Workplace bullying has drawn greater attention in the last one and half decades. Despite its recognition by many organizations and countries, it is still rife. Why is that so? Could it be that the root of the problem has not been addressed? Or, could it be due to difficulties and resistances in embarking preventive and control measures. In this paper, we will examine the possible causes of workplace bullying based on a proposed model. In depth discussion of the personal and organizational factors are made while the work group and societal factors are dealt with in brief. In summary, the root of workplace bullying is multi-factorial. Understanding the complexity and subtlety of workplace bullying is pertinent in the effort to prevent or curtail it.
Background: A cross-sectional study on work-related stressors among nurses in a public teaching hospital had also attempted to explore functions of coping strategies in determining stress.
Materials and Methods: A structured bilingual questionnaire (English-Malay) on symptoms and sources of stress, and coping style measure was disseminated to medical and surgical nurses working in a teaching hospital in Kuala Lumpur. Socio demographic information and stress management methods were inquired. Frequency in workplace stressors were assessed using Nursing Stress Scale. Stress symptoms and home-life stressors were evaluated using Personal Stress Inventory. Measurement of coping strategies was performed using Coping Orientation for Problems Experienced questionnaire.
Results: A total of 181 questionnaires were disseminated and 151 (83.4%) were satisfactorily completed by nurses. It was found that the prevalence of work-related stress among medical and surgical nurses was 49.3% (N=74/150). Analysis of dichotomized outcome (between Stress and No stress group) illustrated high workload (t-value=4.122; p
Introduction : It is no doubt that the success of any health organization depends so closely on its managerial functions. To achieve this, the leader or manager as the core strategist of its organization must in all time be updated with the latest evidence-based information so that he or she can be easily operationalized his or her management function in more effective and sustainable manners. It depends largely on scientific literatures that published relevant articles within this scope. Unfortunately, management topics related to health care system is scattered published and this has indirectly affect manager to access the latest scientific documents.
Methods : We examined the practice of well known international journal in health care namely New England Medical Journal (NEMJ) on its role in propagating latest health management topics to its prospective clients.
Results : The result showed that a total of 31% health management topics were published throughout 2007 out of 1140 articles appeared. Of these, about 33% were confined to general health administration. The remaining articles were related to healthcare delivery practices (24%), medical ethics and legal matters (17% each), and manpower issues and training (9%).
Conclusion : Focus on managerial related articles relatively low as compared to clinical and other evidence-based medicine that clearly dominated health management issues.
Background : Visual impairment among the rural community has rarely been studied in this country. The purpose of this study is to determine the prevalence of visual impairment and its related factors among the adult population of Kampung Kuala Pajam, Branang.
Methodology : A cross sectional study was carried out in Kampung Kuala Pajam, Mukim Beranang from 25th of December till 30th of December 2007. Universal sampling is adopted and the sample size consists of 321 respondents who is 18 years and above. Trained interviewer has been used to obtain the data through questionnaire and eye examinations using logMAR chart, Red Reflex eye test, Relative Afferent Pupillary Defect (RAPD) test and Pin-Hole test.
Result : A total of 261 respondents who fulfil the criteria were interviewed and had eyes examination during the study period. The prevalence of visual impairment in this population was 9.2% and factors that showed significant association were age (p
Introduction : Human displacement during disaster would cause women and their dependent children to be particularly vulnerable. Yet, women failed to make their voices heard. Thus their needs, priorities and perceptions would not be identified which in turn could hinder an effective emergency response and a full recovery process.
Objective : This paper provides a general overview of problems and issues experienced by women and their dependent children during the Johore flood disaster. With this information, relevant agencies shall focus, among other considerations, on the special needs of women and children in planning and carrying out emergency responses in the future.
Methodology : This paper was written based on data and information obtained from the Johore Flood Disaster Report and observations made by the health teams on the flood victims throughout the flood period.
Findings and Discussions : Pregnant mothers with 36 weeks of gestation or more were evacuated from their homes to the health centres or hospitals when the Johore flood disaster struck. Regular maternal and child health (MCH) services were conducted at the flood relief centres. Despite the efforts by health care providers, we observed women facing some unique issues and problems. These include: 1) Effects of loss of security and protection; 2) Disruption of social relations and privacy; 3) Inadequate supply of basic items and; and 4) Economic disruption. Recommendations for future relief work are: i) Predisaster planning for emergency response must engage and involve women representatives. Women must also be recruited as emergency and relief workers; ii) Assessment of predetermined capacity of identified relief centres with gender consideration for evacuees must be done; iii) All relief centres shall have physical partition between families. Breast feeding room with access to clean water should also be provided; iv) Gender, cultural and religious sensitivity with regards to social protection and relations shall be observed at all times; v) Women should engage and be made occupied with suitable activities to encourage healthy social interaction thus avoiding feelings of boredom and helplessness; vi) Basic personal items for women and adolescent girls, such as sanitary towel and undergarments, and places to wash and hang them in privacy must be provided; vii) Elderly women may have to temporarily stay at unaffected relatives’ or old folk homes throughout the disaster period, and; viii) No smoking policy shall be enforced at all times in flood relief centres.
Conclusion : Women and their dependent children have been recognised as one of the vulnerable groups during disasters. Thus, women shall be empowered as partners in formulating any emergency response plan so that together they would be able to complement all disaster mitigation, relief and recovery efforts in amore effective manner.
Past major flooding events for the state of Johore, Malaysia were recorded in 1926, 1967, 1968 and 1971. However, major meteorological phenomena that hit Johore on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) were claimed to be the worst flood disaster in Johore in a 100 years. All eight districts were affected displacing 157,018 and 155,368 population during the first and the second wave event respectively. The Johore Health Department deployed substantial number of medical and health personnel to deal with the Johore flood crisis. Flood-related data were collected on daily basis between 19th December 2006 and 19th February 2007 using spreadsheet format from Flood Operational Rooms located at respective District Health Offices. Among flood victims 34,530 were found to have non-communicable diseases and 19,670 with communicable diseases. No major food- and water-borne disease outbreaks, such as cholera and typhoid, were reported in Johore. High success of public health measures was depending on the workforce of medical and health personnel on the ground. On the other hand, voluntary services offered by non-governmental organisations (NGOs), private sector and other volunteers should be well coordinated without compromising regulatory and ethical requirements. Crisis guidelines and plan of actions shall be updated so that they would be more relevant to the crises encountered on the ground.
Background: A cross sectional study was carried out to determine the prevalence of microbiological contamination in ready- to-eat food and factors affecting it in Melaka from February 2008 till May 2008 in collaboration with the Food Safety and Quality Unit and District Health Offices in Melaka Tengah, Alor Gajah and Jasin.
Methods: A purposive sampling of 101 food premises was carried out and 202 ready- to-eat food samples were collected and analysed microbiologically using standard methods. A total of 202 food handlers were randomly selected for questionnaire interview while rectal and nasal swabs were taken from them to determine their healthy carrier status of pathogenic food bacteria.
Results: Results showed that the overall prevalence of microbiological contamination in ready- to-eat food was 35.1%, while prevalence by type of food was 42.0% for main dishes and 9.8% for staple food. The majority of the contaminations were due to coliforms (14.9%), total plate counts (12.4%) and Staphylococcus aureus (3.5%). The mean score for food premise inspection was 77.21 ± 10.32 and the prevalence of healthy carrier status of pathogenic food bacteria among the food handlers was 15.8%. The level of food handling practices among food handlers was influenced by sex (p=0.012) and formal training on food handling courses (p=0.009). There was a significant negative correlation between age and level of food handling practices among the food handlers (r = -0.163; p = 0.02). Poor food handling practices (p=0.02) and poor hygiene status among the food handlers (p
Introduction : The purpose of this study is to explore the differences of quality of life (QOL) of Malay and non-Malay breast cancer survivors using qualitative method.
Methods : Data was collected using in-depth face to face interview. List of the patients were obtained from Oncology & Surgery Departments and contact numbers were obtained from the medical record. The interviews were conducted either in their home or in the hospital after the appointment has been made.
Results : The majority of the Malays were unable to fulfill the needs of their families. However, the non-Malays were able to fulfill the needs of their families. The majority were satisfied with social interaction and the relationships with their families and friends. In terms of feelings, most survivors felt sad, angry and sometimes they feel like they were going to die early. However the majority coped well with their illness. Regarding sleep, all Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. All survivors were worried about the other female members of the family of getting the same illness. Most survivors did not have any problems with altered body image.
Conclusion : Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. However, the majority of survivors coped well with their illnesses.
Introduction : Family Health Development Division is one of the earliest divisions in Public Health Department, Ministry of Health Malaysia. The division has progressed each year with the extension and expansion of the scopes of services since the establishment of Maternal and Child Health Unit in 1956. The services currently include school children, adolescent, adult and elderly health and also known as life-course perspective: from womb to tomb.
Objectives : The objective is to elaborate and explain the reformation of primary health care services implemented in the past and present.
Methods : The methodology applied is compilation, data review and comparison from annual report, action plan report, articles, speeches, specialists and stake holder view.
Results : The focus of Primary Health Care Service is covering health promotion, disease prevention, early detection and treatment, acute disease care, disease limitation and rehabilitation, clinical support services and teleprimary care. The reformation is caused by factors such as globalization, modernization, growth of health market, emergence and re-emergence of diseases, and development of medical technology. Three health fields that have underwent and under going reformation are concept and wellness practise in primary healthcare, primary healthcare clinical support services development and primary healthcare informatics development. The outcome of these reformations is the increment of service quality and outstanding services for patients and health staffs.
Conclusion : Health reformation in primary healthcare is greatly needed to give excellent services for primary health care for today and future.
Background: The COMBI concept is a novel approach by the WHO to control communicable diseases which are influenced by community behaviour. The Ministry of Health is currently evaluating its use against dengue in selected areas throughout Malaysia. COMBI doctrine differs from previous dengue campaigns. It acknowledges that the factors contributing to dengue proliferation may differ between areas. Factors for a given area are analysed, then a single precise behavioural goal to overcome those problems is formulated. To inculcate this behavioural change, the target community is subjected to an intensive campaign using Integrated Marketing Communication techniques adapted from the advertisingindustry, particularly involving volunteers from the community itself.
Methodology: In Selangor the pilot project was implemented in Section 3 and Section 4 of Bandar Baru Bangi, in the district of Hulu Langat. Here, Aedes breeding was found to occur mainly in water containers of semi permanent nature (eg. ‘kolah’, aquatic plant jars, flower pot bases etc). A total of 172 volunteers were recruited to disperse the message of “Suluh – Suluh, Basuh - Basuh” whilst distributing leaflets and flashlights to 2666 homes. Residents were instructed to illuminate such water containers twice weekly and scrub any containers found to contain larvae. The program commenced on 23/5/2004 and lasted 16 weeks.
Results : During this period, the initial Aedes Index of 5 was reduced to 0.96 while combined cases of Dengue Fever / Dengue Haemorraghic Fever in Sections 3 and 4 reported to the Hulu Langat District Health Office also dropped to 1 (unconfirmed).
Conclusion : The COMBI approach in Hulu Langat successfully demonstrated that correct problem identification synergized with community engagement can potentially reduce Aedes proliferationand dengue morbidity.
Background : A safety culture practice through prevention needs skillful, knowledgeable and competencies workers. The effectiveness of occupational safety and health programme implementation needs the knowledge related to Occupational Safety and Health Acts, 1994 (OSHA 1994) and its regulations.
Objective : This study was to determine the level of knowledge and awareness towards Occupational Safety and Health (OSH) aspects among workers in medical laboratory.
Methodology : A cross-sectional study was carried out on 34 medical laboratories in which 17 were from private and another 17 laboratories were from public sectors. It consists of 112 medical laboratory disciplines. Data were obtained using self-administered questionnaire consisting of 33 questions related to Occupational Safety and Health (OSH). Each question was coded “know” and “do not know” and respondents were needed to state their understanding towards each OSH issue tendered.
Results : Respondent’s level of knowledge was analyzed according to socio-demography and socioeconomic factors. OSH level of knowledge among medical laboratory workers showed that there are significant differences (p0.05) in OSH knowledge according to between sex, marital status, income and services sectors among workers in medical laboratories. Only about 60.5% of respondents knew the existence of OSHA 1994, whereas those who knew about OSHA 1994 regulations were below than 50.0% from overall respondents.
Conclusion : Promotion and practices of dynamic safety culture through prevention needs high knowledge of OSH.
Background: This cross-sectional study aimed to investigate the prevalence of the caregiving burden among women who are caregivers to elderly with stroke and factors influencing it. Respondents identified through purposive sampling at the Universiti Malaya Medical Centre from October to December 2007.
Methods: Direct methods of data collection (clinical and housing) and indirect (postal) used a structured questionnaire distributed to the guards. Measurements taken include sociodemographic variables of patients and caregivers, the patient, the care, relationships with caregivers and patients with information about stroke. Zarit Burden Interview (ZBI) short version was used to measure the burden of care. Carers' Assessment of Managing Index (Cami) was used to assess coping strategies. A total of 96 respondents took part in this study.
Results: The study showed that prevalence of caregiving burden was 35.4%. Burden of care was found to have significant relationships with factors such as marital status, caregivers (p = 0.017), family income (p = 0040) and the patients (p = 0.000). Significant correlation obtained for the coping strategies with the burden (r =- 0228, p 0026).
Conclusion: The conclusion shows that policy makers and program managers should appreciate and assist caregivers in performing the role of care. Intervention programs should be designed to suit the needs of the heterogeneous guardian.
Stres di tempat kerja terjadi apabila keperluan kerja tidak sepadan dengan kebolehan, sumber, dan kehendak pekerja. Ia boleh memberi kesan ke atas psikologi dan fisiologi manusia. Seseorang individu yang berasa tertekan dengan kerja yang dilakukan akan menunjukkan kemurungan yang berpanjangan. Apabila rasa tertekan, psikologi akan terganggu dan pekerja gagal membuat keputusan dengan baik. Situasi ini boleh menjejaskan prestasi kerja mereka dan menggugat produktiviti organisasi. Masalah paling dibimbangi adalah stres di tempat kerja boleh menyebabkan penyakit berbahaya seperti tekanan darah tinggi, sakit jantung dan melemahkan sistem pertahanan badan terhadap penyakit. Stres di tempat kerja juga boleh menyebabkan kemalangan di tempat kerja, peningkatan kos keselamatan dan kesihatan pekerjaan, gangguan trauma kumulatif, menjejaskan prestasi kerja serta mengganggu kehidupan sosial individu. Masalah keselamatan dan kesihatan pekerjaan akibat stres di tempat kerja seharusnya tidak diabaikan oleh organisasi kerana ia boleh menyebabkan sumber manusia sesebuah negara kehilangan daya saingnya. Sumber manusia yang berasa terancam akibat masalah keselamatan dan kesihatan akan gagal menggunakan sepenuhnya kreativiti mereka dan melakukan tugas pada tahap minimum. Fenomena ini seharusnya dibimbangi dalam persekitaran perniagaan masa kini yang sangat kompetitif. Di Malaysia, kajian yang berkaitan dengan stres seharusnya dipertingkatkan kerana kajian lepas terhadap stres di tempat kerja adalah tidak menyeluruh. Perkembangan ini sejajar dengan perubahan yang berlaku di persekitaran kerja seperti teknologi, sosial, ekonomi, undang-undang buruh dan seumpamanya. Kajian stres di tempat kerja perlu dijalankan kerana sumbangannya amat bernilai dalam menghasilkan sumber manusia yang lebih produktif dan berdaya saing.
Introduction : Stress is part of our life. It can happen anywhere including in medical school. Medical school is perceived as being stressful because their difficulties in education, longest period of study and dealing with the patients. Stress can be perceive as negative or positive. Coping strategies are the method that we can use to prevent stress when it comes to us. The aim of this study was to determine the prevalence of stress and coping strategies among of medical students in National University of Malaysia, Malaysia University of Sabah and Universiti Kuala Lumpur Royal College of Medicine Perak.
Methods : This study involved 450 medical students through stratified sampling in which 150 medical students from each of the three universities. This study was conducted through self administered questionnaires. The questionnaires included were socio demographic factor, Personal Stress Inventory (using Stress Symptoms Scale with 52 items), BRIEF COPE (Coping Orientation for Problems Experienced with 28 items). The determination of cut off point for stress symptoms score was using Receiver Operating Characteristic (ROC) curve.
Results : Response rate was 90.8%. The prevalence of stress among medical students were 44.1%. The contributory factors to the stress were financial problems, stress of up coming examination period, relationship problems with parents, peers, siblings and lecturers. Coping mechanisms which had significant association with stress includes self distraction, venting of emotion, denial, behavioral disengagement, humor and self blaming. Multiple linear regression analysis revealed a significant association (p
Introduction : Studies on stress among diabetic patients with complications are not much conducted locally. In this study the researchers would like to find out the magnitude of the problem among the Malaysian.
Methodology : A cross- sectional study was conducted to determine the prevalence of stress and its associated factors among the diabetes mellitus patients with complications at Raja Perempuan Zainab II Hospital, Kota Bharu, Kelantan. The translated Personal Stress Inventory questionairse was used to measure the stress among the respondents.
Finding : The prevalence of stress was 36.8%. The study showed that the employment status of respondents has significant association with stress in which higher numbers of unemployed respondents were stressed as compared to the employed respondents. Other sociodemographic factors, namely duration of having diabetes mellitus and type of complications developed by the patients were not significant.
Conclusion : Once the poor and unemployed patients were diagnosed to have diabetes mellitus either with or without complication, the health staffs should refer them immediately to the relevant agencies for help. By doing so, these patients could be prevented from having stress later. Outreach programmes in the community should be carried out regularly for an early detection and treatment of chronic diseases including diabetes mellitus to prevent patients from developing any complication.
Background : Study of stress among adults in rural community is seldom been conducted and this study aims to see the prevelence of the stress among this group of population.
Methodology : A cross sectional study was conducted to measure the prevalence of stress among the rural people in Hulu Langat District, Selangor using O`Donnell Personal Stress Inventory and coping mechanism practiced by them.
Result : A total of 265 respondents through universal sampling participated in this study. The stress prevalence identified was 16.2%. The factors which have significant association with stress were age, education level, marital status, working women, duration of working per day and body mass index. Diseases such as diabetis mellitus and hypertension showed no association with stress. Preferred coping mechanism used by respondents included emotional support, instrumental support, behavior modification and denial.
Conclusion : Stress among the rural population is high in Malaysia. Measures has to be taken to reduce the stress as it can effect the general health of the people.
Background: An effective doctor-patient communication has increasingly being recognized as an important factor in patient care. All means should be oriented towards narrowing communication gap. The essential methods must be searched and doctor must be able to conduct communication session in more pleasing manner.
Methodology: This is a systematic review on observations made on doctor-patient relationship on various setting and supported by feedbacks from many scholars who are involved in research, teaching and also papers and studies on the said subject.
Results: It is been realized that effective communication is not easily done if its process not well complemented and the gap is left widening. From all possible communication gaps recognized and listed, at least ten have identified to be the most essential methods to be prioritized while counseling or consulting a patient.
Conclusion: Effective communication between patient and doctor is the essential prerequisite of good medical practice and especially important for accurate diagnosis and effective treatment. Its mutual benefit can only be observed if all efforts are centered towards managing the communication gap.
The state of Johore, Malaysia had been hit by the worst flood in the Malaysian modern history on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) affecting all the eight districts. A total number of 157,018 and 155,368 Johore population had been displaced by the first and the second wave event respectively. The Johore State Health Department activated the Flood Action Plan which include mobilising medical teams to conduct daily clinical examinations on the flood victims and health teams to inspect flood relief centres, food premises and homes at flood-hit areas with regard to prevent and control communicable diseases. The spreadsheet format was used to collect data on diseases, injury and death throughout the Johore flood disaster period starting from the 19th December 2006 until 19th February 2007. Analyses showed that 19,670 flood victims (36.3%) had communicable diseases and 34,530 (67.0%) had non-communicable diseases. As for the communicable diseases and symptoms/syndromes related to communicable disease, 41.3% were acute respiratory infections (ARI) followed by 25.9% skin infections, 19.1% fever, 10.1% acute gastroenteritis (AGE) and 3.0% acute conjunctivitis. Other infectious diseases include 61 notifiable diseases (46 food poisoning, 14 dengue fever and one tuberculosis), 20 leptospirosis (with two deaths), 20 chicken pox and two melioidosis cases. The Batu Pahat district had the highest incidence for the majority of the communicable diseases because of the prolonged flooding period. No cholera, typhoid, malaria, measles or hand-foot-mouth disease (HFMD) cases were detected among the Johore flood victims. Trends of disease incidence follow the number of evacuees placed in the relief centres corresponding to respective wave. A total of 507 flood victims had physical injuries related to flood mostly due to fall onto wet floor at the relief centres. Fifteen deaths due to drowning were mainly caused by accidental fall into the flood water. The incidence of communicable diseases encountered had been appropriately anticipated and managed attributed to enhanced public health control programmes augmented by syndromic and laboratory surveillance on potentialy fatal infectious diseases. Equal emphasis should be given to the surveillance and control of chronic diseases.
Background : Safety and health is one of major concerns in public health issues. There are lots of injuries or accidents reported in the news which include school accidents and injuries.
Methodology : This survey was conducted among head of primary schools in Kota Bharu from May to June 2004. The objective of this study was to investigate the awareness about safety and health status among school’s head using a questionnaire.
Result : The study showed that knowledge on safety and health among the school’s heads were relatively low (7.7%). Forty-two percent of the schools did not implement any safety and health programme while more than 50 % did not have safety policies in their school.
Conclusions : It is necessary to have specific safety programmes in school in order to improve the safety and health awareness among teachers, staff, students and community.
Introduction: To determine the effectiveness of the enhance enforcement programmes (The Ops) on the percentage of seatbelt wearing among front occupants in Malaysia.
Methodology: The roadside observations for measuring the seatbelt wearing among front occupant were conducted before, two weeks and six months after the Ops. The study was conducted in selected states representing four different zones (Northern, Southern, Eastern and Central zones) of Peninsular Malaysia.
Result: A total of 12,298 drivers and 11,212 front occupants were observed for their seatbelt wearing status through out the study. Percentage of seatbelt wearing among drivers and front passengers were increased from the baseline of 82.6 % and 74.4 % to 92 % (95 % CI: 91.2, 92.7) and 87.0 % (95 % CI: 85.9, 88.0) after two week, but declined to 85.7 % (95 % CI: 84.4, 86.8) and 76.8 % (95 % CI: 75.2, 78.3) after six months of the Ops respectively. Pre and post analysis revealed that after 2 weeks, the Ops were significantly effective in increasing the seatbelt wearing among front passengers and drivers with the RR (95 % CI) of 1.17 (1.14, 1.20) and 1.12 (1.10,1.13) respectively. However, after six months, the effectiveness of the Ops was reduced for both type of vehicle occupant.
Conclusion: This study sheds light on the importance of the enhance enforcement programme for increasing the seatbelt wearing in Malaysia. However, in order to give more impact on seatbelt wearing, the strategy and the frequency of the enhance enforcement programme in Malaysia may need to be revised.