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  1. Fadzil F, Jaafar S, Ismail R
    Prim Health Care Res Dev, 2020 02 24;21:e4.
    PMID: 32090729 DOI: 10.1017/S146342362000002X
    This paper illustrates the development of Primary Health Care (PHC) public sector in Malaysia, through a series of health reforms in addressing equitable access. Malaysia was a signatory to the Alma Ata Declaration in 1978. The opportunity provided the impetus to expand the Rural Health Services of the 1960s, guided by the principles of PHC which attempts to address the urban-rural divide to improve equity and accessibility. The review was made through several collation of literature searches from published and unpublished research papers, the Ministry of Health annual reports, the 5-year Malaysia Plans, National Statistics Department, on health systems programme and infrastructure developments in Malaysia. The Public Primary Care Health System has evolved progressively through five phases of organisational reforms and physical restructuring. It responded to growing needs over a 40-year period since the Alma Ata Declaration in 1978, keeping equity, accessibility, efficiency and universal health coverage consistently in the backdrop. There were improvements of maternal, infant mortality rates as well as accessibility to health services for the population. The PHC Reforms in Malaysia are the result of structured and strategic investment. However, there will be continuing dilemma between cost-effectiveness and equity. Hence, continuous efforts are required to look at opportunity costs of alternative strategies to provide the best available solution given the available resources and capacities. While recognising that health systems development is complex with several layers and influencing factors, this paper focuses on a small but crucial aspect that occupies much time and energies of front-line managers in the health.
    Matched MeSH terms: Primary Health Care/organization & administration*
  2. Hisham R, Liew SM, Ng CJ
    BMJ Open, 2018 07 12;8(7):e018933.
    PMID: 30002004 DOI: 10.1136/bmjopen-2017-018933
    OBJECTIVE: This study aimed to compare the evidence-based practices of primary care physicians between those working in rural and in urban primary care settings.

    RESEARCH DESIGN: Data from two previous qualitative studies, the Front-line Equitable Evidence-based Decision Making in Medicine and Creating, Synthesising and Implementing evidence-based medicine (EBM) in primary care studies, were sorted, arranged, classified and compared with the help of qualitative research software, NVivo V.10. Data categories were interrogated through comparison between and within datasets to identify similarities and differences in rural and urban practices. Themes were then refined by removing or recoding redundant and infrequent nodes into major key themes.

    PARTICIPANTS: There were 55 primary care physicians who participated in 10 focus group discussions (n=31) and 9 individual physician in-depth interviews.

    SETTING: The study was conducted across three primary care settings-an academic primary care practice and both private and public health clinics in rural (Pahang) and urban (Selangor and Kuala Lumpur) settings in Malaysia.

    RESULTS: We identified five major themes that influenced the implementation of EBM according to practice settings, namely, workplace factors, EBM understanding and awareness, work experience and access to specialist placement, availability of resources and patient population. Lack of standardised care is a contributing factor to differences in EBM practice, especially in rural areas.

    CONCLUSIONS: There were major differences in the practice of EBM between rural and urban primary care settings. These findings could be used by policy-makers, administrators and the physicians themselves to identify strategies to improve EBM practices that are targeted according to workplace settings.
    Matched MeSH terms: Primary Health Care/organization & administration*
  3. Chen PCY, Tan YK
    Med J Malaysia, 1982 Mar;37(1):25-34.
    PMID: 7121343
    A joint pilot project between the Ministry of Health and the Department of Social and Preventive Medicine, University of Malaya, to test the value of village aides in extending the health care system into isolated Iban communities was started in May 1979 in the Entabai District of Sarawak. A group of 15 village aides consisting of 11 traditional Iban manangs (medicine-men) and 4 youths were trained to provide primary health care including simple curative care, preventive care and to assist in the detection of malaria. Evaluation carried out 2 years later showed the following. In respect of curative care, the village aides were each, on the average, treating 70.6 patients per month, the most common illness being headaches (30.4 percent), which together with abdominal pain, constipation, bodyaches, diarrhoea, vomiting, fever, worm infestations, cough and sore throat, accounted for 89 percent of all illnesses seen by them. Subsequent to the introduction of village aides in the project area, the number ofseriously ill patients requiring admission to the rest beds of the klinik desa dropped by 43.8 percent and the number of emergency referrals to the back-up divisional hospitals fell by 46.1 percent showing that patients were coming to the klinik desa for treatment at an earlier stage. The 11 traditional Iban manangs, who had received training had, on their own accord, drastically reduced the use of traditional Iban modes of therapy in preference for "modern" medicine. During the 24 months immediately after the introduction of village aides into Entabai, 9 gravity feed water supply systems together with the related "health package" advocating general cleanliness, the use of latrines andfences were effected, whereas only 6 such systems were installed in the previous 24 months, indicating that it is likely that the village aides were of some assistance in mobilizing the community is respect of these self-help efforts. During the same period, the majority of longhouses in the area successfully established a number of vegetable gardens growing foods for home consumption, and continue to vigorously advocate breast feeding of infants in opposition to bottle feeding. During the 23 months after village aides were introduced, a total of 1,093 blood films were collected by the 15 village aides, the average number of blood films per village aide being 3.2 blood slides per month. Village aides are socially accepted by the Iban community who utilize their curative skills when mild illnesses disturb them, but who proceed directly to the klinik desa when more serious illnesses such as fevers strike them. The project has established clear lines of communication between the health team and the community, and has stimulated the community to organize itself to achieve an increasingly high level of health through community participation and self reliance. Plans have been approved in principle to train a further 2000 village aides in primary health care for the state of Sarawak.
    Matched MeSH terms: Primary Health Care/organization & administration*
  4. Mustapha F, Omar Z, Mihat O, Md Noh K, Hassan N, Abu Bakar R, et al.
    BMC Public Health, 2014;14 Suppl 2:S4.
    PMID: 25080846 DOI: 10.1186/1471-2458-14-S2-S4
    The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, "The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014", and the "NCD Prevention 1Malaysia" (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems.
    Matched MeSH terms: Primary Health Care/organization & administration*
  5. Low LL, Ab Rahim FI, Johari MZ, Abdullah Z, Abdul Aziz SH, Suhaimi NA, et al.
    BMC Health Serv Res, 2019 Jul 16;19(1):497.
    PMID: 31311538 DOI: 10.1186/s12913-019-4312-x
    BACKGROUND: Amid the current burden of non-communicable (NCD) diseases in Malaysia, there is a growing demand for more efficient service delivery of primary healthcare. A complex intervention is proposed to improve NCD management in Malaysia. This exploratory study aimed to assess primary healthcare providers' receptiveness towards change prior to implementation of the proposed complex intervention.

    METHOD: This study was conducted using an exploratory qualitative approach on purposely selected healthcare providers at primary healthcare clinics. Twenty focus group discussions and three in-depth interviews were conducted using a semi-structured interview guide. Consent was obtained prior to interviews and for audio-recordings. Interviews were transcribed verbatim and thematically analysed, guided by the Consolidated Framework for Implementation Research (CFIR), a framework comprised of five major domains promoting implementation theory development and verification across multiple contexts.

    RESULTS: The study revealed via CFIR that most primary healthcare providers were receptive towards any proposed changes or intervention for the betterment of NCD care management. However, many challenges were outlined across four CFIR domains-intervention characteristics, outer setting, inner setting, and individual characteristics-that included perceived barriers to implementation. Perception of issues that triggered proposed changes reflected the current situation, including existing facilitating aspects that can support the implementation of any future intervention. The importance of strengthening the primary healthcare delivery system was also expressed.

    CONCLUSION: Understanding existing situations faced at the primary healthcare setting is imperative prior to implementation of any intervention. Healthcare providers' receptiveness to change was explored, and using CFIR framework, challenges or perceived barriers among healthcare providers were identified. CFIR was able to outline the clinics' setting, individual behaviour and external agency factors that have direct impact to the organisation. These are important indicators in ensuring feasibility, effectiveness and sustainability of any intervention, as well as future scalability considerations.

    Matched MeSH terms: Primary Health Care/organization & administration*
  6. Lim ES
    PMID: 1364867
    The Malaria Eradication Program was started in 1967 in Peninsular Malaysia. Since then and up to 1980, there was a reduction in the number of reported malaria cases from 160,385 in 1966 to 9,110 cases for Peninsular Malaysia. Although the concept of eradication has changed to one of control in the 1980, the anti-malaria activities have remained the same. However, additional supplementary activities such as the use of impregnated bednets, and the Primary Health Care approach, have been introduced in malarious and malaria-prone areas. Focal spraying activity is instituted in localities with outbreaks in both malaria-prone and non-malarious areas. Passive case detection has been maintained in all operational areas. In 1990, 50,500 cases of malaria were reported of which 69.7% (35,190) were from Sabah, 27.8% (14,066) from Peninsular Malaysia and 2.5% (1,244) from Sarawak. Until June 1991 a total of 18,306 cases were reported for the country. Plasmodium falciparum continues to be the predominant species, contributing to 69.6% of the parasites involved. The case fatality rate for 1990 was 0.09%. There were 43 deaths all of which were attributed to cerebral malaria. The problems faced in the prevention and control of malaria include problems associated with the opening of land for agriculture, mobility of the aborigines of Peninsular Malaysia (Orang Asli) and inaccessibility of malaria problem areas. There is need to ensure prompt investigation and complete treatment of cases especially in malarious areas. The promotion of community participation in control activities should be intensified. Primary Health Care should be continued and intensified in the malarious areas.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Primary Health Care/organization & administration
  7. Ng CW, How CH, Ng YP
    Singapore Med J, 2017 Feb;58(2):72-77.
    PMID: 28210741 DOI: 10.11622/smedj.2017006
    Major depression is a common condition seen in the primary care setting. This article describes the suicide risk assessment of a depressed patient, including practical aspects of history-taking, consideration of factors in deciding if a patient requires immediate transfer for inpatient care and measures to be taken if the patient is not hospitalised. It follows on our earlier article about the approach to management of depression in primary care.
    Matched MeSH terms: Primary Health Care/organization & administration*
  8. Chen PCY
    Asia Pac J Public Health, 1987;1(1):34-7.
    PMID: 3452377 DOI: 10.1177/101053958700100109
    Unlike much of Peninsular Malaysia, the Baram District of Sarawak remains sparsely populated and underserved, one of the most underserved peoples being the nomadic and semi-nomadic Penans of the Baram. Until quite recently these Penans lived as small nomadic bands of hunter-gatherers. More recently, they have begun to settle in longhouses. However, lacking the necessary skills to live a settled mode of life, these Penans suffer a great deal of hunger, malnutrition, disease and death. Primary health care with its emphasis on the seven essential elements, including food production and nutrition, environmental sanitation, good maternal and child health, knowledge of disease and how it can be prevented as well as the treatment and control of locally endemic diseases, is of critical value in the survival of the semi-nomadic Penans. The specially designed primary health care programme for the Penans of the Baram is outlined briefly in this paper.
    Keyword: Baram, Penans, Primary Health Care, Sarawak, Village Health Promoter.
    Matched MeSH terms: Primary Health Care/organization & administration*
  9. Khairani O, Zaiton S, Faridah MN
    Med J Malaysia, 2005 Jun;60(2):134-9.
    PMID: 16114152
    The aims of the study were to determine the prevalence of the common health problems namely acne, overweight, smoking and depressive symptoms among adolescents attending a primary healthcare clinic, whether they seek treatment for these problems and the reasons for not consulting health professionals. It was a clinic-based, crosssectional study. All adolescents aged 13 to 20 years who attended the clinic during the study period were included in the study. The respondents were given self-administered questionnaires and their weights were measured to assess if they had the above disorders. A total of 215 adolescents were included in the study. The proportion of adolescents who had acne were 70.7%, overweight 8.9%, smoking 41.9% and depressive symptoms 9.8%. Only 25% of those who had acne, 47% of those who were overweight, 9.5% who had depressive symptoms and none of those who smoked had ever sought treatment for these problems. The common reasons given for not consulting the health professionals were 'did not consider it as a problem', 'shy' and 'thought there was no treatment available'. The majority of the adolescents who attended the clinic did not consult health professionals the above common health problems. It is important to educate them on these disorders and encourage health-seeking behaviour in adolescents.
    Matched MeSH terms: Primary Health Care/organization & administration*
  10. Muthupalaniappen L, Omar J, Omar K, Iryani T, Hamid SN
    PMID: 23431837
    We carried out a cross sectional study to detect emotional and behavioral problems among adolescents who smoke and their help-seeking behavior. This study was conducted in Sarawak, East Malaysia, between July and September 2006. Emotional and behavioral problems were measured using the Youth Self-Report (YSR/11-18) questionnaire; help seeking behavior was assessed using a help-seeking questionnaire. Three hundred ninety-nine students participated in the study; the smoking prevalence was 32.8%. The mean scores for emotional and behavioral problems were higher among smokers than non-smokers in all domains (internalizing, p = 0.028; externalizing, p = 0.001; other behavior, p = 0.001). The majority of students who smoked (94.7%) did not seek help from a primary health care provider for their emotional or behavioral problems. Common barriers to help-seeking were: the perception their problems were trivial (60.3%) and the preference to solve problems on their own (45.8%). Our findings suggest adolescent smokers in Sarawak, East Malaysia were more likely to break rules, exhibit aggressive behavior and have somatic complaints than non-smoking adolescents. Adolescent smokers preferred to seek help for their problems from informal sources. Physicians treating adolescents should inquire about smoking habits, emotional and behavioral problems and offer counseling if required.
    Matched MeSH terms: Primary Health Care/organization & administration
  11. Ariffin F, Ramli AS, Daud MH, Haniff J, Abdul-Razak S, Selvarajah S, et al.
    Med J Malaysia, 2017 04;72(2):106-112.
    PMID: 28473673 MyJurnal
    INTRODUCTION: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM.

    METHODOLOGY: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension.

    RESULTS: there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases.

    DISCUSSION: the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.
    Matched MeSH terms: Primary Health Care/organization & administration*
  12. Foong AL, Ng SF, Lee CK
    J Adv Nurs, 2005 Apr;50(2):134-42.
    PMID: 15788077 DOI: 10.1111/j.1365-2648.2005.03372.x
    AIM: This paper reports a study aimed at identifying the primary health care experiences of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in Malaysia. The rationale behind the study was to enable informed action for developing more responsive and effective primary care.
    BACKGROUND: Reports such as from the World Health Organisation forecast sharp escalations in the incidence of HIV/AIDS in Malaysia and the Asia-Pacific region within the next few years. With sparse information on the course of infection on the local population and an understanding of health care needs of those afflicted, health services would be ill-prepared for projected increases.
    METHOD: Semi-structured interviews were conducted with a convenience sample of 99 patients attending two major HIV/AIDS clinics in Malaysia.
    FINDINGS: Several gaps in care provision were highlighted, such as with treatment/consultation facilities and availability and accessibility of information. What is also evident is that there are a number of good support services available but not well publicized to those in need of them. That includes health professionals who could be making appropriate referrals. The lack of communications and inter-professional working appears to be part of the problem.
    CONCLUSION: The findings provide baseline data and preliminary insights to government and other service providers towards advancing, optimizing and refining existing policies and infrastructure. Although the availability of a number of primary care facilities have been identified, the study indicates the need for more effective co-ordinated efforts with clear leadership to pull together scarce resources towards the aim of some degree of seamless primary care provision. It is suggested that nurses would be well placed for such a role in view of the nature of their education and training that helps prepare them for the multi-faceted role.

    Study site: One is located
    in the main general hospital in the capital city of Kuala
    Lumpur, and the other in an outpatient clinic on the outskirts
    of the city
    Matched MeSH terms: Primary Health Care/organization & administration*
  13. Lim SC, Mustapha FI, Aagaard-Hansen J, Calopietro M, Aris T, Bjerre-Christensen U
    Med Educ Online, 2020 Dec;25(1):1710330.
    PMID: 31891330 DOI: 10.1080/10872981.2019.1710330
    Background: Continuing Medical Education (CME) is a cornerstone of improving competencies and ensuring high-quality patient care by nurses and physicians. The Ministry of Health (MOH) Malaysia collaborated with Steno Diabetes Centre to improve diabetes-related competencies of general physicians and nurses working in primary care through a six-month training programme called the Steno REACH Certificate Course in Clinical Diabetes Care (SRCC).Objective: This impact evaluation aimed to assess the effect of participation of general physicians and nurses in the SRCC in selected public primary healthcare clinics in Kuala Lumpur and Selangor, Malaysia.Design: The quasi-experimental, embedded, mixed-methods study used concurrent data collection and the Solomon four-group design. Participants in an intervention group (Arm 1) and control group (Arm 3) were assessed by pre-and post-test, and participants in separate intervention (Arm 2) and control (Arm 4) groups were assessed by post-test only. Quantitative and qualitative methods were used to assess the effect of the programme.Results: Thirty-four of the 39 participants in the intervention groups (Arms 1 and 2) completed the SRCC and were included in the analysis. All 35 participants in the control groups (Arms 3 and 4) remained at the end of the study period. Significant improvements in diabetes-related knowledge, skills and clinical practise were found among general physicians and nurses in the intervention group after the six-month SRCC, after controlling the pretest effects. No clear changes could be traced regarding attitudes.Conclusion: SRCC participants had significant improvements in knowledge, skills and clinical practice that meet the current needs of general physicians and nurses working in primary care in Malaysia. Thus, SRCC is an effective CME approach to improving clinical diabetes care that can be scaled up to the rest of the country and, with some modification, beyond Malaysia.
    Matched MeSH terms: Primary Health Care/organization & administration
  14. Ekman B, Pathmanathan I, Liljestrand J
    Lancet, 2008 Sep 13;372(9642):990-1000.
    PMID: 18790321 DOI: 10.1016/S0140-6736(08)61408-7
    For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management skills. Furthermore, districts need to be supported by national strategies and policies, and, in the case of the least developed countries, also by international donors and other partners. If packages for maternal, newborn and child health care can be integrated within a gradually strengthened primary health-care system, continuity of care will be improved, including access to basic referral care before and during pregnancy, birth, the postpartum period, and throughout childhood.
    Matched MeSH terms: Primary Health Care/organization & administration*
  15. Ooi CY, Hanafi NS, Liew SM
    Singapore Med J, 2019 Nov;60(11):596-604.
    PMID: 30644527 DOI: 10.11622/smedj.2019011
    INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor.

    METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening.

    RESULTS: The response rate was 86.4% (n = 197/228). Less than half (39.1%) of the respondents answered correctly for all risk stratification scenarios. Mean knowledge score on CRC screening modalities was 48.7% ± 17.7%. The knowledge score was positively associated with having postgraduate educational qualification and usage of screening guidelines. Overall, 69.9% of PCPs reported that they practised screening. However, of these, only 25.9% of PCPs screened over 50% of all eligible patients. PCPs who agreed that screening was cost-effective (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.69‒6.59) and those who agreed that they had adequate resources in their locality (OR 1.92, 95% CI 1.01‒3.68) were more likely to practise screening. Knowledge score was not associated with the practice of screening (p = 0.185).

    CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening.

    Matched MeSH terms: Primary Health Care/organization & administration*
  16. Tong SF, Low WY, Ismail SB, Trevena L, Willcock S
    BMC Fam Pract, 2011;12:29.
    PMID: 21569395 DOI: 10.1186/1471-2296-12-29
    BACKGROUND: Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour.
    METHODS: A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview.
    RESULTS: The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's overall health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia.
    CONCLUSIONS: The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.
    Matched MeSH terms: Primary Health Care/organization & administration*
  17. Lim RBL
    J Pain Palliat Care Pharmacother, 2003;17(3-4):77-85; discussion 87-9.
    PMID: 15022953 DOI: 10.1080/j354v17n03_11
    Palliative care first began in Malaysia in 1991, and since then there has been a growing interest in the field and its development both from the government and nongovernmental organizations. It is important to recognize the potential advantages and disadvantages of palliative care provided by both government and private programs to maximize development for the greater benefit of patients. A close relationship between these two bodies must be created so that there is smooth continuity of service and no overlapping of roles. This article highlights some thoughts on how palliative care has developed over the years from the perspective of a clinician who is currently working in the government sector and cooperating with nongovernmental organizations to develop a palliative care network in the region.
    Matched MeSH terms: Primary Health Care/organization & administration
  18. Lim MT, Lim YMF, Teh XR, Lee YL, Ismail SA, Sivasampu S
    Int J Qual Health Care, 2019 Aug 01;31(7):37-43.
    PMID: 30608582 DOI: 10.1093/intqhc/mzy252
    OBJECTIVE: To determine the extent of self-management support (SMS) provided to primary care patients with type 2 diabetes (T2D) and hypertension and its associated factors.

    DESIGN: Cross-sectional survey conducted between April and May 2017.

    SETTING: Forty public clinics in Malaysia.

    PARTICIPANTS: A total of 956 adult patients with T2D and/or hypertension were interviewed.

    MAIN OUTCOME MEASURES: Patient experience on SMS was evaluated using a structured questionnaire of the short version Patient Assessment of Chronic Illness Care instrument, PACIC-M11. Linear regression analysis adjusting for complex survey design was used to determine the association of patient and clinic factors with PACIC-M11 scores.

    RESULTS: The overall PACIC-M11 mean was 2.3(SD,0.8) out of maximum of 5. The subscales' mean scores were lowest for patient activation (2.1(SD,1.1)) and highest for delivery system design/decision support (2.9(SD,0.9)). Overall PACIC-M11 score was associated with age, educational level and ethnicity. Higher overall PACIC-M11 ratings was observed with increasing difference between actual and expected consultation duration [β = 0.01; 95% CI (0.001, 0.03)]. Better scores were also observed among patients who would recommend the clinic to friends and family [β = 0.19; 95% CI (0.03, 0.36)], when health providers were able to explain things in ways that were easy to understand [β = 0.34; 95% CI (0.10, 0.59)] and knew about patients' living conditions [β = 0.31; 95% CI (0.15, 0.47)].

    CONCLUSIONS: Our findings indicated patients received low levels of SMS. PACIC-M11 ratings were associated with age, ethnicity, educational level, difference between actual and expected consultation length, willingness to recommend the clinic and provider communication skills.

    Matched MeSH terms: Primary Health Care/organization & administration*
  19. Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R
    Singapore Med J, 2012 Jul;53(7):468-73.
    PMID: 22815016
    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.
    Matched MeSH terms: Primary Health Care/organization & administration
  20. Chen PC, Tan YK
    Trop Geogr Med, 1981 Dec;33(4):403-9.
    PMID: 7342391
    Matched MeSH terms: Primary Health Care/organization & administration*
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