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Fulltext Risk factor awareness and expectations of outpatients attending the Cardiology Clinic, Universiti Kebangsaan Malaysia

Yusoff K, Roslawati J, Almashoor SH

Med J Malaysia, 1992 Sep;47(3):194-9.
PMID: 1491645

One hundred consecutive patients attending the UKM (Universiti Kebangsaan Malaysia) Cardiology Clinic completed a questionnaire enquiring about their own assessment of their knowledge about their illness, their awareness of cardiac risk factors and their expectations in their management. Only 11% of our patients had graduated from tertiary education. 59% of our patients were being treated for ischaemic heart disease. Although only 28% of our patients considered having considerable knowledge of their illness, a majority of our patients were aware of cardiac risk factors. This was independent of the formal education achieved. However this awareness did not necessarily result in appropriate behaviour; 32% of patients admitted to smoking despite being aware of the harmful effects of smoking. 74% of our patients expected a cure from their doctors; only 37% of our patients thought they required medication indefinitely. Thus, patients could be made aware of their illness regardless of their formal educational status. However this may not necessarily result in appropriate behaviour. The high expectations which the patients have of their doctors is unrealistic and may be detrimental to appropriate long-term management of their chronic illness.

Study site: Cardiology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Patient Satisfaction*
Fulltext Topical nasal anaesthesia for fibreoptic bronchoscopy: lignocaine spray or gel?

Zainudin BM, Rafia MH, Sufarlan AW

Singapore Med J, 1993 Apr;34(2):148-9.
PMID: 8266157

Lignocaine spray for anaesthetising the nasal mucosa for fibreoptic bronchoscopy often causes discomfort to the patient. We compared two techniques of applying nasal topical anaesthesia using either lignocaine spray (group A: 25 patients) or gel (group B: 30 patients) to assess patients' tolerance to the procedure. Both groups received 100 mg of lignocaine in the nostril, 40-50 mg to oropharynx, 120 mg to vocal cords and 40-100 mg to trachea and bronchi. Throat anaesthesia was the most common unpleasant part experienced by both groups of patients (34.5%), followed by examination of bronchi (30.6%) and nasal anaesthesia (21.8%). Significantly more patients in group A experienced discomfort or pain during nasal anaesthesia as compared to group B (p < 0.001). Patients' tolerance to the bronchoscopy was similar in both groups and the examination was performed satisfactorily in all patients. Thus, lignocaine gel is a simple technique, effective and less irritating as compared to lignocaine spray for topical nasal anaesthesia.

Matched MeSH terms: Patient Satisfaction
Attitude and perception of patients and public towards services of Hospital Universiti Sains Malaysia

Kamaruzaman WS, Siti Minah D, Che Rahim A

Family Physician, 1993;5:22-25.

A study was done in 1987 to find out the attitudes and perceptions of patients toward treatment in the Hospital Universiti Sains Malaysia (HUSM). A similar study was repeated five years later covering both patients and relatives of patients. In 1987, 17% of patients were not satisfied with the treatment mainly because of poor patient-staff relationship. In 1991, 5% of the patients were dissatisfied. The reasons attributed for their dissatisfaction were rudeness of staff, the presence of medical students and attitude of the patients and public of the nurses. There was a positive change of attitude of the aptients and public towards the hospital services after five years. Factors that lead to this improvement like education and better public relations is discussed.

Matched MeSH terms: Patient Satisfaction
Fulltext Nasal scarring by joss stick burns

Krishnan G, Khanijow VJ

Med J Malaysia, 1994 Mar;49(1):90-2.
PMID: 8057998

Vasomotor rhinitis is a common condition in Malaysia. Patients' dissatisfaction with medical treatment of this recurring condition leads them to seek other forms of traditional cures. This paper highlights the complications in such patients who seek traditional cures for their chronic condition.

Matched MeSH terms: Patient Satisfaction
Fulltext Survey of postoperative pain in University Hospital Kuala Lumpur

Vijayan R, Tay KH, Tan LB, Loganathan

Singapore Med J, 1994 Oct;35(5):502-4.
PMID: 7701371

One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.

Matched MeSH terms: Patient Satisfaction/ethnology
Fulltext Preliminary experience with moclobemide for the treatment of depressive disorders in Malaysia

Indran SK

Singapore Med J, 1995 Apr;36(2):189-90.
PMID: 7676265

The objective of this study was to describe preliminary experience with moclobemide in the treatment of depressive disorders in the University outpatient clinic in Malaysia. Twenty patients who satisfied DSM III R criteria for depressive disorders and scored more than 16 on the Hamilton Rating Depression Score at the initial interview were recruited into this open study. The primary diagnosis of 4 patients was later ascertained to be panic disorder(2), schizophrenia(1) and social phobia(1). Patients rated themselves as improved by first follow up (7-14 days), and rated their depression as very mild to mild by the third follow up visit (ie at a mean of 46 days). Side effects were minimal and compliance good.

Study site: outpatient psychiatric clinic at the General Hospital, Kuala
Lumpur.

Matched MeSH terms: Patient Satisfaction
A randomized, controlled trial to assess the safety of switching stable renal transplant patients from Sandimmun to Sandimmun Neoral

Loo CS, Morad Z, Lim TO, Fan KS, Suleiman AB

Transplant Proc, 1996 Jun;28(3):1328-9.
PMID: 8658680
Matched MeSH terms: Patient Satisfaction
Hypoxia during upper gastrointestinal endoscopy with and without sedation and the effect of pre-oxygenation on oxygen saturation

Wang CY, Ling LC, Cardosa MS, Wong AK, Wong NW

Anaesthesia, 2000 Jul;55(7):654-8.
PMID: 10919420

In Study A, the incidence of arterial oxygen desaturation was studied using pulse oximetry (SaO2) in 100 sedated and 100 nonsedated patients breathing room air who underwent diagnostic upper gastrointestinal endoscopy. Hypoxia (SaO2 92% or less of at least 15 s duration) occurred in 17% and 6% of sedated patients and nonsedated patients, respectively (p < 0.03). Mild desaturation (SaO2 94% or less and less than 15 s duration) occurred in 47% of sedated patients compared with 12% of nonsedated patients (p < 0.001). In Study B, the effects of supplementary oxygen therapy and the effects of different pre-oxygenation times on arterial oxygen saturation (SaO2) in sedated patients were studied using pulse oximetry. One hundred and twenty patients who underwent diagnostic upper gastrointestinal endoscopy with intravenous sedation were studied. Patients were randomly allocated to one of four groups: Group A (n = 30) received no supplementary oxygen while Groups B-D received supplementary oxygen at 4 1 x min(-1) via nasal cannulae. The pre-oxygenation time in Group B (n = 30) was zero minutes, Group C (n = 30) was 2 min and Group D (n = 30) was 5 min before sedation and introduction of the endoscope. Hypoxia occurred in seven of the 30 patients in Group A and none in groups B, C and D (p < 0.001). We conclude that desaturation and hypoxia is common in patients undergoing upper gastrointestinal endoscopy with and without sedation. Sedation significantly increases the incidence of desaturation and hypoxia. Supplementary nasal oxygen at 4 1 x min(-1) in sedated patients abolishes desaturation and hypoxia. Pre-oxygenation confers no additional benefit.

Matched MeSH terms: Patient Satisfaction
Epidural analgesia in primigravidae in spontaneous labour at term: a prospective study

Leong EW, Sivanesaratnam V, Oh LL, Chan YK

J Obstet Gynaecol Res, 2000 Aug;26(4):271-5.
PMID: 11049237

OBJECTIVES: To prospectively study the intervention rate, duration of labour, malpositions, fetal outcome, maternal satisfaction, voiding complications and adverse events in healthy primigravidae in spontaneous labour at term following epidural analgesia.
METHODS: A prospective randomized study involving 55 patients in the epidural group and 68 in the control pethidine--inhalational entonox group.
RESULTS: There were significantly more obstetric interventions (instrumental deliveries) in the epidural group (p < 0.01). The total duration of labour and the duration of the second stage was prolonged in the epidural group (p < 0.01). There were more malpositions at the second stage of labour in the epidural group (p < 0.02). There were no differences in fetal outcome (Apgar scores and Special Care Nursery admissions). Patients in the epidural group were consistently happier with their method of pain relief (p < 0.01). Two patients required blood patches while another 2 patients had persistent backache post epidural analgesia.
CONCLUSION: Epidural analgesia in primigravidae in spontaneous labour at term led to an increased instrumental delivery rate, prolonged duration of labour, greater rate of malpositions in the second stage, increased oxytocin requirements but with no difference in fetal outcomes but with happier mothers as compared to the control group.

Matched MeSH terms: Patient Satisfaction
Fulltext Acceptance of the Accuhaler, a multi-dose powder inhaler, among asthmatic patients: a comparison with the pressurized metered-dose inhaler

Liam CK, Lim KH, Wong CM

Asian Pac J Allergy Immunol, 2000 Sep;18(3):135-40.
PMID: 11270467

This study aimed to evaluate dry powder inhaler naive asthmatic patients' perception and preference of the Accuhaler, a multidose dry powder inhaler and the pressurized metered dose inhaler (pMDI). After the first instruction, 66.7% of 48 patients enrolled in the study could demonstrate the correct use of the Accuhaler. When the patients were asked to compare the pMDI and the Accuhaler after using the Accuhaler to administer salmeterol for 4 weeks, the Accuhaler scored significantly better than the pMDI for the following features: knowing how many doses are left, presence of an attached cover, taste, instruction for use, attractiveness, ease of use, ease of holding, shape, and comfortable mouthpiece. The pMDI scored better to the Accuhaler in terms of size. More patients preferred the Accuhaler than the pMDI; the presence of a dose counter and perceived ease of use were the main reasons cited for their preference for the Accuhaler.
Study site: Asthma Clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Patient Satisfaction
Fulltext The orthotic management of the congenitally short lower limb--a new appliance

Devnani AS

Singapore Med J, 2000 Nov;41(11):534-7.
PMID: 11284611

To describe an appliance used for equalisation of severe congenital lower limb length discrepancy for patients who refuse to undergo any operative correction but wish to walk and look better.

Matched MeSH terms: Patient Satisfaction
The development and evaluation of a health education programme for pregnant women in a regional hospital, southern Thailand

Thassri J, Kala N, Chusintong L, Phongthanasarn J, Boonsrirat S, Jirojwong S

J Adv Nurs, 2000 Dec;32(6):1450-8.
PMID: 11136413

The maternal mortality rate (MMR) in Thailand is higher than neighbouring developing countries including Malaysia and Singapore. The 1993 MMR of Thailand was 249 per 100 000 livebirths which was four times higher than the rates in Malaysia and Singapore (World Health Organization 1995). The major causes of these deaths were haemorrhage, toxaemia of pregnancy and sepsis which were likely to be prevented by adequate prenatal care (Thailand Ministry of Public Health 1996). A large proportion of Thai pregnant women have poor health. Between 1994 and 1995, a national study conducted by Thailand Ministry of Health showed that 39% of pregnant women were anaemic, defined as haemoglobin concentration lower than 33% (Supamethaporn 1997). Another study conducted in the southern region also indicated that 13.8% of pregnant women were anaemic caused by iron deficiency (Phatthanapreechakul et al. 1997). Other behaviours which increased risks associated with child birth included non-antenatal care (ANC) attendance, undertaking physically demanding tasks and failure to increase nutritional intake during their pregnancy period (N. Phiriyanuphong et al. 1992, unpublished report). These factors emphasize the importance of a health education programme which could facilitate women to, for example, increase protein and iron intake during pregnancy which would reduce complications from their poor health status. This study was conducted in a regional hospital in Thailand where there was no systematic and well-planned health education programme for pregnant women. The initial aim was to design a health education programme using input from the hospital health care professionals including obstetricians, nurses, nutritionists, health educators and health promoters. An active involvement of these personnel assisted to sustain the provision of the programme provided for pregnant women after the cessation of the study project. Another aim of the study was to evaluate the outcomes of the programme using a pre-test-post-test method among selected pregnant women who participated in the newly designed health education programme.

Matched MeSH terms: Patient Satisfaction
Penile prosthesis implantation in a transsexual neophallus

Tan HM

Asian J Androl, 2000 Dec;2(4):304-6.
PMID: 11202422

Reconstruction surgery for a female to male transsexual usually involves mastectomy, hysterectomy and creating an aesthetically appealing neophallus. We have successfully inserted an inflatable prosthesis using the AMS CX prosthesis in a 45 year old transsexual, who had a large bulky neophallus constructed from the anterior abdominal subcutaneous fat, about 9 years ago. The single cylinder CX prosthesis was well anchored to the symphysis pubis using a dacron windsock tubing, the activation pump was placed in the dependent pouch of the right labium and the reservior in the usual perivesical space. The patient subsequently had debulking procedure using liposuction to create a more aesthetic and functional phallus. To date, the inflatable neophallus prosthesis is functioning well.

Matched MeSH terms: Patient Satisfaction
The quality of life outcome following treatment for lower urinary tract symptoms

Quek KF, Low WY, Razack AH, Loh CS, Chua CB

Asia Pac J Public Health, 2000;12(2):107-17.
PMID: 11836919 DOI: 10.1177/101053950001200210

This study aims to assess the impact of medical and surgical treatment on treating lower urinary tract symptoms (LUTS) on pain, prostatic symptoms, disease-specific quality of life and health-related quality of life. Patients scheduled for medical (alpha-blockers) and surgical treatment (transurethral resection of the prostate, TURP) were recruited in the study. The patients were assessed using the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), International Prostate Symptom Score (I-PSS) and Health-Related Quality of Life (HRQOL) at 3-month, 6-month and 12-month (baseline). Before treatment, most of the patients with LUTS had severe pain, LUTS and deterioration of health-related quality of life. Following treatment, both medical and surgical treatment improved their pain, LUTS and health-related quality of life. Both treatments are effective in relieving the symptoms of pain, LUTS and health-related quality of life.

Matched MeSH terms: Patient Satisfaction
Fulltext Social and health profiles of rural elderly Malays

Shahar S, Earland J, Abd Rahman S

Singapore Med J, 2001 May;42(5):208-13.
PMID: 11513058

To evaluate the social and health functions of rural elderly Malays.

Matched MeSH terms: Patient Satisfaction
Fulltext The effects of treating lower urinary tract symptoms on sexual function

Quek KF, Loh CS, Low WY, Razack AH

Med J Malaysia, 2001 Jun;56(2):158-66.
PMID: 11771075

We prospectively evaluated the effect of the treatment of lower urinary tract symptoms (LUTS) on sexual function. The patients were assessed by using the International Index of Erectile Function (IIEF-15) inventory at baseline and three months after medical (alpha-blockers) or surgical treatment (transurethral resection of the prostate, TURP). Following treatment, there were improvement in erectile function and intercourse satisfaction while orgasmic, overall satisfaction and sexual drive were relatively unchanged in the medication group. Patients who had surgical treatment suffered retrograde ejaculation, dissatisfaction in sexual intercourse and overall sexual satisfaction compared to patients who were on alpha-blockers.
Study site: Urology ward and clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Patient Satisfaction
Quality of life assessment before and after transurethral resection of the prostate in patients with lower urinary tract symptoms

Quek KF, Loh CS, Low WY, Razack AH

World J Urol, 2001 Nov;19(5):358-64.
PMID: 11760785

The aim of this study was to determine the effects of surgical treatment of lower urinary tract symptoms (LUTS) in a Malaysian population by evaluating the quality of life before and after treatment.

Matched MeSH terms: Patient Satisfaction
Patient empowerment via 'pushed' delivery of Personalised Healthcare educational content over the internet

Abidi SS, Han CY, Abidi SR

Stud Health Technol Inform, 2001;84(Pt 2):1425-9.
PMID: 11604961

We present an Internet-based Personalised Healthcare Information (PHI) dissemination system. Information personalisation is guided by the individual's current health profile as recorded in his/her EMR. A PHI package is composed by intelligently selecting and synthesizing various topic-specific documents, each corresponding to some health parameter noted in the EMR. To ensure medical consistency, constraint satisfaction techniques are employed during the information selection phase. The resultant PHI package--covering both long-term and immediate health-maintenance requirements--can be pro-actively pushed to the individual via email, thereby ensuring the timely availability of situation-specific health maintenance information. The featured work is in line with the Malaysian Multimedia Super Corridor Telemedicine initiative and can serve as a test-bed to evaluate the effectiveness of PHI, system design and operational considerations for larger-scale deployment.

Matched MeSH terms: Patient Satisfaction
Fulltext Does integration of information and communication technology (ICT) in a primary health care clinic improves client’s satisfaction ?

Nora 'i Mohd Said., Hamzah Abdul Ghani, Farizah Hairi

Malaysian Journal of Public Health Medicine, 2001;1(1):30-38.
MyJurnal

The objective of this study was to find out whether integration of Information and Communication Technology (ICT) in a Primary Health Care Clinic improves client’s waiting time. This was a descriptive study based on a total of 588 clients, i.e. 291 clients from an ICT integrated primary health care clinic, which was Putrajaya Health Clinic and 297 clients from a manual health clinic, which was Salak Health Clinic, from 5th December 2000 until 10th January 2001. Clients attending both clinics during this study period were systematically random sampled. Information was obtained from structured questionnaires. Data were analysed with Statistical Package for Social Sciences (SPSS) version 10.0. Selected quantitative time variables, their mean and standard deviation were calculated. Integration of ICT in a primary health care clinic did not improve client’s waiting time. It was demonstrated by this study that the integration of ICT in Putrajaya Health Clinic led to significantly longer average waiting time (39.76 minutes) and longer average total time spend in the clinic (57.14 minutes) as compared to a manual clinic, Salak Health Clinic where its average waiting time was only 23.13 minutes and average total time spend in the clinic was 39.15 minutes. Based on the findings, it is possible that integration of ICT in a primary health care clinic could not play as a significant factor for improving or reducing client’s waiting time in Putrajaya Health Clinic yet, at least not for the time being. This is the first study to document waiting times specifically in our first ICT integrated primary health care clinic. Since it was found that integration of ICT in a primary health care clinic had made client’s waiting time significantly longer than the waiting time in a manual clinic, it could be interesting for future research to look into client’s satisfaction in an ICT environment clinic.
Key words: ICT, client satisfaction, primary care

Matched MeSH terms: Patient Satisfaction*
Fulltext Thoracoscopic sympathectomy for primary palmar hyperhydrosis: the Penang Hospital experience

Gooi BH, Manjit S, Premnath N

Med J Malaysia, 2002 Mar;57(1):66-9.
PMID: 14569720 MyJurnal

Background: Primary palmar hyperhidrosis is a functionally and socially disabling condition. The choice of treatment is controversial.
Objective: To examine the clinical presentation of primary palmar hyperhidrosis and the results of treatment with thoracoscopic sympathectomy in a local setting.
Materials and Methods: A retrospective study of 7 patients involving 10 sympathectomies between October 1997 and October 2000 was undertaken.
Results: The duration of anaesthesia ranged from 55 to 130 minutes with the majority being 1 hour. The immediate results were good, with all operated limbs dry soon after operation. There was no mortality or serious morbidity in this study. All were satisfied with the results of surgery.
Conclusions: Primary palmar hyperhidrosis is not uncommon but rather underdiagnosed. Thoracoscopic sympathectomy is an effective treatment with minimal complications.

Matched MeSH terms: Patient Satisfaction/statistics & numerical data

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