Table 3 Results of factor analysis of the PSS

1st factor: Difficulty and feeling of incompetence in patient care

 13. I cannot give support to suffering patients or families

 14. I have to see patients unable to have prospects for their future

 2. I cannot give satisfactory care to patients

 3. I cannot have contact with or talk to patients at leisure

 51. I am helpless about the exacerbation of patients’ symptoms

 38. I cannot adequately handle patients’ and families’ anxiety and wishes

 39. Death of patients I am in charge of or I have made friends with

 26. I am helpless in the care of terminal patients

 1. I cannot have prospects of patient care as a pharmacist

 27. I am not sure how I should deal with patients not informed of their prognoses

 11. I cannot intervene in home care as I wish to and exercise my professional skill

 37. The services that I can provide with my skills or by my pharmacy are deficient

 18. I do not have enough time to give satisfactory care

 21. I am not sure about what explanation patients and families are given by the physicians about the treatment and prognosis

2nd factor: Relationship with superiors and work environment

 53. My superiors do not support me when I am in trouble

 5. My superiors have views different from mine

 29. My superiors respond slowly

 54. I have to work with uncooperative staff members

 16. My superiors do not trust me

 17. I have no one at my workplace to confide in or consult with

 35. The employer’s policy prevents me from doing what I want to do for patients

 41. My colleagues and workers of other professions do not help me when I am in trouble

 48. I am urged by the management to improve work efficiency

3rd factor: Burdens related to work load and work contents

 44. I have to handle unexpected jobs

 55. I have to work under time pressure

 56. I have to deal with patients outside duty hours

 36. Preparation of papers such as reports complicates my job

 31. I am required to respond immediately in emergencies

 7. I cannot secure enough time to rest

 19. I have difficulty in arranging time for home visits

 60. I feel burdened by having to visit homes alone (e.g., carrying a heavy baggage, fear of entering the house of a man living alone)

 49. I feel burdened by the heavy liaison work with other profession

 42. Manpower is deficient

 6. There is too much to do other than pharmacist’s work, such as office work

 24. I am paid inadequately for my drug dispensation workload

 61. I cannot give care to all patients equally when I have to take care of many home visits

4th factor: communication with patients and families

 28. Patients order me to do things

 15. Patients shout at or talk abusively to me

 40. Patients commit harassing and malicious behavior

 33.I must give care to patients who change their language and attitude according to the profession of the healthcare worker

 34. I am not trusted by patients and families

 46. I have to take care of patients who change their language and attitude according to the pharmacist providing service

 22. Care that I gave for the good of patients and families is misunderstood by them

 10. The poor hygienic environment of the homes I visit makes me feel disagreeable

 47. My sincere care is not understood by patients and families

 58. I have to give care to patients difficult to have communication with

5th factor: communication with other professions

 45. My work is not understood by physicians

 8. I cannot agree with the physicians’ policies or thoughts

 25. The work of pharmacists is not understood by other professions

 57. I have to work with uncooperative physicians

 32. Physicians respond slowly

Inter-factor correlations

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 2

 3

 4

 5