Introduction : Health management is a tool to ensure an effective running of health program and at the same time avoiding flaws to its components including patients, workers and the entire organization. Risk management is a new concept in health management where the determinants of the problems or the risks are put to minima. It’s strategies are oriented towards prevention as well as controlling to all its administrative system.
Methodology : This is a systematic review on various papers, studies and observations put forwards by risk management experts. It is also supported by feedbacks from many scholars who are involved in research and teaching.
Results : It is been observed that risk management activities have been on practiced in health care delivery system. It is not a new form, but rather a situational action based on certain issues. In fact, it happens in any organization – public or private. Close observation on this area has triggered development of various risk management models including some administrative standard and guidelines.
Conclusion: Risk management is a new approach that need to be practiced by all manager and leader. Its discipline involves interpretation of risk at all angles. It is not only confined to the explicit component, but should also be expended to others area as well. It needs a good sense and good attitude of the manager. The essence of risk management is to minimize the risk to patient, staff, public and the entire organization.
Introduction: In view of high healthcare expenditure, Malaysia also faces problems in healthcare financing. The policy option is to establish a national health financing scheme. However, it is a problem to develop mechanisms to cover social insurance package to more than one third of the population working in informal sector such as farmers. Therefore, there is an urgent need to assess the ability and willingness of the farming community. The main objective was to study the ability and willingness in the farming community to contribute to national healthcare financing scheme.
Methodology: This a cross sectional study involved 400 farmers in Selangor. A total of 92.3% farmers were able to pay for the healthcare.
Results: Willingness to contribute to The national healthcare financing scheme were RM2.00 per month.
Conclusion: The education level influenced the ability to pay while the educational level and per capita income influenced willingness to pay.
Introduction : Diabetes mellitus is recognized as a major public health problem worldwide. The burden of diabetes to society are morbidity, mortality and extensive usage of health care services.
Methodology : This study aimed to determine the provider’s cost in treating diabetic foot patient per day in orthopaedic ward, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in year 2006. Result : A total of 54 patients fulfilled the inclusion and exclusion criteria, only 29 were eligible for analysis. The cost of health care providers derived from cost calculation on capital and recurrent costs. Results showed that the average cost for treating diabetic foot patient per day is RM 634.57. Recurrent costs contributed 75.3% of the total diabetic foot treatment and Intensive Care Unit costs was the biggest percentage (40.5%).
Discussion : The results were comparable with findings by Case-Mix Unit of UKMMC. Treatment cost of diabetic foot is substantial and therefore avoidance of this complication must be emphasized to all diabetic patients.
Background: All healthcare services are moving towards quality management system including ISO 9000 due to pressure from various stakeholders involves and also to improve healthcare quality. The objective of this study was to measure the satisfaction level among the outpatients in ISO Certified Klinik Kesihatan Bandar Baru Bangi, Selangor. Also to identify the relations of patient’s satisfaction with the sociodemographic factors and service dimensions such as general satisfactions, technical quality of clinic staffs, interpersonal aspect of clinic staffs, time with doctors, communications with clinic staffs and availability/accessibility of clinic.
Methodology: A cross sectional study was carried out from February 2008 to Jun 2008 and a total of 240 respondents in the clinic were selected using universal sampling. Only those who are Malaysians aged 18 and above and complied with the inclusions criteria’s were selected as the respondents to fill up the Patient’s Satisfaction Questionnaire III.
Results: The study found that the satisfaction level of the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with 78.8%.It has been shown that the predictor factors of total patient’s satisfaction were general satisfaction (AOR=5.06, CI= 1.51-16.96), technical quality of clinic staff (AOR = 3.09, CI= 1.13-8.43), interpersonal aspect of clinic staff (AOR = 2.96,CI= 1.04-8.42), availability/accessibility of clinic (AOR = 9.38, CI= 9.37-87.95) and communication of clinic staff ( AOR=17.90, CI=3.74-85.73) with the R2 = 67.7%.
Conclusion: The satisfaction level among the respondents in Klinik Kesihatan Bandar Baru Bangi, Selangor were remarkable with percentages of 78.8%. The study has shown that service dimensions factor influenced the patient’s satisfaction such as general satisfaction, interpersonal aspect of staff, communication of staff, technical quality of clinic staff and availability/accessibility of clinic. It could have also been contributed by the implementation of ISO and it can only be confirmed by carrying out a comparison study of patient’s satisfaction in clinics with and without ISO certification.
Study site: Klinik Kesihatan Bandar Baru Bangi, Selangor, Malaysia
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.
Introduction : Economic evaluations can provide “value-for money” information to those making decisions about the allocation of limited health care resources. In particular, economic evaluations can be used to identify interventions that are worth providing and those that are not. Furthermore, evaluations can be used with other approaches to help set priorities, such as program-budgeting marginal-analysis.
Methodology : Compile and systematically describe from the publications, articles and reports on economic evaluation in healthcare decision making.
Result : A high quality economic evaluation should provide decision makers with information that is useful, relevant, and timely. In addition, evaluations should be based on rigorous analytical methods, be balanced and impartial (credible), and be transparent and accessible to the reader. There are many situations where economic evaluations can assist decision makers: decisions by various levels of government or administrative bodies (e.g., regional health authorities, hospitals, drug plans) to fund a program, service or technology, pricing decisions by government regulators and technology manufacturers, clinical practice guidelines, priorities for research funding by governments and researchbased firms, post-marketing surveillance and updates of economic information based on the use of the technology in the “real world” (which can then be used to inform one of the other types of decisions).
Conclusion: This requires that decision makers take a broad view of the impact of a technology, and decision that are more explicit and transparent. The ultimate test of an evaluation is whether it leads to better decision in the presence of uncertainty, and results in the more efficient and effective use of resources.
Skim Sistem Saraan Malaysia (SSM) telah diperkenalkan pada tahun 2002 menggantikan skim Sistem Saraan Baru (SSB) kepada kakitangan sektor awam. Satu kajian keratan rentas telah dijalankan ke atas Pakar Perubatan Kesihatan Awam (PPKA) pada 2004 yang bertujuan untuk mendapatkan persepsi mereka mengenai skim SSM. Semua PPKA yang berdaftar dengan Persatuan Pakar Perubatan Kesihatan Awam (PPPKA) yang berkhidmat dengan Kementerian Kesihatan Malaysia (KKM) dipilih sebagai responden. Kajian ini menggunakan borang soalselidik yang diisi sendiri oleh responden. Kadar respon kajian ini ialah 70.0% iaitu 217 responden. Kajian ini mendapati sebanyak 80.6% PPKA tidak bersetuju dengan pelaksanaan SSM, hanya 7.4% bersetuju dan sebanyak 12.0% berkecuali. Kelemahan-kelemahan utama SSM yang dikenalpasti oleh responden yang tidak bersetuju dengan SSM ialah prosedur atau skim perkhidmatan yang kabur(83.9%), peperiksaan Tahap Kecekapan yang tidak releven (54.1%) dan kenaikan pangkat terjejas (40.5%). Hasil kajian ini dapat membantu pihak-pihak yang terlibat memperbaiki kelemahan-kelemahan SSM supaya pelaksanaannya menjadi lebih mantap dan dapat menangani kelemahan yang wujud di dalam skim tersebut.
Background: Cardiovascular disease is the number one cause of death globally and is projected to remain the leading cause of death. If the trend is allowed to continue, by 2015 an estimated 20 million people will die from cardiovascular disease (mainly because of myocardial infarction and strokes). The number of cardiovascular disease cases in Malaysia has increased to 14% in five years from 96,000 cases in 1995 to 110,000 cases in 2000.
Methods: The cost to treat patients admitted to Universiti Kebangsaan Malaysia Medical Center (UKMMC) Malaysia, diagnosed with Acute Uncomplicated ST Elevated Myocardial Infarction (STEMI) was calculated by using two different methodologies, namely step down costing methodology and activity based costing using clinical pathway.
Results: Cost for each stay per day at the cardiology ward using the step down methodology is RM596.42. The treatment cost is estimated from RM1, 789.26 to RM 4,771.36. The average cost per episode for STEMI care with the average length of stay for 5.6 days is RM3, 340(SD ±596.42. The cost of coronary PCI procedure in step costing is RM 13,950.00. Hence, the total cost incurs for STEMI with PCI is RM 17,290.00(SD ±596.42) by using step down method. (an average cost per episode is RM3,340, plus the cost of coronary procedure of RM 13,950.00 . However by using the ABC the cost of STEMI (PCI) with an average length of stay for 5.6 days is RM 20,431.39. The study showed the ABC method was higher by 15.3% than the step down costing.
Conclusion: The cost in managing STEMI (PCI) with the average length of stay of 5.6 days was calculated by using two different methodologies, namely step down costing methodology and activity based costing. Cost of treatment calculated by using activity based costing are higher because all resources used are incorporated in detail. The ABC method was higher by 15.3% than the step down costing. The difference is within 80-20 rules and the biggest percentage of cost in both methodsis procedure or PCI cost.
Introduction : Globalization has made health tourism possible and continues to flourish. For participating countries, this new industry rakes in billions of dollars a year, and is worth focusing on and being developed.
Objective : This write up aims to find out the history and success of health tourism in countries around the world, study the scenario in Malaysia and propose strategies which could make Malaysia prosper with this multibillion dollar industry.
Methodology: The methodology applied was compilation, data review and comparison from annual report, action plan report and articles.
Result : In the ASEAN region, Malaysia is making a mark in the health tourism industry, thanks to the availability of medical and technical expertise, political and economical stability, high quality infrastructure, and scenic beauty of the land. Nonetheless, despite all these, Malaysia has yet to be at par with her neighbours- Thailand, Singapore and India, in terms of the number of foreign patients and the revenue gained from this industry. Thus there is a serious and urgent need to conduct research to analyze the current situation and future prospects of health tourism in Malaysia. This industry is open to all countries around the world. It is those countries that can continually analyze and adapt that will prosper in the emerging medical tourism industry. Some of the key issues which need to be addressed are those of promotion, finding the niche market, branding, legislations, immigration and quality of healthcare. In addition to these, matters regarding human resource, particularly that of internal brain-drain, need to be looked into.
Conclusion : Malaysia has great potential of becoming the giant of the health tourism industry provided appropriate and timely actions are taken towards achieving it. The negative impact must not be ignored or overlooked; instead it must be thoroughly studied and rectified.
Introduction: Back pain associated with sense of pain and less comfort in back part of the body especially at the lower back area. Back pain is an occupational health problem with significant impact to productivity of workers.
Methodology: A cross sectional study was conducted to study the prevalence of back pain towards individual, physical and psychosocial factors associated among body shop’s operators at national Automotive Manufacturers.
Result: A total of 32 operators were involved in this study. Nordic Musculoskeletal questionnaire has been used in this study and body position assessment was done by using Ovako Working Posture Analyzing System (OWAS) method. Study showed the prevalence of back pain among operators throughout their work and in the last 12 months was 93.8% and 87.5% respectively. There are significant association (p0.05) between prevalence of back pain with another individual, physical and psychosocial factor.
Conclusion: This study shows that back pain prevalence were influenced by types of activity and body posture during working at assembling division among workers. Attention should be given to ergonomics factors to prevent back pain incident among automotive industry assembly workers.
Background: Nowadays, most medical laboratories in Malaysia practice occupational safety and health based on standard operating procedure and sometimes ad-hoc characteristic limited to only internal use. The level of compliance of the national occupational safety and health management system (OSHMS) guidelines among medical laboratories in Malaysia is still largely unexplored.
Methods: This study was carried out on 34 medical laboratories consisting of 17 public medical laboratories and 17 private medical laboratories in Klang Valley using self-administered questionnaire based on guideline of OSHMS6. This study covered 112 medical laboratories units including pathology chemistry (18), microbiology (20), virology (7), histopathology (16), cytopathology (17), hematology (19) and 15 multi discipline medical laboratories.
Results: This study showed the level of compliance to the national OSHMS guideline among medical laboratories who are MS ISO 15189:2004 accredited & have a higher scores (p
Background: The occupationally acquired accident and injuries in Malaysian medical laboratories are still largely unexplored prior to this survey. Some of these questions are attempted in this survey and act as source of reference for the number and accident injuries in medical laboratories in the area of Klang Valley and also in Malaysia.
Methods : This survey was carried out based on recordable cases throughout the calendar year of 2001 to 2005 from 3 main medical laboratories of Hospital Kuala Lumpur (HKL), Hospital Universiti Kebangsaan Malaysia (HUKM) and Pusat Perubatan Universiti Malaya (PPUM).
Results : The average annual incident rate for this three medical laboratories is 2.05/100 full time equivalent (FTE) employees. The annual incident rate in individual medical laboratory is 2.04/100 FTE (HKL), 2.07/100 FTE (HUKM) and 2.04/100 FTE (PPUM) employees, respectively. The most common injury that is 25.3% of the total cases reported was due to cuts by sharp objects and the second most common injury was exposure to biohazard and chemical substances which constitutes 19.9% of the total cases. . Needle prick injury (16.8%), fire (8.4%), fall/slip (6.3%) and gases leak and locked in cold room were reported as one case each.
Conclusion : The average incident rate from this study is remarkably similar compared with the incident injury rate reported by BLS (2006) which is 2.1/100 FTE in the average size of medical laboratory and diagnostic. Besides this incident rate of injury and illness as a comparison, it also can be used as a benchmark to evaluate the safety performance among medical laboratories in Malaysia.
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 : Risk management strategy at the workplace needs two way interactions between employee and employer. Therefore, study on risk perception among workers based on scientific analysis is needed to gain knowledge and understanding on how workers perceived risk at the workplace in order to design risk management strategies more effectively.
Methodology : A cross sectional study was carried out among 628 respondents from 36 medical laboratories in the public and private sector in Klang Valley. Using a self administered questionnaire, respondents were required to perceive risk on 30 hazards which have been identified in the medical laboratory. Each hazard was encoded by using Likert scale 1= not risky, 2= risky but low, 3= moderate risk, 4= high risk and 5= very high risk.
Result : Overall, the study showed that working in the medical laboratory was perceived to of moderate risk. When comparing among ethic groups, the Malays had the highest perception of risk (3.07±0.88) as compared with Indians (3.03±0.88) and the Chinese (2.78±0.90). Employee with higher education and position level perceived low level of risk compared to those with lower education and position level. For those working in different types of laboratories, there are significant difference on risk perception, (p=0.001). Employees who work in government sector perceived higher (3.12±0.93) risk compared to workers in private sector (2.85±0.88). In terms of OSH based knowledge, those with higher level of education and position have a high score knowledge on OSH compared to those have lower education and position level.
Conclusion : This study showed that risk perception among workers in medical laboratory is influenced by socio-demography factor such race, education level, job position and the laboratory where the respondents are working.
Background : The implementation of Occupational Safety and Health Management System (OSHMS) requires a level of measurement. The effectiveness of OSHMS implementation was influenced by inhibiting and supporting factors. The objective of this study was to determine the inhibiting and supporting factors towards the implementation of OSHMS in medical laboratories.
Methodology : The implementation of Occupational Safety and Health Management System (OSHMS) requires a level of measurement. The effectiveness of OSHMS implementation was influenced by inhibiting and supporting factors. The objective of this study was to determine the inhibiting and supporting factors towards the implementation of OSHMS in medical laboratories.
Result : This study showed the level of compliance to the OSHMS MS1722 guideline among medical laboratories who are MS ISO 15189 accredited & have a higher scores in overall measurement indicators OSHMS compared to those do not have SAMM accreditation. Private medical laboratories services have higher scores in overall measurement indicators OSHMS, compared to government medical laboratories. However, there was no significant difference (p>0.05) between medical laboratories which have ISO 9000 quality management system certification, compared to level of compliance to the OSHMS MS 1722 guideline among medical laboratories. There was also no significant difference (p>0.05) between the laboratories who had been operating for more than 10 years compared to those with less than 10 years, towards implementing the OSHMS. Results showed that majority of medical laboratories management perceived that difficulty and complexities of OSH legislation are the most important factor that prevent them from implementing OSHMS in their organization. The most important supporting factor, that medical laboratories management perceived as the most important to comply to the OSHMS were their moral responsibilities towards the community.
Conclusion : In conclusion, the study shows there were many inhibiting and supporting factors that contribute towards effective implementation of OSHMS elements in workplace.
Background: Level of comfort in working environment can contribute to increase level of health, emotion during working, level of safety, quality and productivity of work. A study of physical factors (heat, noise and lighting) is important to determine the level of comfort during working. This study was carried out to study those physical factors upon comfort level during working among Casting Shop workers in a car manufacturing factory.
Methods: Instruments for the physical monitoring including Questemp°36 Thermal Environment Monitor, Sound Level Meter and Lux Meter were used at seven measured areas. The information about the level of comfort during working was collected using questionnaires among 65 respondents by random sampling method.
Results: Measured data showed there were four measured areas which Wet Bulb Globe Temperature indoor (WBGTi) value are above the standard limit recommended by ACGIH, three measured areas recorded noise level above the standard limit recommended by Factories and Machineries (Noise Exposure) 1989, while there was no measured area recorded lighting reading below the standard limit recommended by MS ISO 8995:2005. Result from questionnaire found that the majority of the workers did not feel comfortable towards the heat and noise level in their workplace while most of the respondents felt comfortable towards lighting level in their workplace. Mean of WBGTi reading and lighting reading have a significant difference (p
Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.
Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.
Introduction: The aim of this study was to assess the overall diet quality of husbands and wives in a selected urban area in Selangor.
Methodology: This cross-sectional study was carried out in Bandar Baru Bangi, Selangor among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not practicing any special diet. Data were collected using a 2-day 24-Hour Dietary Recall and a Food Frequency Questionnaire (FFQ) to evaluate the quality of diet among husbands and wives using the Diet Quality Index Revised (DQI-R).
Result: Majority of husbands and wives in this study were in the middle-age group, had received tertiary education, had household monthly income of more than RM3, 500 and encompass household size of 3 to 5 persons. The mean DQI-R score for husbands (mean age= 43.33 + 11.16 years) and wives (mean age= 41.28 + 10.93 years) were 67.8 + 9.1 and 64.4 + 9.3 respectively and there was a significant different in scores between the husbands and wives (p < 0.001). In general, the diet quality of this study population was not satisfactory and that the diet quality of husbands was better compared to their wives.
Conclusion: This study gives an insight picture of husbands and wives’ quality of diet. It can be used as a guideline to improve health intervention programs in the future.
Low back pain (LBP) is a major medical and social problem associated with disability and work absenteeism. Since the effect on unawareness on back care among hospital staff may affect the smooth running of the services to the public and patients, it is the objective of this study to identified the awareness of back care among nurses so that preventive measures can be taken. About 80 nurses working in the outpatient clinic was survey using self addressed questionnaires which were adapted from Zutphen Physical Activity Questionnaire at Queen Elizabeth Hospital, Kota Kinabalu. Demographic analysis demonstrated that among the eighty nurses that responded, 37.5% (n=30) are Malays, 25% (n=25) Chinese and 37.5% (n=30) ( to include other Sabahan tribes). Their age group varies between 23 to 55 years of age. A total of 72 nurses, both agreed (45%,n=36) and strongly agreed (45%,n=36) that understanding good postures is important to prevent LBP. They felt strongly (55%, n=44) about the importance of correct lifting techniques, and having a well-designed workplace (50%,n=40). Regarding factors that cause LBP, 55% (n=44) of them strongly agreed that good lifting technique can prevent LBP while 56 (70%) agreed that prolong sitting doing computer work can cause LBP. About 60% (n=48) also agreed that LBP can cause stress and that 45% (n=36) of them strongly agreed that being overweight than average can worsen LBP. However, 40% (n=32) provide a neutral answer to whether height have any influence on LBP while 50% (n=40) agreed that weak back muscles can worsen the backache further. However, 45% (n=36) agreed that games that involved back movement have high risks and 55% (n=44) agreed that swimming helps to strengthen back muscle. The environmental factors addresses issues of footwear and soft mattress where 60%(n=48) agreed while 15%(n=12) strongly agreed that good footware and appropriate use of soft mattresses 60% (n=48) can prevent LBP. This study have demonstrated that the nurses that participated had a clear understanding and knowledge on back care even though a wider study need to be carried out to ensure validity of study finding.
Study site:outpatient clinic, Queen Elizabeth Hospital, Kota Kinabalu