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  1. Aryane Suwin, Faye Borine, Hasya Putri Sari Amrizal, Muhammad Fakhrulraazi Rajiei, Muhammad Hafizul Zainal, Muhammad Syamil Zolpakar, et al.
    MyJurnal
    Introduction: Clinical and sharp bins are commonly found in clinical settings. The usage of these bins is vital to ensure that health care facilities remain hygienic, free from any microbial transmissions and incidences of needle stick injuries. ‘oQ-Ba’ is a Japanese phrase that means bin. In real clinical settings, it is difficult to gather all bins at once while performing procedure due to limitations of space, frequency and mobility of bins. Therefore, ‘oQ-Ba’ the Universal Bins Trolley is developed to improve the waste management practice and increase the efficiency and effectivity of care delivery. Methods: A total of 40 respondents comprised of staffs from Emergency and Trauma De- partment and Haemodialysis Unit at Serian District Hospital were selected to use “oQ-Ba” the Universal Bins Trolley. They were given self-administered questionnaires pre and post-trials whichcomposed of ‘yes’ or ‘no’ answers to ob- tain feedbacks on the effectiveness of this project. Descriptive statistics include frequencies, means and percentages were used to analyze the data using the SPSS version 22. Results: The staffs found that the prototype helps to ensure the availability of the three bins as the bins are all attached together under one compartment. The staffs also found that the prototype is more convenient compared to the existing waste bins because of its mobility and unique design which consumed little amount of space. Conclusion: ‘oQ-Ba’ the Universal Bins Trolley provides handful of benefits to medical practitioners as it can ensure the availability of the three bins during a procedure.
    Matched MeSH terms: Delivery of Health Care
  2. Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI
    Malays J Med Sci, 2021 Apr;28(2):142-156.
    PMID: 33958968 DOI: 10.21315/mjms2021.28.2.13
    Background: Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.

    Methods: A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying.

    Results: The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.

    Conclusion: The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.

    Matched MeSH terms: Delivery of Health Care
  3. Idris IB, Hamis AA, Bukhori ABM, Hoong DCC, Yusop H, Shaharuddin MA, et al.
    BMC Womens Health, 2023 Dec 02;23(1):643.
    PMID: 38042837 DOI: 10.1186/s12905-023-02792-4
    OBJECTIVES: Although there are calls for women's empowerment and gender equity globally, there are still large disparities regarding women's autonomy in healthcare decision making. The autonomy of women is believed to be crucial in improving their health-related outcomes. This review discusses factors that influence autonomy among women in healthcare decision making.

    DESIGN: Systematic review.

    DATA SOURCES: PubMed, Web of Science and Scopus were searched from 2017-2022.

    ELIGIBILITY CRITERIA: The inclusion criteria include original articles, case studies and reports that has been written in the English Language, while manuscripts with no full article, reviews, newspaper reports, grey literatures, and articles that did not answer the review objectives were excluded.

    DATA EXTRACTION AND SYNTHESIS: We carried out data extraction using a standardized data extraction form, that has been organized using Microsoft Excel. A narrative synthesis was carried out to combine the findings of all included articles.

    RESULTS: A total of 70 records were identified and 18 were reviewed, yielding eight articles to be included in the accepted list of studies. All studies were conducted in developing countries and most of the studies were cross sectional. Factors that were associated with women's autonomy in healthcare decision making were age, women's education and occupation, husbands'/partners' education and occupation, residential location or region of residence, household wealth index as well as culture and religion.

    CONCLUSIONS: Identification of these factors may help stakeholders in improving women's autonomy in healthcare decision making. Policymakers play a crucial role in healthcare decision making by enacting laws and policies that protect women's rights, promoting gender-sensitive healthcare services, ensuring access to comprehensive information, promoting health education, and supporting vulnerable populations. These efforts ensure women's autonomy including able to access to unbiased and effective healthcare services.

    Matched MeSH terms: Delivery of Health Care
  4. BasheeruddinAsdaq SM, Naveen NR, Gunturu LN, Pamayyagari K, Abdullah I, Sreeharsha N, et al.
    Biomed Res Int, 2021;2021:9195965.
    PMID: 34977249 DOI: 10.1155/2021/9195965
    Since its outbreak, the coronavirus (COVID-19) pandemic has caused havoc on people's lives. All activities were paused due to the virus's spread across the continents. Researchers have been working hard to find new medication treatments for the COVID-19 pandemic. The World Health Organization (WHO) recommends that safety and self-measures play a major role in preventing the virus from spreading from one person to another. Wireless technology is playing a critical role in avoiding viral propagation. This technology mainly comprises of portable devices that assist self-isolated patients in adhering to safe precautionary measures. Government officials are currently using wireless technologies to identify infected people at large gatherings. In this research, we gave an overview of wireless technologies that assisted the general public and healthcare professionals in maintaining effective healthcare services during COVID-19. We also discussed the possible challenges faced by them for effective implementation in day-to-day life. In conclusion, wireless technologies are one of the best techniques in today's age to effectively combat the pandemic.
    Matched MeSH terms: Delivery of Health Care
  5. Cheah WL, Francis Wing CB, Zahari AN, Idris AS, Maksul NAA, Yusman NAL, et al.
    Ethics Med Public Health, 2021 Jun;17:100651.
    PMID: 33754125 DOI: 10.1016/j.jemep.2021.100651
    Background: The COVID-19 pandemic has resulted in many changes in the delivery of health service which not only affect the public as well as healthcare workers, and also among medical and nursing students who are currently undergoing their training. This study aims to determine the commitment and willingness of medical and nursing students in Sarawak in treating patients with COVID-19 and its associated factors.

    Methods: It was a cross-sectional study using online questionnaire, carried out in a public university in Sarawak, Malaysia. All medical and nursing students were invited to participate in this study. Data was entered and analysed using IBM SPSS version 22.

    Result: A total of 304 respondents participated in the study, with 81.6% female and 69.4% medical students. Majority of the respondents were most willing to take a medical history, do a physical examination, throat swabbing, draw blood and perform IV drip insertion. There was a high commitment among respondents to treat COVID-19 patients regardless of personal risks. Majority of the respondents also agreed that medical staff who are involved in treating COVID-19 patients should be receiving a salary increase and compensation should be given to affected healthcare families, and all non-medical staff should be involved in treating COVID-19 patients. About 71% agreed about a law mandating medical staffs to treat patient.

    Conclusion: The willingness and commitment of medical and nursing students to treat COVID-19 patients was high, indicating their potential work force as healthcare providers.

    Matched MeSH terms: Delivery of Health Care
  6. Khalib, A.L., Nirmalini, R.
    MyJurnal
    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.
    Matched MeSH terms: Delivery of Health Care
  7. Tan CSS, Lee SWH
    Br J Clin Pharmacol, 2021 02;87(2):352-374.
    PMID: 32478963 DOI: 10.1111/bcp.14404
    AIMS: To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin.

    METHODS: A systematic literature review was performed on 5 databases from inception up to 31 December 2019. These interactions were classified depending on the likelihood of interaction and supporting evidences.

    RESULTS: A total of 149 articles describing 78 herbs, food or dietary supplements were reported to interact with warfarin. These reports described potentiation with 45 (57.7%) herbs, food or dietary supplements while 23 (29.5%) reported inhibition and 10 (12.8%) reported limited impact on warfarin pharmacokinetics and pharmacodynamics. Twenty unique herb and dietary supplements also reported to result in minor bleeding events, such as purpura and gum bleeding as well as major events such as intracranial bleeding that led to death.

    CONCLUSION: While most food, herbs and supplements can be safely taken in moderation, healthcare professionals should be aware of the increased risk of bleeding when taking several food and herbs. These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco. Patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.

    Matched MeSH terms: Delivery of Health Care
  8. Peng JY
    IDRC Rep, 1977;6(2):8.
    PMID: 12335042
    Matched MeSH terms: Delivery of Health Care
  9. Sreeramareddy CT, Sathyanarayana TN, Kumar HN
    PLoS One, 2012;7(12):e51904.
    PMID: 23284810 DOI: 10.1371/journal.pone.0051904
    BACKGROUND: Information about utilization of health services and associated factors are useful for improving service delivery to achieve universal health coverage.
    METHODS: Data on a sample of ever-married women from India Demographic and Health survey 2005-06 was used. Mothers of children aged 0-59 months were asked about child's illnesses and type of health facilities where treatment was given during 15 days prior to the survey date. Type of health facilities were grouped as informal provider, public provider and private provider. Factors associated with utilization of health services for diarrhea and fever/cough was assessed according to Andersen's health behavior model. Multinomial logistic regression analyses were done considering sampling weights for complex sampling design.
    RESULTS: A total of 48,679 of ever-married women reported that 9.1% 14.8% and 17.67% of their children had diarrhea, fever and cough respectively. Nearly one-third of the children with diarrhea and fever/cough did not receive any treatment. Two-thirds of children who received treatment were from private health care providers (HCPs). Among predisposing factors, children aged 1-2 years and those born at health facility (public/private) were more likely to be taken to any type of HCP during illness. Among enabling factors, as compared to poorer household, wealthier households were 2.5 times more likely to choose private HCPs for any illness. Children in rural areas were likely to be taken to any type of HCP for diarrhea but rural children were less likely to utilize private HCP for fever/cough. 'Need' factors i.e. children having severe symptoms were 2-3 times more likely to be taken to any type of HCP.
    CONCLUSION: Private HCPs were preferred for treatment of childhood illnesses. Involvement of private HCPs may be considered while planning child health programs. Health insurance scheme for childhood illnesses may to protect economically weaker sections from out-of-pocket health expenditure during child illness.
    Matched MeSH terms: Delivery of Health Care*
  10. Khan SA, Omar H, Babar MG, Toh CG
    J Dent Educ, 2012 Dec;76(12):1675-83.
    PMID: 23225687
    Health economics, a special branch of science applying economic principles to the health delivery system, is a relatively young subdiscipline. The literature is scanty about teaching health economics in the medical and dental fields. Delivery methods of this topic vary from one university to another, with lectures, seminars, and independent learning reported as teaching/learning tools used for the topic. Ideally, debates should foster the development of logical reasoning and communication skills. Health economics in dentistry is taught under the community oral health module that constitutes part of an outcome-based dental curriculum in a private dental school in Kuala Lumpur, Malaysia. For this study, the students were divided into two groups: active participants (active debaters) and supporting participants (nonactive debaters). The debate style chosen for this activity was parliamentary style. Active and nonactive debaters' perceptions were evaluated before and after the activity through a structured questionnaire using a five-point rating scale addressing the topic and perceptions about debate as an educational tool. Cronbach's alpha coefficient was used as a measure of internal consistency for the questionnaire items. Among a total of eighty-two third-year dental students of two successive cohorts (thirty-eight students and forty-four students), seventy-three completed the questionnaire, yielding a response rate of 89 percent. Students' responses to the questionnaire were analyzed with the Kruskal-Wallis analysis of variance test. Results revealed that the students felt that their interest in debate, knowledge of the topic, and reinforcement of the previous knowledge had improved following participation in the debate. Within the limitations of this study, it can be concluded that debate was a useful tool in teaching health economics to dental students.
    Matched MeSH terms: Delivery of Health Care/economics*
  11. Bandaranayake RC, Singh PJ
    Med Educ, 1993 Nov;27(6):509-17.
    PMID: 8208159
    The tracer concept was applied to evaluate the delivery of family health care and the training of family health workers. A retrospective evaluation permitted linking the products of care to process, input and context, by isolating and analysing potential factors contributing to a limited number of representative concerns. Contributory learning deficiencies identified in health workers, one input to health care as well as a product of training, enabled the evaluation of training programmes to be focused on related segments of the courses. The latter were evaluated through a pathway analysis which followed the same deficiency model as the evaluation of health care. Links were thus established between the traditionally compartmentalized training and service sectors in health.
    Matched MeSH terms: Delivery of Health Care
  12. Mothupi M, Dasgupta J, Hosseini Jebeli SS, Stevenson J, Berdichevsky K, Vong S, et al.
    BMJ, 2023 Jun 07;381:e072243.
    PMID: 37286226 DOI: 10.1136/bmj-2022-072243
    Intersectional analysis and action are needed to prepare for future pandemics and ensure more inclusive health services, say Mamothena Mothupi and colleagues
    Matched MeSH terms: Delivery of Health Care
  13. Abd Khalim MA, Sukeri S
    PLoS One, 2023;18(1):e0278404.
    PMID: 36649258 DOI: 10.1371/journal.pone.0278404
    Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.
    Matched MeSH terms: Delivery of Health Care
  14. Raza A, Jauhar J, Abdul Rahim NF, Memon U, Matloob S
    PLoS One, 2023;18(10):e0288527.
    PMID: 37796908 DOI: 10.1371/journal.pone.0288527
    In Pakistan, women outnumber men in medical colleges with 80 percent enrollment, yet many fail to practice medicine following graduation. Pakistan Medical Council (PMC) states 50 percent of graduated women doctors either did not practice or left employment in a short period. Thus, the non-servicing women doctors are assumed as the one of the major causes for the overall doctors' shortage in the country. Addressing this enduring matter, this study aims to explore and understand the factors that discourage women doctors from practicing medicine in Pakistani hospitals. The study employed qualitative exploratory inquiry with an interpretive paradigm to attain a deeper understanding of the problem. 59-semi structured interviews were conducted by non-working women doctors across the entirety of Pakistan. The narratives were then analyzed by thematic analysis using ATLAS.ti 22. The findings have resulted in the three major themes, i.e., workplace challenges, socio-cultural obstructions, and familial restrictions that possibly obstruct women from practicing medicine in hospitals. The findings suggested that accepting traditional cultural values, including entrenched gender roles in society, deters women from practicing medicine. The prevailing patriarchal societal system includes stereotypes against working women; early marriages hinder women from practicing medicine. The prevailing societal system upholds the influence of in-laws and a husband for women doctor professional employment. As a result, severe work-life conflict was reported where most women doctors ended up in their profession in the middle of struggling between socially rooted gender roles as homemakers and their professional careers-furthermore, the study found various workplace issues that posit an additional burden on already struggling women doctors. Issues include poor recruitment and selection process, transfer constraints, excessive workload with inadequate salary, harassment, gender discrimination, unsafe work environment, and little support from the administration highly contribute to the shortage of women doctors in Pakistan.
    Matched MeSH terms: Delivery of Health Care
  15. Zakaria N, Zakaria N, Alnobani O, AlMalki M, El-Hassan O, Alhefzi MI, et al.
    Int J Med Inform, 2023 Feb;170:104914.
    PMID: 36521421 DOI: 10.1016/j.ijmedinf.2022.104914
    BACKGROUND: During the past two decades, various sectors and industries have undergone digital transformation. Healthcare is poised to make a full transformation in the near future. Although steps have been taken toward creating an infrastructure for digital health in the Middle East, as it stands, digital health is still an emerging field here. The current global health care crisis has underscoredthe need for digitization of the healthcare sector to provide high-value, high-quality care and knowledge generation. With the advent of digital transformation in countries around the globe, there is a rising demand for investment and innovation in health information technology. With the demand for health informatics (HI) graduates in different disciplines (e.g., healthcare professions, information technology, etc.), there is an urgent need to determine and regulate clear career pathways and the core competencies necessary for digital health professional to practice effectively and to allow technology to add value to the healthcare systems. Given the changing landscape of the profession, the Kingdom of Saudi Arabia (KSA) and the Gulf Cooperation Council (GCC) countries are experiencing a rising demand to produce digital health professionals who can meet the needs of all the stakeholders involved, including patients, healthcare professionals, managers, and policymakers. However, despite the number of region-wide initiatives in the form of training programs, there remains a knowledge-practice gap and unclear job roles within the HI community. In recent years, regional digital health workforce initiatives have been put forward, such as the GCC Taskforce on Workforce Development in Digital Healthcare. The taskforce initiated a survey and several workshops to identify and classify HI disciplines according to the needs of the job market and through comparisons with similar efforts developed across the globe, such as the TIGER project and the EU*US eHealth Work project. Digital health implementation has been flourishing in the Middle East for the past 15 years. During this period, while digital health professions have been thriving in the industry to deliver tools and technologies, academic institutions have offered some amount of training and education in digital health; however, the career pathway for digital health professionals is not clear due to mismatch about the qualifications, skills, competencies and experience needed by the healthcare industry.

    OBJECTIVES: Due to this discrepancy between the academic curriculum and the skills needed in the healthcare industry, the objectives of this study are to define the career pathway for eHealth professions and identify the challenges experienced by academic institutions and the industry in describing digital health professionals.

    METHODS: We elicited qualitative data by conducting six focus groups with individuals from different professional backgrounds, including healthcare workers, information managers, computer sciences professionals, and workers in the revenue cycle who participated in a workshop on November 2-3, 2019, in Dubai. All focus group sessions were audio-recorded and transcribed, and participants were de-identified before analysis. An exploratory method was used to identify themes and subthemes. Saturation was reached when similar responses were found during the analysis. In this study, we found that respondents clearly defined eHealth career pathways based on criteria that included qualifications, experience, job scope, and competency. We also explored the challenges that the respondents encountered, including differences in the required skill sets and training and the need to standardize the academic curriculum across the GCC region, to recognize the various career pathways, and to develop local training programs. Additionally, country-specific projects have been initiated, such as the competency-based Digital Health framework, which was developed by the Saudi Commission of Healthcare Specialties (SCFHS) in 2018. Competency-based digital health frameworks generally include relevant job definitions, roles, and recommended competencies. Both the GCC taskforce and the Saudi studies capitalized on previous efforts by professional organizations, including Canada's Digital Health formerly known as (COACH), the U.S. Office of the National Coordinator for Health Information Technology (ONC), the American Medical Informatics Association (AMIA), and the Health Information and Management Systems Society (HIMSS).

    RESULTS: In this study, we found that respondents defined eHealth career pathways based on different criteria such as: qualifications; various background of health and IT in the HI field; work experiences; job scope and competency. We also further explore the challenges that the respondents encountered which delineates four key aspects such as need of hybrid skills to manage the digital transformation, need of standardization of academic curriculum across GCC, recognition of the career pathways by the industry in order to open up career opportunity and career advancement, and availability of local training programs for up-skilling the current health workforce.

    CONCLUSION: We believe that successful health digital transformation is not limited to technology advancement but requires an adaptive change in: the related competency-based frameworks, the organisation of work and career paths for eHealth professionals, and the development of educational programmes and joint degrees to equip clinicians with understanding of technology, and informaticians with understanding of healthcare. We anticipate that this work will be expanded and adopted by relevant professional and scientific bodies in the GCC region.

    Matched MeSH terms: Delivery of Health Care*
  16. Ng CW, Md Hairi NN, Ng CJ, Kamarulzaman A
    Socioeconomic development in Malaysia, over the past few decades, has led to the improvement and expansion of the public healthcare system. This system has provided universal access to a low-priced package of comprehensive health care leading Malaysia to claim to have achieved universal health coverage (UHC). However, the Malaysian health landscape is changing rapidly. Provision of private care has grown especially in large urban towns, mainly in response to public demand. Thus far, private care has been predominantly bought and utilised by the rich but because of differentials in quality of care between the public and private sector, unabated expansion of the private health sector has the potential to adversely affect universal access to care. This effect may be accentuated in the coming years by demographic changes in the country specifically by the ageing of the population. This paper is intended to highlight challenges to UHC in Malaysia in the face of the changing health landscape in the country and to offer some suggestions as to how these challenges can be met.
    Matched MeSH terms: Delivery of Health Care
  17. Risso-Gill I, Balabanova D, Majid F, Ng KK, Yusoff K, Mustapha F, et al.
    BMC Health Serv Res, 2015;15:254.
    PMID: 26135302 DOI: 10.1186/s12913-015-0916-y
    The growing burden of non-communicable diseases in middle-income countries demands models of care that are appropriate to local contexts and acceptable to patients in order to be effective. We describe a multi-method health system appraisal to inform the design of an intervention that will be used in a cluster randomized controlled trial to improve hypertension control in Malaysia.
    Matched MeSH terms: Delivery of Health Care/organization & administration*
  18. Sahathevan S, Khor BH, Ng HM, Gafor AHA, Mat Daud ZA, Mafra D, et al.
    Nutrients, 2020 Oct 15;12(10).
    PMID: 33076282 DOI: 10.3390/nu12103147
    Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.
    Matched MeSH terms: Delivery of Health Care
  19. LILY LIM, ZABIDAH PUTIT, CHANG CHING THON
    MyJurnal
    A qualitative study was conducted to assess the nursing students’ experiences of their clinical practice at one public university in Sarawak, Malaysia. Purposive sampling was used to recruit nine undergraduate nursing degree students at a medical faculty. An in-depth interview based on an open-ended questionnaire was used to collect data. The open-ended questionnaire was used to assess the students’ expectation, feelings, challenging experiences related to work culture, knowledge and skills in patient care, teaching learning supports, people interpersonal relationship, students’ role and their coping mechanism in clinical practice. Data were analysed using content analysis approach facilitated by Nvivo software (Version 8.) The themes emerged from the data analysis included (a) Gaining insight into the reality of clinical working environment and (b) challenges. The subthemes illustrated the students’ challenges were interpersonal relationship with people at the work place, different ward environment, theorypractice gap and insufficient clinical practice, and anxiety. The participants also reported experiencing anxiety due to challenges; however, after a period of time, they learnt to cope with them. The students were able to use different coping mechanism such as internal and external motivation, and this increased their confidence as they progressed in their learning. The learning difficulties faced by nursing students during clinical placement show that a supportive learning environment is important. This study proposed practical strategies to empower students in clinical learning and increase their self-esteem and confidence. In order to improve quality of students’ clinical education, adequate and effective work collaboration between nursing education and health care services are recommended. Future research should focus on how to create a supportive clinical learning environment in local setting
    Matched MeSH terms: Delivery of Health Care
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