METHODS: A discrete choice experiment was developed to include 7 attributes valued in cancer management: physical, psychological and social functioning, pain control, survival, place of death, and cost. Patients were recruited via convenience sampling from 2 Malaysian public hospitals. The survey questionnaire was administered to patients within 6 months of their cancer diagnosis with a follow-up 3 months later. Conditional logit regression was used to estimate the preference weight, relative attribute importance, and willingness to pay.
RESULTS: One hundred valid responses were collected at baseline and 45 at follow-up. Respondents placed higher values on QoL improvements from severe to moderate or mild levels and to achieve home death over survival extension from 6 to 18 months. However, additional improvements (from moderate to mild) in some of the QoL outcomes were not valued as highly as life extension from 12 to 18 months, showing that it was vital for patients to avoid being in "severe" health dysfunction. Improving physical dysfunction from severe to mild yielded 3 times as much value as additional 1-year survival. After 3 months, the respondents' preferences changed significantly, with increased relative attribute importance of physical functioning, pain control, and cost.
CONCLUSIONS: As QoL outcomes are valued more than survival, palliative care should be introduced as early as possible to alleviate suffering related to advanced cancer.
METHOD: In the largest test of the mate preference priority model to date, we asked an international sample of participants (N = 2,477) to design an ideal long-term partner by allocating mate dollars to eight traits using three budgets. Unlike previous versions of the task, we included traits known to vary in importance by culture (e.g., religiosity and chastity).
RESULTS: Under low budget conditions, Eastern and Western participants differed in their mate dollar allocation for almost every trait (average d = 0.42), indicating that culture influences prioritization. Despite these differences, traits fundamental for the reproductive success of each sex in the ancestral environment were prioritized by both Eastern and Western participants.
CONCLUSION: The tendency to prioritize reproductively fundamental traits is present in both Eastern and Western cultures. The psychological mechanisms responsible for this process produce similar prioritization patterns despite cross-cultural variation.
METHODS: Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literature. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
RESULTS: Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and steadfast despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs.
CONCLUSIONS: Women may choose unassisted home birth to express their personal views and values, at the expense of the health risks. Apart from increasing mothers' awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers' beliefs and values.
METHODS: A cross-sectional survey was conducted using an online questionnaire on 385 respondents collected through convenience sampling. The survey consisted of four parts: socio-demographic background, health awareness, understanding and usage of health and nutrition claims, and purchase intention measured through the use of a mock packaging. Data collected were analyzed using SPSS version 22.
RESULTS: Most of the respondents aged 18-30 (81.0%) and almost half of them were Malay (45.7%) with bachelor/master or PhD qualification (60.0%). The distribution of household income for all categories was almost similar (18.2-20.8%). There was a significant statistical relationship between health awareness and purchase intention among respondents (r=0.391, p<0.01).
CONCLUSIONS: Health and nutrition claims influenced consumer's perceptions and purchase intention, especially for those who were more concerned about their health, thus, more focus on policy regarding claims is needed.
Methods: A cross-sectional study was conducted among elderly patients that seeking treatment in a primary care clinic in Malaysia from September to November 2018 using a set of researcher-assisted and validated questionnaire on their consent.
Findings: A total of 182 elderly patients were included in this study. A majority of participants (n = 87, 47.8%) admitted experiencing practical problems with their medication use. There are varieties of choice of management strategy employed by elderly patients to overcome the problems. For the willingness to deprescribing, there were positive correlation for patients' age (rs (182) =0.183, P < 0.05) and number of medications (rs (182) =0.271, P < 0.01) with the burden factor. There were also a negative correlation of age (rs (182) = -0.174, P < 0.05) and number of medication (rs (182) = -0.176, P < 0.04) with appropriateness of medications.
Conclusion: A majority of Malaysian elderly experience practical problems with their medication use. Elderly patients' belief and attitudes toward deprescribing were influenced by age and number of medications.
Method: A quasi-experimental study was conducted using 254 first-year medical students with no prior exposure to the lecture topic during the 2016/17 and 2017/18 academic sessions. The students from each batch were divided into two groups and exposed to different video material. Group A watched an action movie, while Group B watched an educational video related to the lecture topic. After 15 min, both groups attended a lecture on the gross anatomy of the heart, which was delivered by a qualified anatomist. At the end of the lecture, their understanding of the material was measured through a post-lecture test using ten vetted multiple choice true/false questions.
Results: Group B's test scores were found to be significantly higher than Group A's (p > 0.001, t-stats [df] = -4.21 [252]).
Conclusion: This study concluded that the pre-lecture activity had successfully provided the students with some prior knowledge of the subject before they attended the lecture sessions. This finding was aligned with cognitive load theory, which describes a reduction in learners' cognitive load when prior knowledge is stimulated.
METHODS: A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest.
RESULTS: Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding.
CONCLUSION: Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.
METHODS: Respondents were sampled with quotas for urbanicity, gender, age, and ethnicity to ensure representativeness of the Malaysian population. The study was conducted using a standardized protocol involving the EuroQol Valuation Technology (EQ-VT) computer-assisted interview system. Respondents were administered ten composite time trade-off (C-TTO) tasks and seven discrete choice experiment (DCE) tasks. Both linear main effects and constrained non-linear regression models of C-TTO-only data and hybrid models combining C-TTO and DCE data were explored to determine an efficient and informative model for value set prediction.
RESULTS: Data from 1125 respondents representative of the Malaysian population were included in the analysis. Logical consistency was present in all models tested. Using cross-validation, eight-parameter models for C-TTO only and C-TTO + DCE hybrid data displayed greater out-of-sample predictive accuracy than their 20-parameter, main-effect counterparts. The hybrid eight-parameter model was chosen to represent the Malaysian value set, as it displayed greater out-of-sample predictive accuracy over C-TTO data than the C-TTO-only model, and produced more precise estimates. The estimated value set ranged from - 0.442 to 1.
CONCLUSIONS: The constrained eight-parameter hybrid model demonstrated the best potential in representing the Malaysian value set. The presence of the Malaysian EQ-5D-5L value set will facilitate its application in research and health technology assessment activities.
DESIGN: Retrospective cross-sectional study.
STUDY SAMPLE: 1068 subjects issued with HAs at a tertiary hospital from 2001 to 2013.
RESULTS: Half of the subjects presented with more severe (>55 dB) hearing loss (HL) in their better ear. In multivariable analysis, older age, Malay ethnicity, conductive and mixed HL, and combination type of HL were associated with more severe HL at first presentation. Over 70% of subjects were older than 65 years. Worse pure tone audiometry (PTA) thresholds of the better ear, gradual onset and sensorineural HL were associated with older age presentation. For unilaterally fitted subjects, PTA thresholds were the only determinant of having the better ear aided. Better PTA thresholds, younger age and sensorineural HL were associated with choosing in ear compared to behind the ear HAs. Younger age and worse PTA of the better ear were associated with ≥4 h of daily HA usage.
CONCLUSIONS: Age, ethnicity and type of HL were important determinants for more severe HL at first HA fitting. Older patients and those with better hearing were less likely to use their HAs regularly.
DATA SOURCES: Twelve electronic bibliographic databases.
REVIEW METHODS: Evidence was extracted from original studies, and integrated in a narrative synthesis guided by the PRISMA statement for reporting systematic reviews. Personal domains were clustered into themes using a modified Delphi technique.
RESULTS: A total of 584 articles were screened. 65 unique studies (80 articles) matched our inclusion criteria of which seven were conducted within nursing/midwifery faculties. Six in 10 studies featured applicants to medical school. Across selection processes, we identified 32 personal domains assessed by MMIs, the most frequent being: communication skills (84%), teamwork/collaboration (70%), and ethical/moral judgement (65%). Domains capturing ability to cope with stressful situations (14%), make decisions (14%), and resolve conflict in the workplace (13%) featured in fewer than ten studies overall. Intra- and inter-disciplinary inconsistencies in domain profiles were noted, as well as differences by entry level. MMIs deployed in nursing and midwifery assessed compassion and decision-making more frequently than in all other disciplines. Own programme philosophy and professional body guidance were most frequently cited (~50%) as sources for personal domains; a blueprinting process was reported in only 8% of studies.
CONCLUSIONS: Nursing, midwifery and allied healthcare professionals should develop their theoretical frameworks for MMIs to ensure they are evidence-based and fit-for-purpose. We suggest a re-evaluation of domain priorities to ensure that students who are selected, not only have the capacity to offer the highest standards of care provision, but are able to maintain these standards when facing clinical practice and organisational pressures.
METHOD: The study was carried out by collecting data from field observation and questionnaire distribution on the street among the public. The data were statistically analyzed by applying multiple linear regression models and a series of chi-square tests.
RESULTS: The study found that the most influential factor cited by pedestrians in decision making regarding using a footbridge is the existence of an escalator. Being in a hurry and the fear of heights were significantly associated with choosing not to use a footbridge. Zebra crossing was chosen as the most favorable type of crossing facility by the majority of respondents. In addition, installation of a fence and barriers was proposed as an effective procedure to prevent jaywalking. To construct new and efficient footbridges in the future, the study suggests consideration of traffic volume, posted speed limit, and the number of lanes, because these are the most influential factors to predict the usage rate.
CONCLUSIONS: The study encourages decision makers and stakeholders to consider providing escalators for new footbridges to enhance the safety of pedestrians.