Displaying publications 1 - 20 of 34 in total

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  1. Tan CE, Admodisastro N, Lau SCD, Tan KA, Teh KH, Lee CC, et al.
    Asia Pac J Oncol Nurs, 2024 Feb;11(2):100363.
    PMID: 38304227 DOI: 10.1016/j.apjon.2023.100363
    OBJECTIVE: Malaysian parents of children diagnosed with leukemia or lymphoma stand to benefit from a comprehensive Malay-language online resource, complementing existing caregiver education practices. This study aimed to develop and assess the efficacy of e-Hematological Oncology Parents Education (e-HOPE), an online caregiver education resource in Malay, designed to enhance the knowledge of parents with children diagnosed with leukemia or lymphoma in Malaysia.

    METHODS: A user profile and topic list were established based on previous needs analysis studies. Content was developed for each identified topic. An expert panel assessed the content validity of both informational content and activity sections. Subsequently, the contents were presented via a learning management system to parents of children newly diagnosed with leukemia or lymphoma. Parents evaluated the quality of e-HOPE using the Website Evaluation Questionnaire (WEQ) after an 8-week period.

    RESULTS: The scale content validity index (S-CVI/Ave) achieved 0.996 for informational content and 0.991 for the activity section. Sixteen parents provided evaluations of e-HOPE after an 8-week usage period. Mean WEQ scores for various dimensions ranged from 4.23 for completeness to 4.88 for relevance.

    CONCLUSIONS: E-HOPE was meticulously designed and developed to offer Malaysian parents a Malay-language resource complementing current caregiver education practices. It exhibited strong content validity and received positive user ratings for quality. Further assessment is warranted to evaluate its effectiveness in supporting parents of children with leukemia or lymphoma. The resource is anticipated to enhance information accessibility and support for Malaysian parents facing hematological cancers in their children.

    TRIAL REGISTRATION: Clinicaltrials.govNCT05455268.

  2. Tan ZC, Tan CE, Choong YO
    Saf Health Work, 2023 Dec;14(4):415-424.
    PMID: 38187210 DOI: 10.1016/j.shaw.2023.10.006
    BACKGROUND: Occupational safety & health management (OSH) has garnered greater attention for its significance in promoting corporate sustainability for organizations in recent decades. The construction industry, in particular, is a major contributor to Malaysia's thirst for corporate sustainability in order to provide long-term support for the country. Thus, the main tenet of this study is to examine the mediating effect of employee affective commitment on the relationship between OSH and corporate sustainability.

    METHODS: A questionnaire was administered to 273 full-time employees of listed construction companies in Malaysia. Smart PLS software version 3 was used to test the proposed model and hypotheses. Both the measurement model and the structural model were evaluated.

    RESULTS: According to the findings, OSH and its dimensions are positively related to employee affective commitment. Employee affective commitment, on the other hand, has been found to be significantly related to corporate sustainability and its dimensions: economic, social, and environmental sustainability. Apart from this, the prominent results reveal that employee affective commitment partially mediates the relationship between OSH and corporate sustainability and its dimensions: economic, social, and environmental sustainability.

    CONCLUSION: This empirical finding adds to the existing literature in explaining how OSH and affective commitment led to corporate sustainability. Several implications are offered to various stakeholders, such as construction companies, policymakers, and relevant regulators.

  3. Tan CE, Lau SCD, Abdul Latiff Z, Lee CC, Teh KH, Mohd Sidik S
    Health Info Libr J, 2023 Jun 18.
    PMID: 37332240 DOI: 10.1111/hir.12491
    BACKGROUND: Timely and relevant information helps parents to cope when a child is diagnosed with cancer. However, obtaining and understanding information is not a straightforward process for parents.

    OBJECTIVES: This article aims to explain paediatric cancer parents' information behaviour related to the care of their child.

    METHODS: Qualitative in-depth interviews were conducted with fourteen Malaysian paediatric cancer parents and eight healthcare professionals who worked with paediatric cancer patients. Reflexivity and inductive approaches were used to interpret the data to identify meaningful themes and subthemes.

    RESULTS: Three themes about how paediatric cancer parents interact with information emerged: Acquiring information, internalising information, and using information. Information may be actively sought or passively acquired. Cognitive and affective aspects influence how information is internalised into meaningful knowledge. Knowledge then leads to further action including further information gathering.

    CONCLUSION: Paediatric cancer parents need health literacy support to meet their information needs. They require guidance in identifying and appraising suitable information resources. Development of suitable supporting materials is needed to facilitate parents' ability to comprehend information related to their child's cancer. Understanding parents' information behaviour could assist healthcare professionals in providing information support in the context of paediatric cancer.

  4. Ang CS, Lee KW, Voon SP, Ho MC, Tan CE, Ching SM, et al.
    Oman Med J, 2023 Jan;38(1):e456.
    PMID: 36937773 DOI: 10.5001/omj.2023.20
    OBJECTIVES: From early 2020, Malaysia had to implement nationwide lockdowns, quarantines, and other social distancing practices to contain the spread of COVID-19 virus, leading to symptoms of psychosocial burnout among the people. The aim of the present research is to develop and validate a Malay language version of the COVID-19 Burnout Scale (M-COVID-19-BS).

    METHODS: This three-phase study was conducted among Malaysian population. Phase 1 involved forward and backward translations of the Scale to Malay language by four professional bilingual translators. In Phase 2, the new M-COVID-19-BS instrument was piloted on 30 participants who suggested minor lexical modifications. Phase 3 consisted of online recruiting of Malaysian citizens to answer a composite questionnaire comprising the M-COVID-19-BS, Copenhagen Burnout Inventory (CBI), World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), and Fear of COVID-19 Scale (FCV-19S). Data were statistically analyzed.

    RESULTS: The composite four-part questionnaire in Malay was answered by N = 225 Malaysian citizens. The M-COVID-19-BS instrument demonstrated a good internal consistency (Cronbach's alpha = 0.926) and had a unidimensional factor structure. M-COVID-19-BS scores positively correlated with the three CBI subscales, showing evidence of convergent validity. Negative correlation was reported between M-COVID-19-BS and WHOQOL-BREF, achieving discriminant validity. M-COVID-19-BS also exhibited moderate positive correlations with the FCV-19S, thus supporting its concurrent validity.

    CONCLUSIONS: Results demonstrate that M-COVID-19-BS is a valid and reliable instrument to assess burnout symptoms related to COVID-19 among Malay-speaking populations either collectively or as a self-care tool to detect burnout symptoms without needing to further burden the already overwhelmed Malaysian healthcare system.

  5. Tong SF, Tan CE
    Malays Fam Physician, 2022 Nov 30;17(3):2-8.
    PMID: 36606174 DOI: 10.51866/cm0004
    Evidence-based medicine is the foundation of current medical practice. Suitable evidence is needed to support the holistic approach in clinical practice. Quantitative research produces some evidence needed for disease treatment based on probabilities or averages. However, the practice of evidence-based medicine should be personalised to individual patients without relying solely on an average perspective. Beliefs, values and expectations are unique for each individual and may differ significantly from the average. Therefore, understanding individual differences requires evidence from qualitative research. This is particularly important in family medicine practice, which focuses on holistic care for the person, family and community. Findings from properly conducted qualitative research can offer in-depth and comprehensive accounts on healthcare issues from patient and practice perspectives. Qualitative research also provides explanatory power and analytical transferability, which can be applied into daily family medicine practice. In conclusion, evidence from qualitative research should be rightfully equally acknowledged in family medicine and healthcare.
  6. Tan CE, Lau SCD, Tan KA, Latiff ZA, Teh KH, Lee CC, et al.
    Cureus, 2022 Oct;14(10):e30903.
    PMID: 36465778 DOI: 10.7759/cureus.30903
    Introduction Validated tools to measure caregiving knowledge among parents of children with hematological cancers are needed to measure the clinical outcome of caregiver interventions. This study reports the development and validation of the Hematological Oncology Parents Education Caregiving Knowledge Questionnaire (HOPE-CKQ) among Malaysian parents of pediatric leukemia and lymphoma patients. Methods Initially, 60 items on caregiving knowledge were developed based on a qualitative needs assessment study. Content validity was evaluated using item content validity index (I-CVI) and scale content validity index (S-CVI/Ave). Parents of pediatric leukemia and lymphoma patients were invited to complete the 60-item version of the HOPE-CKQ. Exploratory factor analysis (EFA) using polychoric correlation resulted in an 18-item version of HOPE-CKQ. Confirmatory factor analysis (CFA) was used to verify the factor structure. Known-group validity was tested by comparing the scores among different levels of parent education. Results The I-CVI ranged from 0.83 to 1.00 whereas the S-CVI/Ave was 0.99, indicating good content validity. A total of 167 complete responses were analyzed for factor analysis. EFA using polychoric correlations resulted in a single-factor structure consisting of 18 items. CFA confirmed that the 18-item single-factor HOPE-CKQ model had a good fit for the data. The internal consistency reliability was good (α=0.80). Parents with tertiary education level had higher caregiving knowledge (M=12.61, SD=3.37) compared to parents with secondary education and below (M=10.33, SD=3.80) (t=3.58, p<0.001). Conclusions The 18-item HOPE-CKQ is valid and reliable for use to measure caregiving knowledge among pediatric leukemia and lymphoma parents. This tool may be considered to measure caregiving knowledge in future preventive and intervention programs.
  7. Ridzuan MH, Ali MF, Tan CE, Abdul Aziz AF
    Cureus, 2021 Jun;13(6):e15410.
    PMID: 34249557 DOI: 10.7759/cureus.15410
    Background and objective Despite the widespread use of traditional and complementary medicine (TCM) during pregnancy, very few studies have focused on the use of these practices during the postpartum period among women in Malaysia. This study aimed to evaluate users' profiles and factors associated with the use of TCM during the postpartum period among women attending a community clinic in rural Malaysia. Materials and methods A cross-sectional study was conducted among 210 women at a maternal and child health clinic in Bagan Serai, Perak, Malaysia from January to April 2019. A self-administered questionnaire was used to determine the prevalence, the different types, and reasons for the use of TCM and perceptions toward TCM. Factors associated with TCM use during the postpartum period were derived from multiple logistic regression analyses. Results The prevalence of TCM use during the postpartum period was 66.2% among the subjects. The most common type of TCM used was massage (88.3%), and the most common reason reported was to improve general well-being (72.1%). "Family belief" had the highest mean for influence toward TCM use (mean: 3.63). Malays (adj. OR: 4.52, 95% CI: 1.93-10.59, p=0.001) and those having a low monthly household income (adj. OR: 3.68, 95% CI: 1.24-10.91, p=0.019) were the groups that were more likely to use TCM. Conclusion TCM use during the postpartum period is highly prevalent among Malay women with low household monthly incomes. Further studies should be conducted to address the benefits and risks of using TCM during the postpartum period.
  8. Lee JX, Chieng WK, Lau SCD, Tan CE
    Front Med (Lausanne), 2021;8:757510.
    PMID: 34722593 DOI: 10.3389/fmed.2021.757510
    This systematic review aimed to provide an overview of the clinical profile and outcome of COVID-19 infection in patients with hemoglobinopathy. The rate of COVID-19 mortality and its predictors were also identified. A systematic search was conducted in accordance with PRISMA guidelines in five electronic databases (PubMed, Scopus, Web of Science, Embase, WHO COVID-19 database) for articles published between 1st December 2019 to 31st October 2020. All articles with laboratory-confirmed COVID-19 cases with underlying hemoglobinopathy were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Thirty-one articles with data on 246 patients with hemoglobinopathy were included in this review. In general, clinical manifestations of COVID-19 infection among patients with hemoglobinopathy were similar to the general population. Vaso-occlusive crisis occurred in 55.6% of sickle cell disease patients with COVID-19 infection. Mortality from COVID-19 infection among patients with hemoglobinopathy was 6.9%. After adjusting for age, gender, types of hemoglobinopathy and oxygen supplementation, respiratory (adj OR = 89.63, 95% CI 2.514-3195.537, p = 0.014) and cardiovascular (adj OR = 35.20, 95% CI 1.291-959.526, p = 0.035) comorbidities were significant predictors of mortality. Patients with hemoglobinopathy had a higher mortality rate from COVID-19 infection compared to the general population. Those with coexisting cardiovascular or respiratory comorbidities require closer monitoring during the course of illness. More data are needed to allow a better understanding on the clinical impact of COVID-19 infections among patients with hemoglobinopathy. Clinical Trial Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218200.
  9. Abdul Aziz AF, Tan CE, Ali MF, Aljunid SM
    Health Qual Life Outcomes, 2020 Jun 20;18(1):193.
    PMID: 32563246 DOI: 10.1186/s12955-020-01450-9
    BACKGROUND: Satisfaction with post stroke services would assist stakeholders in addressing gaps in service delivery. Tools used to evaluate satisfaction with stroke care services need to be validated to match healthcare services provided in each country. Studies on satisfaction with post discharge stroke care delivery in low- and middle-income countries (LMIC) are scarce, despite knowledge that post stroke care delivery is fragmented and poorly coordinated. This study aims to modify and validate the HomeSat subscale of the Dutch Satisfaction with Stroke Care-19 (SASC-19) questionnaire for use in Malaysia and in countries with similar public healthcare services in the region.

    METHODS: The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study.

    RESULTS: One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge.

    CONCLUSIONS: The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes.

    TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016.

  10. Tan CE, Hi MY, Azmi NS, Ishak NK, Mohd Farid FA, Abdul Aziz AF
    Cureus, 2020 Mar 24;12(3):e7390.
    PMID: 32337117 DOI: 10.7759/cureus.7390
    Background Most family caregivers of stroke patients in Malaysia do not receive adequate prior preparation or training. This study aimed to determine levels of patient positioning knowledge and caregiving self-efficacy among caregivers of stroke patients. Methods This cross-sectional study was conducted at an urban teaching hospital involving 128 caregivers of stroke patients. The caregivers were conveniently sampled and completed the data collection forms, which comprised their socio-demographic data, patients' functional status, the Caregiving Knowledge For Stroke Questionnaire: Patient Positioning (CKQ-My© Patient Positioning) to measure caregiver's knowledge on patient positioning, and the Family Caregiver Activation Tool (FCAT©) to measure caregivers' self-efficacy in managing the patient. Descriptive and multivariate inferential statistics were used for data analysis. Results Among the caregivers sampled, 87.3% had poor knowledge of positioning (mean score 14.9 ± 4.32). The mean score for FCAT was 49.7 ± 6.0 from a scale of 10 to 60. There was no significant association between knowledge on positioning and self-efficacy. Multiple linear regression showed that caregivers' age (B = 0.146, p = 0.003) and caregiver training (B = 3.302, p = 0.007) were independently associated with caregivers' self-efficacy. Conclusion Caregivers' knowledge on the positioning of stroke patients was poor, despite a fairly good level of self-efficacy. Older caregivers and receiving caregiver training were independently associated with better caregiver self-efficacy. This supports the provision of caregiver training to improve caregiver self-efficacy.
  11. Abdul Razak S, Makmor Bakry M, Mohamed Said MS, Tan CE, Md Redzuan A
    Front Pharmacol, 2020;11:572260.
    PMID: 33240088 DOI: 10.3389/fphar.2020.572260
    Background: The biologic disease-modifying antirheumatic drugs (bDMARDs) are currently incorporated as part of the pharmacotherapy management of inflammatory arthritis (IA). Adherence to bDMARDs is crucial to ensure treatment success in IA. However, most of the recent studies evaluated adherence level in patients using subcutaneous injections of bDMARDs utilized the indirect methods adapted from adherence assessment for oral medication. Aim: This study aimed to develop a questionnaire to assess adherence to the self-injectable subcutaneous bDMARDs. Methods: The development of the Subcutaneous bDMARDs Adherence Score (SCADS) involved evaluation of content validity. Literature reviews provide the basis for domain identification and item formation. Four experts evaluated the instrument by using a four-point ordinal scale with a rubric scoring on relevance, importance, and clarity of each item in measuring the overarching construct. The item-level content validity index (I-CVI) and the scale-level content validity index (S-CVI) were calculated. The factor structure and internal consistency reliability of SCADS were estimated using principal component analysis (PCA) and Cronbach's alpha, respectively. Results: Both S-CVI/UA (universal agreement) and the average item-level content validity index (S-CVI/Ave) (average) for the entire instrument showed excellent criteria with a value of >0.90. Cronbach's alpha coefficient value for SCADS was 0.707 indicating good internal consistency. All items showed corrected item-total correlation coefficients above 0.244. Questionnaire items with a factor loading of 0.30 or above were considered in the final factor solution. The factor analysis resulted in 3-factor solutions, which corresponded to 66.62% of the total variance. Conclusion: The SCADS is a consistent and reliable instrument for evaluating adherence among IA patients using the subcutaneous bDMARDs. It is simple to use, yet comprehensive but still requiring further clinical and international validation.
  12. Law DS, Tan CE, Tong SF
    Sex Reprod Health Matters, 2019 Dec;27(1):1571316.
    PMID: 31533560 DOI: 10.1080/09688080.2019.1571316
    Family planning is extremely important for women with diabetes due to the various health risks and other social impacts of pregnancy in this population. Unfortunately, contraceptive use among women with diabetes remains low. This study explored the reasons influencing the decision to use contraception among East Malaysian (Sarawakian) women with diabetes. This was an exploratory qualitative study conducted at an urban public health clinic in Sarawak. Purposive sampling was used to recruit 12 women with type 2 diabetes mellitus. Semi-structured in-depth interviews were audio recorded and transcribed and then subjected to interpretive thematic analysis. Five themes appear to influence the decision to use contraception: likelihood of becoming pregnant, desired family size, personal health risks associated with getting pregnant, social implications of getting pregnant, and opinions of significant others. Among Sarawakian women with diabetes, the decision to use contraception was influenced by more than just health-related factors. Contraception counselling for this group of women should factor in their health beliefs, personal values, and social factors. Community involvement and peer support are potential strategies to improve contraception use.
  13. Tan CE, Abdul Aziz AF, Hi MY, Azmi NSA, Ishak NK, Farid FAM, et al.
    Indian J Palliat Care, 2018 11 10;24(4):406-410.
    PMID: 30410251 DOI: 10.4103/IJPC.IJPC_99_18
    Aim: The majority of caregivers for stroke patients in Malaysia are informal caregivers, although there are no valid tools to measure their knowledge regarding caregiving. Therefore, this study validated the Caregiving Knowledge Questionnaire (CKQ-My) as an assessment of Malaysian stroke caregivers' knowledge regarding patient positioning and feeding.

    Methods: Back-to-back translation was used to produce a bilingual version of the questionnaire. Hand drawings were used to replace photographs from the original questionnaire. Face validity and content validity were assessed, and construct validity was determined by comparing responses from informal caregivers, medical students, and primary care doctors. Finally, the internal consistencies of the subscales were determined.

    Results: Pretesting showed that the translated version was sufficiently easy to understand. Internal consistency for the positioning subscale (28 items, Cronbach's α = 0.70) and feeding subscale (15 items, Cronbach's α = 0.70) was good. Mean scores for the positioning subscale for caregivers (mean: 17.1 ± 3.9), medical students (mean: 18.9 ± 3.1), and doctors (mean 21.5 ± 2.2) were significantly different (F = 5.28, P ' = 0.011). Mean scores for the feeding subscale for caregivers (mean 13.1 ± 2.5), medical students (mean 16.1 ± 1.9), and doctors (mean 16.1 ± 2.4) also differed significantly (F = 6.217, P = 0.006).

    Conclusions: CKQ-My has good internal consistency and construct validity for the subscales measuring stroke caregivers' knowledge about positioning and feeding of stroke patients. It has potential as an assessment of effectiveness of caregiver training and for future studies on long-term stroke outcomes in Malaysia.

  14. Bong WT, Tan CE
    Open Access Maced J Med Sci, 2018 Oct 25;6(10):1928-1933.
    PMID: 30455776 DOI: 10.3889/oamjms.2018.339
    BACKGROUND: Parental anxiety regarding fever may be unwarranted as most cases are owing to self-limiting causes.

    AIM: To assess the level of knowledge and concerns regarding childhood fever among parents with young children in a public health clinic in Kuching, East Malaysia.

    METHODS: This cross-sectional study was conducted among parents recruited from a maternal and child health clinic, with children aged 6 months to 6 years. The participants completed a self-administered questionnaire regarding their knowledge and concerns about childhood fever. Descriptive statistical analyses were performed, and associations between dependent and independent variables were determined.

    RESULTS: Only 26.1% of participants were found to have good knowledge. Knowledge regarding childhood fever was significantly associated with parent's ethnicity, education level, and household income. About 72% of parents were always worried about their child's illness. Three major reasons for their concerns were persistently rising temperature; discomfort caused by the fever, and feared complications of fever.

    CONCLUSION: Excessive parental anxiety due to poor knowledge and misconceptions about fever may lead to poor quality of life and inappropriate management of fever. Healthcare providers may help by educating parents about fever and serious signs that indicate the need to seek healthcare advice.

  15. Rashid AA, Zuhra H, Tan CE
    Med J Malaysia, 2018 08;73(4):197-201.
    PMID: 30121681 MyJurnal
    INTRODUCTION: Social support and self-efficacy are factors that influence patients' health behaviour. However, the relationship between these two factors among patients with Type 2 Diabetes Mellitus (T2DM) has not been adequately explored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.

    METHODS: This cross-sectional questionnaire study involved 329 patients with T2DM who received their follow up at a public primary care clinic. Patients were selected via systematic random sampling. Patients self-completed locally adapted versions of the Medical Outcomes Study (MOS) Social Support Survey and Diabetic Management Self Efficacy Scale (DMSES). The scores of both tools were analysed to determine the association and correlation between social support and self-efficacy.

    RESULTS: The mean score for overall social support was 72.7±21.40 score range (0-100). "Affectionate support" was rated the highest averaged mean score at 78.31±23.71 (score range: 0-100). The mean DMSES score was 147.6±35.5 (score range :0-200), of which "medications" subscale was rated the highest with averaged mean scores 9.07±1.67 (score range: 0-10). Overall social support and self-efficacy were found to be weakly correlated (r=0.197, p<0.001). However, all subscales of social support were moderately correlated with "medications" subscale of self-efficacy.

    CONCLUSION: Social support is significantly associated with patients' self-efficacy in handling their own medications.

  16. Tan CE, Jaffar A, Tohit N, Hamzah Z, Hashim SM
    Perspect Med Educ, 2017 Jun;6(3):182-188.
    PMID: 28386758 DOI: 10.1007/s40037-017-0353-1
    INTRODUCTION: Direct contact with patients for medical education is essential in healthcare professional training. Patients who were recruited for a medical education home visit program in Malaysia did so on a voluntary basis without remuneration. This paper aims to explore their reasons for participation in this program.

    METHODS: An exploratory qualitative study was conducted on patients who had been visited during the 2012/2013 academic session. Purposive sampling was done to select adult participants from varying ethnicities and ages from the list of patients. In-depth interviews were conducted at the participants' homes and were audio recorded. The transcripts of these interviews were analyzed using thematic analysis.

    RESULTS: A total of nine in-depth interviews were conducted. Four main themes were identified from thematic analysis: 1) Perceived meaning of the visit; 2) Perceived benefits and risks; 3) Past healthcare experiences; 4) Availability for visits. The home visits meant different things to different participants, including a teaching-learning encounter, a social visit, a charitable deed or a healthcare check-up. The benefits and risks of accepting unknown students to their homes and sharing their health issues with them had been weighed prior to participation. Prior experience with healthcare services such as gratitude to healthcare providers or having a relative in the healthcare profession increased their receptivity for involvement. Lastly, enabling factors such as availability of time would determine their acceptance for home visits.

    DISCUSSION: Patients agree to participate in medical education activities on a voluntary basis for various reasons. Providing good healthcare service and sufficient preparation are crucial to increase patient receptivity for such activities.

  17. Tan CE, Mohd Roozi AH, Wong WHR, Sabaruddin SAH, Ghani NI, Che Man Z
    MyJurnal
    Introduction: The common cold is the commonest reason for primary care encounters worldwide. This paper aims to describe the reasons that influence patients to seek medical consultation for the common cold.
    Methods: This was a cross-sectional survey conducted among adult patients of an urban teaching primary care clinic. An adapted bilingual survey form was administered by the researchers to obtain data regarding their decision to seek medical consultation for a cold and the reasons for their decision. Quantitative analyses were done to describe the close-ended responses. Open-ended responses were analysed using a qualitative approach and
    the frequencies of the themes were reported. Results: A total of 320 respondents participated in this study, with a response rate of 91.4%. They were predominantly females (59.4%), Malay (70.9%), and had tertiary education (65.9%). More than half of the patients (52.5%) said they would seek consultation for cold symptoms. Fever was the commonest symptom (57-61%) which compelled them to seek consultation. The commonest reason for seeking consultation was to get medications (41.7%), whereas the commonest reason not to seek consultation was the practice of self-medication (44.2%). Ethnicity was found to be significantly associated with the decision to seek doctor’s consultation.
    Conclusion: Colds are usually self-limiting and do not result in complications. Empowering
    patients by providing appropriate self-care knowledge can help to reduce the burden of primary care services.
    Patients should be taught about red flag symptoms as well as drug safety for medications commonly taken for
    colds.
    Keywords: Upper respiratory tract infections, patient acceptance of health care, primary health care.
  18. Tan CE, Fok MW, Luk KD, Cheung KM
    J Orthop Surg (Hong Kong), 2014 Aug;22(2):224-7.
    PMID: 25163961
    PURPOSE. To evaluate the insertion torque and pullout strength of pedicle screws with or without repositioning. METHODS. 20 fresh porcine lumbar vertebrae of similar size were used. The entry point was at the site just lateral and distal to the superior facet joint of the vertebra, and to a depth of 35 mm. A 6.2-mm-diameter, 35-mm-long pedicle screw was inserted parallel to the superior end plate on one side as control. On the other side, an identical screw was first inserted 10º caudal to the superior end plate, and then repositioned parallel to the superior end plate. The insertional torque and pullout strength were measured. RESULTS. Three of the specimens were excluded owing to pedicle fractures during the pullout test. Repositioned pedicle screws were significantly weaker than controls in terms of the maximum insertional torque (3.20 ± 0.28 vs. 2.04 ± 0.28 Nm, 36% difference, p<0.01) and pullout strength (1664 ± 378 vs.1391 ± 295 N, p<0.01). CONCLUSION. Repositioning pedicle screws should be avoided, especially when the pedicle wall is breached. If repositioning is deemed necessary, augmentation with polymethyl methacrylate or a screw with a larger diameter should be considered.
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