Displaying publications 1 - 20 of 50 in total

Abstract:
Sort:
  1. Fulltext Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study
    Chew KS, Durning SJ, van Merriënboer JJ
    Singapore Med J, 2016 Dec;57(12):694-700.
    PMID: 26778635 DOI: 10.11622/smedj.2016015
    INTRODUCTION: Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.

    METHODS: Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.

    RESULTS: The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.

    CONCLUSION: The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.

    Matched MeSH terms: Prejudice
  2. Review paper: gender competencies in the medical curriculum: addressing gender bias in medicine
    Wong YL
    Asia Pac J Public Health, 2009 Oct;21(4):359-76.
    PMID: 19661102 DOI: 10.1177/1010539509337730
    Gender inequalities in health and gender bias in medicine are interrelated challenges facing health care providers and educators. Women and girls are disadvantaged in accessing health care because of their low social status and unequal treatment in medical care. Gender bias has long been inherent in clinical practice, medical research, and education. This can be traced to the medical curriculum that shapes the perceptions, attitudes, and behavior of the future doctor. The author advocates medical curricula change to address gender inequalities in health and gender bias in medicine. She analyses the reasons for integration of gender competencies in the medical curriculum, discusses what gender competencies are, and reviews ways to in-build gender competencies and their assessment. Efforts to change and gender sensitize medical curricula in developed and developing countries are also reviewed. The review hopes to contribute to strategic medical curriculum reform, which would lead to gender-sensitive health services and equity in health.
    Matched MeSH terms: Prejudice*
  3. Gender issues in medical and public health education
    Wong YL
    Asia Pac J Public Health, 2000;12 Suppl:S74-7.
    PMID: 11338745
    There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.
    Matched MeSH terms: Prejudice*
  4. Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study
    Wong LP
    Prev Med, 2013;57 Suppl:S60-3.
    PMID: 23583477 DOI: 10.1016/j.ypmed.2013.03.013
    OBJECTIVE: The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination.
    METHOD: A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated.
    RESULTS: Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting.
    CONCLUSIONS: The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.
    KEYWORDS: Discriminatory; HIV/AIDS; Knowledge; Stigma
    Matched MeSH terms: Prejudice/psychology; Prejudice/statistics & numerical data*
  5. Fulltext Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: a cross-sectional population-based study
    Wong LP
    AIDS Care, 2013;25(11):1356-69.
    PMID: 23406514 DOI: 10.1080/09540121.2013.766302
    The objective of this study was to identify demographic characteristics and correlates of the uptake of HIV testing, willingness to be tested and perceived HIV-related stigma of Malaysian lay public. A cross-sectional computer-assisted telephone interview survey of a representative sample of multiracial Malaysians aged 18 years and above was conducted between December and July 2011. The survey collected information on demographics, knowledge about HIV transmission and religious beliefs on attitudes to HIV/AIDS. A total of 2271 households were successfully interviewed. The response rate was 48.65%. The HIV transmission knowledge score ranged from 0 to 15 (mean =10.56; SD±2.42). Three of the most common misconceptions about HIV transmission were mosquito bite (42.8%), eating in a restaurant where the cook is HIV positive (20.4%) and using a public toilet (20.1%). Only 20.6% reported ever having been tested for HIV, 49.1% reported a willingness to be tested for HIV and 30.3% had no intention of getting an HIV test. Low-risk perception (63.7%) constitutes a major barrier to HIV testing. Being Malay and Chinese (relative to Indian) were the strongest predictors of low-risk perception. Other significant predictors of low-risk perception were being male, being married and living in an urban locality. Perceived self-stigma if tested positive for HIV was prevalent (78.8%). Multivariate findings showed that being female, Malay, low income, living in rural localities and public stigma were significant correlates of self-stigma. These findings warrant interventions to reduce the disproportionate HIV transmission misconception, barriers to HIV testing and stigma and discriminative attitudes to involve considerations of sociocultural economic and demographic characteristics.
    Matched MeSH terms: Prejudice/psychology
  6. A Qualitative Study of HIV "Test-and-Treat" Experience Among Men Who Have Sex With Men in Malaysia
    Lim SH, Alias H, Kien JKW, Akbar M, Kamarulzaman A, Wong LP
    AIDS Educ Prev, 2019 06;31(3):193-205.
    PMID: 31145000 DOI: 10.1521/aeap.2019.31.3.193
    This study aimed to examine the barriers and facilitators to HIV testing and treatment among Malaysian MSM. Between June 2014 and December 2015, in-depth interviews were conducted in 20 HIV-positive MSM recruited from a teaching hospital and NGO in Kuala Lumpur. Thematic analysis was used to identify, analyze, and report themes. Most participants investigated their HIV status after long period of sickness. Others sought testing upon partner's diagnosis and some were diagnosed via blood donation. Barriers to testing include personal (perceived good health, fear of positive result, denial); social and structural factors (stigmatization by health providers and family, lack of information about free HIV testing and long wait time). Barriers to treatment comprise personal factors (perceived HIV as incurable and treatment as complicated), social factors (HIV and homosexual stigma), and cost. Promoting benefits of regular testing and early treatment is needed to improve HIV care continuum among MSM in Malaysia.
    Matched MeSH terms: Prejudice
  7. Fulltext Evaluating Physicians' Intention to Discriminate Against Patients Living with HIV in Malaysia
    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: Prejudice*
  8. Fulltext Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia
    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: Prejudice
  9. Support for weight-related anti-discrimination laws and policies: Modelling the role of attitudes toward poverty alongside weight stigma, causal attributions about weight, and prejudice
    Swami V, Voracek M, Furnham A, Robinson C, Tran US
    Body Image, 2023 Jun;45:391-400.
    PMID: 37116305 DOI: 10.1016/j.bodyim.2023.04.005
    In the present study, we sought to position support for weight-related anti-discrimination laws and policies within a broader political and socioeconomic context. Specifically, we hypothesised that individualistic (rather than structural) anti-poverty attitudes would provide the basis for negative weight-related dispositions. To test this hypothesis, we asked 392 respondents from the United Kingdom to complete measures of support for weight-related anti-discrimination laws and policies, attributions about the causes of being larger-bodied, and weight-related stigma and prejudice. Path analysis with robust maximum likelihood estimation indicated that greater individualistic anti-poverty attitudes were significantly and directly associated with lower support for weight-related anti-discrimination laws and policies. This direct association was also significantly mediated by weight-related stigma and via a serial mediation involving both weight-related stigma and prejudice. Although greater individualistic anti-poverty attitudes were significantly associated with greater personal attributions for being larger-bodied, the latter did not emerge as a significant mediation pathway. The present findings highlight the importance of considering broader political and socioeconomic contextual factors that may provide a basis for the development, maintenance, and manifestation of negative weight-related dispositions.
    Matched MeSH terms: Prejudice
  10. The relationship between poverty and fertility in Peninsular Malaysia: a district analysis
    Teo Cheok Chin P
    Tijdschr Econ Soc Geogr, 1989;80(5):284-301.
    PMID: 12157771
    Matched MeSH terms: Prejudice*
  11. Fulltext Epilepsy stigma in Asia: the meaning and impact of stigma
    Lim, Kheng-Seang, Tan, Chong-Tin
    Neurology Asia, 2014;19(1):1-10.
    MyJurnal
    Stigma is conceptually broad and culturally variable. Understanding stigma from the conceptual theories, culturally application based on the word stigma in other languages, the definition of stigma and its synonyms, as well as the medical implications in other stigmatized disease such as AIDS, will help us to understand the complexity of stigma in epilepsy. This review investigated the meaning and types of stigma from different perspectives, leading to staging stigma into 5 levels, i.e. social identity, stereotype, prejudice, discrimination and social disability. In addition to the conventional categorization of stigma into social, felt, self-perceived or internalized stigma, new categories of stigma i.e. personal and general attitudes towards epilepsy based on a newly developed Public Attitudes Toward Epilepsy (PATE) scale was introduced. Courtesy stigma was further elaborated in related to Asian culture. Based on well-established and recently developed theories, the causation and impact of epilepsy stigma was discussed in an Asian context, especially from the aspects of language and society values which are culturally specific. Integrating these theories of causation, illness and stereotype perceptions were proposed to be the mediating mechanism of stigma, which led to the development of a practical and multi-dimensional stigmatization model, aiming to guide, widen and deepen the scope of future stigma research in epilepsy. Using the established model, together with review of related studies, research priorities in epilepsy stigma research especially in Asia focusing on five aspects, i.e. expanding population studies especially on significant others, understanding stigma from personal attitude perspective, investigating the cultural and social causation of stigma, and the impacts of stigma on patients as well as the family members, were proposed.
    Matched MeSH terms: Prejudice
  12. Stigmatization and discrimination towards people living with or affected by HIV/AIDS by the general public in Malaysia
    Wong LP, Syuhada AR
    Southeast Asian J. Trop. Med. Public Health, 2011 Sep;42(5):1119-29.
    PMID: 22299438
    Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.
    Matched MeSH terms: Prejudice*
  13. Fulltext HIV-related stigma among healthcare workers in health clinics in Hulu Langat, Selangor: a preliminary result
    Natalia Che Ishak, Hayati Kadir Shahar, Rosliza Abdul Manaf
    Malaysian Journal of Medicine and Health Sciences, 2019;15(104):89-89.
    MyJurnal
    Introduction: HIV-related stigma refers to prejudice, negative attitudes and abuse directed at people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. This study was designed to examine drivers of HIV-related stigma among healthcare workers in health clinics in Hulu Langat, Selangor. Methods: This is a sin-gle-blinded, cluster randomised controlled trial (parallel groups). A total of 158 participants from the intervention group and 158 participants from the control group were randomised via balloting process at the cluster (clinic) level. A comprehensive self-administered questionnaire based on the stigma index tool was used. Data were analysed using IBM SPSS version 25 involving descriptive and bivariate analyses. The baseline results were analysed using the chi-square test and Mann-Whitney U test. Results: The response rate for the intervention group was 83.5% and 81.6% for the control group (82.3% combined response rate). Majority of the respondent’s age between 30 – 39 years old, female, nurses, have experience working with PLHIV and worked for 0 – 9 years in the healthcare setting. Comparison of total infection concern score (p = 0.001) and total willingness to treat key populations (KPs) score (p = 0.025) between intervention and control group at baseline were significant. However, comparison of total opinion/perception about PLHIV score, total knowledge about HIV score, total intention to stigmatise score and total health facility policies and guidelines score between intervention and control group at baseline showed no significant dif-ference. Conclusion: The significant difference between groups on certain scores above might be due to different job category between the two groups thus influence how willing they are in treating PLHIV. These findings may assist stigma reduction intervention programmes targeting healthcare providers in Hulu Langat, Selangor and ensure quality care for PLHIV.
    Matched MeSH terms: Prejudice
  14. Fulltext Does the granting of legal privileges as an indigenous people help to reduce health disparities? Evidence from New Zealand and Malaysia
    Phua KL
    Pac Health Dialog, 2009 Nov;15(2):117-27.
    PMID: 20443525
    Both the Maori of New Zealand and the Orang Asli of Malaysia are indigenous peoples who have been subjected to prejudice, discrimination and displacement in its various forms by other ethnic groups in their respective countries. However, owing to changes in the socio-political climate, they have been granted rights (including legal privileges) in more recent times. Data pertaining to the health and socio-economic status of the Maori and the Orang Asli are analysed to see if the granting of legal privileges has made any difference for the two communities. One conclusion is that legal privileges (and the granting of special status) do not appear to work well in terms of reducing health and socio-economic gaps.
    Matched MeSH terms: Prejudice*
  15. Malaysia can't thrive while it excludes minority talent
    Phang IY
    Nature, 2005 Sep 15;437(7057):318.
    PMID: 16163325
    Matched MeSH terms: Prejudice*
  16. Knowledge, attitudes, and perceptions of epilepsy in Asia: toward a uniform study protocol
    Lim SH, Pan A
    Epilepsia, 2005;46 Suppl 1:48-9.
    PMID: 15816980
    Knowledge, attitudes, and perceptions of epilepsy (KAPE) among the public play a major role in determining the extent to which people with epilepsy can be integrated into their society.
    Matched MeSH terms: Prejudice
  17. A doctor's duty is to heal the unhealthy: the story of Tun Dr Mahathir Mohamad
    Ong HT
    Ann Acad Med Singap, 2005 Jul;34(6):45C-51C.
    PMID: 16010379
    Mahathir Mohamad was born in 1925 in Alor Star, Kedah. He entered the King Edward VII College of Medicine in Singapore in 1947 and graduated in 1953. His years in the medical school equipped young Mahathir with the training necessary to assess and diagnose a problem, before dispensing the appropriate treatment. Throughout his later years in the political limelight, Dr Mahathir recognised the very important role the medical college had in laying the strong foundation for his successful career. He joined UMNO in 1945, already interested in politics at the tender age of 20; he was first elected into Parliament in 1964. The vigorous expression of his candid views did not go down well during the troubled days following the 13 May 1969 racial riots and he was expelled from UMNO, his writings were banned, and he was considered a racial extremist. Nevertheless, his intellectual and political influence could not be ignored for long; he returned to Parliament in 1974, and became the fourth, and longest serving, Prime Minister of Malaysia in 1981. Dr Mahathir has found fame as a Malay statesman, and an important Asian leader of the twentieth century with much written, locally and internationally, debating his policies. This article, using Dr Mahathir's own writings, starts with his description of his early life, proceeds to look at his medical career, then touches on his diagnosis of the problems plaguing the Malays, before concluding with his views on the need to stand up to the prejudices and pressures of the Western world. Throughout his life, Dr Mahathir behaved as the ever-diligent medical doctor, constantly studying the symptoms to diagnose the cause of the ills in his community and country, before proceeding to prescribe the correct treatment to restore good health. It is a measure of his integrity and intellectual capability that he did not seek to hide his failures, or cite unfinished work in an attempt to cling to political power.
    Matched MeSH terms: Prejudice
  18. Fulltext Effect of Psychiatric Clinical Posting on Attitudes among Student Nurses in Universiti Malaysia Sabah
    Segaran R., Olga, Wilfred
    Borneo Journal of Medical Sciences, 2018;12(101):47-0.
    MyJurnal
    Students taking up nursing course bring with them stereotypes and prejudice towards mentally-ill clients. Nurses harbouring such stigmatising attitude can have a profound effect on their subsequent therapeutic relationship and quality of care rendered for the mentally-ill clients. Typically, students who harbour stigmatising views, develop positive mindset after psychiatric posting.
    Matched MeSH terms: Prejudice
  19. Medicine in Malaysia. Shadows of transition
    Nicks R
    Med J Aust, 1983 Nov 26;2(11):578-9.
    PMID: 6633393
    Matched MeSH terms: Prejudice
  20. "Comfort women" in Malaysia
    Nakahira M
    Crit Asian Stud, 2001;33(4):581-89.
    PMID: 21046839 DOI: 10.1080/146727101760107442
    Matched MeSH terms: Prejudice
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links