Using self-determination theory to evaluate well-being and burnout of community pharmacists

This study used self-determination theory (SDT) to examine: 1) the relationships between basic psychological need (BPN) fulfillment, autonomous motivation, and well-being and burnout in community pharmacists, and 2) factors that impact BPN fulfillment. An online survey was designed based on SDT concepts. A grocery store chain and Community Pharmacy Enhanced Services Networks in Texas, Florida, and Iowa distributed the survey via e-newsletters in the Fall of 2022. The survey included measures of BPN fulfillment (24 items), autonomous motivation (18 items), burnout (22 items), positive mental health (14 items), perceived health (1 item), overall job satisfaction (1 item), depression risk (2 items), intention to leave their current job (1 item) or the pharmacy profession (1 item), and demographic/practice information (11 items). Descriptive statistics, structural equation modeling, and multiple linear regression were used for data analysis. There were 146 usable responses. Among the BPN (range 1 to 5, higher mean scores indicating higher fulfillment), fulfillment of the need for autonomy was the lowest (3.1±1.0). Overall need fulfillment was 3.8±0.7. For positive mental health, 53.4% had flourishing mental health; 6.9% had languishing mental health. Two-thirds met the high-risk criteria of ≥1 burnout symptom. Confirmatory factor analysis of each of the included scales indicated that none of the scales fit their intended factor structure without the addition of covariances between error terms, an indication of poor construct validity. For Objective 1, bivariate analyses indicated that BPN fulfillment was positively related to autonomous motivation, which was positively associated with well-being and negatively associated with ill-being. The full hypothesized model did not fit the data adequately. Exploratory methods indicated BPN fulfillment may have a strong positive effect on positive mental health and strong negative effects on burnout symptoms. For Objective 2, the model explained 25.7% of the variance in BPN fulfillment; the only significant predictor was working at an independent pharmacy. Although SDT may provide a useful framework for evaluating community pharmacist well-being and burnout, this study was limited by issues in construct measurement. Further work is needed to adapt measures to this population and investigate how BPN can be better fulfilled within community pharmacies