In recent years, the popularity of using complementary and alternative medicine (CAM) as a health care option has increased dramatically all over the world especially in developing countries. As Malaysian statistics showed an increased in chronic diseases among our population, the demand to consume CAM for healing process as well as in pursuit of health and well-being also has increased. Thus it increased patient’s interest to request more information from medical practitioners and nurses who are front health care providers. The objective of this study is to compare the knowledge, attitudes, and practice (KAP) of CAM among final year nursing and medical students in Universiti Sains Malaysia (USM). A cross-sectional comparative study was conducted among final year medical and nursing students using self administered questionnaire. This study utilized the Knowledge-Attitude-Practice (KAP) model to explain how level of knowledge may reflect nursing and medical students’ attitudes and practice of CAMs. There were 74 students participated where 33 of them were nursing students, and 41 were medical students. Independent t-test was used to compare the KAP of CAM between both groups of students and there was a significant different. As a conclusion, this study revealed that nursing students were more knowledgeable about CAM, possessed positive attitudes, and more willing to practice CAM compared to medical students.
Introduction: Just-in-Time Teaching (JiTT) is a novel method of teaching-learning used in various disciplines of science and humanities. It is a technique that scaffolds the students learning process by reducing the cognitive load which is the load related to the executive control of working memory. Just in time teaching underpins the concept that expertise in learning originates from the knowledge already stored in long term memory and with subsequent interaction between the learner and teacher motivates enhanced active learning and optimizes the intellectual performance.
Objective: The objective of the study is to assess the acceptability of JiTT over traditional lecture teaching among the medical students.
Method: In a cross sectional pilot study, three hundred thirty five students participated in a questionnaire based study that grades the various aspects of the traditional lecture series. After the implementation of JiTT method for a period of four months, three hundred two students completed the questionnaire, grading the same variables for JiTT. The analysis was done by using SPSS version 11 applying Paired t test and McNemar's Test.
Result: The results of our study highlighted that JiTT technique was perceived superior to traditional teaching with statistically significant outcomes in the clarity of the topic (p=0.003,) duration of the session (p=0.002), knowledge gained and orientation for exams (p=0.044). The students perceived JiTT method as less monotonous (p=0.005) increasing their alertness during these sessions (p=0.002).
Conclusion: We therefore propose that Just-in-Time Teaching method is a more interactive and acceptable teaching-learning tool shifting the nature of teaching to a more student-centric approach as perceived by the medical students. This is the first pioneer study on JiTT to be performed on undergraduate medical students so far.
Introduction: Medical and allied health educators around the globe agreed that an optimal educational climate is a vital aspect for effective learning to take place. Without a doubt, appraisal of the educational climate has been emphasized as a key to the delivery of high quality medical education. In addition, the appraisal provides useful feedback to particular institution to improve their curriculum.
Objective: This study was employed as part of the School of Medical Sciences (SMS) Universiti Sains Malaysia curriculum review process. It aimed to explore the strengths and weaknesses of the current medical curriculum thus could provide useful information to guide the curriculum review committee during the review process.
Method: A cross sectional study was conducted on a total of 656 medical students from the first, third and fifth year of study. Purposive sampling method was applied. DREEM was administered to the medical students to evaluate the educational climate in the studied medical school.
Result: A total of 511 (77.9%) medical students completely responded to the 50 statements of DREEM. The mean global score across phases of medical training was 128.36/200. The global scores for year 1, year 3 and year 5 were 138.94/200, 122.27/200 and 125.49/200 respectively. Results showed that; 1) the medical school had reasonably level of educational climates across phases of medical training; 2) the medical teachers were knowledgeable and well prepared for the teaching; 3) the students were overloaded with factual knowledge; 4) the medical teachers were quite harsh to students during teaching session especially in clinical phase; 5) students experienced a significant amount of stress that led to poor memory; 6) the learning process was inclined toward teacher-centered rather than student-centered learning; 7) students had a considerable healthy social relationships with peers as well as others; and 8) academic dishonesty became more apparent in the clinical phase.
Conclusion: The medical school's educational environment across different phases of study was more positive than negative. However, there are plenty of rooms for improvement as perceived by the medical students. The medical school should address various important issues highlighted in this article during the curriculum review process.
Smoking in adolescence is a great health concern as it is related to many chronic diseases and mortality in later life. It is also associated with other high-risk behaviours among adolescents. The objective of this study was to determine the prevalence and reasons for smoking among upper secondary schoolboys. This was a cross-sectional study conducted among Form 4 and Form 5 students. Three schools in the District of Hulu Langat were identified and students from these schools were selected randomly. The students were given a self-administered questionnaire. A total of 343 students were included in the study. The prevalence of smoking among the schoolboys was 37%. Although the majority of them initiated smoking between 13-15 years old (67%), 21% of them began smoking below 12 years of age (primary school). There was a significant association between adolescent smoking and smoking among family members (p<0.05). The common reasons reported for
initiating smoking were curiosity (69%) and peer pressure (51%). However, the common reasons for continuing smoking were stress (70%) and addiction (49%). Schoolwork was reported as the most important factor which contributed to their stress. Smoking prevention programmes should begin early in primary schools. Adolescents should be educated on effective coping strategies in managing stress and learning to be assertive.
Keywords: smoking, adolescents, secondary school, reasons.
Percutaneous coronary intervention (PCI) is an invasive diagnostic investigation that may result in high level of anxiety and “fear of the unknown” among cardiac patients. An increment in anxiety among PCI patients will augment the level of stress and this extreme stress level will then aggravate depression. The objective of this study was to determine the incidence of anxiety and depression before and after PCI. This was a cross-sectional descriptive study. The Hospital Anxiety and Depression Scale (HADS) was used. It measured two elements, namely, the anxiety and depression levels of patients before and after PCI. This study was conducted in the cardiology wards Anggerik and Dahlia, and Day Care of the National Heart Institute, from January to February 2006. A sample of 61 patients before and after PCI who fulfilled the inclusion criteria were recruited in this study. Of these, 40 and 38 patients before and after PCI respectively, had low anxiety levels; while, 47 and 46 patients before and after PCI respectively, had low depression levels. Anxiety and depression levels before and after PCI were not significantly correlated to socio demographic status. However, a significant correlation (p
A proportion of patients with acute viral fever with thrombocytopaenia does not necessary have dengue infection. Managing them indiscriminately as dengue infection may not be appropriate. The prevalence of this problem is not exactly known. The objective of this study is to determine the prevalence of acute non-dengue febrile thrombocytopaenia among adult patients presenting with acute non-specific febrile illness in an outpatient setting. This was a clinic-based cross sectional study. Consecutive patients presenting with non-specific febrile illness of less than two weeks were selected from the Primary Care Centre of Hospital Universiti Kebangsaan Malaysia (HUKM) and the Batu 9 Cheras Health Clinic. Full blood count was done on the day of visit and dengue serology was done on day five of illness for all patients enrolled. Seventy three patients participated in this study from May to November 2003. Among the patients, 35 (47.9%) were noted to have thrombocytopaenia. Fourteen (40%) patients with thrombocytopaenia were serologically negative. The prevalence of non-dengue febrile thrombocytopaenia was 19.2%. A significant number of patients with acute non-specific febrile illness with thrombocytopaenia were negative for dengue serology. These patients should be differentiated from those with acute febrile thrombocytopaenia, as they might differ in their natural history from those with dengue infection, and hence require different management strategies.
Study site: Primary Care Centre of Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
A cross sectional study on work stress prevalence was carried out among 185 executives and managers in the head quarter of an international tobacco company. The aim of the study was to identify work stress prevalence in this company and work stressors that were associated with stress experienced by the workers. A questionnaire based on the Personal Stress Inventory by O'Donell (1984) was used. Data collected from participants included sociodemography factors, symptoms of stress and work stressors related to organizational policy, organizational structure, organizational process, and work environment. The study showed that the prevalence of stress among executives was 68.1% and managers were 67.9%. There was no significant difference in the level of stress between the executives and the managers in the company. The sociodemographic factors that were significantly associated with stress were salary, number of children and personal factors. The significant stressors in the workplace were lack of job recognition, over focusing on quality of work, heavy workload and long working hours.
The primary objective of the present study was to investigate the impact of sociodemographic factors on smoking and alcohol consumption among adults in Penang (Malaysia). A cross-sectional primary survey data with 398 respondents was used for analysis. The present study applied logistic regression models to examine the factors affecting the odds of smoking and alcohol consumption. The results showed that gender, ethnicity and education could significantly affect smoking. In particular, males (OR: 26.678) had a higher likelihood of smoking compared to the females, whereas Chinese (OR: 0.177), Indians/others (OR: 0.331) and individuals with tertiary education (OR: 0.258) had a lower likelihood of smoking than others. In terms of alcohol, gender, ethnicity and marital status were found to have a significant influence on the likelihood of alcohol consumption. Specifically, males (OR: 5.051), Chinese (OR: 37.796) and Indians/others (OR: 10.863) were more likely to consume alcohol than others, while married individuals (OR: 0.380) were less likely to consume alcohol than unmarried individuals. Based on the findings of the present study, numerous population-based intervention measures were suggested.
A cross-sectional study was conducted to ascertain the relationship between parental oral health perception on the importance of the deciduous dentition and the dental caries status of their preschool children. Clinical oral examination of the preschool children was performed and self-administered questionnaires were given to the parents to be completed. Four hundred and eight preschool children were examined and 390 of their parents responded to the self-administered questionnaire. Those parents who brought their children for regular dental check-up at least once a year; favoured restorative treatment and practised tooth brushing habit before bedtime were more likely to have children with significantly lower mean 'dft' as well as higher proportions of caries free mouth (> 50 %). Those children who started early in practising tooth brushing also had better dental caries status but the differences were not significant. However, there were no significant and appreciable differences in their mean 'dft' with respect to the frequencies of tooth brushing per day. It was concluded that parents with better oral health perception as reflected by those parents who (a) practiced regular dental check-up for their children; (b) favoured restorative treatment for their children's decayed deciduous teeth; (c) ensured their children brushed their teeth before bedtime are associated with better dental caries status of their preschool children.
Dental fear is a hindrance to the effective provision of oral health care and causes patients to delay, or even avoid necessary care altogether. The aim of this study was to determine the prevalence and level of dental fear, to identify specific fear provoking stimuli and also to explore the avoidance behaviour among the respondents. A cross-sectional study was conducted on a sample of 407 antenatal mothers utilizing the Kleinknecht's Dental Fear Survey Questionnaire. The overall prevalence of dental fear was 94.1% of which 67.6% of the subjects reported low fear levels, 26.5% were moderately fearful while none were highly fearful. Only 5.9% of the subjects reported no fear. The drill and anaesthetic needle were identified as the most fear provoking objects. Subjects with moderate fear were about 6.4 times (OR=6.39; 95%CI 3.81-10.75) more likely to avoid making appointments and 6 times (OR=6.05; 95% CI 3.20-11.50) more likely to cancel appointments compared to subjects with lower levels of fear. This. study indicates that dental fear is a common problem among antenatal mothers contributing to poor dental attendance.
In light of the increases in alcohol-induced diseases and social problems, the present study sets out to examine the factors affecting alcohol consumption among adults in Penang (Malaysia) using a cross-sectional survey sample consisting of 398 respondents. The results of the logistic regression analysis show that age, gender, ethnicity, marital status and smoking are significantly associated with alcohol consumption. In particular, males (OR: 3.720; 95% CI: 1.939, 7.136), Chinese (OR: 3.628; 95% CI: 1.808, 7.279) and smokers (OR: 5.083; 95% CI: 1.876, 13.774) are more likely to consume alcohol than others, whereas, old individuals (OR: 0.971; 95% CI: 0.941, 1.002), Malays (OR: 0.059; 95% CI: 0.021, 0.165) and married individuals (OR: 0.419; 95% CI: 0.211, 0.833) are less likely to consume alcohol than others. Based on the findings of the present study, several intervention strategies toward reducing alcohol consumption are proposed. Specifically, these strategies should be targeted at young individuals, males, Chinese, unmarried individuals and smokers.
Rural health clinics in Sri Aman Division in Sarawak, Malaysia lack diagnostic tests for malaria. Many of the medical assistants in the clinic diagnose malaria solely on clinical ground. The study was to determine the sensitivity, specificity and positive predictive value of clinical diagnosis of rnahtria made by medical assistants using results of microscopy examination as gold standard. The study period was from September to December 2003. Three rural clinics without laboratory or diagnostic tests services and one urban clinic with laboratory facility serving malarious areas were selected. All patients clinically diagnosed as malaria by the attending medical assistants were included as clinical malaria cases. Blood slides were taken for examination of malaria parasites. Non clinical malaria cases were all other patients without clinical malaria for whom blood slides were taken for malaria parasites. Out of 362 patients included in the study, 75 were clinically diagnosed as having mahria. The sensitivity of headache, history of fever and chills/rigors to detect malaria cases was above 90% but the specificity and positive predictive value was low, below 40% and 20% respectively. The sensitivity, specificity and positive predictive value of malaria clinical diagnosis made by medical assistants was 82.1 %, 84 .4% and 30.7% respectively. Clinical diagnosis of malaria increases the slide positive rate by four folds. However the sensitivity, specincity and positive predictive value of clinical diagnosis by medical assistant and clinical characteristics was insufficient to enable each of them to be used alone to differentiate true malaria cases from non mahiria cases.
All road users are at risk of being involved in motor vehicle crashes (MVCs). Approximately 52.2% of all fatalities and 70.9% of all casualties related to MVCs in Kelantan were motorcycle riders and pilliori riders. A number of risk factors have been established in the relationship between traffic accidents and road-user, the vehicle as well as road and traffic conditions. The study was a cross-sectional study to identify factors associated with the severity of injury sustained by motorcyclist accident patients admitted to the Emergency Department, Hospital Universiti Sains Malaysia (HUSM), assessed through face to face interview based questionnaire and, at the same time the severity of injury was determined through Revised Trauma Score. Data analysis was done using simple and multiple logistic regressions. The study revealed that age more than 5O years, no motorcycle license, no stressful condition and crashes on two·way road showed higher risk of sustaining a more severe injury. However, sleep time of six to less than nine hours per day, crash on a straight roadway and wet road surface were associated with less severe injury. We recommend that public education, licensing and enforcement on accident prevention and safety riding should be given a priority.
A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
Non-Leisure Time Physical is the main component of physical activity in Malaysia. The aim of this study is to study the associated factors related to Non-Leisure Time Physical (occupational & travel) in Malaysia. This data is from the Third National Health and Morbidity Survey, consisting of 32,575 respondents. It was a cross-sectional study among Malaysian adult, aged 18 years and was conducted using proportional to the size stratified sampling method. Chi square test and logistic regression model were used to analyse the data. The result showed that non-leisure time physical activity (NLTPA) gives more contribution to total physical activity, as compared to leisure time physical activity with percentage of 64.3% and 35.7% respectively. There was a significant association between NLTPA with age (P < 0.001), gender (P < 0.001), ethnicity (P < 0.001), education (P < 0.001), occupation (P < 0.001), income (P < 0.001), marital status (P < 0.001), region (P < 0.001). The main component of physical activity in Malaysia is NLTPA. Promoting NLTPA may have potential to increase physical activity levels in Malaysia.
Study name: National Health and Morbidity Survey (NHMS-2006)
Posttraumatic stress disorder (PTSD) is a psychiatric diagnosis made when someone including children who experiences traumatic stressor. Those who are exposed to a more severe trauma have highest level of PTSD. The aim of this study was to measure the prevalence of PTSD and its associated factors among 219 children who were affected by a form of natural disaster which is the tsunami waves in a rural area in Malaysia. A cross sectional study was carried out among children aged 10-12 years 6 months after the traumatic event. Child Posttraumatic Stress Disorder –Reaction Index (CPTSD-RI) was used as a screening instrument which was answered by the affected children through a self-administered questionnaire. Forty six percent of these children had PTSD symptoms; 31.1% of these children had mild, 11.4% had moderate, 3.7% had severe PTSD and none had very severe PTSD. Result also showed that 91.8% had re-experiencing symptoms, 28.3% had numbing/avoidance symptoms and 49.3% had hyperarousal symptoms. Children with low social support (Adj OR = 2.3 (95% CI: = 1.3- 4.2)), and children who experienced deaths among someone close to them (Adj OR = 3.7 (95% CI =1.2 - 11.5)) were more likely to have symptoms of PTSD. This showed that children are at higher risk of developing PTSD as early as 6 months after the event and thus early intervention should be offered to them. Future longitudinal study can be carried out among affected children to assess whether these PTSD symptoms persist over time.
Student's feedback is one of the most important considerations in health profession quality management. One of the most popular approaches for receiving feedback from students within individual institutions is the Student Satisfaction Approach. The aim of this study was to measure the satisfaction with educational services among health profession students and the determinants of satisfaction. Cross-sectional study was conducted in the main campus of the High Institute of Health Sciences in Yemen, including its eight branches. A self-directed questionnaire was distributed to 327 students who were randomly selected. The participation rate was very high: 94% (309/327); 57.9% were male and 42.1% were female. Overall, 59% of students were totally satisfied, 35% were partially satisfied; however only 6% of them were not satisfied. Results showed that personal development was the highest component of satisfaction among students, while the research subjects showed less–satisfaction with the learning resources. The findings provide valuable insights and offer recommendations for improvement in terms of quality management in health profession education.
The uprising needs of traditional & complementary medicine (T&CM) despite the availability of conventional medical (CVM) treatments has gained a serious concern to the authorities in hospital care delivery systems. It was about suffices the supply and demand for T&CM and its absence may interfere the quality of patient care. Malaysia was not exempted of this phenomenon. Moreover, its rich tropical biodiversity and multi-ethnical medical systems promoted T&CM usage. This research was aimed to determine the overall T& CM preferences, the preferred future patient care services (FPCS) and its socio-demographic and warding characteristics. Using a self-administered standardised questionnaire, instrumented by cross sectional study, a total 132 warded patients in a UKM Medical Center (UKMMC) were interviewed. T&CM preferences were the composite of seven domains. The finding revealed that the T&CM preference was 64.4%, dominated by older age (66.2%), women (68.2%), low education (66.0%), employed (66.7%), high income (67.5%) and married (66.0%). Oncology (81.3%) and orthopaedic (75.7%) ward patients were more in preference compared to other wards. When asked about the FPCS preference, about 80.3% expected integrative medicine services to be provided, whereas the remaining were still exclusively preferred modern medicine (15.2%) and alternative medicine (4.5%) respectively. As conclusion, this study has affirmed that there is a great need towards T&CM among hospitalized patients who are accessible to modern CVM.
Introduction: Praying represents a fundamental activity of daily living in Muslim community. Muslims need to adopt several postures that require deep flexion of the knee and hip to perform this daily obligation. This is a preliminary report of the study on hip and knee range of motion conducted to obtain normative passive and functional range of flexion data during Muslim prayers in both weight-bearing joints of normal Muslim adults. Methods: A cohort of Malay men aged between 20 to 30 years was recruited in this cross-sectional study. Passive range of motion and flexion angles of the joints in various postures during prayer were measured using a standard goniometer. The difference against existing normative range of motion database available and the influence of various factors were analysed. Factors analysed include body mass index and other anthropometric measurements. Results: Sixty participants recruited for the preliminary phase of this study. The mean (SD) of passive hip and knee flexions were higher compared to other existing normative range of motion database. A unit increase in body mass index will have 0.782 units lower of knee range of motion. The hip and knee flexion arc were from 74.1° to 119.0° and from 3.3° to 119.7° respectively. Conclusion: The range of motion involved for prayers was more for the knee but less for the hip as compared to the measured passive range of motion. Body mass index has a significant linear negative relationship with the passive range of motion of the knee, but not the hip.
Heart failure is chiefly the end stage of primary hypertension and a major public health problem in Malaysia. The aim of this work is to investigate the level of BNP that may discriminate between primary hypertension patients without heart failure and primary hypertensive patients with heart failure. This study was conducted on 60 hypertensive patients without any clinical symptoms of heart failure referred for echocardiography to evaluate the ventricular function. Patients with metabolic diseases and terminal diseases were excluded from the study. The BNP levels were assessed using the Triage Meter from Biosite Diagnostics. Results showed that BNP level display a negative correlation with ejection fraction (Pearson correlation test). The significant result (paired t test, p < 0.05) proves that both predictors are very important and relates to each other. Low ejection fraction is significantly marked with raised BNP level suggesting that BNP may play potential role as screening tool for early detection of heart failure in primary hypertensive patients.
Study site: (Universiti Kebangsaan
Malaysia Medical Center and International Medical University cardiology clinic, Seremban