essential in terms of supportive cooperation as well as positive communication with colleagues, which is also important in health service delivery.27,28

In this study, it was revealed that women had more NOS in terms of the NOS factor. Women’s views on solidarity have been studied since the end of the 90’s.6 Webber and Giuffre29 identified that women face various obstacles when it comes to solidarity. In this context, the current results are consistent with the extant literature.

Moreover, solidarity is important in terms of public health and essential to ensure sustainability.30 The World Health Organization and the United Nations20 emphasized the importance of solidarity in this period in the documents they published. Garros et al.31 aver its importance for physicians. In addition, it is suggested that global solidarity is important in terms of pharmaceutical services during the pandemic period.32 Supporting this, when the scores of the pharmacists participating in the study of the colleague solidarity scale were examined, it was found that the scale scores of pharmacists who thought that solidarity increased during the pandemic process were statistically higher.


Study limitations

There were numerous limitations in this study. The survey was conducted via the online platform and only pharmacists who received the survey participation link became aware of the study. Further studies may be done by conducting the survey on more specific pharmacist groups, making it possible to determine the level of colleague solidarity in different areas.


CONCLUSION

As a result of this study, it was revealed that the “Colleague Solidarity Scale Among Nurses” with three factors and 15 statements is appropriate to a pharmacists’ sample. Colleague solidarity among pharmacists should be addressed profoundly as an element specified in legislation and education processes. It is crucial to determine the level of colleague solidarity and improve it by applying this scale for different practice areas in pharmacy. In this regard, it will be possible to make positive contributions to professional satisfaction and motivation. The increase in satisfaction and motivation levels will also increase pharmacists‘ contributions to the improvement of public health.


ACKNOWLEDGMENTS

The researchers would like to thank all the pharmacists who answered the questionnaire voluntarily.

Conflict of interest: No conflict of interest was declared by the authors. The authors are solely responsible for the content and writing of this paper.

Images

  1. De Deken JJ, Ponds E, Van Riel B. Social solidarity. In: Clark GL, Munnell AH, Orszag MJ, Willams K, eds. The Oxford Handbook of Pensions and Retirement Income. Oxford; Oxford University Press; 2006:41-160.
  2. Prainsack B, Buyx A. Solidarity: Genesis of a concept. Solidarity: Reflections on an emerging concept in bioethics. London: Colour Ltd; 2011:6-9.
  3. Uygun O. İbni Haldun’un Toplum ve Devlet Kuramı. İstanbul: On İki Levha Yayıncılık; 2019.
  4. Starrels ME, Ingersoll-Dayton B, Neal MB, Yamada H. Intergenerational solidarity and the workplace: Employees’ caregiving for their parents. J Marriage Fam. 1995;751-762.
  5. Silver H. Social exclusion and social solidarity: three paradigms. Intl Lab Rev. 1994;133:531-578.
  6. Fajak A, Haslam SA. Gender solidarity in hierarchical organizations. Br J Soc Psychol. 1998;37:73-94.
  7. Çoban AE. Psikolojik danışmanlar için meslektaş dayanışması. Mersin Eğitim Fakültesi Dergisi. 2005;1:167-174.
  8. Benshoff JM, Paisley PO. The structured peer consultation model for school counselors. J Couns Dev. 1996:74;314-318.
  9. Carroll M. Counseling supervision: theory, skills and practice. London: SAGE Publications; 2006.
  10. Ellenbecker CH, Boylan LN, Samia L. What home healthcare nurses are saying about their jobs. Home Healthcare Nurse. 2006;24:315-324.
  11. Hall JN, Wong SH. A call for collegiality in residency. J Grad Med Educ. 2017;9:401.
  12. Burr SA, Collett T, Leung LY. The value and challenges of collegiality in practice. Br J Hosp Med. 2017;78:486-487.
  13. Gül P, Bahçecik AN. Hemşirelerde Meslektaş Dayanışması ve İş Stresi, Marmara University Institute of Health Sciences, Department of Nursing, Master‘s Thesis, İstanbul; 2019.
  14. Karasu F, Aylaz R, Dadük S. X and Y Generation: The Relationship Between Nurses ‘Professional Solidarity and Job Satisfaction. Arch Health Sci Res. 2017;4:180-189.
  15. Türk Eczacıları Deontoloji Tüzüğü, Resmi Gazete 27.7.1968, no: 12961.
  16. Eczacılık Fakülteleri Dekanlar Konseyi. Ulusal Eczacılık Çekirdek Eğitim Programı (EczÇEP-2019). Ankara.
  17. Taşdan M. Solidarity between colleagues in contemporary educational supervision. Ankara Üniversitesi Eğitim Bilimleri Fakültesi Dergisi. 2008;41:69-92.
  18. Kılıç E, Altuntaş S. The effect of collegial solidarity among nurses on the organizational climate. Int Nurs Rev. 2019;66:356-365.
  19. Uslusoy EC, Alpar SE. Developing scale for colleague solidarity among nurses in Turkey. International J Nurs Pract. 2013;19:101-107.
  20. United Nations. Shared Responsibility, Global Solidarity: responding to the socio-economic impacts of COVID-19. 2020.
  21. Khozhamkul R, Kosherbaeva L, Izmukhambetov T, Tolegenova S, Jurgutis A, Sydykov B, Davletov K. Building bridges between community, primary healthcare and academia for solidarity in health. Eur J Public Health. 2019;29:384.
  22. Gomes D, Ramos FRS. Solidarity, alliance and commitment among healthcare professionals in the practices of the Brazilian Health System (SUS): a bioethical debate. Interface-Comunicação, Saúde, Educação. 2015;19:9-20.
  23. Horn R, Kerasidou A. Sharing whilst caring: solidarity and public trust in a data-driven healthcare system. BMC Med Ethics. 2020;21:1-7.
  24. Bağcı H, Atasever M. Türkiye Serbest Eczane Sektör Analizi. Ankara; TEB; 2020.
  25. Arslan M, Tarhan N, Kalender S, Şar S. Investigation of factors affecting ethical decision-making process of community pharmacists in professional life. J Res Pharm. 2019;23:140-145.
  26. TEB. COVID-19 Mücadelesinde Türk Eczacıları Birliği. Ankara; TEB; 2021.
  27. Abrahamsen C, Nørgaard B, Draborg E, Nielsen D. Reflections on two years after establishing an orthogeriatric unit: a focus group study of healthcare professionals’ expectations and experiences. BMC Health Serv Res. 2017;17:602.
  28. Göktepe N, Yalçın B, Türkmen E, Dirican Ü, Aydın M. The relationship between nurses’ work-related variables, colleague solidarity and job motivation. J Nurs Manag. 2020;28:514-521.
  29. Webber GR, Giuffre P. Women’s relationships with women at work: barriers to solidarity. Sociol Compass. 2019;13:e12698.
  30. West-Oram P. Solidarity is for other people: identifying derelictions of solidarity in responses to COVID-19. J Med Ethics. 2021:47;65-68.
  31. Garros D, Austin W, Dodek P. How can i survive this?: coping during coronavirus disease 2019 pandemic. Chest. 2021;159:1484-1492.
  32. Chan AHY, Rutter V, Ashiru-Oredope D, Tuck C, Babar ZUD. Together we unite: the role of the Commonwealth in achieving universal health coverage through pharmaceutical care amidst the COVID-19 pandemic. J Pharm Policy Pract. 2020;13:1-7.