METHODS: Questionnaire study conducted in May-December 2012 on 847 physicians from 255 ICUs in 10 low-middle-income countries and regions according to the World Bank's classification, and 618 physicians from 211 ICUs in six high-income countries and regions.
RESULTS: After we accounted for personal, ICU, and hospital characteristics on multivariable analyses using generalised linear mixed models, physicians from low-middle-income countries and regions were less likely to limit cardiopulmonary resuscitation, mechanical ventilation, vasopressors and inotropes, tracheostomy and haemodialysis than those from high-income countries and regions. They were more likely to involve families in end-of-life care discussions and to perceive legal risks with limitation of life-sustaining treatments and do-not-resuscitate orders. Nonetheless, they were also more likely to accede to families' requests to withdraw life-sustaining treatments in a patient with an otherwise reasonable chance of survival on financial grounds in a case scenario (adjusted odds ratio 5.05, 95 % confidence interval 2.69-9.51, P
OBJECTIVES: The current study aimed to assess student nurses' intentions to work with older people and to determine the predictors of working intentions among nursing students.
DESIGN: The study adopted a cross-sectional design.
SETTINGS: Multistage sampling was used to recruit nursing students from five states in Malaysia.
PARTICIPANTS: A total of 1462 nursing students from eleven nursing education institutions participated in this study.
METHODS: A self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students' intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.
RESULTS: The present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.
CONCLUSION: The primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.
DESIGN: Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMed and Google Scholar. The Crowe Critical Appraisal Tool and Melnyk Levels of Evidence were used to assess quality and level of evidence of eligible studies. Behaviours of hearing healthcare professionals were summarised descriptively.
STUDY SAMPLE: 17 studies met the inclusion criteria.
RESULTS: Twelve studies described behaviours of audiologists and five studies were intervention studies. Audiologists were typically task- or technically-oriented and/or dominated the interaction during hearing aid consultations. Two intervention studies suggested that use of motivational interviewing techniques by audiologists may increase hearing aid use in patients.
CONCLUSIONS: Most studies of clinicians' behaviours were descriptive, with very little research linking clinician behaviour to patient outcomes. The present review sets the research agenda for better-controlled intervention studies to identify which clinician behaviours better promote patient hearing aid outcomes and develop an evidence base for best clinical practice.
METHODS: Qualitative study using one-to-one semi-structured interviews conducted with 22 HCPs involved in the care of diabetic patients (6 endocrinologists, 4 general practitioners, 4 nurses and 8 pharmacists). Participants were recruited through general practices, community pharmacies and a diabetic centre in Saudi Arabia. Data were analyzed using thematic analysis.
RESULTS: Five key themes resulted from the analysis. HCPs generally demonstrated negative perceptions toward CAM, particularly regarding their evidence-based effectiveness and safety. Participants described having limited interactions with diabetic patients regarding CAM use due to HCPs' lack of knowledge about CAM, limited consultation time and strict consultation protocols. Participants perceived convenience as the reason why patients use CAM. They believed many users lacked patience with prescribed medications to deliver favourable clinical outcomes and resorted to CAM use.
CONCLUSIONS: HCPs have noted inadequate engagement with diabetic patients regarding CAM due to a lack of knowledge and resources. To ensure the safe use of CAM in diabetes and optimize prescribed treatment outcomes, one must address the communication gap by implementing a flexible consultation protocol and duration. Additionally, culturally sensitive, and evidence-based information should be available to HCPs and diabetic patients.
METHODS: The Noor Evidence-Based Medicine Questionnaire was tested among physicians in a government hospital between July and August 2018. Exploratory factor analysis and internal consistency reliability-based Cronbach's alpha statistic were conducted.
RESULTS: The questionnaire was distributed among 94 physicians, and 90 responded (response rate of 95.7%). The initial number of items in the KAP domains of the Noor Evidence-Based Medicine Questionnaire were 15, 17, and 13, respectively; however, two items in the practice domain with communalities <0.25 and factor loadings <0.4 were removed. The factor structure accounted for 52.33%, 66.29%, and 55.39% of data variance in the KAP domains, respectively. Cronbach's alpha values were 0.81, 0.81, and 0.84 for KAP domains, respectively, indicating high reliability.
CONCLUSIONS: This questionnaire can be used to evaluate the knowledge, attitudes, and behaviour of healthcare professionals toward EBM. Future testing of this questionnaire among other medical personnel groups will help expand the scope of this tool.
OBJECTIVE: To determine the validity and reliability of the PPCI for physicians in Malaysia.
SETTING: An urban tertiary hospital in Malaysia.
METHODS: This prospective study was conducted from June to August 2014. Doctors were grouped as either a "collaborator" or a "non-collaborator". Collaborators were doctors who regularly worked with one particular clinical pharmacist in their ward, while non-collaborators were doctors who interacted with any random pharmacist who answered the general pharmacy telephone line whenever they required assistance on medication-related enquiries, as they did not have a clinical pharmacist in their ward. Collaborators were firstly identified by the clinical pharmacist he/she worked with, then invited to participate in this study through email, as it was difficult to locate and approach them personally. Non-collaborators were sampled conveniently by approaching them in person as these doctors could be easily sampled from any wards without a clinical pharmacist. The PPCI for physicians was administered at baseline and 2 weeks later.
MAIN OUTCOME MEASURE: Validity (face validity, factor analysis and discriminative validity) and reliability (internal consistency and test-retest) of the PPCI for physicians.
RESULTS: A total of 116 doctors (18 collaborators and 98 non-collaborators) were recruited. Confirmatory factor analysis confirmed that the PPCI for physicians was a 3-factor model. The correlation of the mean domain scores ranged from 0.711 to 0.787. "Collaborators" had significantly higher scores compared to "non-collaborators" (81.4 ± 10.1 vs. 69.3 ± 12.1, p < 0.001). The Cronbach alpha for the overall PPCI for physicians was 0.949, while the Cronbach alpha values for the individual domains ranged from 0.877 to 0.926. Kappa values at test-retest ranged from 0.553 to 0.752.
CONCLUSION: The PPCI for physicians was a valid and reliable measure in determining doctors' views about collaborative working relationship with pharmacists, in Malaysia.
METHODS: The study from March 2016 to April 2017 was conducted to validate the 'Work Readiness Scale' (WRS; Deakin University) using Principal Component Analysis and Cronbach - α for internal consistency. It was modified to a four-item even-point scale and distributed as an online survey to 335 final year students of the three programs.
RESULTS: A reduction from 64 to 53 items provided good internal consistency in all factors: WC 0.85, OA 0.88, SI 0.88 and PC 0.71. The PC domain had the greatest item reduction from 22 to 6, whilst the SI domain increased in items from 8 to 19. These changes may be associated with difference in understanding or interpretation of the items in the SI domain.
CONCLUSION: The modified WRS can be used to evaluate job readiness in HP graduates. However, it needs further refinement and validation in specific educational and employment contexts.
DESIGN/METHODOLOGY/APPROACH: This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.
FINDINGS: The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker-Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as "during your registration," "hospital staff attitude," "doctor's attitude" and "overall assessment."
RESEARCH LIMITATIONS/IMPLICATIONS: Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.
PRACTICAL IMPLICATIONS: Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.
SOCIAL IMPLICATIONS: Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.
ORIGINALITY/VALUE: The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.
METHOD: We conducted a preliminary study using semi-structured interviews with sixteen (16) Malaysian female expatriate nurses working in SA to obtain a broader understanding of their experiences with cross-cultural adaptation and their use of social media tools to connect with their families and friends in their home country.
RESULTS: This study uncovers numerous social media communication tools being used by female expatriate nurses to help curb their loneliness and lessen the culture shock of living and working in a foreign country. Continuous engagement with these tools helps Malaysian female expatriate nurses maintain their emotional stability, thereby enabling them to remain mentally strong and ultimately prolonging their stay in SA.
CONCLUSIONS: This study's outcomes contribute significantly to the knowledge of the government, various organizations, and aspiring female expatriate nurses in the healthcare industry because the results can assist female expatriate nurses during the adjustment period, enabling them to work efficiently and successfully in the host country.
AIM: To examine the use of hermeneutic phenomenology and the ethnographic principle of cultural interpretation in a research study conducted with Malaysian nurses on part-time, transnational, post-registration, top-up nursing degree programmes provided by one Australian and two UK universities.
DISCUSSION: To enable the researcher to undertake international cross-cultural research and illuminate Malaysian nurses' views for the reader, cultural aspects need to be considered, as they will influence the information participants provide. Useful strategies that western researchers can adopt to co-create research texts with interviewees are outlined. The paradigm and research designs used in the study revealed the views and experiences of Malaysian nurses.
CONCLUSION: Hermeneutic phenomenology enabled the exploration of participants' experiences, and the ethnographic principle of cultural interpretation enabled the researcher's reflexivity to provide emic and etic views for the reader.
IMPLICATIONS FOR PRACTICE: This paper adds to the discussion of the paradigms and research designs used for international, cross-cultural research in Asia. It identifies the influence participants' cultural values have on their confidence and level of disclosure with western researchers.
METHOD: Four hundred and twenty-three subjects were recruited from center records using a systematic random sampling technique. Subjects who consented were interviewed by telephone using a specially designed semi-structured questionnaire. Descriptive as well as comparative analyses were carried out. Differences between groups were tested using the Chi-square test when applicable.
RESULTS: The majority of users surveyed (89.6%) had called the center from within Khartoum State and 10.4% of users had called from other states. Of the enquiries, 36.1% were from pharmacists, 29.5% from physicians, and 22.3% from laypersons. The vast majority (93.1%) of respondents were educated to degree level or higher. Approximately one fifth, one half, and one third of the users surveyed had consulted the center >5 times, 2-5 times, and once, respectively. More than 90% of users rated the services provided as good to excellent and 94.7% declared their probable intention to continue utilizing the center in the future.
CONCLUSION: The center succeeded in satisfying and retaining its users by providing an acceptable quality of service.
BACKGROUND: A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals.
DESIGN: A cross-sectional study was used.
METHODS: A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses (n = 309) in twelve wards of a teaching hospital in Kuala Lumpur.
RESULTS: Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint. Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint.
CONCLUSION: This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint.
RELEVANCE TO CLINICAL PRACTICE: Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals.