This case study illustrates an ongoing therapeutic dilemma which continues to place the patient's welfare at risk. The safety predicament is associated with the transfusion of blood or their products to the correct patient. Predictably, healthcare scholars declare that when clinical practice is ineffective, a “theory-practice gap” is typically responsible. Within this paradigm there is often a gap between theoretical knowledge and its application in clinical practice. Most of the evidence relating to the non-integration of theory and practice makes the premise that environmental factors will influence learning and practice outcomes, hence the "gap". However, it is the author's belief, that to "bridge the gap" between theory and practice an additional component called “Ethics” must be appreciated. This introduces a new concept “theory-practice-ethics gap” which must be considered when reviewing some of the unacceptable appalling outcomes in health care practice
HIV/AIDS is a matter of concern and has become a pandemic disease that threatens the world population. It
has remained one of the priorities in global public health challenges. Caring for people with HIV/AIDS
requires clinical expertise as well as high-quality skills for health care providers. The purpose of the study was
to examine knowledge and attitude on HIV/AIDS patients among nursing students. A cross-sectional study
was conducted in Public University at Wast Cost Malaysia. The 126 respondents of nursing students agreed to
participate in the study using a self-administered questionnaire that was designed and modied after reading
and referring to articles, books, and journals. The results of the research revealed that nursing students, in
general, have a satisfactory knowledge (mean score 30.71), but had a moderate attitude toward HIV/AIDS
patient with total mean score 2.34. Most of the students (89.3%) get the knowledge regarding HIV/AIDS
through the internet. The majority of the students knew that blood transfusion (99.4%) and sharing
needles/syringe (99%) were the higher sources HIV/AIDS modes of transmission. Most of the students agreed
that peoples with HIV/AIDS should be treated in society with support from the community (97.0%). Although
the knowledge level of nursing students seems to be satisfactory, but they still showed the moderate attitude
towards HIV/AIDS patients. Thus, structured education programmes should be conducted by nursing faculty
to ensure that nursing students gain the necessary accurate knowledge and an appropriate attitude towards the
care of HIV/AIDS patients.
This article is a brief personal reflection on the ongoing development of professional education and practice in nursing. The reflection and its narratives are anecdotal and are based on the author's recent experience of teaching and working with fellow nursing lecturers in Malaysia in a nursing faculty within a local University. The author has almost 40 years career in nursing, nurse education and curriculum planning in the United Kingdom before her retirement. The study reflects on the key aspects of nursing and nurse education from her wealth of experiences while in the UK, and also highlights some positive and valuable insights gained from her brief experience in Malaysia. She also provides some reflections of the challenges that lie ahead, specifically, the emphasis on feelings and emotions in nursing, that provide the inspiration to continue with passion, dedication, and determination in our ongoing quest in the pursuit of nursing excellence for all the nurses, in practice and in education. This will hopefully and ultimately lead to a higher standard of nursing care for all patients, and continue the long journey towards the unique professional identity that we have been seeking, and that we can all proudly claim to be our own.
Stroke is the most important cause of death and foremost cause for dysfunction around the globe. As a result increase in the numberof elderly population the incidence of stroke has emerged as an important public health problem. Major developments have taken place in the field of medication for the prevention and treatment of stroke during the past decade. In spite of major interventions proposed by several organizations and the government, the present scenario of the stroke management facilities is still not promising. This article intends to investigate the health care facilities present for the elderly individuals with high risk of strokereoccurrence through proper analysis of the health system in Malaysia. The objectives are to find out evidence-based, reasonably priced and endurable measures to control the recurrences of stroke and to evaluate the outcomes of these interventions. It was noticed that in Malaysia though there many amenities for stroke patients are available but reorganizing and strengthening of few aspects such as human resource by multidisciplinary input is necessary for proper management of senior stroke patients. Moreover monitoring is essential to support patients after discharge from the hospital. The ethical variations among patient with stroke recurrence and the risk factor associated with stroke is not fully understood by healthcare workers. So, this study attempts to guide the stroke patient, their families and the health care workers to prevent stroke recurrence.
Keywords: Stroke, Stroke Interventions, Stroke in Malaysia
In Malaysia, women had breast cancer always reported at their late stage. One of the causes is due to the delay in seeking medical attention. Poor knowledge about the breast cancer is one of the factors that cause the delay. Aim: This study was designed to assess the knowledge on breast cancer symptoms and risk factors, screening method, and practice among participants. Methodology: This was a cross-sectional study done from 1st of March till 15th of March 2016 involving 89 nursing students from School of Nursing Science, Medical Faculty, University Sultan Zainal Abidin (UniSZA). Data analysis was carried out using Statistical Package for the Social Sciences (SPSS) Version 21. Results: Eighty-nine participants responded. Majority of the students (>80.0%) knew the symptoms of breast cancer and common method of screening. Less than 50.0% knew the high risk factor for developing breast carcinoma. Less than 50.0% carried out the breast self-examination. Conclusion: Students had excellent knowledge on symptoms of breast carcinoma and its screening method. Majority (>50%) of the students were still not clear about high risk factors group. Lack of breast self-examination practice among students was noted.
Burnout can be conceptualized in three different aspects consisting of emotional exhaustion, depersonalization and reduced personal accomplishment. It can lead to increment of the turnover rate, absenteeism and low organizational commitment. Stress and job dissatisfaction will lead to psychological distress and burnout. Nurses are one in the health care profession that is susceptible to burnout because they are dealing with patient management and service care delivery. The aim of this study is to determine whether nurses working in Clinical Training Centre (CTC), Faculty of Medicine, University Teknologi MARA (UiTM) are experiencing burnout. A descriptive study design with convenient sampling technique using self-reported questionnaires adapted from Maslach Burnout Inventory (MBI) was conducted involving 120 of nurses in CTC. High levels of burnout were identified in 83.3% of the respondent in the area of depersonalization and 42.5% of the respondent in the area of reduced personal achievement. Marital status was significantly associated with emotional exhaustion (p
Caring behaviours presented by the nurses while providing care is the essence of nursing. However, operation theatre nurses must also adhere to the nursing value in social sciences and humanities to address the patient's needs. The concern of the nurses should not only be for the basic life sustaining needs but also for physiological, psychological, socio cultural and spiritual dimension ofpatient's human responses. The purposes of this study were to determine the perception regarding caring behaviours and the level of caring among the Operation theatre nurses in Hospital Universiti Sains Malaysia. In addition, there were associations when the determination between demographic variables like genders and years of experience of the nurses in relation to their caring behaviours is necessary. It isa quantitative, descriptive survey design and 95 nurses participated in the study. The revised Wolfs Caring Behaviours Inventory was used to measure the dimensions of caring. "Professional knowledge and skill" was identified to be the highest among the five dimensions of caring that was being measured. Findings show that the nurses demonstrated a high level of caring behaviours during their course of work. However, none of the demographic factors studied were significantly associated to their caring behaviours.
Keywords: Caring attitudes, Caring behaviours, Dimensions of caring
The evolution of nursing profession and education has taken its pace over the past years. Therefore, with the changes in nursing education over the years, the level of professional socialization among the students has become an area of interest. The objectives of this pilot study were to explore and compare the level of professional socialization between the diploma and degree nursing students (ﬁrst year and ﬁnal year) using the measuring tool of NPVS-R as well as to identify the demographic variables related to the level of professional socialization among the nursing students. From this pilot study, it was found that there was no signiﬁcant difference in the level of professional socialization between the diploma and degree nursing students (p = 0.133). With regards to the demographic variables related to the level of professional socialization, signiﬁcant difference was found only for the variable of father's educational level (p = 0 .035).
Keywords: Professional Socialization, Diploma and Degree Nursing Students, Nursing Education
Introduction: The effectiveness of teaching and learning process is highly dependent on the methods and
strategies of teaching and learning practices. As a result, nurse educator must choose and use the suitable
method to help the nursing students to achieve the learning objective.
Methodology: There were 218 respondents. This study consisted of two-group quasi experimental study
with pre- and post-test design. The experimental and control groups received education using concept
mapping and lecture method respectively. The data was analyzed using inferential and descriptive statistic.
Results: In the pre-test, students were taught using concept mapping. These students had achievement
mean scores of 11.23, SD=2.59 and post–test was 13.19, SD=1.71 with mean gain scores of 1.96. Students
who were taught using lecture method had an achievement mean scores of 10.71, SD=2.23 in the pre-test
and post-test was 12.60, SD=1.64 with mean gain scores of 1.89. The results showed an increase in grade
achievement, the percentage pass for the experimental group increased from 95.4% in pre-test to 100% in
the post-test. The percentage pass for control group had increased from 93.57% in pre-test increased to
99.08% in the post-test.
Conclusion: Student-centered learning is a teaching method that is active and can change passive to active
learning. Findings from several reviewed studies suggest that using concept mapping can improve
academic performance in nursing education and is a valuable teaching strategy.
Advanced nursing practice involves higher level of knowledge and skills of nurses to perform autonomous practice in clinical settings in order to meet the needs of individuals, families and communities. Advanced practice in nursing is also known as adjusting boundaries for future practice, pioneering and developing new roles of nurses in clinical practice, research and education. Advanced practice of nursing in the developed countries are recognized with different nomenclatures such as advanced nurse practitioner, clinical nurse specialist, specialized nurse practitioner, nurse practitioner, certified nurse practitioner and advanced practice registered nurse. Malaysia is one of the pioneering Asian countries to introduce clinical nurse specialist in hospital settings, which is a stepping stone for the development of advanced nursing practice.
Keywords: Nurses in Malaysia, Clinical Nurse Practitioner, Advanced Nurse Practice
Nurses play a key role in caring for the mentally ill and in rehabilitating them after an episode of illness. The nurses' attitude towards a patient is generally considered to be one of the basic factors contributing to the administration of total therapeutic nursing care. The purpose of this study was to examine whether attitudes towards mental patients improve after psychiatric attachment as well as the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career. The study was conducted on sixty nursing students of fifth semester at the Kolej Kejururawatan Kubang Kerian, Kelantan who are doing their psychiatric postings in Hospital Raja Perempuan Zainab II, Kota Bharu. The sampling technique for this study was convenient sampling. The instrument used for this study surveyed questionnaire developed by Brenda Happell (Happell, 2008). This quasi-experimental study measured changes in students' attitudes and satisfaction with clinical experience following a placement in mental health nursing. The questionnaire was administered to the nursing students on the first and last day of their psychiatric clinical placement session. The findings suggested that clinical experience during psychiatric clinical posting can positively influence attitudes, preparedness for practice and the popularity of mental health nursing. Satisfaction with clinical experience was also high. The findings of this study suggest that clinical postings had positive effects on nursing students' attitudes towards psychiatric patients and confidence in this field of practice.
Study site: Hospital Raja Perempuan Zainab II, Kota Bharu
Background: Hospital medicine is characterized as a multifaceted team-based activity with a necessity for a high level of accuracy, timely, and reliable communication. Effective communication among healthcare providers is the key to successful collaboration within the healthcare system. Effective communication can improve patient safety, job satisfaction, and reduce burn out syndrome among nurses. The purpose of the study was to identify the factors contributing to the competency gap between and doctors in four private hospitals in Malaysia. Method: The study used a descriptive qualitative design to elicit the experience of 15 doctors from three private hospitals. A semi-structured interview was conducted to collect the data. The data were analyzed using Colaizzi's method for thematic data analysis. Results: The findings of the study suggested three main categories as the factors contributing to the communication gap among nurses and doctors as perceived by specialist doctors. The three categories include nurses training attributes, graduate nurse attributes, and work environment attributes. The nurses training attributes include entry requirements for student's recruitment into the nursing program, undergraduate training process, and assessment of student nurses. The graduate nurse's attributes had nine elements. The elements include a post-registration thirst for knowledge, medical English knowledge, self-confidence, stress management skills, critical thinking, and clinical judgment skills, perceived power on the authority of doctors, passion to work, time management skills as well as stress and personal factors of nurses. The working environment attributes included workload of nurses, teamwork among nurses Preceptorship, and appreciation of nurses by the organization. The informants also suggested measures to overcome the competency gaps among nurses. Conclusion: In conclusion, the nurse's communication competency is a vital factor in determining patient safety and quality of care. The quality of nursing care has a significant impact on the image of any health care organization. Therefore, it is crucial to identify the factors contributing to poor communication among nurses and doctors and to initiate interventions to fill the communication gap.
Neonate Resuscitation Program, NRP training is given to nurses in batches. Such programs are vital because neonate resuscitation procedure or aid given to new born during delivery, help them begin breathing on their own, which can save many lives. Although such training is given to the nurses, no assessment has been done on the effectiveness of such training with regard to knowledge retention and transfer of training among the trainees. This study is retrospective in nature; it evaluates the level of knowledge and the conﬁdence in carrying out the neonate resuscitation procedure among 91 nurses involved such training. Besides that, the study ascertains their preparedness before undergoing the training and the opportunities provided to them to practice the skills learnt from the training at their work place. Factors that inﬂuence both their knowledge and skills after the training are also indentiﬁed. Study sample consist of 51 nurses from hospitals and 40 nurses from health clinics. Results show that skills acquired from training as measured by their conﬁdence at carrying out the learnt skill deteriorate faster than knowledge. Level of knowledge retained, conﬁdence at carrying out the neonate resuscitation procedure and opportunities for practicing the skill are all signiﬁcantly higher for the nurses at the hospitals compared to their counterparts in the health clinics at the 95 percent level. The recent trainees (2009) scored higher compared to the old trainees (2007 and 2008) with regard to their preparedness or motivation before the training although memory factor could play a part here. Conﬁdence at carrying out the neonate resuscitation procedure at the work place is a measure of the effectiveness of the NRP training because it constitutes transfer of training. Level of knowledge retained and opportunities for practicing skill at work place after the training, together with trainees' preparedness and motivation before the NRP training, all three contribute 35.7% towards trainees' conﬁdence in carrying out the NRP procedure at their work place. Contribution of these three variables is signiﬁcant at the 95% level or p< 0.05. Findings are consistent with the Model of factors that affect Learning Outcomes and Transfer of Training by Goldstein and Ford (2002).
Keywords: NEONATE RESUSCITATION
Psychological well-being is relatively complex notions with a variety of components that may contribute to it. Individuals differ in their overall levels of psychological health and well-being. Mother with low birth weight (LBW) babies required hospitalization especially in the Neonatal Intensive Care Unit (NICU) more exposed to the experience of anxious symptoms. Therefore, it would become a stressful event that might cause psychological distress or even emotional crisis in mother's when their infants were LBW especially premature. Health promotion is very important to prevent this problem. Health promotion efforts aimed at improving infant health status must do so by improving women's health. Improving women's health before, during, and after pregnancy is the key to reduce the human and economic costs associated with infant mortality and morbidity. To improve both women's and infants' health, efforts should include an emphasis on preventive health care services, family-oriented work site options, changes in social norms, and individual behavior modification. Therefore, it is important for health care professionals in NICU to be able to assess the factors associated psychological well-being of mother's with LBWinfant.
Introduction: Birth weight is the single most important factor which determines infant morbidity and
mortality. Birth weight of the newborn is believed to be influenced by several factors. Therefore, it is
important to understand the possible factors that influence birth weight.
Methodology: The respondents were 230 postnatal mothers who participated in this study. A selfadministered
questionnaire was used for interviewing the postnatal mothers. One Way Analysis of
Variance (ANOVA), Chi-square tests and the independent t-test were used. Statistically significant data
were those that had a p- value < 0.05.
Results: The mean birth weight was 3080.02±400.61g. The incidence of low birth weight (LBW) was
12.6%. By using One-Way ANOVAtest, the factors that were found to be significantly associated with birth
This quantitative-oriented research was conducted to identify factors that contributed to errors in dispensing medication among nurses and to understand why nurses did not report their errors in dispensing. In this study a total of 284 U29 nurses participated in focusing on factors contributing to medication errors and failure to report the errors. In this study, analysis of the data collected was made in two sections; dispensing errors and failure to report the errors in giving medication. According to Evans et al. (2006) although nurses may not admit directly to such errors, they expressed their perceptions towards situations described in the questionnaire items as contributing to medication errors among nurses. Almost all in the sample of 284 chose not to report medication errors because they could not identify the cause of dispensing errors; other nurses perceived that the individual involved is not competent in performing the task. Other reasons include fear that the action will be exposed by the management, to avoid publicity from the media, and there is no difference in reporting or not reporting the medication errors. This study was done not only for exploring factors of medication errors; it also aspires to identify problems that arise in hospital services and in order to maintain the quality of health care. The management should consider the impact of medication errors and failure to report medication errors on the nursing profession and quality image of the hospital.
Dengue incidence has grown dramatically in recent decades and become a global incidence especially in the
urban area. Ministry of Health (MOH) Malaysia reported that the number of dengue cases since January
2014 until June 2014 was 38. 411 cases which was higher compared to the number reported in year 2013 (10,
910 cases). The objective of the study was to determine the knowledge and preventive practices of dengue
among residents in Flat Pandan Indah, Ampang Selangor. A cross sectional study design with convenience
sampling method was adopted in this study. A total of 298 respondents living in Flat Pandan Indah were
recruited based on the inclusion criteria. A validated questionnaire that measures knowledge and preventive
practices of dengue was completed by respondents. More than half of the respondents had scored 61.7%
with good knowledge regarding dengue. However, 50.3% of the respondents had a limited extent of dengue
practice. Almost all of the respondents (95.6%) reported that television or radio as the main source for
information on dengue. The common preventive measures used by the respondents were cleaning the
house (n=148, 49.7%), eliminating standing water around the house (n=123, 41.3%) and covering water
containers in the home (n=120, 40.a3%). There was no correlation between dengue knowledge and
preventive practice score (p = 0.109). The study revealed that majority of the respondents had good
knowledge regarding dengue but the practices to prevent dengue are poor. Thus, health education program
focusing on dengue prevention practices should be done on the community members in the future.
Background: Having multiple kinds of health problems among metabolic syndrome patients may cause
them stress. Life events also may worsen their stress. Negative stress affects not only their physical but also
emotional health. Various coping styles are used in order to deal with their stress. However, not all coping
styles can overcome their stress.
Objectives: This study aims to explore the coping styles that have been employed by the stressed metabolic
syndrome patients in Hospital Universiti Sains Malaysia, Malaysia.
Method: Semi-structured interviews were conducted with the stressed metabolic syndrome patients in
Hospital Universiti Sains Malaysia. A purposive sampling was selected among stressed respondents, as
fifteen of them participated in this study after saturation data was reached. The qualitative data was analysed
using content analysis and was categorized into dysfunctional, problem-focused and emotion-focused
Results: The themes that emerged were; self-distraction, venting, behavioural disengagement, denial and
self-blame. These were categorized as dysfunctional coping; acceptance, religion and emotional support as
emotion-focused coping and active coping and instrumental support which were categorized as problemfocused
coping. Other new coping styles identified were physical intervention, avoidance and emotion
Conclusion: Coping styles has direct influence on the feeling of stress. Stressed patients used many
dysfunctional coping styles rather than other categories of coping which lead them to remain in stress. These
data highlighted the need to educate patients about good coping styles to give them additional skills in
managing their stress thus improving their health.
Background: Consistent with other countries, Malaysia suffers from a shortage of nursing faculty. In several studies it has been seen that job satisfaction has been shown to contribute to retention of nurse educators. The majority of these studies are from developed countries and were conducted over ten years ago. As a result these findings may not be relevant to contemporary Malaysia. So, the purpose of this study was to investigate the levels of job satisfaction among nurse lecturers in Malaysia.
Methods: A total of 20 nursing colleges throughout Malaysia were selected for random sampling, of which 30% agreed to participate. The Minnesota Satisfaction Questionnaire with additional demographic and organizational characteristics questions was used to collect the data. Descriptive statistics was used to examine differences in job satisfaction between demographic and organizational variables. Spearman’s rho was used to test the relationship between each of the demographic / organizational characteristics and overall job satisfaction.
Results: A total of 73 nurse lecturers (73% response rate) returned the completed questionnaire. The findings indicated only a moderate level of job satisfaction. There were no significant correlations between demographic or organizational variables and overall job satisfaction levels with the exception of the number of students (p = 0.017).
Conclusions: An understanding of the factors affecting job satisfaction among nursing faculty could enhance retention and recruitment in this profession. Further research using a combination of quantitative and qualitative approaches is recommended to provide an in-depth understanding of nursing lecturers’ perceptions of job satisfaction.
Keywords: Nurse Job Satisfaction, Nurse Lecturers, Nurse Job
Diabetes Mellitus has become one of the major and rising diseases affecting population all around the world. The most common complication that rises from the Diabetes Mellitus is diabetic foot ulcer. The increasing rate in diabetic foot ulcer among elderly has become a challenge that continues to rise and worsen. This study is conducted to determine the knowledge and practice of foot care and also the relationship between socio demographic data with knowledge of foot care among diabetic elderly in UKM Medical Centre (UKMMC). This is a quantitative cross-sectional descriptive study. A total of 81 respondents are being participated in this study. More than half of the study participants are female and majority of them are 60-74 years old. The result showed a significant relationship between gender and marital status with the knowledge of foot care among elderly diabetic patient in UKMMC. The present study showed that there was no significantly relationship between age, occupation, monthly income, duration of diabetes, body image and level of education with the knowledge and the level of foot care. In conclusion, the result of this study will help the health organization, hospital, nurses and care giver to take more responsibilities of foot care for diabetic elderly individuals.
Study site: Elderly patients from orthopaedicf emale or male ward, surgical ward, medical ward, orthopaedic clinic and medical clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia