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.
Low back pain is a common occupational health issue especially among nurses that leads to suffering, disability and days of work lost that affect the continuity and quality of patients care. This study aims to determine prevalence of low back pain among registered nurse at Surgical Unit in RPZ II Hospital and identify the associated factors. It is a cross-sectional study that used a self-administered questionnaire to collect the data among a convenience sample of 60 nurses. Data was analyzed using Pearson Chi-Square. Majority of them were aged 31 to 40 years (53.3%), Malays (91.5%), married (84.6%), had working experience from 11 to 15 years (50.8%), had formal manual handling training (64.9%) and are overweight(58.3%). The prevalence of low back pain was 63.8%. The study revealed statistical significance for race (p=0.002), number of patients they have to handle (p=0.005), satisfaction with working environment (p=0.007) and emotional and social problems (p=0.007, p=0.038, respectively).
Sociocultural contexts of motherhood have been found to have a link with postnatal depression. Malaysia has a wide-range of cultural and ethnic backgrounds that offers a wonderful chance to understand the different role of cultures and postnatal practices in relation to postnatal depression. The purpose of this paper is to discuss the link between the Malaysian healthcare system, social and cultural context, the existing health policy and postnatal depression. This paper highlights that while there are different levels of nurses who work collaboratively to manage pregnant and postnatal mothers in the maternal and child health clinic, the focus of their care is more on physical health. The international guidelines for diagnosing PND were not commonly used within the clinics, although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has been widely used within psychiatric setting in Malaysia. There is no formal mechanism or assessment to detect PND in the clinics. There were no guidelines found that specifically focused on the management of PND. It is questionable whether the current approaches to promote and manage maternal mental health in Malaysia have a sense of cultural-based strategies. These significant gaps call for empirical evidence that explicitly focussed on the experiences and perceptions of PND in Malaysia.
Effective and skilful communication is crucial and an important element in the quality of nursing care. This enables nurses to assess patients' needs and provide them with the appropriate physical care, emotional support, knowledge transfer and exchange of information. However, nurses find it difficult to communicate effectively and therapeutically with their patients. Aim: To identify the nurses' and adult inpatients' perceptions of barriers to effective nurse-patient communication. Methodology: A descriptive study was used to collect data from nurses (n=40) and adult inpatient (n=63) in multidisciplinary wards in a private hospital in Malaysia. Two sets of self-administered questionnaire for the two different groups of participants, the patients and nurses were used. Data were analysed using the SPSS version 20.0. Results: Nurses and adult in patient perceived heavy workload, dialect and negative attitudes towards nurses as main barriers that hinders effective communication among nurses and patients. Conclusion: Communication places an important part in patients' satisfaction of care and the ability of the nurse to provided patient centred care. Nurses should take in to account those communication barriers that affect the patients and be confident enough to take the first step to initiate communication and be able to handle patients' dynamic emotions.
Diabetes is a chronic complicated disease. For that reason, self-care management and education are necessary to control blood glucose levels to decrease mortality and morbidity rate, the risk of complications and adverse medication related events. Lack of knowledge about a diabetic medication and non-adherence contribute to poor glycemic control among diabetes patients. Therefore, this study aims to assess relationship between medication knowledge and medication adherence among T2DM. A cross sectional study was carried out in outpatient's diabetic clinic in University Malaya Medical Centre via recruiting 250 participants. A set of questionnaires from earlier research were used to collect the data. Descriptive and inferential statistical analysis is used to analyze the data. The inclusive results indicated that, the mean age of the participants was 57.90 ±13.22 within 56years. More than half of patients (52.5%) had poor medication knowledge, and 47.5% had good knowledge. In terms of medication adherence, most of the participants (87.0%) had medium medication adherence; whereas, only 1.3% showed high medication adherence. However, there was no correlation between medication knowledge and medication adherence (p=0.743). The chi-square results indicated that medication knowledge was associated significantly with gender, educational level, employment status and monthly income (p value < 0.05). In conclusion it can be said that this study provides insight for healthcare professional about medication knowledge and adherence which are important for managing diabetes. Awareness of these factors will allow them to be more effective about medication counseling so that patients can become self-responsible and realize the benefits of prescribed therapies.
Study site: Diabetic Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Introduction: Students learn in many ways. Some students are visual learners, while others are auditory or kinesthetic learners. The purpose of the study is to identify the learning style of the students and factors that influence their learning styles. Methods: This is a descriptive study with cross-sectional design. Convenient sampling was used. In this study, a total of 51 nursing students were involved. A set of questionnaires using VARK (Visual; Auditory; Read/Write; Kinesthetic) inventory was used. Descriptive statistics and Chi-square test were use. Results: The learning styles of the respondents were mostly kinesthetic learning style and auditory learning styles which is 14(27.5%) for both, ten respondent had combinations of various styles, seven respondents had read write learning style and six respondent had visual learning style which is 13.7% and 11.8% respectively. Chi-square test shows that there was significant difference between learning style and respondents' demographic factors of previous school and number of siblings, where p-value 0.05). Conclusion: In order to achieve the goal of student learning it is important to use a combination of teaching methods and to make the classroom environment as stimulating and interactive as possible
LBW infants are at risk not only due to neonatal complications but also by other risk factors (eg. congenital anomalies associated with LBW). This research is motivated by the high incidence of LBW in Tasikmalaya City Hospital each year. The purpose of the study was to determine the relationship between demographic factors in this case the mother's age, maternal education level, socio-economic level with the incidence of LBW. The research hypothesis has a relationship between maternal age, maternal education level, socioeconomic level, pregnancy with LBW incidence. The benefits of research provide a basis for evidencebased practice to nursing practitioners, that there is a relationship between demographic factors (maternal age, education level and socioeconomic level) with the incidence of LBW. Quantitative research method was used with cross sectional approach. The data was processed using univariate and bivariate analysis. The results of the study show no significant relationship between the factors of maternal age, education level, socioeconomic level with the incidence of LBW in Tasikmalaya City Hospital with p value > 0.05 for all variables. From the present study it is suggested that nurses should improve health education so that people can understand better about the risk of LBW.
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
Pain is a sensation that is difficult to remember. Pain exposure is a stimulus that can damage the development of the baby's brain and contribute to learning disorders and behavior in childhood. Therefore nursing intervention is needed that can reduce the pain response in infants, especially during hospital treatment. The aim of the study was to determine the effect of non-nutritive sucking (NNS) and ASI (Air Susu Ibu or Breast Milk) on oral responses to acute pain in the neonate when invasive actions were performed. The benefits of research as evidence-based practiced about administering NNS and ASI orally to pain responses in neonates when experiencing pain. The research design uses experimental nonequivalent control group before and after design. The population of all neonates admitted to Dr. Soekardjo Tasikmalaya, with a total sample of 30 respondents consisting of 15 ASI respondents and 15 respondents for the NNS group. Pain assessments instruments CRIES (Crying, Requiring an increase in oxygen, Increased vital sign, Expression, Sleeplessness) was applied. Data analysis used non parametric tests Mann Whitney and Wilcoxon. The results of the study showed no significant differences in pain response before and after the intervention (p-value 0.236). It was suggested that nurses can improve health education for parents to be able to provide breastfeeding during treatment, especially when the baby receives invasive action
Purpose:The aim of this study was to investigate the relationship between workplace mindfulness, cognition, emotion, behaviour and psychology on job performance. In addition, age was tested as the moderating factor on the relationship between workplace mindfulness, cognition, emotion, behaviour and psychology on job performance. Method: The research was conducted on nurses working in Malaysian government hospitals among 127 respondents were chosen. Data was collected from the respondents using a structured questionnaire. The data were analysed with factor analysis, reliability test and multiple regression analysis. Results: Results indicated that only workplace mindfulness, cognition and behaviour had a positive significant influence on job performance. Age moderated the relationship between the cognition, behaviour and psychology positively and significantly on job performance. Contribution: The Malaysian government hospital management is suggested to focus on these three factors in order to overcome job performance issue among nurses.
Background: Mentoring of new staff nurses is frequently performed. Internationally researches have reported that this exercise helped the new staff to retain information better, adopt a professional conduct, and be more satisfied with their jobs. Mentoring programmes are usually conducted to encourage cooperation as well as socialisation among the new registered nurses (RNs) in specific units or organisations. Aim: This research aims to evaluate the outcome of mentorship programs based on six specific criteria and nurses' willingness to stay in the profession in hospital settings. Method: A comparative cross-sectional study designed via convenience sampling was conducted in nine hospitals using the self-administered mentorship for nurses (MNMSN) questionnaire. Findings:Atotal of 593 respondents were recruited, mostly female (87.6%), under 25 years old (84.7%), from Malay (71%) and highest nursing education of diploma level (99.2%). The predisposing factors that influence performance for pre- and post-program are 'patients assessment' (mean=4.763, S.D=0.52 and mean=4.733, S.D=0.536); 'clinical decision' (mean=4.722, S.D=0.527 and mean=4.73, S.D=0.54); 'cultural competencies' (mean=4.42, S.D=0.443 as well as mean=4.354, S.D=0.442); and 'professionalism' (mean=4.764, S.D=0.533 and mean=4.698, S.D=0.563) respectively. Each predisposing factor showed a significant correlation (strong and moderately positive). Overall result for 'willingness to stay' is significant [F, (5,585)=556.308, p
Background: Working in the healthcare industry has its effects on the female workers fecundity. Disorders of reproduction is listed as one of the top ten leading work-related diseases and injuries. The objective of this study is to observe the occurrences of adverse pregnancy outcomes among female healthcare workers in relation to their work schedules and identify the most frequent adverse pregnancy outcome. Methods: A cross-sectional study was carried out obtaining pregnancy history and work schedule in the past three years. In the present study 469 respondents were obtained; 339 healthcare and 130 non-healthcare workers reporting a total of 564 pregnancies. Results: In this study, adverse pregnancy outcomes among female healthcare workers is significantly higher than non-healthcare workers. There is no significant findings between healthcare and non-healthcare workers with respect to the types of adverse pregnancy outcomes and the work schedule. However, from the respondents' lifetime pregnancy outcome, it is found that complete miscarriage occurred most frequently at 26.7% and among healthcare workers who work on shift. Conclusion: Healthcare workers carry a higher risk to experience adverse pregnancy outcome with complete miscarriage being the most common and most of these experiences occurs among those who work on shift/on-call.
Introduction: Ministry of Health (MOH) Malaysia colleges, offer diploma and advanced diploma programmes for nursing, assistant medical officer and other allied health personnel. As academic institutions, the trainers are encouraged to participate and enhance the colleges' research productivity. The aim of this study is to explore the perceived barriers and motivation factors for research in MOH colleges. Method: Aqualitative research design was conducted among MOH colleges trainers. Semi structured questions were used in 11 Focus Group Discussion (FGD) and 13 In-Depth Interview (IDI) among 98 respondents from seven MOH colleges. Thematic analysis was used to identify emerging themes from the interviews. Results: Three institutional factors motivate engagement in research: key performance indicator, research support and research skills. Majority of respondents were aware of the importance of research, but their research productivity is low due to perceived barriers related to human resource, research material, technical and funding support. Conclusion: The findings are useful in understanding research motivation as well as ascertain barriers that can be overcome through better support and recognition. Such understanding will help improve the policy for research across the colleges.
Introduction: Critical thinking is an important element in nursing practice as well as being a vital educational outcome in any nursing curriculum. Critical thinking can influence the outcome of patient care and patient satisfaction. Objective: To determine the level of critical thinking ability among nursing students in two nursing colleges and its differences according to social demographic variables. Method: This was a cross sectional descriptive study design in which Critical Ability Scale for College Students were used to collect data from 158 nursing students in two private nursing colleges in Malaysia. Participants were recruited through convenience sampling. Results: The mean overall score for critical thinking ability was 70.6±6.98 with scores ranging from 56 to 89. The mean score of the subscales was 3.63±0.50 for intellectual, eagerness and health skepticism abilities, 3.63±0.42 for intellectual honesty ability, 3.61± 0.41 for prudence ability and 2.68±0.64 for objectivity ability. There are no significant differences between the independent variables and level of critical thinking ability. Conclusion: A high critical thinking ability score was reported with intellectual, eagerness and health skepticism being the highest subscale. The way forward requires academicians and clinicians to work together to ensure a transfer of knowledge and skills from the classroom to the clinical environment in order to develop and enhance the ability to think critically in making clinical decision and produce thinking nurses for the future.
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.
This paper aims to review the literature with regards to the family caregivers of severe traumatic brain injury survivors and their needs for care at home. The search started by finding the relevant keywords from EBSCOhost: MeSH database. There were many related studies found by searching the following multiple databases. They are from Evidence Based Medicine (EBM) reviews @ Ovid, Journal @ Ovid Full text, Medline with Full text via EBSCOhost, CINAHL Plus with Full Text, Science Direct, and Google scholars' articles. The search terms were limited to publications ranging from 2010 to 2016. Several points were highlighted regarding the needs of family caregivers who had been taking care of traumatic brain injury survivors. It also provided information on the needs of family caregivers in terms of care, traumatic brain injury, TBI survivor complications, family caregiver's burden, caregiver challenges and the impact of traumatic brain injury to family caregiver's quality of life. Overall, the study shows that family caregivers face significant challenges toward care of TBI survivors. The review highlighted the support needed from the family caregivers, and other important facts about severe traumatic brain injury in order to understand the condition. Further research should focus on rehabilitation efforts on traumatic brain injury survivors.
The production of Z bosons associated with jets is measured in pp collisions at s=13TeV with data recorded with the CMS experiment at the LHC corresponding to an integrated luminosity of 36.3fb-1. The multiplicity of jets with transverse momentum pT>30GeV is measured for different regions of the Z boson's pT(Z), from lower than 10GeV to higher than 100GeV. The azimuthal correlation Δϕ between the Z boson and the leading jet, as well as the correlations between the two leading jets are measured in three regions of pT(Z). The measurements are compared with several predictions at leading and next-to-leading orders, interfaced with parton showers. Predictions based on transverse-momentum dependent parton distributions and corresponding parton showers give a good description of the measurement in the regions where multiple parton interactions and higher jet multiplicities are not important. The effects of multiple parton interactions are shown to be important to correctly describe the measured spectra in the low pT(Z) regions.
A search for decays to invisible particles of Higgs bosons produced in association with a top-antitop quark pair or a vector boson, which both decay to a fully hadronic final state, has been performed using proton-proton collision data collected at s=13TeV by the CMS experiment at the LHC, corresponding to an integrated luminosity of 138fb-1. The 95% confidence level upper limit set on the branching fraction of the 125GeV Higgs boson to invisible particles, B(H→inv), is 0.54 (0.39 expected), assuming standard model production cross sections. The results of this analysis are combined with previous B(H→inv) searches carried out at s=7, 8, and 13TeV in complementary production modes. The combined upper limit at 95% confidence level on B(H→inv) is 0.15 (0.08 expected).
The mass of the top quark is measured in 36.3fb-1 of LHC proton-proton collision data collected with the CMS detector at s=13TeV. The measurement uses a sample of top quark pair candidate events containing one isolated electron or muon and at least four jets in the final state. For each event, the mass is reconstructed from a kinematic fit of the decay products to a top quark pair hypothesis. A profile likelihood method is applied using up to four observables per event to extract the top quark mass. The top quark mass is measured to be 171.77±0.37GeV. This approach significantly improves the precision over previous measurements.