Patient's satisfaction has become increasingly important as patients evaluate healthcare services for both medical cost and quality. The purpose of this study was to measure the prevalence and the factors influencing caregivers' satisfaction. A cross sectional study of 262 respondents using universal sampling method was conducted at the paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Overall, 90.5% were satisfied with the services provided. Satisfaction rates based on various healthcare delivery domains were: 95.0% for communication skills, 88.5% for interpersonal aspect, 83.6% for technical quality, 82.1% for financial aspect, 72.9% for time spent with doctors and 64.9% for ease of contact. This study shows that the caregivers (an unpaid person who helps a person cope with disease) were highly satisfied with the communicational aspect delivered by the clinic. However, there is still room for improvement on ease of contact domain and waiting time in order to produce high quality service.
Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
A cross-sectional study on organizational factors that influences job stress was carried out among Medical Laboratory Technologists (MLT) in Klang Valley's Hospitals. There were three organizational factors that were measured, interpersonal factor, job condition and career development. A total of 249 respondents participated in this study, 126 were from the private hospitals and 123 from the government hospitals. The prevalence of stress was found higher in the private hospitals with the percentage of 16.7% compared to the government hospitals of 15.4%. All three organizational factors were significantly associated with job stress (interpersonal factor p <0.001, job condition p<0.001 and career development p < 0.001). Management team in hospitals as well as the laboratory managers should introduce stress prevention programmes to assist MLTs in stress management.
Physical activity is the first line approach and one of the main factors in preventing chronic diseases. Currently there is the increasing percentage of sedentary life style or lack of exercise among adolescents. The main objectives of the study were to determine the prevalence of inactivity and the factors influencing physical activity in adolescents. A cross sectional study was carried out among secondary school students aged 14 and 16 in Petaling District, Selangor, Malaysia. A total of 519 respondents participated in this study. Their physical activity level was measured using the International Physical Activity Questionnaire (IPAQ). The active group was classified as those having levels of equal or more than 600 met-min per week while less than 600 met-min per week was considered inactive. Response rate in this study was 95.4%. The prevalence of inactive in adolescents was 20.8%. Female adolescents, non-working mother, time constraint, exercise only when having ample time and stretching before exercise are predictor factors for being inactive among adolescents. Steps need to be taken to persistently ensure that the physical activity among adolescents be increased continuously.
Extracorporeal shockwave lithotripsy (ESWL) and ureteroscopy (URS) are two main methods of treating proximal ureteric stones. Success rates and cost-effectiveness of the two methods were compared. A total of 67 patients who underwent treatment between January 2007 and July 2007 at a state general hospital were included in the study. The success rate for ESWL group was 81.8% and for URS group was 84.6%. ESWL technique produced a significant higher overall cost per patient than URS (RM930.02 versus RM621.95 respectively). There was no significant difference in quality of patient's life. Cost-effectiveness ratio was lower for URS. The analysis suggested that URS was more cost-effective than ESWL.
Psoriasis imposes a great economic burden as a result of higher expenditures for different interventions, diagnostic procedures, pharmaceuticals and loss of productivity. Less is known about the economic impact of psoriasis treatment in Asean region. The aim of this research was to calculate the costs associated with four psoriasis treatment modalities. A prospective cohort study was conducted in five hospitals involving 91 moderate to severe psoriasis patients. Costs were calculated from the societal perspective using the principle of Step Down and Activity Based Costing (ABC) within a six (6) months follow-up duration. The components of the costs borne by the provider were inpatient cost, cost of medication, laboratory investigation and radiology. Patient’s cost included out of pocket expenses, travelling cost and loss of productivity. Cost per patient per day was RM1,105.24 (inpatient) (US$315.94) and RM298.02 (outpatient) (US$85.19). Medication accounted for almost 90% (RM457,014.00) (US$130 638.45) of the total provider cost. Meanwhile, loss of productivity represented 84% (RM167,439.00) (US$47,862.80) of the total patient’s cost. Biologic treatment exhibited the highest cost which was RM342,377.00 (US$97,869.21), followed by systemic treatment (RM105,607.00) (US$30,187.99), topical treatment (RM38,280.00) (US$10,942.42) and topical phototherapy treatment (RM21,824.00) (US$6,238.44). Understanding the relationship between direct and indirect costs from both perspectives is important to accurately identify and evaluate effective treatment for psoriasis.
Penyakit lemah jantung merupakan antara lima punca utama kematian penyakit kronik tidak berjangkit berdasarkan rujukan World Health Organization. Sekitar 20% pesakit kegagalan jantung di seluruh dunia memasuki wad semula dalam jangka masa 30 hari selepas discaj. Hal ini demikian biasanya akibat daripada tidak mematuhi penyekatan sukatan air diminum atau pun perkembangan penyakit. Kajian ini bertujuan untuk mengenalpasti kadar masuk wad dalam 30 hari selepas discaj daripada kegagalan jantung dan faktor berkaitan di Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) pada tahun 2016-2017 dengan menggunakan data casemix. Berdasarkan data kod, perbelanjaan digunakan untuk masuk wad semula dalam 30 hari diambilkira. Kadar masuk wad untuk kegagalan jantung dalam 30 hari selepas discaj bagi punca yang sama adalah 53.5% dan 43.5% bagi tahun 2016 dan 2017, sama kadar dengan hospital mengajar yang lain tetapi lebih tinggi daripada kadar di negara maju. Selepas diselaraskan, hanya faktor umur pesakit dan tahap keterukan penyakit menunjukkan kaitan yang bermakna dengan kemasukan wad dalam 30 hari selepas discaj bagi kegagalan jantung. Jangka masa berada dalam wad dan perbelanjaan untuk kemasukkan wad adalah lebih rendah daripada yang sepatutnya dicapai. Sebanyak RM80,329.73 telah dijimatkan pada tahun 2017 atas rawatan yang pantas dan rancangan penjagaan yang komprehensif diberi kepada 19.3% pesakit gagal jantung tahap keterukan tiga. Penurunan kadar kemasukan wad semula dalam 30 hari selepas discaj juga menjimatkan kos pesakit dan menunjukkan penjagaan klinikal yang mantap dan strategi rawatan yang rapi. Kajian casemix ini boleh digunakan sebagai rujukan untuk penentuan bajet bagi unit kardiologi di PPUKM.
Penilaian anestetik pra-operasi adalah penting semasa penjagaan perioperatif. Matlamat utama kajian ini adalah untuk menilai tahap kepuasaan pesakit dan faktor-faktor yang mempengaruhi kepuasaan pesakit terhadap klinik pra-anestetik. Sejumlah 304 orang pesakit yang menghadiri klinik pra-anestetik telah terlibat dalam kajian ini. Kajian kepuasaan selidik dwibahasa (Bahasa Inggeris dan Bahasa Melayu) dengan berjumlah 18 soalan menguji faktor-faktor bukan penyedia (kemudahan klinik, kesesuaian masa menunggu) dan faktor-faktor penyedia (perkhidmatan doktor, pegawai kaunter, jururawat dan kakitangan sokongan) telah dikaji. Kajian kepuasaan selidik menggunakan format skala Likert lima mata skor sangat setuju/tidak setuju telah digunakan untuk menilai tahap kepuasaan pesakit. Secara keseluruhan, peratusan kepuasaan pesakit terhadap penilaian pra-anestetik dilaporkan sebagai 98.7% dengan skor purata untuk perkhidmatan doktor (4.49 + 0.60), pegawai kaunter (4.48 + 0.61), kakitangan sokongan (4.47 + 0.62), kemudahan klinik dan kesesuaian masa menunggu (4.40 + 0.62). Semua faktor-faktor yang dikaji menunjukkan hubungan yang signifikan (p
Job satisfaction level of workers is among the important factors influencing the performance and productivity of an organization. A cross sectional study was conducted among Public Health Specialists in the Ministry of Health of Malaysia to identify their job satisfaction level and the factors influencing it. The respondents are from the Association of Public Health Specialists of Malaysia. A working in Ministry of Health. Focus group discussions were conducted in four states to develop a relevant and comprehensive questionnaire. Survey questionnaires were then mailed to the respondents. The response rate was 7 2.3%. In measuring the job satisfaction level seven aspects were studied. The study showed that ‘job and workload` is the main contributor to job dissatisfaction followed by ’management and policy aspect’, 'salary and remuneration: aspect’ and resources and facilities aspect. Most of the respondents (94.0%) were dissatisfied with their job. Gender and income were the predictors of general job satisfaction. As a conclusion, the management, policy and remuneration shouM be revised in order to overcome the problems identified and subsequently increase job satisfaction levels among Public Health Specialists in the Ministry of Health, Malaysia.
Employee motivation affects productivity and need to be channeled towards the accomplishment of organizational goals. A cross sectional study was conducted among Public Health Specialists (PHS) in the Ministry of Health Malaysia to study their motivation level and the factors influencing this. The respondents were from the Association of Public Health Specialists of Malaysia working in the Ministry of Health. Quantitative Technique self-administered questionnaires were used in this study and the questionnaires were mailed to the respondents. The response rate for this study was 72.3%. In measuring the motivation level, five (5) aspects were studied. The social aspect, self -achievement aspect and autonomy aspect were found to be the main aspects that motivated the respondents. With regard to motivation level, 55.8 % respondents had low motivation level. In order to improve the motivation level among PHS, the aspect of self actualization and autonomy required serious attention. In the future, PHS are expected to play a major role in controlling, promoting, preventing, maintaining, restoring and solving problems in order to enhance the health of the Malaysian population.
The physiotherapy services have played major roles as a part of rehabilitation components and emerging in most hospitals throughout Malaysia as well as internationally. As such, there is still a lack of scientific research and reporting about the finding of service quality studies in physiotherapy services at teaching hospitals settings in Malaysia. This study was to assess the level of patients' satisfaction and its contributing factors as well as to assess the quality of physiotherapy services at teaching hospitals in Klang Valley. The cross sectional study was conducted from March until July 2011 among outpatients (311 patients) who has been referred to the Physiotherapy Clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Universiti Malaya Medical Centre (UMMC) in Klang Valley. Patients were recruited using simple random sampling technique and data were collected by using the validated self-administered Service Quality (SERVQUAL) Questionnaire. About 62.4% respondents in teaching hospitals have met their expectation. ‘Assurance’ showed the highest satisfaction score and ‘Caring Services’ showed the lowest satisfaction score among the entire dimension studied. The factors which significantly influence patient satisfaction include age, education status, working status and number of visit. There are relationships between patient satisfaction with SERVQUAL, Outcome and Corporate Culture components. However, the predictors contributed for overall patient satisfaction at Physiotherapy Clinics at teaching hospitals was not influenced by factors studied (p>0.05). The levels of satisfaction that met patients’ expectation is ‘Moderate’ for teaching hospitals and the ‘Caring Services’ should be focus in order to improve the level of patient satisfaction.
Study site: Physiotherapy department, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and University Malaya Medical Centre (UMMC)
Despite the debates of the benefits of continuing mammography screening among elderly women, studies in Malaysia have shown that the prevalence of breast examination declines after age 45 years and for mammogram per se, the prevalence of examination increases until age of 64. This study aims to determine the prevalence of mammogram screening among elderly women in Hulu Langat, Selangor and its relationship with factors such as demographic factors, family history of breast cancer, perceived health status, perceived general psychological factor and lifestyle factors. Data used were from a cross sectional study of health status among community in Hulu Langat area by the Department of Community Health, Universiti Kebangsaan Malaysia carried out from the year 1998 till 2002. However this paper focused on the database involving elderly women age 60 and above. The sample population was 652. The mean (standard deviation) age was 67.17 (5.995). Only 8.3% of the elderly women claimed to ever had mammogram screening done. Hence, the prevalence of mammogram screening is still low among elderly women in Hulu Langat. Having family history of breast cancer (p < 0.001) and perceived positive psychological status (p=0.003) had shown significant associations with mammogram screening among them. It is therefore important for researcher to further look into the reasons behind this and qualitative exploration is highly recommended.
Obesity is a major health concern and the growing rate raises important issues specific to concurrent rise of the related diseases especially hypertension. This study aimed to determine the relationship between hypertension and obesity based on body mass index and waist circumference besides relevant sociodemographic factors according to gender specific analysis. The analysis is important to determine in depth insight of two genders. This cross-sectional study was conducted among community in Tanjung Karang, Selangor, Malaysia in 2009 and included a total of 439 male and 668 female respondents aged 18-59 years old. Data was collected by interview-guided questionnaire and anthropometric measurements. SPSS version 21.0 was used for analysis of the relationship between socio demographic factors, smoking, body mass index and waist circumference with hypertension. Finally logistic regression analysis was used to assess the predictors of hypertension according to gender. The prevalence of hypertension was 25.5% in males and 23.1% in females, giving a total of 24%. Significantly higher prevalence of hypertension was found in overweight and obese categories (42.2% and 60.5% in males; 39.5% and 48.9% in females). Those with abdominal obesity also had significantly greater risk in having hypertension (41.6% in males and 33.2% in females). The logistic regression analysis indicated that age, high BMI and abdominal obesity were significantly associated with hypertension in women, and on the other hand age and BMI only for men. Both obesity and abdominal obesity are significantly important predictors of hypertension in females but BMI obesity only in males. Effective weight management strategies targeting obese people and abdominally obese women should be implemented in order to prevent hypertension and related cardiovascular diseases.
Globally, the health of the indigenous people is lagging behind as compared to the mainstream population in countries in which they live. Despite improved overall prosperity and population longevity, social and health inequalities seem to persist in this underprivileged community. Failure in delivering effective health promotion toward the indigenous community is determined by a range of factors. This includes the absence of culturally sensitive awareness among the healthcare workers, ineffective communication of the healthcare providers, poor access to health service, lack of culturally specific health promotional materials, lack of involvement by indigenous healthcare workers, lack of community based programs and inefficiency of indigenous health data collection. Effective interventions for indigenous health require a trans-disciplinary and holistic approach that incorporates indigenous health beliefs and engages with the social and cultural drivers of health.Such culturally congruent health promotion strategies are hoped to narrow down the existing wide gap of health outcomes that contribute to inequalities between indigenous communities and the mainstream population.
The Universal Declaration of Human Rights, 1948 stated that everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international cooperation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality. Equity, solidarity and social justice are understood as basic characteristics of universal access to social health protection founded on burden sharing, risk pooling, empowerment and participation. It is up to national governments and institutions to put these values into practice. The financing of social health protection can be through a mixture of taxation and contributions to public and mandated private insurance. Through risk pooling, these funds provide for equity, solidarity and affordability of services. According to International Labour Organization (ILO), ultimate objective in social health protection is to achieve universal social health protection coverage defined as effective access to affordable health care of adequate quality and financial protection. Social protection plays a vital part in reducing the vulnerability of the poor so that they can fruitfully access health and education services.
Hospital information systems have evolved with the recent widespread, involving technology and target functions, and this involves the critical computer systems from multiple perspectives. Healthcare organizations increasingly use information technology as a basis for improving productivity and user satisfaction. A research had been done about the level of satisfaction in using the Hospital Information System. Data was obtained by using a set of questionnaires that have been tested for reliability and validity. The staff are comprised of two (2) categories: Nurses (community nurses / Head nurse / staff nurse, nurse managers and others) while the second category consists of administrative officers (administrative officers, administrative assistants and clerks) in selected departments. Variables consist of sociodemographic factors, occupational factors and perception factors. A total of 152 respondents identified using stratified sampling method. The factors studied were age, gender, marital status, level of qualifications, length of service, knowledge of the system, attitude towards the use of the system, behavioral intention to use the system and compatibility with work. Majority of respondents were females (88.2%). The level of satisfaction among the staff in using the hospital information system is high (88.8%) compared to the dissatisfied staff in UKMMC (11.2%). In overall, the staffs in UKMMC are satisfied using the hospital information system available now but there are always a room for improvement so that the system can be used more intensively.
The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
A cross-sectional study was carried out in July-October 2012 in UKM to remeasure, evaluate and compare the changes in health services utilization level among women staff in UKM with a previous study done in 2001 and its influencing factors. The services studied were blood pressure (BP) measurement and Pap smear test. A total of 234 respondents aged between 18 and 55 were selected using stratified random sampling from Bangi, Kuala Lumpur and UKMMC, Malaysia. Data was collected via self-administered questionnaire and was analyzed by using SPSS version 17.0. Majority 85.9% of the respondents were found to have utilized at least one BP measurement which is higher compared to previous study. The Pap smear test, 64.5% of women have had a Pap smear test done also higher compared to previous study. Multivariate analysis shows the factors associated with BP measurement are age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). The factors associated with Pap smear test are marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5), family planning (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). The level of health services utilization on BP measurement and Pap smear test in 2012 is higher than 2001. For both BP measurement and Pap smear test the determinant factors are differed in the aforesaid years.
Prevalence of visual impairment among students is increasing in trends especially in rural area. A cross sectional study was conducted among secondary school students in Taman PKNS Beranang, Selangor in March 2008 with the objective of determining the prevalence of visual acuity impairment and its influencing factors. A total of 77 secondary school students were interviewed using guided questionnaire. The prevalence of visual acuity impairment among the respondents was 25.0% and study found that being female and have been watching television at a distance of less than two meters were significantly associated with visual acuity impairment. In conclusion, the problem occurred maybe due to the students sit nearer to the television (
Stroke is among the main cause of death and loss of work capability in Malaysia. Government hospitals statistic shows drastic increase of stroke cases and deaths resulting from it. Hospital Kuala Lumpur's statistic recorded about 30% to 35% fatality in cases of stroke. The study was carried out to identify the level of stroke recovery and its associated factors. The study was carried out at University Kebangsaan Malaysia Medical Center (UKMMC), Hospital Kuala Lumpur (HKL) and National Stroke Association of Malaysia (NASAM). The sampling method was universal sampling and respondents were interviewed using guided questionnaire. The stroke recovery was studied to identify the relationshiP with social support, age, coping, stroke severity and lifestyle. The response rate of this study was 50.3%. A total of 47.0% ofstroke patient received high stroke recovery. Among five factors studied, three factors have shown the significant relationship with stroke recovery; coping style OR 0.293 (95% Confidence Interval (CI), 0.129·0.668, P "0.004); lifestyle, OR 0.347 (95% Confidence Interval (CI), 0.154· 0.782, p" 0.01) dan social support OR 0.291 (95% Confidence Interval (CI), 0.128· 0.664, P"0.004), Establish significant relationshiP of stroke recovery with three studied factors which were social support, coping style and lifestyle. Most of the stroke patients in this study are retirees and housewives. These three factors are required further attention to ensure stroke patients recover.
Key words: Recovery, stroke, social support, coping, lifestyle
Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.