BACKGROUND: Blended learning addresses significant challenges in nursing education by offering flexible and adaptive learning environments that support the development of both theoretical knowledge and practical skills. Its importance grew post-COVID-19. Although some reviews have synthesized its effects in nursing education, they often focused on a limited scope and studies, leaving gaps in understanding its broader impact.
DESIGN: Systematic literature review.
METHODS: We employed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search for literature published in PubMed, CINAHL, Web of Science, EMBASE, ERIC, Scopus and Cochrane Library from 2000 to June 26, 2024. Two researchers independently screened each article for eligibility and extracted the data.
RESULTS: This review included 54 studies and found that blended learning positively influenced nursing students in five key areas: academic performance and skill development, learning engagement and motivation, self-management in learning, psychological and emotional well-being, learning experience and satisfaction. These were captured in a visual model showing the comprehensive impact of blended learning. Critical research gaps were identified, including a lack of randomized controlled trials and limited studies on mental health and clinical thinking abilities.
CONCLUSIONS: The results of the study showed that the effects of blended learning in nursing education were positive and multi-dimensional. Despite some inconsistencies in findings, blended learning was shown to offer significant advantages over traditional learning, though further research is required to address areas of uncertainty.
METHOD: This is a qualitative research design where focus group discussions among audiologists were held. The interview data were analyzed using reflexive thematic analysis to identify patterns and reconstruct meaning.
STUDY SAMPLE: Ten audiologists with at least 1 year of work experience in providing remote hearing aid adjustment services to adult patients were recruited.
RESULTS: Even though there has been an increased utilization of remote fine-tuning among audiologists in Malaysia due to the coronavirus disease 2019 pandemic, its use among audiologists remains limited at present. Five thematic areas were identified: "Adoption of Practice," "Challenges and Limitations," "Benefits and Opportunities," "Satisfaction," and "Recommendations for Improvement." The TedAP challenges (T-technical challenges: e-ease of use, d-digital competency; A-abuse of system, and P-physical examinations) have been identified under the "Challenges and Limitations" theme. Suggestions for improvement include integrating the applications and video calls on a common platform, assigning a "standby" trained audiologist, and incorporating remote fine-tuning into audiology education.
CONCLUSION: Challenges and limitations associated with the provision of tele-audiology have been documented based on the views and experiences of audiologists in Malaysia. Despite the barriers, audiologists acknowledged the benefits associated with remote systems and recommendations were provided to improve the services. The results of this study could contribute to the increase in the use of tele-audiology in Malaysia. This would be instrumental in developing further the audiology profession in terms of the adoption of tele-audiology and telehealth in Malaysia.
METHODS: Adult TBI patients who received any neurosurgical or neuroradiological interventions during the year 2015-2022 in the Pan-Asian Trauma Outcome Study database were analyzed. The time to intervention, as the main exposure, was classified into three groups (Early, Intermediate, and Delayed) using Restricted Cubic Spline (RCS) analysis. The outcomes were in-hospital mortality and unfavorable neurological outcomes. W score was utilized to compare the quality of care among exposure groups. Multivariable logistic regression analysis and interaction analysis were performed to identify the association between the exposure groups and outcomes, reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).
RESULTS: A total of 1,780 patients were included. From the RCS analysis, patients were classified into three groups according to time to intervention: Early ( 4.1 h). According to the time to intervention, W score was - 8.6 in the early group, -1.1 in the intermediate group, and + 0.4 in the delayed group. Patients receiving intermediate and delayed intervention showed significantly lower mortality (AOR 0.64, 95% CI 0.47-0.86 and AOR 0.66, 95%CI 0.48-0.90, respectively).
CONCLUSION: Early neurosurgical and neuroradiological interventions in TBI patients in the Asia-Pacific region were associated with lower quality of care and higher mortality. The quality of care should be focused and improved during the early hours of TBI.
METHODOLOGY: A cross-sectional community survey was conducted in September till November 2020 across nine government health clinics focusing on diabetes mellitus (Type 1 or Type 2) patients, aged 18 years and older, receiving Diabetes Medication Adherence Counseling (DMTAC) services and able to use smart devices. A self-developed questionnaire with four sections was used to gather demographic information, explore mHealth apps usage and understand both users and non-users' experiences and perceptions. The questionnaire was tested through cognitive debriefing, translated into Malay, pre-tested and finalized by the expert committee. The questionnaire was digitally implemented using Google® Form and QR code. After obtaining informed consent, data collection was performed by the trained DMTAC pharmacists. Statistical analyses involved descriptive and inferential analyses.
RESULTS: The study analyzed the engagement of 295 patients living with diabetes with mHealth apps. Females (54.9%), of Malay ethnicity (58.3%) and with a mean age of 53.8 years (SD: 12.38) constituted the majority. Diabetes duration had a median of 6 years (IQR: 3.0, 10.0) with prevalent comorbidities like hypertension (58.0%) and dyslipidemia (42.7%). Most patients were employed (44.7%) and their primary source of diabetes management information was through healthcare providers (92.5%). Despite the high app use for social interaction, only 13.6% used mHealth apps for disease management. Users were influenced by social media (65.0%) and favored for wellness apps and disease monitoring. Users perceived the mHealth app as useful (97.5%), yet faced challenges over the app initiation, charges and data security. Non-users cited lack of awareness (70.2%), struggled with app startup (22.4%) and preference for conventional healthcare visits (22.0%). In multivariable analysis, longer diabetes duration reduced mHealth app usage (p = 0.046), while multimorbidity increased the likelihood (p = 0.001). Awareness of the availability of health apps significantly influenced the usage of mHealth apps (p
DESIGN: Data from the SEANUTS II cohort were used. Questionnaires, including a COVID-19 questionnaire, were used to study the impact of the pandemic on parents/guardians and their children with respect to work status, household expenditures and children's dietary intake and lifestyle behaviours.
SETTING: Data were collected in Malaysia, Indonesia, Thailand and Vietnam between May 2019 and April 2021.
PARTICIPANTS: In total, 9203 children, aged 0·5-12·9 years, including their parents/guardians.
RESULTS: Children and their families were significantly affected by the pandemic. Although the impact of lockdown measures on children's food intake has been relatively mild in all countries, food security was negatively impacted, especially in Indonesia. Surprisingly, in Malaysia, lockdown resulted in overall healthier dietary patterns with more basic food groups and less discretionary foods. Consumption of milk/dairy products, however, decreased. In the other countries, intake of most food groups did not change much during lockdown for households based on self-reporting. Only in rural Thailand, some marginal decreases in food intakes during lockdown persisted after lockdown. Physical activity of children, monthly household income and job security of the parents/guardians were negatively affected in all countries due to the pandemic.
CONCLUSION: The COVID-19 pandemic has significantly impacted societies in South-East Asia. To counteract negative effects, economic measures should be combined with strategies to promote physical activity and eating nutrient-adequate diets to increase resilience of the population.