METHODS AND ANALYSIS: The scoping review will follow Arksey and O'Malley's framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis.
ETHICS AND DISSEMINATION: The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field.
TRIAL REGISTRATION DETAILS: The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.
AIM: The study aimed to identify the effectiveness of the buddy program training module to enhance the daily living function, social participation and emotional status of older adults in residential aged care homes.
METHODS: A quasi-experimental study was conducted with 30 pairs of buddies and older adults for both the experimental group and control group in two randomly selected residential aged care homes. The buddies in the experimental group received the buddy program training module related to activities of daily living (basic and instrumental) while the buddy-older adults pairs in the control group continued to perform their usual daily life activities in residential aged care homes. Baselines were performed before intervention and at eight weeks post-intervention.
RESULTS: Over the eight weeks, for the older adults in the experimental group, there was a significant main effect of time after the intervention on BADL (p = 0.010). There were no significant interaction effects for the experiment group and control group on IADL and social participation. Also, there were no significant interaction effects for all domains in emotional status: depression, anxiety and stress. For buddies, there was a significant interaction effect for depression (p = 0.045) in the control group.
CONCLUSIONS: The buddy program training module can be used as a guideline for older adults with more significant disabilities in residential aged care homes in managing activities of daily living. Future studies could be implemented to explore the intergenerational buddy program among older adults and young children in the community.
METHODS: The development process was managed by a technical working group led by the Institute for Health Systems Research in the Ministry of Health. Situational analysis was conducted through a multi-pronged approach, underpinned by a review of the past and present healthcare sectoral and quality plans and guided by the WHO NQPS framework. This approach involved: (i) review of quality-related policy documents, (ii) online surveys of healthcare providers and the public, (iii) key-informant facilitated discussions and (iv) mapping of existing quality improvement initiatives (QIIs). Data gathered from these approaches informed the content of the new policy. Following thematic analysis, the findings were grouped into specific domains, which were then organized into a strengths, weaknesses, opportunities, and threats (SWOT) framework.
RESULTS: Ten key areas of concern identified were (i) a people-centred holistic approach, (ii) governance for quality, (iii) resources, (iv) quality culture, (v) stakeholder engagement, (vi) health management information system, (vii) workforce competency, (viii) knowledge exchange, (ix) quality indicators and (x) monitoring and evaluation of quality activities. These led to the formulation of seven strategic priorities for the planning of improvements aimed at addressing the key areas of concern. The national definition of quality was affirmed. A total of 40 QIIs were mapped and grouped into three broad categories, namely (i) regulatory, (ii) domain-specific QIIs and (iii) Quality Improvement (QI) method.
CONCLUSIONS: The National Policy for Quality in Healthcare for Malaysia was developed through a comprehensive situational analysis using a multi-method approach that identified priorities across national, state, institutional and community levels. This evidence-informed approach led to meaningful contextual adaptation of the NQPS framework to shape the strategic direction to advance quality and achieve effective and safe outcomes for all Malaysians.
DESIGN/METHODOLOGY/APPROACH: The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.
FINDINGS: The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.
ORIGINALITY/VALUE: Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.
METHOD: In-depth interviews were conducted face-to-face or via telephone among patients with a clinical diagnosis of LTBI using a semi-structured topic guide developed based on the common-sense model of self-regulation and literature review. Audio recordings of interviews were transcribed verbatim and analysed thematically.
RESULTS: We conducted 26 In-depth interviews; Good knowledge of active tuberculosis (TB) and its associated complications, including the perceived seriousness and transmissibility of active TB, facilitates treatment. LTBI is viewed as a concern when immune status is compromised, thus fostering TPT. However, optimal health is a barrier for TPT. Owing to the lack of knowledge, patients rely on healthcare practitioners (HCPs) to determine their treatment paths. HCPs possessing comprehensive knowledge play a role in facilitating TPT whereas barriers to TPT encompass misinterpretation of tuberculin skin test (TST), inadequate explanation of TST, and apprehensions about potential medication side effects.
CONCLUSIONS: Knowledge of LTBI can influence TPT uptake and patients often entrust their HCPs for treatment decisions. Improving knowledge of LTBI both among patients and HCPs can lead to more effective doctor-patient consultation and consequently boost the acceptance of TPT. Quality assurance should be enhanced to ensure the effective usage of TST as a screening tool.
METHODS: Several methods were implemented. Firstly, a modified Delphi process for the contextualisation of learning outcomes was implemented with a purposefully sampled expert group of Malaysian Family Medicine Specialists. Secondly a small group review for supporting materials was undertaken. Finally, qualitative data in relation to the family medicine specialists' experiences of the processes was collected via online questionnaire and analysed via template analysis. Descriptive statistics were used.
RESULTS: Learning outcomes were reviewed over three rounds; 95.9% (1691/1763) of the learning outcomes were accepted without modification, with the remainder requiring additions, modifications, or deletions. Supporting materials were extensively altered by the expert group. Template analysis showed that Family Medicine Specialists related positively to their involvement in the process, commenting on the amount of similarity in the medical curriculum whilst recognising differences in disease profiles and cultural approaches.
CONCLUSIONS: Learning outcomes and associated material were transferable between "home" and "host" institution. Where differences were discovered this novel approach places "host" practitioners' experiences and knowledge central to the adaptation process, thereby rendering a fit for purpose curriculum. Host satisfaction with the outcome of the processes, as well as ancillary benefits were clearly identified.
OBJECTIVE: This study aims to develop and validate SafeHIT, an instrument to assess self-reported safe use of HIT among health care practitioners.
METHODS: Systematic literature review and a semistructured interview with 31 experts were adopted to generate SafeHIT instrument items. In total, 450 physicians from various departments at three Malaysian public hospitals participated in the questionnaire survey to validate SafeHIT. Exploratory factor analysis and confirmatory factor analysis (CFA) were undertaken to explore the items that best represent a specific construct and to confirm the reliability and validity of the SafeHIT, respectively.
RESULTS: The final SafeHIT consisted of 14 constructs and 58 items in total. The result of the CFA confirmed that all constructs demonstrated adequate convergent and discriminant validity.
CONCLUSION: A reliable and valid theoretically underpinned measure of determinants of safe HIT use behavior has been developed. Understanding external factors that influence safe HIT use is useful for developing targeted interventions that favor the quality and safety of health care.
METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings.
ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.
METHODS: A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations.
RESULTS: The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours).
CONCLUSIONS: The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.