Displaying publications 181 - 200 of 497 in total

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  1. Rhule ELM, Allotey PA
    Infect Dis Poverty, 2020 Jan 13;9(1):3.
    PMID: 31931879 DOI: 10.1186/s40249-019-0616-7
    BACKGROUND: Social Innovation in health initiatives have the potential to address unmet community health needs. For sustainable change to occur, we need to understand how and why a given intervention is effective. Bringing together communities, innovators, researchers, and policy makers is a powerful way to address this knowledge gap but differing priorities and epistemological backgrounds can make collaboration challenging.

    MAIN TEXT: To overcome these barriers, stakeholders will need to design policies and work in ways that provide an enabling environment for innovative products and services. Inherently about people, the incorporation of community engagement approaches is necessary for both the development of social innovations and accompanying research methodologies. Whilst the 'appropriate' level of participation is linked to intended outcomes, researchers have a role to play in better understanding how to harness the power of community engagement and to ensure that community perspectives form part of the evidence base that informs policy and practice.

    CONCLUSIONS: To effectively operate at the intersection between policy, social innovation, and research, all collaborators need to enter the process with the mindset of learners, rather than experts. Methods - quantitative and qualitative - must be selected according to research questions. The fields of implementation research, community-based participatory research, and realist research, amongst others, have much to offer. So do other sectors, notably education and business. In all this, researchers must assume the mantel of responsibility for research and not transfer the onus to communities under the guise of participation. By leveraging the expertise and knowledge of different ecosystem actors, we can design responsive health systems that integrate innovative approaches in ways that are greater than the sum of their parts.

    Matched MeSH terms: Qualitative Research*
  2. Ng YK, Mohamed Shah N, Loong LS, Pee LT, Chong WW
    PLoS One, 2021;16(10):e0258249.
    PMID: 34618863 DOI: 10.1371/journal.pone.0258249
    BACKGROUND: Patient-centred care (PCC) has been suggested to provide benefits such as improved patient-healthcare provider communication and better disease self-management to patients. The practice of PCC should involve all healthcare professionals, including pharmacists who are well-positioned in providing pharmaceutical care to patients. However, a better understanding of the factors that can affect the practice of PCC in pharmacists' consultations is needed.

    OBJECTIVE: To explore the perceptions of Malaysian hospital pharmacists and patients on the barriers and facilitators of a PCC approach in pharmacist consultations.

    DESIGN: This study employed a qualitative, explorative semi-structured interview design.

    SETTING AND PARTICIPANTS: Interviews were conducted with 17 patients and 18 pharmacists from three tertiary hospitals in Malaysia. The interviews were audiotaped and transcribed verbatim. Emerging themes were developed through a constant comparative approach and thematic analysis.

    RESULTS: Three themes were identified in this study: (i) patient-related factors (knowledge, role expectations, and sociocultural characteristics), (ii) pharmacist-related factors (personalities and communication), and (iii) healthcare institutional and system-related factors (resources, continuity of care, and interprofessional collaboration). Pharmacists and patients mentioned that factors such as patients' knowledge and attitudes and pharmacists' personality traits and communication styles can affect patients' engagement in the consultation. Long waiting time and insufficient manpower were perceived as barriers to the practice of PCC. Continuity of care and interprofessional collaboration were viewed as crucial in providing supportive and tailored care to patients.

    CONCLUSION: The study findings outlined the potential factors of PCC that may influence its implementation in pharmacist consultations. Strategic approaches can be undertaken by policymakers, healthcare institutions, and pharmacists themselves to address the identified barriers to more fully support the implementation of PCC in the pharmacy setting.

    Matched MeSH terms: Qualitative Research*
  3. Ramdzan SN, Khoo EM, Cunningham S, Hussein N, Ramli R, Senawi SA, et al.
    J Glob Health, 2024 May 17;14:03027.
    PMID: 38751315 DOI: 10.7189/jogh.14.03027
    Matched MeSH terms: Qualitative Research*
  4. Bakri NN, Ferguson CA, Majeed S, Thomson WM, Oda K, Bartlett S, et al.
    Community Dent Oral Epidemiol, 2024 Aug;52(4):389-397.
    PMID: 37950336 DOI: 10.1111/cdoe.12924
    BACKGROUND: The workplace is an ideal-and priority-setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.

    OBJECTIVE: To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.

    METHODS: This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4-6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.

    RESULTS: Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.

    CONCLUSIONS: Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.

    Matched MeSH terms: Qualitative Research*
  5. Rajasegaran S, Chandrasagran RA, Tan SK, Ahmad NA, Lechmiannandan A, Sanmugam A, et al.
    Pediatr Surg Int, 2024 May 03;40(1):119.
    PMID: 38700671 DOI: 10.1007/s00383-024-05709-w
    PURPOSE: Patients with anorectal malformation (ARM) and Hirschsprung's disease (HD) live with long-term impact of these diseases even into adulthood. We aimed to explore the physical, social and emotional impact of these diseases in adolescents and young adults to develop best practices for transition care.

    METHODS: We conducted one-on-one in-depth interviews with ARM and HD patients aged  ≥ 11 years who had undergone surgery at four tertiary referral centers. All interviews were audio-recorded and transcribed verbatim. We analyzed transcripts for recurring themes, and data were collected until data saturation was reached. Three researchers independently coded the transcripts for major themes using thematic analysis approach.

    RESULTS: We interviewed 16 participants (11 males) between October 2022 and April 2023. Ages ranged from 11 to 26 years. Five major themes emerged: (1) personal impact (subthemes: physical, emotional and mental health, social, school), (2) impact on family, (3) perceptions of their future (subthemes: relationships, career, state of health), (4) sources of support (subthemes: family, peers, partner), and (5) transition care (subthemes: concerns, expectations). Only females expressed concerns regarding future fertility.

    CONCLUSION: This study highlights the evolving problems faced by adolescents and young adults with ARM and HD, especially gender-specific concerns. Our findings can inform efforts to provide individualized care.

    Matched MeSH terms: Qualitative Research*
  6. Wahid MNA, Muhamad R, Mohamad N, Draman N
    Support Care Cancer, 2024 Jul 20;32(8):531.
    PMID: 39031298 DOI: 10.1007/s00520-024-08741-7
    PURPOSE: Experiencing sexual dysfunction (SD) alongside a breast cancer (BC) diagnosis has significant consequences, not only for wives but also for their husbands. Therefore, we explored husbands' perspectives on sexuality and their encounters in dealing with wives' SD following a BC diagnosis.

    METHODS: This qualitative study, conducted within the phenomenological framework, focused on sexually active husbands whose wives faced SD after being diagnosed with BC in Kelantan. Husbands with an International Index of Erectile Function (IIEF-5) score above 11, indicating the absence of erectile dysfunction, were invited to participate in in-depth interviews conducted between September 2019 and March 2021. The interviews were recorded and transcribed verbatim, and the transcriptions were then managed and analyzed using the NVivo® analytic computer software. Thematic analyses were performed, taking into account the meaning-making theory.

    RESULTS: To grasp husbands' experiences, three themes emerged. "Sex, a calming act," delves into their understanding of sexuality and its impact severity. "Distressing sequelae yet provide better tolerance" underscores that husbands experienced adverse consequences due to their wives' imperfections and sexual challenges, but they exhibited improved tolerance in dealing with these difficulties. Lastly, "Improving lives with multiple strategies" highlights how husbands sought alternative activities in response.

    CONCLUSION: This study illuminates the experiences of husbands coping with their wives' SD following a BC diagnosis. Husbands had to reconsider their understanding of sexuality and sexual needs and employed various response and coping strategies. These strategies included emphasizing influences of culture (husbands' roles and rights), religious beliefs, and self-distraction, redirecting the focus to health concerns, and engaging in alternative activities.

    Matched MeSH terms: Qualitative Research*
  7. Nasir A, Hassan II, Ma'ruf A, Suharno NE, Goenharto S, Purwanto CR, et al.
    PLoS One, 2024;19(7):e0303331.
    PMID: 39078843 DOI: 10.1371/journal.pone.0303331
    The psychological burden is greatly felt by people living with tuberculosis because the characteristics of the disease are very visible and very contagious, and the obligation to take the right dose of medication with long treatment. This is what makes tuberculosis a very stigmatic disease. The aim of this research is to explore the psychological burden felt by people living with tuberculosis due to social stigma by society and how coping efforts are made. This research uses a qualitative phenomenological design through in-depth face-to-face interviews which take place in a semi-structured manner with the hope of obtaining complete data. The purposive sampling method was used in this research with Participatory Interpretative Phenomenology analysis involving 25 participants consisting of 16 men and 9 women. This research produced several themes, including 1) "The Perception of stigma limiting space and time", 2) "The Opportunities for interpersonal interaction become narrow", 3) "The mental stress as a challenging emotion", and 4) " Expanding coping efforts". The psychological burden is felt by people living with tuberculosis because society's treatment is felt to be very discriminatory due to the social stigma that has developed in society so they lose the opportunity to interact with society. For that reason, they tried to explore some of the personal and environmental resources used to modify adaptive coping in resolving perceived psychological burdens. Given the possibility of ongoing stigma and discrimination during tuberculosis treatment programs, it is important to consider the psychological burden in this context, both on the general population and on groups affected by stigma.
    Matched MeSH terms: Qualitative Research*
  8. Khan AJ, Sabri BAM, Omar AFB, Ahmad MS
    Can J Dent Hyg, 2024 Oct;58(3):161-173.
    PMID: 39513095
    INTRODUCTION: Community-based rehabilitation (CBR) centres in Malaysia were established to enhance the quality of life of persons with disabilities (PWDs), including their health care. It is unknown to what extent PWDs have been taught about oral health care at CBR centres.

    OBJECTIVE: This qualitative study investigated the perceptions of CBR managers regarding the level of training in oral health care received by CBR workers, the current oral health care program for PWDs, and the barriers and enablers in providing oral health education, care, and services for PWDs in CBR centres.

    METHODS: A semi-structured interview questionnaire and face-to-face in-depth interviews were conducted with CBR managers (n = 9) from 9 districts in Kuala Lumpur and Selangor, Malaysia, to seek their views on the focus topics. Audiorecorded interviews were transcribed verbatim, and transcripts were analysed in MAXQDA software. Qualitative data were analysed via thematic analysis.

    RESULTS: Interview content analysis revealed 4 themes, 11 subthemes, and 13 codes. The 4 identified themes were oral health care education and training for CBR workers, oral health care programs and protocol for CBR trainees (PWDs), barriers and enablers to care.

    CONCLUSION: In all CBR centres, CBR workers and PWDs receive an oral health presentation, training in oral health care, and are provided with treatment by a dentist assigned by the Ministry of Health. No specific programs, training or special courses were provided by the Department of Social Welfare. Several personal, professional, and social factors were identified as affecting the provision of oral health care to the PWDs.

    Matched MeSH terms: Qualitative Research*
  9. Selamat MH, Loh SY, Mackenzie L, Vardy J
    PLoS One, 2014;9(9):e108002.
    PMID: 25259847 DOI: 10.1371/journal.pone.0108002
    BACKGROUND:
    Cognitive impairment, colloquially termed "chemobrain", occurs in 10-40% of all cancer patients, and is an emerging target of cancer survivorship research.
    AIM:
    This study reviews published qualitative studies to explore cognitive impairments or chemobrain among breast cancer survivors, with particular attention given to the impact on quality of life.
    METHOD:
    Using keywords, we searched ten electronic databases (CINAHL, EMBASE, Proquest, OVID SP, MEDLINE, Oxford Journal, Science Direct, PubMED).
    FINDINGS:
    Of 457 papers, seven relevant papers were included. Data was extracted and concepts were analysed using a meta ethnography approach. Four second order intepretations were identified, on the basis of which, four third order intrepretations were constructed. Linked together in a line of argument, was a consistent account on their struggles to self-manage the chemobrain impairments that impact their daily lives. Five concepts emerged from the analysis of the primary findings: i) real experiences of cognitive changes, ii) calls for help, iii) impact of cognitive impairments, iv) coping and v) survivorship and meaning. Further synthesis resulted in four new order intepretations: i) The chemobrain struggle, ii) The substantial impact of chemobrain on life domains, iii) The struggle to readjust and to self manage, and iv) 'thankful yet fearful' representation.
    DISCUSSION:
    Awareness of cognitive changes were context-dependent on healthcare settings and cultural contexts as strong determinants. Subjects verified the existence of chemobrain but healthcare providers mis-recognised, under-recognised, and sometimes negated it perhaps due to its unknown aetiology. Asian breast cancer survivors appear less vocal than their western counterparts.
    CONCLUSION:
    The current literature on the lived experiences of how women experienced chemobrain provides a consistent report that chemobrain is real, persistent and with detrimental impacts on quality of life - manifested as a constant struggles. A greater awareness of the effects of chemobrain with improved functional assessment and interventions is warranted.
    Matched MeSH terms: Qualitative Research
  10. Lee YK, Low WY, Lee PY, Ng CJ
    Int J Nurs Pract, 2015 May;21 Suppl 2:125-31.
    PMID: 24804909 DOI: 10.1111/ijn.12355
    Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP.
    Study site: Public university hospital-based primary care clinic, Public health-care clinics (Klinik Kesihatan), Private specialist clinic, Malaysia
    Matched MeSH terms: Qualitative Research
  11. Norlehan AS, Aisyah MZ, Rozimah O, Lee PY, Ng CJ
    Malays Fam Physician, 2014;9(2):34-40.
    PMID: 25883763
    INTRODUCTION: Continuous professional development (CPD) is an important aspect of a medical practitioner's career. AIMing to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors.
    AIM: The aim of the study was to explore the private general practitioners' (GPs) views, experiences and needs regarding CPD programme in the primary care service.
    METHODS: This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers' discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach.
    RESULTS: GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients' expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring.
    CONCLUSIONS: Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.
    KEYWORDS: Private general practitioner; continuous; medical education; primary care; professional development; qualitative study
    Matched MeSH terms: Qualitative Research
  12. Syed Hassan ST, Jamaludin H, Abd Raman R, Mohd Riji H, Wan Fei K
    Trauma Mon, 2013 Sep;18(2):56-61.
    PMID: 24350153 DOI: 10.5812/traumamon.11522
    CONTEXT: As with care giving and rehabilitation in chronic illnesses, the concern with traumatic brain injury (TBI), particularly with diffuse axonal injury (DAI), is that the caregivers are so overwhelmingly involved in caring and rehabilitation of the victim that in the process they become traumatized themselves. This review intends to shed light on the hidden and silent trauma sustained by the caregivers of severe brain injury survivors. Motor vehicle accident (MVA) is the highest contributor of TBI or DAI. The essence of trauma is the infliction of pain and suffering and having to bear the pain (i.e. by the TBI survivor) and the burden of having to take care and manage and rehabilitate the TBI survivor (i.e. by the TBI caregiver). Moreover many caregivers are not trained for their care giving task, thus compounding the stress of care giving and rehabilitating patients. Most research on TBI including DAI, focus on the survivors and not on the caregivers. TBI injury and its effects and impacts remain the core question of most studies, which are largely based on the quantitative approach.

    EVIDENCE ACQUISITION: Qualitative research can better assess human sufferings such as in the case of DAI trauma. While quantitative research can measure many psychometric parameters to assess some aspects of trauma conditions, qualitative research is able to fully reveal the meaning, ramification and experience of TBI trauma. Both care giving and rehabilitation are overwhelmingly demanding; hence , they may complicate the caregivers' stress. However, some positive outcomes also exist.

    RESULTS: Caregivers involved in caring and rehabilitation of TBI victims may become mentally traumatized. Posttraumatic recovery of the TBI survivor can enhance the entire family's closeness and bonding as well as improve the mental status of the caregiver.

    CONCLUSIONS: A long-term longitudinal study encompassing integrated research is needed to fully understand the traumatic experiences of caregivers. Unless research on TBI or DAI trauma is given its proper attention, the burden of trauma and injury on societies will continue to exacerbate globally.

    Matched MeSH terms: Qualitative Research
  13. Lee Y, Wakabayashi M
    Global Health, 2013;9:34.
    PMID: 23889997 DOI: 10.1186/1744-8603-9-34
    The World Health Organization (WHO) selected antimicrobial resistance (AMR) as the theme for World Health Day 2011. The slogan was "Combat Drug Resistance - No action today, no cure tomorrow" A six-point policy package was launched as a core product for World Health Day. It aimed to stimulate extensive and coherent action to overcome the many challenges presented by antimicrobial resistance.
    Matched MeSH terms: Qualitative Research
  14. Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R
    BMC Public Health, 2012;12:743.
    PMID: 22950371 DOI: 10.1186/1471-2458-12-743
    Malaysia has relatively liberal abortion laws in that they permit abortions for both physical and mental health cases. However, abortion remains a taboo subject. The stagnating contraceptive prevalence rate combined with the plunging fertility rate suggests that abortion might be occurring clandestinely. This qualitative study aimed to explore the experiences of women and their needs with regard to abortion.
    Matched MeSH terms: Qualitative Research
  15. Ali S, Abu Osman NA, Naqshbandi MM, Eshraghi A, Kamyab M, Gholizadeh H
    Arch Phys Med Rehabil, 2012 Nov;93(11):1919-23.
    PMID: 22579945 DOI: 10.1016/j.apmr.2012.04.024
    To investigate the effects of 3 dissimilar suspension systems on participants' satisfaction and perceived problems with their prostheses.
    Matched MeSH terms: Qualitative Research
  16. Loh SY, Packer T, Yip CH, Low WY
    Asia Pac J Public Health, 2007;19(3):52-7.
    PMID: 18333303 DOI: 10.1177/101053950701900309
    Naturalistic inquiry using focus group interviews was undertaken to explore experiences and perceived barriers to self management in women with breast cancer. The aim was to identify their perceived barriers to self management to aid the development of rehabilitation programmes. Successful programmes are strongly linked to patients' perceived needs. Four focus groups consisted of 39 women, were purposively recruited. Women's needs within the three areas of medical, emotional and role management of breast cancer were explored. The main barriers were unavailability of information, inability to access services-and-support, and socioeconomic-cultural issues (entrenched myths, low-socioeconomic status, and inadequate insurance-health legislative coverage). The findings provide the critically lacking 'expert-view' of survivors, who verified the importance of the medical, emotional and role management tasks, and highlighted barriers and structural solutions. With breast cancer becoming recognised as a form of chronic illness, this study is timely.
    Matched MeSH terms: Qualitative Research
  17. Chong L, Abdullah A
    Am J Hosp Palliat Care, 2017 Mar;34(2):125-131.
    PMID: 26424764 DOI: 10.1177/1049909115607296
    OBJECTIVE: The aim of this study was to explore the experience of community palliative care nurses providing home care to children.

    METHOD: A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports.

    CONCLUSIONS: These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.

    Matched MeSH terms: Qualitative Research
  18. 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
  19. Ng CJ, Lai PS, Lee YK, Azmi SA, Teo CH
    Int J Clin Pract, 2015 Oct;69(10):1050-70.
    PMID: 26147376 DOI: 10.1111/ijcp.12691
    AIM: To identify the barriers and facilitators to start insulin in patients with type 2 diabetes.
    METHOD: This was a systematic review. We conducted a systematic search using PubMed, EMBASE, CINAHL and Web of Science (up to 5 June 2014) for original English articles using the terms 'type 2 diabetes', 'insulin', and free texts: 'barrier' or 'facilitate' and 'initiate'. Two pairs of reviewers independently assessed and extracted the data. Study quality was assessed with Qualsyst.
    RESULTS: A total of 9740 references were identified: 41 full-text articles were assessed for eligibility. Twenty-five articles (15 qualitative, 10 quantitative) were included in the review. Good inter-rater reliability was observed for the Qualsyst score (weighted kappa 0.7). Three main themes identified were as follows: patient-related, healthcare professional and system factors. The main patient-related barriers were fear of pain and injection (n = 18), concerns about side effects of insulin (n = 12), perception that insulin indicated end stage of diabetes (n = 11), inconvenience (n = 10), difficulty in insulin administration (n = 7), punishment (n = 7) and stigma and discrimination (n = 7). Healthcare professionals' barriers were as follows: poor knowledge and skills (n = 9), physician inertia (n = 5) and language barriers (n = 4). System barriers included lack of time (n = 5). The most common facilitators were understanding the benefits of insulin (n = 7), not being afraid of injections (n = 5), and patient education and information (n = 5).
    CONCLUSION: Major barriers to insulin initiation persist despite availability of newer and safer insulin. Healthcare professionals should explore and address these barriers. Targeted interventions should be developed to overcome these barriers.
    Matched MeSH terms: Qualitative Research
  20. Kim YJ, Qian L, Aslam MS
    JMIR Res Protoc, 2020 Nov 20;9(11):e23112.
    PMID: 33216000 DOI: 10.2196/23112
    BACKGROUND: Workplace cyberbullying harms the psychological and social functioning of professionals working in an organization and may decrease the productivity and efficiency of daily life tasks. A recent study on trainee doctors across 8 different United Kingdom National Health Service trusts found health issues and job dissatisfaction in people who have experienced workplace cyberbullying. This disabling effect is even more noticeable in low-socioeconomic communities within low-income countries. In Malaysia, there is a need to create a personalized mobile mental health intervention program for health care professionals. These programs should be directed to prevent and decrease psychosocial issues and enhance coordination among health care professionals to solve health issues in the community.

    OBJECTIVE: Our main objective is to study the pre-effects and posteffects of the Personalized Mobile Mental Health Intervention (PMMH-I) for workplace cyberbullying in public and private hospitals in Malaysia.

    METHODS: A hospital-based multimethod multi-analytic evidential approach is proposed, involving social and psychological health informatics. The project has been subdivided into 3 stages, starting with Phase 1, a prevalence study, followed by exploratory studies. Phase 2 consists of a quasi-experimental design, whereas the development of a prototype and their testing will be proposed in Phase 3. Each stage includes the use of quantitative and qualitative methods (mixed-method program), using SPSS (version 26.0; IBM Corp) and Stata (version 16.1; StataCorp) as tools for quantitative research, and NVivo (version 1.0; QSR International) and Atlas.ti (version 9.0.16; ATLAS.ti Scientific Software Development GmbH) for qualitative research.

    RESULTS: The results of this study will determine the pre- and posteffectiveness of an integrated PMMH-I for health care professionals. The prototype system platform will be developed and implemented in a public and private hospital. Results from Phase 1 will be published in 2021, followed by the implementation of Phase 2 in subsequent years.

    CONCLUSIONS: This study will provide evidence and guidance regarding the implementation of a personalized mobile mental health intervention for health care professionals into routine public and private hospitals to enhance communication and resolve conflicts.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23112.

    Matched MeSH terms: Qualitative Research
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