Displaying publications 1 - 20 of 26 in total

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  1. Fletcher E, Burns A, Wiering B, Lavu D, Shephard E, Hamilton W, et al.
    BMC Prim Care, 2023 Jan 20;24(1):23.
    PMID: 36670354 DOI: 10.1186/s12875-023-01973-2
    BACKGROUND: Electronic clinical decision support tools (eCDS) are increasingly available to assist General Practitioners (GP) with the diagnosis and management of a range of health conditions. It is unclear whether the use of eCDS tools has an impact on GP workload. This scoping review aimed to identify the available evidence on the use of eCDS tools by health professionals in general practice in relation to their impact on workload and workflow.

    METHODS: A scoping review was carried out using the Arksey and O'Malley methodological framework. The search strategy was developed iteratively, with three main aspects: general practice/primary care contexts, risk assessment/decision support tools, and workload-related factors. Three databases were searched in 2019, and updated in 2021, covering articles published since 2009: Medline (Ovid), HMIC (Ovid) and Web of Science (TR). Double screening was completed by two reviewers, and data extracted from included articles were analysed.

    RESULTS: The search resulted in 5,594 references, leading to 95 full articles, referring to 87 studies, after screening. Of these, 36 studies were based in the USA, 21 in the UK and 11 in Australia. A further 18 originated from Canada or Europe, with the remaining studies conducted in New Zealand, South Africa and Malaysia. Studies examined the use of eCDS tools and reported some findings related to their impact on workload, including on consultation duration. Most studies were qualitative and exploratory in nature, reporting health professionals' subjective perceptions of consultation duration as opposed to objectively-measured time spent using tools or consultation durations. Other workload-related findings included impacts on cognitive workload, "workflow" and dialogue with patients, and clinicians' experience of "alert fatigue".

    CONCLUSIONS: The published literature on the impact of eCDS tools in general practice showed that limited efforts have focused on investigating the impact of such tools on workload and workflow. To gain an understanding of this area, further research, including quantitative measurement of consultation durations, would be useful to inform the future design and implementation of eCDS tools.

    Matched MeSH terms: General Practice*
  2. Chan CM, Ahmad WA
    Int J Clin Pract, 2012 Jan;66(1):16-20.
    PMID: 22171901 DOI: 10.1111/j.1742-1241.2011.02831.x
    Aims: There is limited study on patient-centred attitudes with regards to the patient–physician relationship in physicians. The objective of this study was to examine and compare physician attitudes toward patient-centredness in four different medical settings.
    Methods: The present study utilised a cross-sectional survey design and purposive sampling to recruit physicians from a single academic medical centre via face-to-face interviews. Patient-centred attitudes of physicians specialising in surgery, oncology, obstetrics and gynaecology and primary care
    (N = 78) were compared on the Patient–Practitioner Orientation Scale (PPOS) using an independent one-way analysis of variance (ANOVA). The four medical
    specialties comprised the four levels, with role orientation (patient-centred orientation vs. doctor-centred orientation) as the dependent measure.
    Results: A significant level of difference (p < 0.001) was found between the four specialisations:
    oncologists were found to have the highest level of patient-centeredness, followed by obstetricians & gynaecologists and primary care physicians, with surgeons being the least patient-centred among specialisations sampled.
    Conclusion: These data are the first from the South-East Asian region to demonstrate differences in
    physician attitudes between medical specialties. Our findings prompt further investigation and confirmation as to whether physicians with particular attitudinal traits are attracted to any particular specialties of medicine, or if physician attitudes are acquired through professional experience and training. In addition, this study offers better insight into the attitudinal differences of physician between medical specialities.
    Questionnaire: Patient–Practitioner Orientation Scale; PPOS
    Matched MeSH terms: General Practice*
  3. Ariffin F
    Br J Gen Pract, 2012 Jun;62(599):316.
    PMID: 22687219 DOI: 10.3399/bjgp12X649214
    Matched MeSH terms: General Practice/education*
  4. Ngeow WC, Chai WL
    Singapore Med J, 2019 07;60(7):383.
    PMID: 31378826 DOI: 10.11622/smedj.2019078
    Matched MeSH terms: General Practice*
  5. Chan CW
    Aust Fam Physician, 2015 Mar;44(3):113-6.
    PMID: 25770575
    Matched MeSH terms: General Practice/methods*
  6. Onn LV, Bickle I, Chua HB, Telisinghe PU, Chong CF, Chong VH
    Malays Fam Physician, 2017;12(3):33-36.
    PMID: 29527279
    Urinary tract infection (UTI) is one of the most common presentations in general practice and, in most instances, occurs in a single episode and is easily treated with a course of anti-microbial therapy. In the case of recurrent urinary tract infections, it is important to consider evaluation for any underlying causes. We report the case of a 32 year old female who had recurrent UTIs; this was a case of recurrent UTI secondary to xanthogranulomatous pyelonephritis from renal stones with resultant reno-colic fistula formation.
    Matched MeSH terms: General Practice
  7. Esslemont I
    Med J Malaya, 1962 Jun;16:306-8.
    PMID: 13890826
    Matched MeSH terms: General Practice*
  8. Fisekovic Kremic MB
    Malays Fam Physician, 2020;15(3):54-61.
    PMID: 33329863
    Introduction: People with diabetes mellitus (DM) may have concurrent mental health disorders and have been shown to have poorer disease outcomes.

    Objective: The aim of this study to determine the prevalence of DASS in patients with diabetes mellitus without mental disorders, aged 20 years or more, in primary health care, and to determine any association between DASS and patients' sociodemographic and clinical attributes.

    Methods: This was a cross-sectional study conducted in a primary health care center, in the department of general practice. Patients with DM who visited the doctor and agreed to fill in the questionnaire were included in the study. Data were collected using the questionnaire DASS-21. Descriptive statistics, the Pearson chi-square test, and logistic regression analysis were used to analyze the data.

    Results: Out of a total of 102 respondents with DM, 29 (28.4%) had some form of psychological symptoms. The prevalence of DASS was 16.7%, 16.6%, and 23.5%, respectively. There was no significant difference between sociodemographic variables according to stress status. Respondents aged 40-49 years more often showed emotional states of depression and anxiety. There was a significant association between emotional status of DASS and HbA1c values. Logistic regression analysis indicated that age (OR=2.57, 95% CI: 1.59-4.13) was a predictor of depression and anxiety.

    Conclusion: Unpleasant emotional states DASS are common in patients with DM, depression (16.7%), anxiety (16.6%), and stress (23.5%). Age is the strongest predictor of DASS status. The screening and monitoring of unpleasant emotional states in people with diabetes should be performed from a young age.

    Matched MeSH terms: General Practice
  9. Nantha YS, Hs AS
    Korean J Fam Med, 2020 Jul;41(4):267-270.
    PMID: 31992021 DOI: 10.4082/kjfm.18.0056
    BACKGROUND: The provision of sick leave to patients in general practice often entails a complex decision-making process. Commonly, general practitioners believe that the act of providing sick leave can become confrontational. We assessed the intention, attitude, subjective norm, and perceived behavioral control of general practitioners in relation to sick leave provision at public health clinics in Malaysia.

    METHODS: A cross-sectional study design was implemented using data from 86 primary health care clinics in two states in Malaysia from February 2014 to March 2015. A questionnaire that comprised indirect measures were developed on the basis of the Theory of Planned Behavior. The questionnaire assessed several dimensions related to sickness certification provision viz., intention, attitude, subjective norm, and perceived behavioral control.

    RESULTS: The mean scores in this study revealed that physicians acknowledged that patient factors such as clinical symptoms (6.59±0.04), debilitating signs and symptoms of diseases (6.45±0.06), importance of illness recovery (6.07±0.07), and approval of employers (5.35±0.09) played an important role in their decision to provide sick leave.

    CONCLUSION: The act of providing sickness certification to patients is a complex decision-making process. The findings of this study can be used to devise a targeted intervention to reduce the conflict that physicians face in issuing sick leaves.

    Matched MeSH terms: General Practice
  10. Kahrilas PJ, Anastasiou F, Barrett K, Beh L, Chinzon D, Doerfler B, et al.
    Br J Gen Pract, 2024 May;74(742):232-235.
    PMID: 38664044 DOI: 10.3399/bjgp24X737349
    Matched MeSH terms: General Practice
  11. Khoo SB
    Malays Fam Physician, 2011;6(1):7-14.
    MyJurnal
    Anaemia is the most common haematological problem in the elderly population. Using WHO criteria for anaemia (Hb of <12 g/dL in women and <13 g/dL in men), the prevalence of anaemia in the elderly has been found to range from 8-44% with the highest prevalence in men 85 years and older. Anaemia must not be considered simply as part of ageing because in 80% of cases, there is an underlying cause for Hb
    levels of <12 g/dL in the elderly. Anaemia has negative impacts on the quality of life for the elderly and there is evidence of improved morbidity and
    mortality after correction of anaemia. Chronic disease and thalassaemia may also cause microcytic anaemia besides iron deficiency and not all vitamin B12 and folate deficiency present with macrocytic megaloblastic anaemia. Nutritional deficiency anaemias are common, easily diagnosed, treatments are simple, inexpensive and effective. Tests for nutritional anaemia have to be given priority in the assessment before a patient is subjected to invasive tests to look for less common causes of anaemia. Serum ferritin which is the best non-invasive test for the diagnosis of iron deficiency anaemia may be increased in the elderly while serum iron and transferrin decrease with ageing. Serum methylmalonic acid (MMA) and homocysteine (HC) levels are sensitive for detecting subclinical vitamin B12 and folate deficiency. Routine iron therapy in non-anaemic elderly or in those without iron deficiency anaemia is of no use and may be detrimental to their health. Folate therapy may improve anaemia but may mask the signs and symptoms of neurological damage due to concomitant
    vitamin B12 deficiency. Blood transfusion offers prompt symptom relief of anaemia in patients with terminal malignancy irrespective of the causes for the anaemia.
    Matched MeSH terms: General Practice
  12. LLEWELLYN-JONES D
    Med J Malaya, 1960 Sep;15:3-9.
    PMID: 13762892
    Matched MeSH terms: General Practice*
  13. Chan SC, Mohd Amin S, Lee TW
    Malays Fam Physician, 2016;11(2-3):2-8.
    PMID: 28461851
    BACKGROUND: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.

    OBJECTIVE: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination.

    DISCUSSION: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).
    Matched MeSH terms: General Practice
  14. MUN CT
    Am J Clin Hypn, 1964 Apr;6:340-4.
    PMID: 14136309
    Matched MeSH terms: General Practice*
  15. Mahmood, W.A., Mohd. Sidek, M.F.
    Ann Dent, 2001;8(1):-.
    MyJurnal
    This is a preliminary survey on cast partial denture designs in the commercial dental laboratories. This survey was carried out for a month in three commercial dental laboratories in Klang Valley and Shah Alam which produce metal dentures in cobalt-chromium. One hundred and ten questionnaires with the designs were collected and analysed. The framework design on the cast was transferred into the design sheet section of the questionnaire. The aim was to investigate communication regarding denture design between clinicians and dental technician and the dentists' dependency on the technician. The design of cobalt-chromium partial dentures in relation to oral health was also assessed. The results indicated that 43.6% of the dentist who used the three laboratories delegated their removable partial design work to the dental technician. More than half of the dentists had some communication with the technicians, and only 18.2 % of the dentists prescribed clear instructions with details of components regarding denture design. Continuing dental education on partial denture design for both clinicians and dental technicians would be of value to provide reinforcement in the knowledge of the basic concept on denture designing. Communication and understanding between both parties would probably improve the quality of cobalt-chromium dentures constructed.
    Matched MeSH terms: General Practice, Dental
  16. Purmal, Kathiravan, Nambiar, Phrabhakaran
    Malaysian Dental Journal, 2008;29(2):104-112.
    MyJurnal
    Radiology is important in the diagnostic assessment, treatment and monitoring progress of patients having dental and maxillofacial diseases. The central question in dental radiology is whether there is any risk with regard to low doses of radiation and what are the necessary protection needed to prevent any hazardous outcome with X-raying. With the emergence of the new millennium, major changes are happening in the field of science and technology. More efficient equipments are being discovered and more researches are being conducted to elicit better understanding of the radiation process and its effect on the human health. This article will review the latest guidelines for proper radiographic practice from the USA and Europe. It will address topics like the risks from dental radiography, selection criteria, protection for patients and staff, improvement to X-ray equipments, room dimensions and lead lining requirements. We have limited our research to intraoral, panoramic and cephalometric radiographs because these are the radiographs or images that are commonly taken in the general practice setting. (Copied from article).
    Matched MeSH terms: General Practice
  17. Arma N, Rosnah I, Noor Hassim I
    Med J Malaysia, 2017 12;72(6):350-355.
    PMID: 29308772 MyJurnal
    BACKGROUND: The General Practice Physical Activity Questionnaire (GPPAQ) is a validated and reliable screening tool to measure the level of physical activity in adults. However, it has never been translated and validated in Malaysian population. This study aimed to translate the GPPAQ into Malay language and to evaluate the psychometric properties of the Malay-translated GPPAQ among shipyard workers.

    METHODS: The original English version of GPPAQ was translated forward and backward into Malay version by experts. The final version of the Malay-translated GPPAQ was then tested for validity and reliability. A cross-sectional study design was performed and systematic random sampling was used to select respondents. Construct validity and internal consistency of the Malay-translated version were tested using exploratory factor analysis and Cronbach's alpha respectively.

    RESULTS: Sixty-two male shipyard workers participated in this study. The GPPAQ showed good factor loading values for all items (0.608-0.834). The exploratory principal component factor analysis delineates all seven items into two factors with variance of 41.65%. The Cronbach's alpha value was good with 0.81, 0.84 and 0.76 for total scale, factor 1 and factor 2 respectively.

    CONCLUSION: The Malay-translated version of GPPAQ has high psychometric properties. Therefore, it is a valid instrument to assess physical activity among Malaysian working population, particularly in male shipyard workers.

    Matched MeSH terms: General Practice*
  18. Anis Safura R, Wijesinha S, Piterman L
    Malays Fam Physician, 2010;5(1):49-52.
    MyJurnal
    Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden to the patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary care globally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT (strengths, weaknesses, opportunities and threats) analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.
    Matched MeSH terms: General Practice
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