Displaying publications 1 - 20 of 35 in total

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  1. Hashmi FK, Hassali MA, Khalid A, Saleem F, Aljadhey H, Babar ZUD, et al.
    BMC Health Serv Res, 2017 07 19;17(1):500.
    PMID: 28724411 DOI: 10.1186/s12913-017-2442-6
    BACKGROUND: In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan.

    METHODS: A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework.

    RESULTS: Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings.

    CONCLUSION: Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan.

    Matched MeSH terms: Physicians/psychology
  2. Wong LP, Edib Z, Alias H, Mohamad Shakir SM, Raja Muhammad Yusoff RNA, Sam IC, et al.
    J Obstet Gynaecol, 2017 Oct;37(7):937-943.
    PMID: 28641049 DOI: 10.1080/01443615.2017.1317239
    Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.
    Matched MeSH terms: Physicians/psychology*
  3. Esmaeilzadeh P, Sambasivan M, Kumar N, Nezakati H
    Int J Med Inform, 2015 Aug;84(8):548-60.
    PMID: 25920928 DOI: 10.1016/j.ijmedinf.2015.03.007
    The basic objective of this research is to study the antecedents and outcomes of professional autonomy which is a central construct that affects physicians' intention to adopt clinical decision support systems (CDSS). The antecedents are physicians' attitude toward knowledge sharing and interactivity perception (about CDSS) and the outcomes are performance expectancy and intention to adopt CDSS. Besides, we include (1) the antecedents of attitude toward knowledge sharing-subjective norms, social factors and OCB (helping behavior) and (2) roles of physicians' involvement in decision making, computer self-efficacy and effort expectancy in our framework.
    Matched MeSH terms: Physicians/psychology*
  4. Mazlina M, Julia PE
    Singapore Med J, 2011 Jun;52(6):421-7.
    PMID: 21731994
    Medical ethics issues encountered in rehabilitation medicine differ from those in an acute care setting due to the complex relationships among the parties involved in rehabilitative care. The study examined the attitudes of Malaysian rehabilitation doctors toward medical ethics issues commonly encountered during patient care.
    Matched MeSH terms: Physicians/psychology*
  5. Lee YY, Medford AR, Halim AS
    J R Coll Physicians Edinb, 2015;45(2):104-7.
    PMID: 26181523 DOI: 10.4997/JRCPE.2015.203
    Increasing numbers of doctors are experiencing burnout now more than ever before and the worrying part is that what we see is just the tip of the iceberg. Burnout, a state of mental exhaustion caused by the doctor's professional life, is characterised by emotional exhaustion, depersonalisation and a reduced sense of accomplishment or success. Burnout has been largely ignored or under-recognised previously. This paper provides a perspective on burnout among doctors, including an overview of symptoms, the scale of the problem, the implications and causes of burnout and, finally, a strategic framework to provide a basis for managing it. Most importantly, professional bodies are urged to start taking steps to help troubled doctors. Medical Colleges should provide essential assistance, support and guidance as well as ensuring fair management and promotion policies.
    Matched MeSH terms: Physicians/psychology*
  6. Ngim CF, Lai NM, Ibrahim H
    Prenat Diagn, 2013 Dec;33(13):1226-32.
    PMID: 24014379 DOI: 10.1002/pd.4233
    OBJECTIVE: Genetic counseling for thalassemia carriers is conducted by nongeneticist health care workers (HCWs) in many countries. The aim of the study was to assess Malaysian HCWs' genetic counseling practices with regards to discussing prenatal diagnosis (PND) and termination of pregnancy (TOP) when counseling thalassemia carriers.
    METHOD: A total of 118 Malaysian HCWs (52 doctors and 66 nurses) completed a structured questionnaire that enquired if they would discuss PND and TOP when counseling couples with thalassemia traits, and reasons for their responses were explored.
    RESULTS: All the nurses and 50 (96.1%) doctors were in favor of discussing PND. Only 29 (58%) doctors and 33 (50%) nurses were agreeable to discuss about the option of TOP. Main reasons given for declining to discuss TOP were views that "the condition was not serious enough" (54.9%), TOP is not permissible by their religion (17.6%) and abortion for this indication was illegal (13.7%).
    CONCLUSION: The results showed that HCWs in Malaysia lacked the comprehensive information and necessary skills required when counseling thalassemia carriers. When nongeneticist HCWs are tasked with such responsibilities, their practices and attitudes should be regularly evaluated so that areas of deficiencies could be identified and addressed.
    Matched MeSH terms: Physicians/psychology
  7. Sararaks S, Jamaluddin R
    Med J Malaysia, 1999 Sep;54(3):310-9.
    PMID: 11045056
    Motivation, especially on the relationship of remuneration of government doctors to it, has long been an issue of concern. This study sought to elucidate the demotivating factors in service and the perceived discrepancy in income. It was conducted amongst doctors serving in the Ministry of Health, Negeri Sembilan, using self-administered questionnaires. Factors considered demotivating were remuneration, workload and recognition given. Career development, promotion prospects, issues with superiors, resources and patient attitudes were other factors identified. On average, respondents expect an income of 1.63 times more than their current drawn salary and 87.2% cited rewards as a recommendation to improve their satisfaction in service. In-service training was desired by almost all. Though the medical profession has traditionally been viewed as altruistic in nature, doctors in service are voicing out their views and perception, and they should be heard.
    Matched MeSH terms: Physicians/psychology*
  8. Mohd Fauzi MF, Mohd Yusoff H, Mat Saruan NA, Muhamad Robat R
    PLoS One, 2020;15(11):e0241577.
    PMID: 33206663 DOI: 10.1371/journal.pone.0241577
    Work-related activities during non-work time may influence the intershift recovery of post-work fatigue. Currently there is no valid and reliable scale available to measure the frequency for such activities among doctors. Therefore, this study aims to develop and validate 'Work-Related Activities during Non-Work Time Scale' (WANTS) that measure the frequency of work-related activities during non-work time for doctors. This was a scale development and validation study among doctors involving item generation, content and construct validation, and reliability assessment. 23-item seven-point Likert-type scale was developed through deductive (literature search) and inductive (interview with source population, authors' experiences, and expert opinion) methods. The content-validated scale was pre-tested, and the improved scale was subsequently administered to randomly-selected 460 doctors working at public hospital setting. Response rate was 77.76% (n = 382). Initial exploratory factor analysis (EFA) with principal axis factoring (PAF) using varimax rotation revealed unstable six-factor structure consisting of 17 variables; thus, we tested one- to six-factor model, and found that four-factor model is the most stable. Further analysis with principal component analysis (PCA) with a single component on each factor found that 17-variables four-factor model is stable. These factors were labelled as 'work-related thought', 'work-to-home conversation', 'task spillover' and 'superior-subordinate communication'. It showed good internal consistency with overall alpha value of 0.837. The scale is thus valid and reliable for measuring the frequency of each construct of work-related activities during non-work time among doctors.
    Matched MeSH terms: Physicians/psychology
  9. Zaini S, Manivanna Bharathy HA, Sulaiman AH, Singh Gill J, Ong Hui K, Zaman Huri H, et al.
    PMID: 29970848 DOI: 10.3390/ijerph15071402
    Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM in the use of antidepressants among patients with major depressive disorder. Nineteen doctors and 11 major depressive disorder patients who are involved in psychiatric outpatient clinic appointments were purposively selected and recruited to participate in one of six focus groups in a large teaching hospital in Malaysia. Focus groups were transcribed verbatim and analyzed using a thematic approach to identify current views on providing information needed for SDM practice towards its implementation in near future. Patients’ and doctors’ views were organized into six major themes, which are; summary of treatment options, correct ways of taking medication, potential side effects of treatments related to patients, sharing of case study related to the treatment options, cost of treatment options, and input from pharmacist. The information may be included in the SDM tool which can be useful to inform further research efforts and developments that contribute towards the successful implementation of SDM into clinical practice.

    Study site: University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Physicians/psychology*
  10. Mohd Fauzi MF, Mohd Yusoff H, Muhamad Robat R, Mat Saruan NA, Ismail KI, Mohd Haris AF
    PMID: 33050004 DOI: 10.3390/ijerph17197340
    The COVID-19 pandemic potentially increases doctors' work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors' fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. b = 2.73), chronic fatigue (adj. b = 3.64), depression (adj. b = 0.57), anxiety (adj. b = 0.47), and stress (adj. b = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. b = -0.53), chronic fatigue (adj. b = -0.53), depression (adj. b = -0.14), anxiety (adj. b = -0.11), and stress (adj. b = -0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. b = 0.74), depression (adj. b = 0.15), anxiety (adj. b = 0.11), and stress (adj. b = 0.11), and lower level of intershift recovery (adj. b = -0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences.
    Matched MeSH terms: Physicians/psychology*
  11. Dharmalingam TK, Muniandy RK
    Med J Malaysia, 2020 01;75(1):68-73.
    PMID: 32008024
    INTRODUCTION: Doctors play an important role to assess and manage pain. Failing to do so properly, pain will affect the quality of life and increase the length of hospital stay for patients. In Queen Elizabeth Hospital (QEH), Kota Kinabalu, Sabah, pain assessment and management programs have been conducted on a regular basis. However, there has been no studies to assess the effectiveness of these programs.

    METHODOLOGY: This is a cross-sectional study to assess the knowledge and attitude on pain assessment and management among medical officers at QEH. A universal sampling technique was used, to represent medical officers from major clinical departments. The Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire was used for this study.

    RESULTS: A total of 278 questionnaires were distributed to medical officers. The study sample consisted of 125 females (44.9%), and 153 males (55.1%). The age group of the participants ranged from 25 to 41 years old. A 116 respondents scored less than 60% on the knowledge of pain (41.7%). These findings show there was a deficit in their knowledge and attitude about pain. There was also a difference of scores between genders, where the male doctors performed better than the female doctors. There was a difference between scores among doctors from different departments. The highest mean score was from the department of Anaesthesia (80.2%). There was also a difference regarding pain knowledge based on the years of working as a doctor, where the highest passing rate was from doctors working for more than five years.

    CONCLUSION: This study demonstrated that there is a lack of knowledge and attitude on pain assessment and management among QEH medical officers who responded to this study. This will support the plan on a more aggressive and continuous education programme to improve pain assessment and management among doctors in QEH.

    Matched MeSH terms: Physicians/psychology*
  12. Brouwer E, Driessen E, Mamat NH, Nadarajah VD, Somodi K, Frambach J
    Med Teach, 2020 02;42(2):221-227.
    PMID: 31630598 DOI: 10.1080/0142159X.2019.1676885
    Introduction: Medical schools increasingly offer curricula that specifically aim to prepare students for an international medical career. This is challenging as well as controversial: curriculum designers must balance specific local healthcare requirements with global health competencies doctors need in our globalised world. By investigating how international medical programme designers experience this balancing act, this study aims to contribute insights to the debate on local versus global medical education.Methods: We conducted a multi-centre instrumental case study across three universities with international medical programmes in three countries. The study involved 26 semi-structured interviews with key curriculum designers recruited through purposive sampling. Additionally, we performed a curriculum document analysis. Data were thematically analysed within a multidisciplinary team.Results: Participants described two profiles of international medical programme graduates: 'a global physician', equipped with specific competencies for international practice, and 'a universal professional', an overall high-level graduate fit for future practice anywhere. These perspectives presented different curriculum design challenges.Conclusions: International medical programmes teach us how we can rethink graduate profiles in a globalising world. Yet, educational standardisation poses risks and securing equity in global health education is challenging, as is preparing students to be adaptable to the requirements of a rapidly changing future local healthcare context.
    Matched MeSH terms: Physicians/psychology*
  13. Al-Dubai SA, Ganasegeran K, Perianayagam W, Rampal KG
    ScientificWorldJournal, 2013;2013:137620.
    PMID: 24367238 DOI: 10.1155/2013/137620
    This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI). Mean (±SD) age of the respondents was 26.5 (±1.6). The most common source of job stress was "fear of making mistakes." Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies. Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the common place, of the common man, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their grief.SirWilliam Osler, Aphorisms from the Student Life (Aequanimitas, 1952).
    Matched MeSH terms: Physicians/psychology
  14. Tee YC, Earnshaw VA, Altice FL, Jin H, Kamarulzaman A, Wickersham JA
    AIDS Behav, 2019 Apr;23(4):1039-1047.
    PMID: 30560483 DOI: 10.1007/s10461-018-2362-4
    People with HIV (PWH) in Malaysia experience high levels of stigma, which may act as a barrier to accessing healthcare. Stigma against PWH in medical settings is understudied in Malaysia. In the present study, we examine factors associated with physicians' intention to discriminate against PWH in Malaysia. A cross-sectional online survey was emailed to all 1431 physicians at two major university hospitals in Malaysia; 568 (39.6%) participants completed the survey and were included in this analysis. Measures included intention to discriminate against PWH, stigma-related constructs, and socio-demographic characteristics. Multivariate linear regression was used to identify factors associated with intention to discriminate against PWH. Participants were comprised of women (53.5%), Malays (43.1%), and Chinese (35.0%) with nearly 10 years of clinical experience. Most participants were from non-surgical specialties (77.6%). The final multivariate linear regression showed that physicians who expressed greater discriminatory intent against PWH also expressed more negative feelings toward PWH, more HIV-related shame, were more fearful of HIV, and believed that PWH do not deserve good care. Physicians from surgical-based specialties were also significantly more likely to endorse discriminatory intent toward PWH. Stigma and intentions to discriminate against a class of patients, including PWH, can undermine engagement in care, which is central to international HIV prevention and treatment strategies. Interventions that reduce stigma toward PWH among physicians are crucial to ensuring equitable and stigma-free healthcare.
    Matched MeSH terms: Physicians/psychology*
  15. Vijay A, Earnshaw VA, Tee YC, Pillai V, White Hughto JM, Clark K, et al.
    LGBT Health, 2018 01;5(1):61-68.
    PMID: 29227183 DOI: 10.1089/lgbt.2017.0092
    PURPOSE: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.

    METHODS: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent.

    RESULTS: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics.

    CONCLUSIONS: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.

    Matched MeSH terms: Physicians/psychology*
  16. Nantha YS
    J Health Organ Manag, 2013;27(2):266-72.
    PMID: 23802402
    In the light of an increasing healthcare burden, this paper seeks to offer insight about how intrinsic motivation could play a pivotal role in improving the pre-existing healthcare service delivery systems by altering clinician behaviour. The paper argues the case for four salient dimensions worth exploring through the lens of intrinsic motivation--non-financial incentives, positive affective states, organizational culture and prescribing quality.
    Matched MeSH terms: Physicians/psychology*
  17. Lian PC, Marnoch G
    J Manag Med, 1999;13(2-3):178-89.
    PMID: 10747449
    This paper describes a study of the knowledge and attitudes of a sample of private medical practitioners in Malaysia in relation to questions posed on guidelines-based medicine. The study was conducted through a postal questionnaire sent to a sample of 2,000 private practitioners. Placing the research in context, a description of Malaysia and its health-care system is provided. Issues surrounding guidelines-based medicine in the Malaysian context are discussed. An analysis of the sample population's personal and professional characteristics is presented. Key research findings include identifying a substantial knowledge deficit--less than half of the respondents claimed to understand "guidelines". A majority of doctors (64 per cent) think guidelines are useful. Only 29 per cent of respondents knew where to find guidelines, with 22 per cent claiming to have used guidelines. The paper concludes with a discussion of issues in the implementation of guidelines-based medicine in Malaysia based on the study's findings.
    Matched MeSH terms: Physicians/psychology*
  18. Jamshed SQ, Hassali MA, Ibrahim MI, Babar ZU
    J Pak Med Assoc, 2011 Jan;61(1):80-3.
    PMID: 22368910
    Matched MeSH terms: Physicians/psychology*
  19. Loh LC
    Respirology, 2018 12;23(12):1198-1199.
    PMID: 30084515 DOI: 10.1111/resp.13382
    Matched MeSH terms: Physicians/psychology*
  20. Al-Naggar RA, Isa ZM, Shah SA, Chen R, Kadir SY
    Asian Pac J Cancer Prev, 2009;10(5):743-6.
    PMID: 20104962
    A cross-sectional study was conducted at the main hospitals in Sana'a, Yemen to determine the attitude and practice of Yemen female doctors on mammography screening. Study subjects were all female doctors who were on duty during the questionnaire distribution. Those who agreed to participate were given the questionnaire to complete. Descriptive statistics were used to analyse socio-demographic variables and variables related to general health. Participants in this study were 105 female doctors with mean age of 32.1 years (SD = 7.17). Thirty-four respondents (36.6%) did not send asymptomatic women for mammography screening. The reasons were because of high cost (58.0%, n= 25), availability of other methods (23.3%, n= 10), instrument not available (11.6%, n= 5) and high risk of radiation (7.0%, n= 3). Twenty-five participants (26.9%) sent patients on regular basis if there was a family or personal history of breast cancer. Twenty-three participants (24.7%) sent the patients for mammogram screening every year regardless of the patients'history or symptoms. Although most doctors (36.5%) do not refer patients for mammography screening, seventy-seven (74.0%) indicated that they would refer patients for mammography screening on personal request by the patients. This study showed a low percentage of doctors who referred patients for routine mammography. The major reason given was the high cost of the procedure.
    Matched MeSH terms: Physicians/psychology*
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