Displaying all 13 publications

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  1. Ab Rahman N, Teng CL, Sivasampu S
    BMC Infect Dis, 2016 05 17;16:208.
    PMID: 27188538 DOI: 10.1186/s12879-016-1530-2
    BACKGROUND: Antibiotic overuse is driving the emergence of antibiotic resistance worldwide. Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia.

    METHODS: We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic.

    RESULTS: Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics.

    CONCLUSIONS: Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing inappropriate prescribing.
    Matched MeSH terms: Patients' Rooms
  2. Ahmad Zubaidi ZS, Ariffin F, Oun CTC, Katiman D
    BMC Palliat Care, 2020 Dec 08;19(1):186.
    PMID: 33292214 DOI: 10.1186/s12904-020-00691-1
    BACKGROUND: Informal caregivers (IC) are often overshadowed by the attention required by the terminally ill. This study aims to reveal the estimated proportion of caregiver burden, psychological manifestations and factors associated with caregiver burden among IC in the largest specialized Palliative Care Unit (PCU) in Malaysia.

    METHODS: This was a cross-sectional study involving IC attending a PCU. Caregiver burden and psychological manifestations were measured using previously translated and validated Zarit Burden Interview and DASS-21 questionnaires respectively. Two hundred forty-nine samples were selected for analysis.

    RESULT: The mean ZBI score was 23.33 ± 13.7. About half of the population 118(47.4%) was found to experienced caregiver burden whereby majority have mild to moderate burden 90(36.1%). The most common psychological manifestation among IC is anxiety 74(29.7%) followed by depression 51(20.4%) and stress 46(18.5%). Multiple logistic regression demonstrated that women who are IC to patients with non-malignancy were less likely to experience caregiver burden. IC who were highly educated and spent more than 14 h per day caregiving were at least twice likely to experience caregiver burden. Finally, those with symptoms of depression and anxiety were three times more likely to suffer from caregiver burden.

    CONCLUSION: Caregiver burden among IC to palliative patients is prevalent in this population. IC who are men, educated, caregiving for patients with malignancy, long hours of caregiving and have symptoms of depression and anxiety are at risk of developing caregiver burden. Targeted screening should be implemented and IC well-being should be given more emphasis in local policies.

    Matched MeSH terms: Patients' Rooms
  3. Khalid F, Chong LA
    Indian J Palliat Care, 2019 3 2;25(1):135-141.
    PMID: 30820116 DOI: 10.4103/IJPC.IJPC_111_18
    Objective: The objective of this study was to estimate palliative care needs and to describe the cohort of children with life-limiting illnesses (LLI) dying in hospitals.

    Design: This study was a retrospective cohort study. The national hospital admissions database was reviewed and children who had died who had life-limiting illnesses were identified.

    Setting: This study was conducted at Ministry of Health hospitals, Malaysia.

    Patients: Children aged 18 years and below who had died between January 1, 2012 and December 31, 2014.

    Main Outcome Measures: Life-limiting diagnoses based on Hain et al.'s directory of LLI or the ACT/RCPCH categories of life-limiting disease trajectories.

    Results: There were 8907 deaths and 3958 (44.4%) were that of children with LLI. The majority, 2531 (63.9%) of children with LLI were neonates, and the most common diagnosis was extreme prematurity <28 weeks with 676 children (26.7%). For the nonneonatal age group, the median age at admission was 42 months (1-216 months). A majority, 456 (32.0%) had diagnoses from the ICD-10 chapter "Neoplasms" followed by 360 (25.3%) who had a diagnoses from "Congenital malformations, deformations, and chromosomal abnormalities" and 139 (9.7%) with diagnoses from "Disease of the nervous system." While a majority of the terminal admissions were to the general ward, there were children from the nonneonatal age group, 202 (14.2%) who died in nonpediatric wards.

    Conclusion: Understanding the characteristics of children with LLI who die in hospitals could contribute toward a more efficient pediatric palliative care (PPC) service development. PPC service should include perinatal and neonatal palliative care. Palliative care education needs to extend to nonpediatric healthcare providers who also have to manage children with LLI.

    Matched MeSH terms: Patients' Rooms
  4. Basma Johari, Nor Azwani Mohd Shukri
    MyJurnal
    Exclusive breastfeeding (EBF) for up to six months is internationally recommended due to its benefits for both maternal and infant health. However, the rate of EBF in Malaysia is still below the desirable levels. This study examined the prevalence of EBF and assessed the knowledge, attitude, and practice (KAP), and determinants of breastfeeding among Malay mothers in Ampang, Selangor. Ninety-two Malay subjects who breastfed healthy children aged six to 36 months, were included in this study. Data were collected by dual-language, self-administered questionnaire (which included Iowa Infant Feeding Attitude Scale, IIFAS), to determine KAP of mothers towards breastfeeding. Socio-demographic, psychosocial, and environmental factors related with EBF were also assessed. Linear logistic regression model was used to identify factors that may determine breastfeeding for six months (exclusively) and beyond. A total of 28% of the subjects practised EBF up to six months, 39% less than six months, and 33% continued BF beyond six months. The mean IIFAS total score was 66.1 ± 8.11, which ranged between Neutral and Positive towards Breastfeeding Practice attitudes. Higher IIFAS score is related to intended and actual exclusive
    breastfeeding. Several variables were significantly related to breastfeeding for six months (exclusively) and beyond. This included maternal age of 30 years or more (OR:3.26, 95% CI:1.27–8.38); higher socioeconomic status (OR:8.50, 95% CI:1.76–41.06); higher educational level (OR:5.21, 95% CI:1.66–16.34); multi-parity (OR:3.15, 95% CI:1.17–8.47); nonworking status (OR:3.81, 95% CI:1.02–14.3); support from spouse (OR:2.39, 95% CI:1.01–5.65); availability of private rooms for breastfeeding at workplace (OR:4.30, 95% CI:1.77–10.63); and child birth place (OR:2.54, 95% CI:1.08–5.98). The right maternal knowledge and attitude play crucial roles in the success of breastfeeding. Hence, more health promotion is needed. Supports from spouse,
    workplace, and hospital staff after delivery, are also essential to improve EBF statistics in Malaysia.
    Matched MeSH terms: Patients' Rooms
  5. Ludin, S.M., Ruslan, R., Mat Nor, M.B.
    MyJurnal
    The presence of nurses and junior doctors in the ward environment are crucial, especially in detecting
    deteriorating patients. However, there is consistent evidence that warning signs may not always be
    identified or acted upon. This paper aimed to analyse the incidence of deteriorating patients, and the
    concept of risk assessment of these patients by nurses and junior doctors in general ward, through a review
    on relevant literature. An extensive literature search was conducted through online research databases, i.e. CINAHL, MEDLINE (Ovid), Science Direct and ProQuest. Professional journals were hand searched for relevant literature based on reference lists and citations made in key publications, and attempts were also made to obtain any relevant grey literature (unpublished materials). A total of eleven papers which focused on patient’s assessment, response to deteriorating patients and knowledge in medication, and a guideline were reviewed. Most of the studies were carried out in the United Kingdom (n=4), followed by Australia (n=2), Sweden (n=2), the Netherlands (n=1) and Taiwan (n=1). Meanwhile, among these studies, the chosen research designs include, qualitative (n=6), quantitative (n=3) and systematic review (n=1). This review concluded that nurses and junior doctors in general ward have a lack of knowledge in risk assessment of deteriorating patients.
    Matched MeSH terms: Patients' Rooms
  6. Amnah, A.B., Bulgiba, A., Omar, R.
    JUMMEC, 2015;18(2):1-7.
    MyJurnal
    We conducted a multi-institutional case study to identify the issues associated with the adoption of information and communication technology (ICT) in five private care hospitals in the Kingdom of Saudi Arabia. We conducted interviews with 37 respondents primarily comprising IT professionals.
    We found that there were three determinants of behavioural intentions in this case study: organisation objectives, facilitating conditions and social influence where there are no effects of performance expectancy or effort expectancy. In all five cases, none of the moderators (age, gender, experience and voluntariness) in the original united theory of acceptance and use of technology model were considered critically important by IT professionals. In the present paper, all qualitative elements such as themes, patterns and overarching in the data were analysed to reach a conclusion. In addition, the various perspectives of using ICT are discussed.
    Matched MeSH terms: Patients' Rooms
  7. Ghawadra SF, Lim Abdullah K, Choo WY, Danaee M, Phang CK
    J Nurs Manag, 2020 Jul;28(5):1088-1097.
    PMID: 32432795 DOI: 10.1111/jonm.13049
    AIM: To assess the effect of a 4-week mindfulness-based training intervention on improving stress, anxiety, depression and job satisfaction among ward nurses.

    BACKGROUND: Previous literature showed that mindfulness-based training is useful for helping nurses cope with stress.

    METHOD: Nurses who have mild to moderate levels of stress, anxiety and depression identified from a teaching hospital were invited to a randomized control trial. The intervention group had a 2-hr Mindfulness-Based Training workshop, followed by 4 weeks of guided self-practice Mindfulness-Based Training website. Both the intervention group (n = 118) and the control group (n = 106) were evaluated pre- and post-intervention, and 8 weeks later (follow-up) using the Depression, Anxiety, and Stress Scale-21, Job Satisfaction Scale and Mindful Attention Awareness Scale.

    RESULTS: There was a significant effect over time on stress, anxiety, depression and mindfulness level (p 

    Matched MeSH terms: Patients' Rooms/organization & administration; Patients' Rooms/standards; Patients' Rooms/statistics & numerical data
  8. Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.
    MyJurnal
    Background: Nowadays, most medical laboratories in Malaysia practice occupational safety and health based on standard operating procedure and sometimes ad-hoc characteristic limited to only internal use. The level of compliance of the national occupational safety and health management system (OSHMS) guidelines among medical laboratories in Malaysia is still largely unexplored.
    Methods: This study was carried out on 34 medical laboratories consisting of 17 public medical laboratories and 17 private medical laboratories in Klang Valley using self-administered questionnaire based on guideline of OSHMS6. This study covered 112 medical laboratories units including pathology chemistry (18), microbiology (20), virology (7), histopathology (16), cytopathology (17), hematology (19) and 15 multi discipline medical laboratories.
    Results: This study showed the level of compliance to the national OSHMS guideline among medical laboratories who are MS ISO 15189:2004 accredited & have a higher scores (p
    Matched MeSH terms: Patients' Rooms
  9. Hafizuddin Awang, Azriani Ab Rahman, Surianti Sukeri, Noran Hashim, Nik Rubiah Nik Abdul Rashid
    MyJurnal
    Introduction: The Ministry of Health Malaysia introduced the national best practices for adolescent-friendly health services in 2018 and it served as an assessment tool in the accreditation of adolescent-friendly clinic status. This study was conducted in Kelantan with the objective to determine the proportion of adolescent-friendly clinics and its determinants and perceptions of healthcare providers regarding the facilitating factors in providing adoles-cent-friendly health services. Methods: The research design was sequential explanatory mixed method. State wide clinics assessment was done to estimate the proportion of adolescent-friendly clinics and to determine the factors associated with adolescent-friendly health services provision. Perceptions of healthcare providers on the facilitating factors for adolescent-friendly health services were explored through in-depth interviews. Descriptive statistics and linear regression analysis were performed for quantitative data, and thematic analysis for qualitative data. Results: Out of 85 health clinics, 30 (35.3%) clinics were accredited as adolescent-friendly. Availability of trained health-care providers in adolescent health modules, private room for adolescent counselling, dedicated team in charge of adolescent programme and adolescent health promotional activities were the statistically significant determinants for adolescent-friendly health services (p
    Matched MeSH terms: Patients' Rooms
  10. Phua, K.L., Chong, J.C., Elangovan, R., Liew, Y.X., Ng, H.M., Seow, Y.W.
    MyJurnal
    Public and private hospitals in Kuala Lumpur and Selangor were evaluated in terms of their accessibility for the physically disabled. The research hypotheses for this study included the following: (1) Both types of hospitals are accessible for the physically disabled as measured by specific criteria but (2) the degree of accessibility is higher in the case of private hospitals as compared to public hospitals. A total of 23 private hospitals and 11 public hospitals in Kuala Lumpur and Selangor were invited to participate in the study. The 5 private hospitals and 5 public hospitals that agreed were evaluated for adequacy of facilities for the physically-disabled. For this purpose, 13 specific criteria were assessed and scored for each hospital. These criteria were also grouped into 5 categories, namely, parking, toilet, door and lift, corridor and ramp. Scores were compared between each hospital and then aggregated and compared for private hospitals versus public hospitals. It was found that none of the 5 private hospitals and 5 public hospitals studied satisfied 100% of the criteria evaluated. Looking at each hospital individually, the overall scores range from 32% to 92% for the criteria set. Only 4 of the 10 hospitals in our sample achieved overall scores of 80% or higher in terms of the evaluation criteria we used. With the exception of availability of ramps where public hospitals scored slightly higher ,for most of the individual criterion, private hospitals scored higher than public hospitals. Looking at each criterion across all hospitals, the scores range from 59.2% (adequacy of parking) to 85% (adequacy of corridors). The median score obtained by private hospitals and by public hospitals for all 13 criteria were analysed for any difference. The difference between private hospitals and public hospitals is not statistically significant (Mann-Whitney U = 6.5, p-value = 0.099). There is no significant difference between Kuala Lumpur/Selangor private and public hospitals in terms of accessibility for physically disabled people. However, some hospitals are more accessible for the physically disabled than other hospitals. These findings indicate that there is room for improvement.
    Matched MeSH terms: Patients' Rooms
  11. Tan AL, Phua VC
    Med J Malaysia, 2014 Jun;69(3):124-5.
    PMID: 25326352 MyJurnal
    PURPOSE: Extravasation with intravenous chemotherapy is a common complication of chemotherapy which carries the risk of devastating complications. This study aims to determine the rate of extravasation with intravenous chemotherapy in a major hospital where chemotherapy is delivered in various departments other than the oncology department.

    PATIENTS AND METHODS: All patients who underwent intravenous chemotherapy in the oncology department and surgical wards in Penang General hospital from 1st February 2008 till 31st June 2008 were recruited retrospectively for this study to look at the rate of extravasation.

    RESULTS: A total of 602 patients underwent intravenous chemotherapy during this period. Fifty patients received chemotherapy in the general surgical ward while another 552 patients received chemotherapy in the oncology department. There were 5 cases of extravasation giving an overall extravasation rate of 0.8% (5/602). however, 4 of these cases occurred in the general surgical ward giving it a rate of 8% (4/50).

    CONCLUSION: The rate of extravasation in our hospital was 0.8%. however, this rate can be significantly increased if it is not done under a specialized unit delivering intravenous chemotherapy on a regular basis. Preventive steps including a standard chemotherapy delivery protocol, staff and patient education must be put in place in all units delivering intravenous chemotherapy.
    Matched MeSH terms: Patients' Rooms
  12. Sim SK, Lim SL, Lee HK, Liew D, Wong A
    Med J Malaysia, 2011 Jun;66(2):138-41.
    PMID: 22106695 MyJurnal
    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.
    Matched MeSH terms: Patients' Rooms*
  13. Rajendiran S, Thahir SSA, Veloo Y, Suppiah J, Pahrol MA, Shakor ASA, et al.
    Trop Biomed, 2021 Sep 01;38(3):462-468.
    PMID: 34608120 DOI: 10.47665/tb.38.3.089
    COVID-19 has spread rapidly worldwide. The role of fomites in facilitating onward transmission is plausible. This study aimed to determine the presence of viable virus and its persistence on the surfaces of fomites in wards treating COVID-19 patients in Malaysia. This study was conducted in two stages. First, environmental sampling was performed on random days in the intensive care unit (ICU) and general wards. Then, in the second stage, samples were collected serially on alternate days for 7 days in two selected general wards. In Stage 1, a total of 104 samples were collected from the surfaces of highly touched and used areas by patients and healthcare workers. Only three samples were tested positive for SARS-COV-2. In Stage 2, three surface samples were detected positive, but no persistence of the virus was observed. However, none of the SARS-CoV-2 RNA was viable through tissue culture. Overall, the environmental contamination of SARS-CoV-2 was low in this hospital setting. Hospitals' strict infection control and the compliance of patients with wearing masks may have played a role in these findings, suggesting adherence to those measures to reduce occupational exposure of COVID-19 in hospital settings.
    Matched MeSH terms: Patients' Rooms/statistics & numerical data
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