Modelling elderly patients' perception of the community pharmacist image when providing professional services

Professional pharmaceutical services may impact on patient's health behaviour as well as influence on patients' perceptions of the pharmacist image. The Health Belief Model predicts health-related behaviours using patients' beliefs. However, health beliefs (HBs) could transcend beyond predicting health behaviour and may have an impact on the patients' perceptions of the pharmacist image. This study objective was to develop and test a model that relates patients' HBs to patient's perception of the image of the pharmacist, and to assess if the provision of pharmacy services (Intervention group-IG) influences this perception compared to usual care (Control group). A qualitative study was undertaken and a questionnaire was created for the development of the model. The content, dimensions, validity and reliability of the questionnaire were pre-tested qualitatively and in a pilot mail survey. The reliability and validity of the proposed model were tested using Confirmatory Factor Analysis (CFA). Structural Equation Modelling (SEM) was used to explain relationships between dimensions of the final model and to analyse differences between groups. As a result, a final model was developed. CFA concluded that the model was valid and reliable (Goodness of Fit indices: x²(80) = 125.726, p = .001, RMSEA = .04, SRMR = .04, GFI = .997, NFI = .93, CFI = .974). SEM indicated that 'Perceived benefits' were significantly associated with 'Perceived Pharmacist Image' in the whole sample. Differences were found in the IG with also 'Self-efficacy' significantly influencing 'Perceived pharmacist image'. A model of patients' HBs related to their image of the pharmacist was developed and tested. When pharmacists deliver professional services, these services modify some patients' HBs that in turn influence public perception of the pharmacist.