Displaying publications 1 - 20 of 288 in total

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  1. Fletcher E, Burns A, Wiering B, Lavu D, Shephard E, Hamilton W, et al.
    BMC Prim Care, 2023 Jan 20;24(1):23.
    PMID: 36670354 DOI: 10.1186/s12875-023-01973-2
    BACKGROUND: Electronic clinical decision support tools (eCDS) are increasingly available to assist General Practitioners (GP) with the diagnosis and management of a range of health conditions. It is unclear whether the use of eCDS tools has an impact on GP workload. This scoping review aimed to identify the available evidence on the use of eCDS tools by health professionals in general practice in relation to their impact on workload and workflow.

    METHODS: A scoping review was carried out using the Arksey and O'Malley methodological framework. The search strategy was developed iteratively, with three main aspects: general practice/primary care contexts, risk assessment/decision support tools, and workload-related factors. Three databases were searched in 2019, and updated in 2021, covering articles published since 2009: Medline (Ovid), HMIC (Ovid) and Web of Science (TR). Double screening was completed by two reviewers, and data extracted from included articles were analysed.

    RESULTS: The search resulted in 5,594 references, leading to 95 full articles, referring to 87 studies, after screening. Of these, 36 studies were based in the USA, 21 in the UK and 11 in Australia. A further 18 originated from Canada or Europe, with the remaining studies conducted in New Zealand, South Africa and Malaysia. Studies examined the use of eCDS tools and reported some findings related to their impact on workload, including on consultation duration. Most studies were qualitative and exploratory in nature, reporting health professionals' subjective perceptions of consultation duration as opposed to objectively-measured time spent using tools or consultation durations. Other workload-related findings included impacts on cognitive workload, "workflow" and dialogue with patients, and clinicians' experience of "alert fatigue".

    CONCLUSIONS: The published literature on the impact of eCDS tools in general practice showed that limited efforts have focused on investigating the impact of such tools on workload and workflow. To gain an understanding of this area, further research, including quantitative measurement of consultation durations, would be useful to inform the future design and implementation of eCDS tools.

    Matched MeSH terms: Referral and Consultation
  2. Muhammad Syafiq Abdullah, Nicholas Pang, Sharinah Abd Kassim, Flora Aurora AmatUdat, NurZiana Ulkaya, NuraisyahNurullah, et al.
    MyJurnal
    Introduction: Isolation and border control measures, with home quarantine measures, are essential to stem the spread of the newly emergent novel Covid-19. Such measures are doomed to fail if reliant on traditional isolation methods, which entail small numbers of overworked healthcare staff screening and surveilling large numbers of well individuals who are potential false positives. Innovative method employed by Hospital UMS to overcome these logistics difficulties. Methods: A total of 440 returning China students to UMS were planned for home quarantine measures for 14 days. In the intervening 14 days, groups of ten quarantined individuals were assigned to 1 Manda- rin-speaking medical student liaison officer (LO). LOs performed assessment toolkit for 14 consecutive days virtually via WhatsApp and WeChat and reported back to NCOV central command if any symptoms ensued. Results: 45 China students have been put on home quarantine. Two (2) students with symptoms were monitored virtually till resolution of symptoms. Also, five (5) students with uncontactable phone numbers required tracking down, using var- ious methods eg: retrieval from close contacts through wide-bore virtual search. No cases so far have been positive for NCOV or have required referral to tertiary hospitals. Qualitatively, such methods are a vital public health inter- vention, as task shifting happens to semi-professionals. Hospital UMS first trial of two cherished founding principles: community-based rather than healthcare-facility center healthcare delivery, and judicious use of digital health com- munications, applications, and rudimentary telemedicine. Conclusion: Student-led virtual telemedicine and digital health delivery has potential in public health crises like NCOV, freeing frontline healthcare staff to devote energies to their specialties of screening and treatment. Integration of video and biometrics to incorporate true telemedicine, allowing individuals to be “hospitalized” in a community setting in situations of low risk.
    Matched MeSH terms: Referral and Consultation
  3. Vengatesh Rao, Irfan Mohamad
    MyJurnal
    The unilateral nasal symptom should trigger a treating physician to a certain diagnosis. The differential
    diagnosis includes foreign body, rhinolith and tumour. The chronicity of symptom helps a lot with the diagnosis.
    Foreign body for example, tends to present with positive history of insertion, mainly by children or the acute
    symptom of local infection. In the presence of prolonged symptom, rhinolith should be suspected especially when
    the patient presents with pathognomonic nasal obstruction with foul smelly discharge. A referral should be made
    for a nasoendoscopy evaluation whenever a rhinitis-like symptoms remain after a period of medical treatment for
    allergy. We share a case of a missed diagnosis of a rhinolith after six years of symptoms.
    Matched MeSH terms: Referral and Consultation
  4. Jin RR, Sutcliffe A, Vento M, Miles C, Travadi J, Kishore K, et al.
    Acta Paediatr, 2018 10;107(10):1733-1738.
    PMID: 29385272 DOI: 10.1111/apa.14242
    AIM: The diagnosis of tongue-tie (or ankyloglossia) has increased more than 10-fold in some countries. Whether this is a global phenomenon or related to cultural and professional differences is uncertain.

    METHODS: An online survey in English, Japanese, Chinese and Spanish was disseminated between May and November 2016 via 27 international professional bodies to >30 clinical professions chosen a priori to represent occupations involved in the management of neonatal ankyloglossia.

    RESULTS: A total of 1721 responses came from nursing (51%), medical (40%), dental (6%) and allied health (4%) clinicians. Nurses (40%) and allied health (34%) professionals were more likely than doctors (8%) to consider ankyloglossia as important for lactation problems, as were western (83%) compared to Asian (52%) clinicians. Referrals to clinicians for ankyloglossia management originated mainly from parents (38%). Interprofessional referrals were not clearly defined. Frenectomies were most likely to be performed by surgeons (65%) and dentists (35%), who were also less likely to be involved in lactation support. Clinicians performing frenectomies were more likely to consider analgesia as important compared to those not performing frenectomies.

    CONCLUSION: The diagnosis and treatment of ankyloglossia vary considerably around the world and between professions. Efforts to standardise management are required.

    Matched MeSH terms: Referral and Consultation
  5. Waran V, Bahuri NF, Narayanan V, Ganesan D, Kadir KA
    Br J Neurosurg, 2012 Apr;26(2):199-201.
    PMID: 21970777 DOI: 10.3109/02688697.2011.605482
    The purpose of this study was to validate and assess the accuracy and usefulness of sending short video clips in 3gp file format of an entire scan series of patients, using mobile telephones running on 3G-MMS technology, to enable consultation between junior doctors in a neurosurgical unit and the consultants on-call after office hours.
    Matched MeSH terms: Referral and Consultation*
  6. Mays Jamal Ali, Nik Mazlan Mamat, Wan Fathin Fariza Bt. Wan Mahmood, Aryati Binti Ahmad, Shaheeda Binti Razali
    MyJurnal
    The purpose of this study is to validate Sugar Craving Assessment Tool (MySCAT) among type II diabetes mellitus patients. A total of 168 respondents were recruited to participate in this cross sectional study. It was conducted in out-patient health clinics in Kuala Terengganu and Kuantan. Patients’ sugar craving and dietary behavior were measures using structured questionnaires which were MySCAT, three-day dietary recall and demographic data. The interview sessions were conducted by a dietician. MySCAT internal consistency test had a Cronbach’s alpha value of 0.75 and showed a significant correlation (r=0.56, p < 0.001) with actual sugar intake collected via three days diet recall. ROC analysis reported a cut-off point for MySCAT as 16.5; the sensitivity value of 0.83 and 1-specificity of 0.38. 62% of respondents were categorized as cravers and 38% as non-cravers. Male and female repondents had no significant differences in craving status. The mean intake of sugar was 46 g/day (SD= 2.26), respondents had a relatively high intake of sugar in comparison to their recommendation. This study found that MySCAT provides an easy efficient tool which is sensitive enough to identify those with sugar craving problem. It also provides an overview of patients’ dietary intake and points out their problem with dietary intake compliance. We suggest MySCAT as an important tool that can assist dietitians in their consultation session.
    Matched MeSH terms: Referral and Consultation
  7. Wharton-Smith A, Green J, Loh EC, Gorrie A, Omar SFS, Bacchus L, et al.
    BMC Infect Dis, 2019 Jan 11;19(1):45.
    PMID: 30634929 DOI: 10.1186/s12879-019-3680-5
    BACKGROUND: Malaysia has rising dengue incidence. World Health Organization clinical practice guidelines for managing dengue have been adapted by the Ministry of Health in Malaysia, with evidence of good awareness by clinicians. However, dengue mortality has not reduced. This study aimed to explore the challenges of dengue management for Medical Officers, with a particular focus on use of clinical practice guidelines.

    METHODS: Qualitative study using six focus groups and 14 semi-structured interviews with doctors responsible for dengue management at a large tertiary hospital in Malaysia.

    RESULTS: Dengue was recognised as difficult to diagnose and manage. Wide awareness and use of both WHO and Ministry of Health guidelines was reported, but several limitations noted in their coverage of particular patient groups. However, the phrase 'guidelines' also referred to local algorithms for fluid management, which were less clinically evidence-based. Where Medical Officers were well trained in the appropriate use of evidence-based guidelines, barriers to use included: the potential for 'following the algorithm' to undermine junior clinicians' claims to clinical expertise; inability to recognise the pattern of clinical progress; and lack of clinical experience. Other reported barriers to improved case management were resource constraints, poor referral practices, and insufficient awareness of the need for timely help seeking.

    CONCLUSIONS: Awareness of clinical practice guidelines is a necessary, but not sufficient, condition for optimal dengue management. In high prevalence settings, all clinical staff would benefit from regular dengue management training which should include diagnosis, practice in monitoring disease progression and the use of clinical practice guidelines in a range of clinical contexts.

    Matched MeSH terms: Referral and Consultation
  8. Syed A, Mohd Don Z, Ng CJ, Lee YK, Khoo EM, Lee PY, et al.
    BMJ Open, 2017 05 09;7(5):e014260.
    PMID: 28490553 DOI: 10.1136/bmjopen-2016-014260
    OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.
    DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.
    SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.
    PARTICIPANTS: Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.
    PRIMARY OUTCOME MEASURES: Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.
    RESULTS: Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.
    CONCLUSIONS: Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.
    Matched MeSH terms: Referral and Consultation*
  9. Saiful Bahri A, Tuan Mahmood TM, Abdul-Aziz SA, Makmor-Bakry M, Mohamed Shah N
    Patient Prefer Adherence, 2021;15:227-235.
    PMID: 33568899 DOI: 10.2147/PPA.S293029
    Context: Globally, breast cancer is the most common cancer affecting women, and adjuvant endocrine therapy (AET) is part of its treatment modality, which improves patients' outcome. However, there are concerns on side effects related to its use, which may affect treatment adherence.

    Purpose: This study was conducted to explore attitude and practice on using AET among breast cancer patients in Malaysia.

    Patients and Methods: Postmenopausal breast cancer patients on at least 3 months of AET attending the outpatient oncology clinic at a tertiary care hospital were interviewed. Patients underwent in-depth interviews exploring their attitude and practices while on AET using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using thematic analysis.

    Results: There were four main themes for attitude toward the use of AET: 1) benefits of using AET, 2) concerns on taking AET, 3) beliefs on alternative treatment, and 4) beliefs toward the doctor. For practice, six themes were obtained: 1) correct use of AET, 2) appointment adherence, 3) information-seeking behavior, 4) counseling services obtained, 5) experienced side effects of AET, and 6) usage of complementary and alternative medicines.

    Conclusion: Several themes concerning attitude and practice of breast cancer patients receiving AET were identified, which may be addressed during treatment consultations in clinical practice.

    Matched MeSH terms: Referral and Consultation
  10. Liew SK, Shim BJ, Gong HS
    Korean J Neurotrauma, 2020 Oct;16(2):126-137.
    PMID: 33163420 DOI: 10.13004/kjnt.2020.16.e48
    Cervical spinal cord injury (SCI) often causes debilitating loss of function of the upper limb. Upper extremity reconstruction surgery can restore some of the upper limb function in tetraplegic patients with SCI. The procedures are typically muscle-tendon unit transfer surgeries, which redistribute the remaining functional muscles to restore active elbow extension, key grip, and finger grasping. In addition to the tendon transfer surgeries, nerve transfers have emerged recently and are showing promising results. However, despite more than half of the tetraplegic patients can benefit from upper limb surgery, only a few of them receive the procedures. This missed opportunity may be due to the lack of communication between SCI specialists and hand surgeons, or the lack of awareness of such options among the specialists and patients. In this review, we provide a basic overview of upper limb reconstruction in tetraplegic patients with target audience of SCI specialists for their better understanding of the basic concept of surgery and information for patient consultation before referring to hand surgeons.
    Matched MeSH terms: Referral and Consultation
  11. Kachewar S, Kulkarni D
    Biomed Imaging Interv J, 2011 Oct;7(4):e27.
    PMID: 22279504 DOI: 10.2349/biij.7.4.e27
    This short case report discusses the various aspects of penile fracture, which is a rare entity. Nevertheless, the incidence of penile fractures is on the rise due to the increased use of performance-enhancing drugs. An individual with a penile fracture should seek immediate medical referral. Prompt diagnosis and management is necessary to prevent undesirable after-effects as discussed. Emphasis is made on how imaging with ultrasound enables a quick and complete assessment of this mishap.
    Matched MeSH terms: Referral and Consultation
  12. Jamal AA, Aldawsari ST, Almufawez KA, Barri RM, Zakaria N, Tharkar S
    Int J Med Inform, 2020 09;141:104202.
    PMID: 32506051 DOI: 10.1016/j.ijmedinf.2020.104202
    BACKGROUND: The use of social media is widespread globally. It provides a quicker and faster means of efficient exchange of communications. The use of Twitter Applications to seek mental health advice is becoming popular.

    OBJECTIVES: This study aims to identify the determinants associated with Twitter use in psychiatric consultations and to assess the level of satisfaction in using the microblogging platform. In addition, the level of e-health literacy is also assessed among users.

    METHODS: The target population included Twitter users seeking psychiatric consultation. A leading psychiatrist's twitter account with 4.5 million followers was selected and consent obtained. A validated Patient Satisfaction Questionnaire was adopted to assess the level of satisfaction in Twitter use and e-health literacy. The questionnaire was tagged to the chosen Twitter account and reminders were sent until the sample size was reached. Data was analysed using SPSS version 22.0. The analysis included descriptive statistics tabulation, multi-response analysis, and cross-tabulation for satisfaction variables and the chi-square test was used to measure association between different variables.

    RESULTS: The study obtained 155 completed response sheets, of which 52 were Twitter users seeking psychiatric advice while the rest sought general health advice. Most of the study participants were females (71.6 %). Women, single status and income range between 4000-9000 Saudi riyal were found to be significantly associated with Twitter use for psychiatric consultation. Generally, most of the participants were satisfied with Twitter in seeking psychiatric consultation that reduced financial disbursement. Furthermore, concerns were expressed regarding the waiting period, word limitations and issues of privacy. The e-health literacy was higher among the participants.

    CONCLUSION: Psychiatric consultations via Twitter is more popular among women. By addressing privacy issues and reducing response time, Twitter may be used as a major platform to deliver mental health services to the population.

    Matched MeSH terms: Referral and Consultation
  13. Ong LK, Sivaneswaran L, Mohd Najib A, Devindran M, Say BL, Rohan MJ
    Med J Malaysia, 2020 07;75(4):400-402.
    PMID: 32724002
    In Malaysia, COVID-19 pandemic recorded considerable number of cases. Many hospitals have been converted into COVID-19 centres to manage these cases. The Penang General Hospital was designated as a hybrid hospital to manage both COVID-19 and non-COVID-19 cases. Consequently, services across specialties, including urology have been affected. Triage of referrals was necessary to ensure optimum patient care, thus we designed a triage system to address this situation. A record screening system of patients was also implemented to limit outpatient appointments. We share this early experience in managing urology patients during this pandemic.
    Matched MeSH terms: Referral and Consultation*
  14. Awang R, Abd Rahman AF, Wan Abdullah WZA, Lajis R, Abdul Majid MI
    Med J Malaysia, 2003 Aug;58(3):375-9.
    PMID: 14750377
    This report describes inquiries relating to poisoning cases which were received by the National Poison Centre of Malaysia from the years 1996 to 2000. The study utilized data from the NPC report forms. Only data relating to patient contact with a poison or chemical were included in the analysis. The poison centre received an average of 186 poisoning inquiries per year. Doctors remained the highest group of caller to the poison centre throughout the five-year period. Nearly 50% of all inquiries was regarding pesticide poisoning and this trend remained constant during the five-year period. Overall, the findings showed that poisoning inquiries relating to patient care were lower than in Japan and the United States.
    Matched MeSH terms: Referral and Consultation/trends*
  15. Saroja KI, Ramphal KG, Kasmini K, Ainsah O, Bakar OC
    Singapore Med J, 1999 May;40(5):349-51.
    PMID: 10489494
    To determine the relationship between absenteeism rates and psychological intervention over a 6-month period in an agency with 334 employees in Klang Valley, Malaysia, which had the highest absenteeism rates.
    Matched MeSH terms: Referral and Consultation
  16. Adham M, Anam K, Reksodiputro L
    Med J Malaysia, 2022 01;77(1):53-59.
    PMID: 35086995
    INTRODUCTION: Treatment of head and neck cancer patients amidst the COVID-19 pandemic is challenging, whereas prolonged treatment initiation in head and neck squamous cell carcinoma may increase mortality and likelihood of recurrence. Special attention is needed to ensure safe and appropriate care of these patients. This article aims to review and discuss existing research on treatment prioritization and risk stratification of head and neck cancer patients during the pandemic.

    MATERIALS AND METHODS: The authors conducted literature search in three databases (PubMed, Cochrane, and Clinical Key) on July 15th, 2020. The keywords were ("Head and Neck Mucosal Malignancy" OR "Head and Neck Cancer") AND ("Management" OR "Head and Neck Surgery") AND ("COVID-19" OR "Pandemic"). The inclusion criteria were cancer in adult patients, published from 2020 in English, and with available access to full text. The exclusion criteria were comments, letters, and case reports. The articles were critically appraised using the Centre of Evidence-based Medicine (CEBM), University of Oxford and Duke University. The literature search strategy is illustrated using Preferred Reporting Items for Systematic review and meta-analysis (PRISMA) flow diagram.

    RESULTS: A total of 150 articles were identified; 21 articles were gathered from Clinical Key, 33 from Cochrane, and 96 from Pubmed. After screening abstracts and reviewing the full text, the authors determined five articles met the inclusion criteria. There are several key points of head and neck cancer management in the COVID-19 pandemic. Head and neck cancer management is considered a high-risk procedure; the clinician should use proper personal protective equipment. Before operative treatment, all patients should undergo a PCR test 14 days before surgery. In diagnosing head and neck cancer, laryngoscopy should be considered carefully; and cytology should be preferred instead. Medically Necessary, Time-sensitive (MeNTS) score is recommended for risk stratification and surgery prioritization; it has three domains: procedure, disease, and patient. However, it is not specified to head and neck cancer; therefore, it should be combined with other references. Stanford University Head and Neck Surgery Division Department of Otolaryngology made surgery prioritization into three groups, urgent (should be operated immediately), can be postponed for 30 days, and can be postponed for 30- 90 days. Some urgent cases and should be operated on immediately include cancers involving the airways, decreased renal function, and metastases. For chemoradiation decision to delay or continue should refer to the goal of treatment, current oncologic status, and tolerance to radiation. In terms of patient's follow up, telephone consultation should be maximized.

    CONCLUSION: MeNTS scoring combined with Guideline from Department of Otolaryngology at Stanford University prioritizing criteria can be helpful in decision making of stratifying Risk and prioritizing surgery in head and neck cancer management.

    Matched MeSH terms: Referral and Consultation
  17. Flaherty GT, Leong SW, Finn Y, Sulaiman LH, Noone C
    J Travel Med, 2020 Sep 26;27(6).
    PMID: 32634210 DOI: 10.1093/jtm/taaa110
    BACKGROUND: Little is known about the awareness of travellers with diabetes about the health effects of international travel. This study aimed to design and validate a questionnaire to examine the travel health knowledge, attitudes and practices of people living with type 1 diabetes.

    METHODS: A set of 74 items based on a conceptual framework analysis underwent revision and its content validity was established. Items were grouped into three domains. A development study was conducted to establish evidence regarding their factorial structure. A construct validation study was then conducted in which the retained items were tested in an independent sample using confirmatory factor analysis (CFA).

    RESULTS: Four factors emerged from our development study and were labelled as pre-travel preparation-insect bites, pre-travel preparation-consultation, insulin and glycaemic control and travel risk behaviour. A CFA confirmed the factorial structure identified in the development study in an independent sample. Each factor loading had a significant (P 

    Matched MeSH terms: Referral and Consultation
  18. Flaherty G, Md Nor MN
    J Travel Med, 2016 Jan;23(1).
    PMID: 26782127 DOI: 10.1093/jtm/tav010
    Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation.
    Matched MeSH terms: Referral and Consultation
  19. Meryl Grace Lansing, Liew Sat Lin Constance, Chang Chee Keong, Pradip Subramaniam
    MyJurnal
    Introduction:Light’s criteria for pleural fluid analysis has long been the standard for distinguishing transudates from exudates. In pleural tuberculosis, the resulting pleural fluids are usually exudates. We present a case of presumed transudative effusion which was eventually diagnosed as pleural tuberculosis. Case description: A 59-year-old man with end-stage renal failure (ESRF) on regular haemodialysis presented with a one-day history of acute onset dys-pnoea associated with pleuritic chest pain and cough. Chest radiograph revealed bilateral pleural effusions and thoracentesis was done. The pleural fluid result was interpreted as transudative effusion according to Light’s criteria because his pleural fluid to serum protein ratio was less than 0.5. AFB 1+ was seen in the pleural fluid with negative gram stain and culture. This resulted in conflicting opinions on whether to start this patient on anti-tuberculous ther-apy (ATT) and there was even a suggestion to get a second opinion for the possibility of AFB fluid contamination. The initial diagnosis was written as fluid overload secondary to ESRF but ATT was started anyway to cover for pleural TB. On further analysis of his pleural fluid, the pleural protein 32 g/L which on its own is a marker of exudative effusion. Subsequent investigations revealed the presence of exudative ascitic fluid which further raised the suspicion for a concomitant peritoneal TB. Conclusion: Premature conclusion that the pleural fluid was transudative occurred prob-ably due to the bilateral nature of the pleural effusion associated with a known tendency for the patient to develop pulmonary overload secondary to his ESRF. This case is a reminder that Light’s criteria also requires serum and fluid LDH measurement for the diagnosis of transudative pleural effusion. More importantly, a high level of suspicion for TB is important when evaluating patients from areas where TB is prevalent and a positive AFB result should not be taken lightly.
    Matched MeSH terms: Referral and Consultation
  20. Marhani Midin, Salina Abdul Aziz, Phang, Cheng-Kar
    ASEAN Journal of Psychiatry, 2010;11(2):206-215.
    MyJurnal
    Objective: Mental health services in Malaysia often face competition from traditional healers especially among patients with psychosis. The objective of the study is to determine whether patients who sought help earlier from traditional healers had longer duration of untreated psychosis (DUP), and more adverse experiences in pathways to psychiatric care. Methods: This is a hospital-based cross-sectional study of 50 inpatients with first-episode
    psychosis in Hospital Kuala Lumpur. Structured Clinical Interview for DSM-IV (Diagnostic and statistical manual, 4th edition) Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Onset of psychosis was defined as any one positive symptom with a score of >3 on the Positive and Negative Syndrome Scale (PANSS). Socio-demographic
    data, information on pathways and treatment delaying factors were determined through face-to-face interview and semi-structured questionnaire. Results: Fifty-four percent of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact
    (48%). Contact with traditional healers was not associated with age, gender, ethnic, education level, longer DUP or treatment delay, and admissions with violent behaviour or police assistance. Of those who had sought help from traditional healers, one third were recommended by at least one of their traditional healers to seek medical help. Conclusion:
    Consultation involving traditional healers was a popular choice, and not associated with treatment delay. Traditional healers in an urban setting may be potential collaborators in managing patients with first-episode psychosis. Future research should explore the frontiers of such collaborative work.
    Matched MeSH terms: Referral and Consultation
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