Displaying publications 1 - 20 of 480 in total

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  1. Mokhzan NS, Sutan R, Yasin RM, Yamat H
    Front Public Health, 2023;11:1042124.
    PMID: 36844841 DOI: 10.3389/fpubh.2023.1042124
    BACKGROUND: Caregivers of elderly people need the right education and empowering skills to manage their own health needs and the elderly people they care for.

    OBJECTIVE: The study aimed to explore youth perceptions of the My-Elderly-Care-Skills Module intervention and its perceived feasibility.

    METHODS: This study involved youth respondents (18-30 years old) from low-income households who are accountable to providing care for independent older people (60 years or above) living in the same house. A qualitative study using a case study design was used to assess youth perceptions based on the content of the My-Elderly-Care-Skills module, by focusing on its implementation usage and usefulness for the care of the elderly. A total of 30 youths voluntarily participated in the online training workshop during the COVID-19 pandemic movement restriction order period. There were multiple sources of data, such as video recorded on reflection of care given at home, text messages in a WhatsApp group, and in-depth interviews during small group online meetings. Data were recorded and transcribed verbatim for common themes before a theme analysis was conducted. Inductive content analysis was performed after the saturation point was met.

    RESULTS: Thematic analysis derived two domains of feasibility: operational and technical feasibility. There were three themes under operational practicality (improving awareness, addressing the caregiving skills needs, and seeking resources for knowledge) and three themes for technical practicality (easily used and informative, skill in effective communication, and program fulfillment).

    CONCLUSION: It was verified that it is feasible for young caregivers of the elderly to participate in the My-Elderly-Care-Skills training intervention as it helps in improving knowledge and skills performance in managing and caring for the elderly.

    Matched MeSH terms: Qualitative Research
  2. Adhikary P, Keen S, van Teijlingen E
    J Immigr Minor Health, 2019 Oct;21(5):1115-1122.
    PMID: 30073437 DOI: 10.1007/s10903-018-0801-y
    There are many Nepali men working in the Middle East and Malaysia and media reports and anecdotal evidence suggest a high risk of workplace-related accidents and injuries for male Nepali workers. Therefore, this study aims to explore the personal experiences of male Nepali migrants of unintentional injuries at their place of work. In-depth, face-to-face interviews (n = 20) were conducted with male Nepali migrant workers. Study participants were approached at Kathmandu International Airport, hotels and lodges around the airport. Interviews were transcribed and analysed using thematic analysis. Almost half of study participants experienced work-related accident abroad. The participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries. Nepali migrant workers would appear to be at a high risk of workplace unintentional injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing existing policies, introduce better legislation where necessary, ensure universal health (insurance) coverage for labour migrants, and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers.
    Matched MeSH terms: Qualitative Research
  3. Ahmad RS, Sulaiman Z, Nik Hussain NH, Mohd Noor N
    BMC Pregnancy Childbirth, 2022 Jan 31;22(1):85.
    PMID: 35100980 DOI: 10.1186/s12884-021-04304-4
    BACKGROUND: Breastfeeding practice is influenced by the mother's attitude toward and knowledge of breastfeeding. Working mothers face many challenges and need support to maintain breastfeeding. This study aimed to explore working mothers' breastfeeding experiences and challenges that can influenced their practices.

    METHODS: The qualitative phenomenological approach involving working mothers in Kota Bharu who fulfilled the inclusion criteria and consented to participate in the study were recruited using purposive sampling. Sixteen participants aged 24 to 46 years were interviewed using semi-structured in-depth interviews in the study. All interviews were recorded in digital audio, transcribed verbatim and analyzed using thematic analysis.

    FINDINGS: Three main themes emerged from the data analysis: perception of breastfeeding, challenges in breastfeeding, and support for breastfeeding. Two subthemes for perceptions were perception towards breastfeeding and towards infant formula. Challenges had two subthemes too which were related to perceived insufficient milk and breastfeeding difficulty. Where else, two subthemes for support were internal support (spouse and family) and external support (friends, employer, and healthcare staff).

    CONCLUSIONS: Maintaining breastfeeding after return to work is challenging for working mothers and majority of them need support to continue breastfeeding practice. Support from their spouses and families' influences working mothers' decision to breastfeed. Employers play a role in providing a support system and facilities in the workplace for mothers to express and store breast milk. Both internal and external support are essential for mothers to overcome challenges in order to achieve success in breastfeeding.

    Matched MeSH terms: Qualitative Research
  4. Sani AM, Arif II, Arshad MM, Mungadi IA, Soh KG, Soh KL
    J Nurs Res, 2020 Feb;28(1):e67.
    PMID: 30855517 DOI: 10.1097/jnr.0000000000000313
    BACKGROUND: Disorders of sex development (DSD) affect the quality of life of people who live with this condition. In developing countries, diagnoses of DSD are associated with a delay in presentation until the patients developed ambiguous physical traits and features.

    PURPOSE: This study explores the menstrual experiences of people with DSD and sex reassignment in Nigeria.

    METHODS: A qualitative approach with a phenomenological study design was employed in this study to explore and describe the experiences of people with DSD at the Usmanu Danfodiyo University Teaching Hospital in Sokoto, Nigeria. The data were collected using face-to-face interviews, transcribed verbatim, and analyzed using NVivo software.

    RESULTS: The findings show that the participants experienced menstrual problems: men with menstruation and women with amenorrhea. The female participants generally described amenorrhea as a disappointment and linked menstruation with womanhood. Amenorrhea evinced both emotional and psychological effects. However, some of the female participants considered amenorrhea in a positive light and were happy with their lives without menstruation. The menstrual experiences of male participants included menarche, lower abdominal pain, regular monthly bleeding, and ovulation. The male participants described menstruation as a disaster in their lives and a source of anxiety, suicidal ideation, and depression. Menstruation negatively affected their psychosocial well-being.

    CONCLUSIONS: The menstrual experience of individuals with DSD negatively affects their quality of life. The women with DSD in this study showed a generally poor knowledge of menarche, menstruation, and puberty, indicating that their parents had ignored the initial symptoms of DSD. DSD were only recognized at puberty because of the development of ambiguous physical traits and of the onset of menstruation in men and the confirmation of amenorrhea in women.

    Matched MeSH terms: Qualitative Research
  5. Bourne A, Cassolato M, Thuan Wei CK, Wang B, Pang J, Lim SH, et al.
    J Int AIDS Soc, 2017 08 02;20(1):21899.
    PMID: 28782336 DOI: 10.7448/IAS.20.1.21899
    BACKGROUND: Men who have sex with men (MSM) continue to be disproportionately affected by HIV in Malaysia. Recent success has been observed within demonstration projects examining the efficacy of HIV pre-exposure prophylaxis (PrEP), an antiretroviral -based medication taken by HIV-negative men to prevent sero-conversion. In order for such promising findings to be translated in real-world settings, it is important to understand the acceptability of PrEP, including perceived barriers to access or uptake.

    METHODS: As part of a larger mixed-methods study exploring acceptability and willingness to use PrEP among MSM in Malaysia, 19 men took part in audio-recorded focus group discussions hosted by a community-based HIV organization and facilitated by a trained researcher. Discussions focussed on awareness and potential information management, general perceptions of PrEP and potential motivations or barriers to the use of PrEP, including those at the personal, social, health system or structural level. Data were transcribed verbatim and underwent a detailed thematic analysis.

    RESULTS: Rather than perceiving PrEP as a replacement for condoms in terms of having safer sex, many participants viewed it as an additional layer protection, serving as a crucial barrier to infection on occasions where condom use was intended, but did not occur. It was also perceived as more valuable to "at-risk" men, such as those in HIV sero-discordant relationships or those with a higher number of sexual partners. Elements of discussion tended to suggest that some men taking PrEP may be subject to stigma from others, on the assumption they may be promiscuous or engage in high-risk sexual behaviours.

    CONCLUSIONS: This qualitative study indicates that, broadly speaking, PrEP may be acceptable to MSM in Malaysia. However, in order for its potential to be realized, and uptake achieved, educative interventions are required to inform the target population as to the efficacy and potential, positive impact of PrEP. Given concerns for how those taking it may be stigmatized, it is crucial that the use of PrEP is presented as a responsible course of action, and one of a range of strategies that men can use to keep themselves safe from HIV.

    Matched MeSH terms: Qualitative Research
  6. Razali S, Kirkman M, Fisher J
    Child Abuse Review, 2020;29:73-84.
    DOI: 10.1002/car.2573
    Although filicide is discussed with concern in the print media and online in Malaysia, there is little empirical evidence about its aetiology or appropriate responses. We sought to elucidate the opinions of health, social work, education and policy professionals in Malaysia on the causes of, and solutions to, filicide. Fifteen informants participated in semi-structured qualitative interviews. Informants attributed responsibility for filicide to girls and women as a consequence of their failure to comply with social norms and religious teachings; the stigmatised social position of women who are pregnant and unmarried was identified as a contributing factor. No informant mentioned the impact of gender-based violence, including sexual violence against girls and women. Informants' views reflect the dominant discourse of filicide in Malaysia, which is that it results from women's failure to adhere to Malaysian norms of morality, religion, customs and traditions. Solutions were largely directed at changing the behaviour of girls and women. Given the disparities between the public discourse and evidence of the experiences of women convicted of filicide, interventions that promote social change might be more effective than strategies targeting women. ‘We sought to elucidate the opinions of health, social work, education and policy professionals in Malaysia on the causes of, and solutions to, filicide’. ‘Filicide is generally agreed to denote the crime of a parent killing her or his child aged up to 18 years’. Key Practitioner Messages: There are adverse consequences for children and women in Malaysia when responsibility for child safety is placed on individual women and not referred to a society structured on strict gender roles and masculine power. Practitioners in Malaysia would benefit from international support to understand the effects of marginalised women's experiences. © 2020 John Wiley & Sons, Ltd.
    Matched MeSH terms: Qualitative Research
  7. Ahmad Tajuddin NAN, Suhaimi J, Ramdzan SN, Malek KA, Ismail IA, Shamsuddin NH, et al.
    BMC Pregnancy Childbirth, 2020 May 19;20(1):309.
    PMID: 32429857 DOI: 10.1186/s12884-020-02987-9
    BACKGROUND: Incidences of unassisted home birthing practices have been increasing in Malaysia despite the accessibility to safe and affordable child birthing facilities. We aimed to explore the reasons for women to make such decisions.

    METHODS: Twelve women participated in in-depth interviews. They were recruited using a snowballing approach. The interviews were supported by a topic guide which was developed based on the Theory of Planned Behaviour and previous literature. The interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.

    RESULTS: Women in this study described a range of birthing experiences and personal beliefs as to why they chose unassisted home birth. Four themes emerged from the interviews; i) preferred birthing experience, ii) birth is a natural process, iii) expressing autonomy and iv) faith. Such decision to birth at home unassisted was firm and steadfast despite the possible risks and complications that can occur. Giving birth is perceived to occur naturally regardless of assistance, and unassisted home birth provides the preferred environment which health facilities in Malaysia may lack. They believed that they were in control of the birth processes apart from fulfilling the spiritual beliefs.

    CONCLUSIONS: Women may choose unassisted home birth to express their personal views and values, at the expense of the health risks. Apart from increasing mothers' awareness of the possible complications arising from unassisted home births, urgent efforts are needed to provide better birth experiences in healthcare facilities that resonate with the mothers' beliefs and values.

    Matched MeSH terms: Qualitative Research
  8. Hisham R, Ng CJ, Liew SM, Hamzah N, Ho GJ
    BMJ Open, 2016 Mar 09;6(3):e010565.
    PMID: 26962037 DOI: 10.1136/bmjopen-2015-010565
    OBJECTIVE: To explore the factors, including barriers and facilitators, influencing the practice of evidence-based medicine (EBM) across various primary care settings in Malaysia based on the doctors' views and experiences.
    RESEARCH DESIGN: The qualitative study was used to answer the research question. 37 primary care physicians participated in six focus group discussions and six individual in-depth interviews. A semistructured topic guide was used to facilitate both the interviews and focus groups, which were audio recorded, transcribed verbatim, checked and analysed using a thematic approach.
    PARTICIPANTS: 37 primary care doctors including medical officers, family medicine specialists, primary care lecturers and general practitioners with different working experiences and in different settings.
    SETTING: The study was conducted across three primary care settings-an academic primary care practice, private and public health clinics in Klang Valley, Malaysia.
    RESULTS: The doctors in this study were aware of the importance of EBM but seldom practised it. Three main factors influenced the implementation of EBM in the doctors' daily practice. First, there was a lack of knowledge and skills in searching for and applying evidence. Second, workplace culture influenced doctors' practice of EBM. Third, some doctors considered EBM as a threat to good clinical practice. They were concerned that rigid application of evidence compromised personalised patient care and felt that EBM did not consider the importance of clinical experience.
    CONCLUSIONS: Despite being aware of and having a positive attitude towards EBM, doctors in this study seldom practised EBM in their routine clinical practice. Besides commonly cited barriers such as having a heavy workload and lack of training, workplace 'EBM culture' had an important influence on the doctors' behaviour. Strategies targeting barriers at the practice level should be considered when implementing EBM in primary care.
    Study site: klinik kesihatan, general practice clinics, Klang Valley, Malaysia
    Matched MeSH terms: Qualitative Research
  9. Kohno A, Dahlui M, Nik Farid ND, Safii R, Nakayama T
    BMC Womens Health, 2020 03 04;20(1):46.
    PMID: 32131810 DOI: 10.1186/s12905-020-00911-z
    BACKGROUND: Child marriage, a marriage that involves someone under the age of 18 years, is a long-standing social issue in Sarawak state, Malaysia. The state has taken several measures to improve situations of inequity for women who get married early; however, the practice is still a common part of the tradition and culture. The aim of this study was to explore the factors leading to child marriage in Sarawak state, Malaysia.

    METHODS: This was an exploratory qualitative study conducted via semi-structured interviews with twenty-two women who were married when they were younger than 18 years old in Kuching, Sarawak, Malaysia. Participants were recruited through purposive and convenient sampling with the use of data from a reproductive health clinic and recruitment in villages. Thematic analysis was used for data analysis.

    RESULTS: Four overarching themes were identified: health risk behaviour, family poverty, early marriage as fate, and family disharmony.

    CONCLUSIONS: In-depth understanding of the unique factors leading to child marriage locally will facilitate the introduction of new approaches to interventions to eradicate child marriage in Sarawak state, Malaysia.

    Matched MeSH terms: Qualitative Research
  10. Tong WT, Vethakkan SR, Ng CJ
    BMJ Open, 2015 Jan 29;5(1):e006407.
    PMID: 25633285 DOI: 10.1136/bmjopen-2014-006407
    OBJECTIVE: To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin.
    RESEARCH DESIGN: A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach.
    PARTICIPANTS: Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year.
    SETTING: The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia.
    RESULTS: Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care.
    CONCLUSIONS: Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients' concerns during consultations and help to improve glycaemic control.
    Study site: Primary Care Clinic and Diabetes Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Qualitative Research
  11. Minhat, H.S.
    MyJurnal
    Diversified leisure involvement pose various health benefits to the elderly population. However, some elderly are too focus on doing a particular type of activity during their leisure time such as religious activity. This study aims to explore factors that could possibly contribute to the higher involvement in religious activity among the Malay ethnic elderly in Malaysia. In depth interviews were conducted, involving a total of 20 elderly aged 60 years and above with stratification by background characteristics. Each interview was conducted for an average of 15 to 30 minutes. They were purposively selected from two health clinics located in two different districts in the state of Selangor, representing an urban and a rural area. Majority of the elderly interviewed perceived that by engaging in religious activities such as prayer and reciting the Holy Quran or old Islamic scripture gives them serenity or calmness. Additionally, they also felt that involvement in such activities is very synonymous with being old and therefore one should be actively involved in religious activities with increasing age. In view of the lack of diversity of leisure involvement among the elderly and the passive and solitary nature of some of the religious activities, the elderly should be made aware of the importance of participating in other types of leisure activities especially physical activities. Although, they gain spiritual and social benefits from involving in religious activities, they also need to perform other form of activities that can improve the physical health status.
    Matched MeSH terms: Qualitative Research
  12. Suhami N, Muhamad MB, Krauss SE
    J Relig Health, 2016 Oct;55(5):1507-18.
    PMID: 26391242 DOI: 10.1007/s10943-015-0114-6
    Islamic healing is frequently referred to as the treatment of choice by many Muslim cancer patients in Malaysia. Despite its widespread use, there is limited information relating to patients' healing preferences. With rising cancer rates in the country, this issue has become a concern to public health policy makers. The purpose of this study was to understand why cancer patients seek Islamic healing. This qualitative study utilized in-depth interviews with 18 cancer patients. The findings indicate three main reasons: (1) recommendations from family, friends and doctors; (2) belief in Islamic healing and (3) the perceived ineffectiveness and dissatisfaction with conventional treatments. Islamic healing will likely continue to be popular complementary cancer treatment in Malaysia as it is grounded in strong cultural and religious beliefs.
    Matched MeSH terms: Qualitative Research
  13. Engkasan JP, Ng CJ, Low WY
    Spinal Cord, 2015 Feb;53(2):130-4.
    PMID: 25403504 DOI: 10.1038/sc.2014.199
    STUDY DESIGN: Qualitative study using individual in-depth interviews.

    OBJECTIVE: To explore the roles of patients, their caregivers and doctors when making decisions on the method of bladder drainage after spinal cord injury (SCI).

    SETTING: Five public hospitals in Malaysia.

    METHODS: Semistructured (one-to-one) interviews with 17 male patients with SCI, 4 caregivers and 10 rehabilitation professionals.

    RESULTS: Eight themes describing the respective decisional roles of patients, their caregivers and doctors emerged from the analysis: patient's right and responsibilities, patient as an informed decision maker, forced to accept decision; surrogate decision maker, silent partner; doctor knows best, over-ride patient's decision, or reluctant decision maker. Both patients and doctors acknowledged the importance of patient autonomy but not all patients had the chance to practice it. Some felt that they were forced to accept the doctor's decision and even alleged that the doctor refused to accept their decision. Doctors considered the caregiver as the decision maker in cases that involved minors, elderly and those with tetraplegia. Some patients considered bladder problems an embarrassing subject to discuss with their caregivers and did not want their involvement. Doctors were described as knowledgeable and were trusted by patients and their caregivers to make the most appropriate option. Some doctors were happy to assume this role whereas some others saw themselves only as information providers.

    CONCLUSIONS: A paternalistic model is prevalent in this decision-making process and there is a discrepancy between patients' preferred and actual decisional roles.
    Matched MeSH terms: Qualitative Research
  14. Olesen AP, Amin L, Mahadi Z, Ibrahim M
    Account Res, 2019 01;26(1):17-32.
    PMID: 30489163 DOI: 10.1080/08989621.2018.1554444
    This study found that less than half of the respondents are willing to blow the whistle. The results reveal that a lack of protection with regard to the whistleblower's identity, the tedious investigative process, and the notion of avoiding confrontation, which is more apparent in Asian cultures as compared to the West, are among the reasons why individuals who witnessed misconduct chose to remain silent. Adhering to the Asian cultural upbringing where the young must respect the old, those of lower rank must obey those with higher authority, and subordinates do not question the actions of their superior, has become a norm even in the working environment. Therefore, emphasize the need for better protection for whistleblowers including using experienced individuals with a research ethics background to handle allegations from whistleblowers. In addition, established guidelines and procedures for whistleblowers with regard to voicing their allegations against colleagues engaged in research misconduct is still lacking or, to a certain extent, is still unknown to researchers. Thus, the concern indicates a need for institutions to create awareness among researchers regarding the existing platform for whistleblowers, or to develop a systematic and clear procedure which is reliable and independent to promote professionalism in academia.
    Matched MeSH terms: Qualitative Research
  15. Tong WT, Ng CJ, Lee YK, Lee PY
    J Eval Clin Pract, 2020 Jun;26(3):755-764.
    PMID: 31115132 DOI: 10.1111/jep.13161
    RATIONALE, AIMS, AND OBJECTIVES: Few studies focus on patients' views on factors influencing implementation of patient decision aids (PDAs). This study aims to explore patients' views on the factors influencing implementation of an "insulin choice" PDA in a primary care setting.

    METHODS: This study used a descriptive qualitative study design. Interviews were conducted using a semistructured interview guide developed based on the theoretical domains framework. Nine in-depth interviews and three focus group discussions were conducted with patients with type 2 diabetes who have been advised to start insulin or were currently using insulin and those who had been seeking diabetes treatment in the clinic for more than 1 year. Interviews were conducted after the participants were familiarized with the PDA. Data were analysed using a thematic approach.

    RESULTS: Five themes emerged from the data analysis: (a) trust in the physician (patients preferred physicians to other health care providers in delivering the insulin PDA to them as they trusted physicians more when it comes to making decisions such as starting insulin), (b) physician's attitude (patients were more likely to trust a physician who is friendly and sympathetic hence would be more willing to use the insulin PDA), (c) physician's communication style (patients were more willing to use the insulin PDA if the physicians would take time and guide them in the PDA use), (d) conducive environment (patients preferred to read the PDA at home), and (e) cost (patients would not be willing to pay to use the insulin PDA unless they needed it).

    CONCLUSIONS: Patients want physicians to play a major role in the implementation of the insulin PDA; physicians' communication style and commitment may influence implementation outcomes. Health care authorities need to create a conducive environment and provide patients with free access to PDA to promote effective implementation.

    Matched MeSH terms: Qualitative Research
  16. Lee EL, Wong PS, Tan MY, Sheridan J
    Int J Pharm Pract, 2018 Apr;26(2):138-147.
    PMID: 28574154 DOI: 10.1111/ijpp.12374
    OBJECTIVES: This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia.
    METHODS: A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively.
    KEY FINDINGS: Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services.
    CONCLUSION: This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia.
    Study site: primary care health clinic (klinik kesihatan), Kuala Lumpur, Malaysia
    Matched MeSH terms: Qualitative Research
  17. Abdullah A, Liew SM, Hanafi NS, Ng CJ, Lai PS, Chia YC, et al.
    Patient Prefer Adherence, 2016;10:99-106.
    PMID: 26869773 DOI: 10.2147/PPA.S94687
    BACKGROUND: Telemonitoring of home blood pressure (BP) is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients' acceptance of such service in routine clinical care.
    OBJECTIVE: This study aimed to explore patients' acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM).
    METHODS: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.
    RESULTS: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and suggested improvement to the BP telemonitoring functionalities to improve interactions. Patients cited being involved in research as the main reason for their intention to use the service. They felt that patients with limited experience with the internet and information technology, who worked out of town, or who had an outdoor hobby would not be able to benefit from such a service.
    CONCLUSION: Patients found BP telemonitoring service in primary care easy to use but needed help to interpret the meanings of monitored BP readings. Implementations of BP telemonitoring service must tackle these issues to maximize the patients' acceptance of a BP telemonitoring service.
    Matched MeSH terms: Qualitative Research
  18. Ng CJ, Haidi NS
    Asia Pac Fam Med, 2005;4(3).
    Aim: To explore the help-seeking behavior of primary care doctors during illness. Methods: This qualitative study used focus group discussions to explore participants' help-seeking behavior during illness. It involved 22 primary care doctors (5 lecturers, 12 postgraduate trainees, 5 medical officers) working in a hospital-based primary care clinic. Result: Most primary care doctors in this study managed their illnesses without seeking help. Although most preferred to seek professional help for chronic illnesses and antenatal care, they tend to delay the consultations and were less likely to comply with treatment and follow-up. Explanations for their behavior include their ability to assess and treat themselves, difficulty to find suitable doctors, work commitment, easy access to drugs, and reluctance to assume a sick role. Conclusions: This study found that the help-seeking behavior of primary care doctors was similar to those in other studies. Due to their professional ability, heavy workload and expectations from peer and patients, primary care doctors were more likely to delay in seeking treatment especially for chronic and serious diseases. This highlights the need to enhance support services for doctors during illness. Key words: doctors, help-seeking behavior, illness
    Matched MeSH terms: Qualitative Research
  19. Teo CH, Ng CJ, White A
    PLoS One, 2017;12(1):e0169435.
    PMID: 28060953 DOI: 10.1371/journal.pone.0169435
    There is a lack of mobile app which aims to improve health screening uptake developed for men. As part of the study to develop an effective mobile app to increase health screening uptake in men, we conducted a needs assessment to find out what do men want from a health screening mobile app. In-depth interviews and focus group discussions were conducted with 31 men from a banking institution in Kuala Lumpur. The participants were purposely sampled according to their job position, age, ethnicity and screening status. The recruitment was stopped once data saturation was achieved. The audio-recorded interviews were transcribed verbatim and analyzed using thematic approach. Three themes emerged from the analysis and they were: content, feature and dissemination. In terms of the content, men wanted the app to provide information regarding health screening and functions that can assess their health; which must be personalized to them and are trustable. The app must have user-friendly features in terms of information delivery, ease of use, attention allocation and social connectivity. For dissemination, men proposed that advertisements, recommendations by health professionals, providing incentive and integrating the app as into existing systems may help to increase the dissemination of the app. This study identified important factors that need to be considered when developing a mobile app to improve health screening uptake. Future studies on mobile app development should elicit users' preference and need in terms of its content, features and dissemination strategies to improve the acceptability and the chance of successful implementation.
    Matched MeSH terms: Qualitative Research
  20. Lee YK, Ng CJ, Lee PY, Khoo EM, Abdullah KL, Low WY, et al.
    PMID: 23378747 DOI: 10.2147/PPA.S36791
    BACKGROUND: Patients with type 2 diabetes often require insulin as the disease progresses. However, health care professionals frequently encounter challenges when managing patients who require insulin therapy. Understanding how health care professionals perceive the barriers faced by patients on insulin will facilitate care and treatment strategies.
    OBJECTIVE: This study explores the views of Malaysian health care professionals on the barriers faced by patients using insulin.
    METHODS: Semi-structured qualitative interviews and focus group discussions were conducted with health care professionals involved in diabetes care using insulin. Forty-one health care professionals participated in the study, consisting of primary care doctors (n = 20), family medicine specialists (n = 10), government policymakers (n = 5), diabetes educators (n = 3), endocrinologists (n = 2), and one pharmacist. We used a topic guide to facilitate the interviews, which were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.
    RESULTS: FIVE THEMES WERE IDENTIFIED AS BARRIERS: side effects, patient education, negative perceptions, blood glucose monitoring, and patient adherence to treatment and follow-up. Patients perceive that insulin therapy causes numerous negative side effects. There is a lack of patient education on proper glucose monitoring and how to optimize insulin therapy. Cost of treatment and patient ignorance are highlighted when discussing patient self-monitoring of blood glucose. Finally, health care professionals identified a lack of a follow-up system, especially for patients who do not keep to regular appointments.
    CONCLUSION: This study identifies five substantial barriers to optimizing insulin therapy. Health care professionals who successfully identify and address these issues will empower patients to achieve effective self-management. System barriers require government agency in establishing insulin follow-up programs, multidisciplinary diabetes care teams, and subsidies for glucometers and test strips.
    KEYWORDS: diabetes; focus groups; insulin; noncommunicable disease; primary care; qualitative study
    Matched MeSH terms: Qualitative Research
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