Martine Kruijtbosch

80 Chap t e r 3.1 TABLE 3: PCA component reliability of the PEP-NL test Number of eligible items Cronbach’s alpha Component 1 ‘Rules and regulations’ 5 0.60 Component 2 ‘Business orientation’ 7 0.63 Component 3 ‘Professional ethics’ 5 0.54 Total PEP-NL PCA components 17 0.63 Rules and regulations As shown in Table 4, the five statements M1, M5, M6, M10 and R10 were considered to represent a moral schema that reflects keeping up with rules and regulations: (M1) ‘whether you are willing to risk legal ramifications for illegal provision of an opioid to a sick patient’, (M5) ‘whether there are strict professional regulations to abide by regardless of circumstances’, (M6) ‘whether calling for legal advice is appropriate in this situation’, (M10) ‘whether your medical indemnity is up to date and renewed’, and (R10) ‘whether it is a pharmacist’s duty to abide by the requirements of the prescription’. In the Australian PEP study, the rules and regulations moral reasoning schema was also identified through statements M1, M5 and R10 but not through statements M6 and M10. Statement M6 was excluded from this component in that study because its correlations were too low; statement M10 correlated in that study with statements that represented the business orientation moral schema. Business orientation Seven statements (O1, O3, O11, M2, R3, R4, R5) were considered to represent a moral schema that reflects a business orientation (Table 4): (O1) ‘whether you, the pharmacist, are under great financial pressure’, (O3) ‘whether you need to offer the client symptom relief to retain her loyalty to the pharmacy’, (O11) ‘whether you don't want to disappoint her and lose her respect for you’, (M2) ‘whether viability of the business, by complying with patients’ needs, is important’, (R3) ‘if the patient has a logical reason for requesting supply there is no point in refusing’, (R4) ‘whether it is a patient's right to choose how and when to take their medicine’, and (R5) ‘if the patient is adequately counselled there is no further responsibility for the pharmacist’. Although this moral reasoning schema was also identified among Australian pharmacists, in the Australian PEP study, statements R3, R4 and R5 correlated with statements that represented the patients’ rights moral reasoning schema.