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
The objective of the study was to determine the prevalence of hypertension in healthy primary school children. A cross-sectional survey by manual blood pressure measurement of healthy children aged 6-12 years attending a national type school was carried out. Children with previous renal, cardiac and endocrine disorders were excluded. Korotkoff 1 represented the systolic blood pressure (SBP) and Korotkoff 5 was taken as the diastolic blood pressure (DBP). Hypertension was defined as the SBP or DBP above the 95th centile according to age group and sex regardless of ethnicity. A total of 1756 children were studied with 895 boy and 861 girls. The results showed that 109 children (6.2%) were found to have hypertension and the incidence was similar in boys and girls (6.4% vs 6.0%, p = 0.69). Fifty-three (48.6%) children had an elevated SBP and the DBP was elevated in 43 (39.4%) children. Only 12 (12.0%) children had both elevated SBP and DBP. Children found to have hypertension were more likely to be Chinese (p = 0.009) and obese (p = 0.04). In conclusion the overall prevalence of hypertension in children aged 6-12 years based on a single blood pressure measurement was 6.2%. Hypertension was more likely to be found in Chinese children and those who were obese.
Objectives: 1) To establish the incidence of rotavirus infection in paediatric patients admitted to a private hospital in Malaysia with a diagnosis of community-acquired acute gastroenteritis. 2) To determine whether patients with rotaviral acute gastroenteritis have greater disease severity. Design Retrospective cross-sectional study. Setting An urban private hospital in Malaysia. Participants All paediatric patients with a discharge diagnosis of acute gastroenteritis (AGE) admitted to the hospital between September 2005 and March 2006. A total of 261 patients were included in the study. Results Rotavirus infection contributed to 54% of paediatric hospital admissions with discharge diagnoses of acute gastroenteritis. 74% of children with rotavirus infection were aged 5 years and below. This study demonstrated that patients with rotaviral gastroenteritis had greater disease severity, as measured by two indicators. Firstly, the average length of hospital stay was longer in patients who were rotavirus positive (5.14 days) compared to those who were rotavirus negative (4.81 days). These results were statistically significant (p
Objective: This study aims to establish the validity and reliability of the Malay- translated version of the CES-D. Methods: This study employed a cross-sectional study design. The participants were female inmates (n=90) from local prisons which were selected based on purposive-selective sampling. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a one-week interval. Results: The mean score for depression among the participants is 18.97 (SD=6.51). Further descriptive analysis showed that 58.9% of them scored above the mean score, which is considered high. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Malay-translated version of the CES-D. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach’s alpha coefficient, was equal to 0.75. The test-retest reliability of the total score, measured by Pearson’s correlation was equal to 0.69. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Malay-translated version of the CES-D. The Malay-translated version of the CES-D was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 54-65.
The objective of this study is to determine the prevalence and factors associated with psychosis in Parkinson’s disease (PD) patients.
Method: This is a cross-sectional study of 108 PD patients from neurological clinic UKM Medical Centre and Kuala Lumpur Hospital. The patients were recruited from August to December 2004. Psychosis was determined using SCID, the severity of psychosis was rated using BPRS. The cognitive functions were evaluated with MMSE and the severity of depression was assessed with HAM-D.
Results: The result shows that the prevalence of psychosis in Parkinson's disease patients in this sample was 13%. The psychosis was found to be significantly associated with advancing age, duration of illness, severity of depression and cognitive impairment. Multivariate analysis demonstrates that severity of depression (OR = 1.08, 95% C.I. = 1.01 - 1.16) and advancing age (OR = 4.72, 95% C.I. = 1.37 - 16.29) increased risk of psychosis in PD patients.
Conclusion: We found that advancing age and severity of depression increase risk to develop psychosis in patients with PD.
Study site: neurological clinic UKM Medical Centre and Kuala Lumpur Hospita
Introduction: In order to produce competent physiotherapy graduates with the generic attributes much sought after by the health care providers in the country, the higher education institution needs to ensure the educational environment of the school is positive. Students' positive perception of their educational environment would facilitate their learning experience to be more meaningful and relevant. Objective: The aim of this study was to measure physiotherapy students' perception of their educational environment at the School of Physiotherapy AIMST University and Kolej Sains Kesihatan Bersekutu Sungai Buloh and to identify the areas of concern for remedial measures. Method: This research was a cross sectional study consisting of two phases using both quantitative followed by qualitative methods. The DREEM inventory consisting of 50 items under 5 domains was circulated to all the students (N=158) from both schools (AIMST and KSKB). The item mean scored below 2.00 were considered as problem areas and it was explored further through focus group discussion (N=12) as a qualitative study. Result: The overall mean score on the 50 items was 132.84 (SD 19.22) out of 200. Students' Perception of Learning (SPOL) scored the highest 32.34 (SD 4.17) followed by students' perception of Atmosphere (SPOA) 30.63 (SD 4.84), Students Perception of Teachers (SPOT) scored 30.52 (SD 3.98),Students Academic Self Perception (SASP) scored 22.03 (SD 3.20) and the last domain Students' Social Self Perception (SSSP) scored the least 17.32 (SD 19.22).All the domains scored toward more positive side of the educational environment. Four items scored less than 2.00 and these items were explored further with focus group discussion. Students from both schools had similarities as well as differences in their views over the concerned areas. Conclusion: This study revealed important information regarding the low scored items. Overall the students from both schools perceived their schools positively. Implementing the remedial measures for the problem areas would further enhance the respective educational environment and thus provide a conducive place for physiotherapy students to excel in their academic endeavour.
The significance of learning research methodology and performing research has been accepted by various medical schools in Malaysia as well as in other countries. The aim of integrating research into medical curriculum is to inculcate the research culture and form part of the evidence-based practice among medical professionals. Hence, the Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak has incorporated the research component into the preclinical year of the medical curriculum. A survey was conducted to gauge the second year medical students' level of knowledge of research process at the end of the course using a set of questionnaires. Seventy nine of second year medical students participated in the study. The outcome of the study shows significant improvement in the students’ knowledge on research components after completing the one year course (p
A cross-sectional study was conducted on 83 female electronics factory workers. The respondents comprised 50 exposed workers who use lead alloy solder and 33 unexposed workers. The objective of this study was to assess the lead exposure of these workers. Breathing zone were sampled using air sampling pumps. Dust samples were collected by wipe method. Venous blood collected and blood pressure were measured. All lead analyses were carried out with Graphite Furnace Atomic Absorption Spectrophotometer. The mean air lead for exposed workers (57 0. ± 0.93 μg/m³) was significantly higher than the unexposed workers (0.0067 ± 0.0045μg/m³) (p
Heat stress is considered to be the sum of heat generated in the body (metabolic heat) plus the heat gained from the environment (environmental heat) minus the heat lost from the body to the environment. The consequences of heat stress can caused heat disorder such as heat stroke, heat syncope, heat exhaustion, heat cramps and other heat related diseases. The objective of this study was to compare the pattern of heat stress in each section. A crosssectional study was carried out in two sections (Paintshop A and Bodyshop B) in a selected automotive assembly plant in Selangor to monitor the environmental heat stress. The environmental heat monitoring was done on 89 March 2005. Heat stress monitor (Model: QUESTemp o 34 Thermal Environment Monitor, Quest Technologies, USA) was used to record the pattern of heat exposure in the workplace over a period of eight hours. Heat parameters such as dry temperature, wet temperature, globe temperature and relative humidity were measured. Wet Bulb Globe Temperature index (WBGT) and workload evaluation were used to compare both sections. Heat parameters such as timeweighted average wet bulb globe temperature for indoor setting (TWAWBGT indoor ), dry temperature (DB), natural wet bulb temperature (WB), globe temperature (GB) in Paintshop A were higher than those in Bodyshop B. The relative humidity in Paintshop A was hotdry compared to Bodyshop B which is hotwarm. Paintshop A was considered a hot area compared to Bodyshop B which is normal. Workers in both sections were not faced with heat stress problems because they were worked under acceptable condition according to American Conference of Governmental Industrial Hygienists standard. Both sections in the automotive assembly plant exhibited acceptable working condition for workers in a tropical environment.
Acne can affect personal appearance and impair quality of life. A cross sectional study, over a period of 12 months was conducted among medical students at Universiti Kebangsaan Malaysia to evaluate the disability, self management and help-seeking behaviour of medical students for acne. A total of 361 students were selected using stratified cluster random sampling. Acne was graded using the Comprehensive Acne Severity Score (CASS) while acne disability was assessed using the Cardiff Acne Disability Index (CADI). Acne self management and helpseeking behaviour was assessed using the acne management questionnaire. Mean CADI score was 3.35 + 2.39, with mostly mild (83.8%, n=206) and moderate (14.6%, n=36) levels of impairment. Female students and those from the nonMalay ethnic group demonstrated higher disability (3.76 + 2.24, p=0.006 and 3.79 + 2.59, p=0.018, respectively). Although the majority of students (87.4%, n=215) knew that acne can be treated, they preferred to discuss their acne problems with friends (54.1%, n=133) rather than consulting a physician (9.3%, n=23). Most of them also practiced non-evidence based measures for their acne. The results of the present study shows that young adults tend to have mild grades of acne severity and disability. However, efforts are needed to enhance their knowledge on evidence based management of acne and modify their help seeking behavior. This would help reduce complications such as permanent scars and improve quality of life, as acne is a treatable dermatological disorder.
Keywords: acne vulgaris, medical, disability, quality of life, students, severity, self care
A cross-sectional study was conducted among 200 Malays in Kuala Pilah, Tampin, Bahau, Gemencheh and Seremban towards food allergy in Negeri Sembilan. Questionnaire were used to determine demographic data, allergy symptom, practice and knowledge of respondents towards food allergy. Majority of the respondents that have food allergy were children 44% and shrimp was the most common allergen among children (25%). Family history is found to be associated with the age group and place of residents (p < 0.05). Common symptom that manisfested by respondents includes rashes (35%). Furthermore, the study showed that the respondents were concerned about their food allergy and 96% of the respondents reduced the intake of food that caused allergy. The level of knowledge related to food allergy was found to be associated with age group (p < 0.05). In conclusion, the study found that shrimp is the most common food allergy for all age group. Response towards food allergy is that they reduce the intake of food that cause allergy and the knowledge
towards food allergy is associated with age group. Therefore, early screening should be conducted to identify types of alergy so that appropriate treatment can be given to the patients. Health education on allergy is also important to improve knowledge and patients’ compliance towards treatment.
Keywords: Food; allergy; Malay; attitude; knowledge
Mental health is an integral component to the formation of human capital performance. Human capital with high productivity is the key factor to the growth of a country. Thus, this study aims to investigate the relationship between the level of mental health of undergraduate students in Universiti Utara Malaysia (UUM) with their performance. Mental health was measured using the General Health Questionnaire 12-item (GHQ-12) and the performance was based on the Cumulative Grade Point Average (CGPA). A total of 316 undergraduate students at UUM had answered questionnaires that were distributed. The data were analysed descriptively and the effect of the level of mental health on performance was tested using probit model. Based on GHQ-12, 48% respondents were found to have a good mental health status. A total of 67.21% of the students who obtain CGPA 3.67 and above have a good level of health compared with only 36.08% for those with CGPA under 3.67. Based on the probit model, the level of mental health was found to be significant at 1% level in influencing the CGPA. These findings provide indication to policy makers of the importance of mental health in influencing the students’ performance. Mental health education programs should be implemented or enhanced to raise awareness of the importance of good mental health state among students in higher education institution.
Keywords: CGPA; GHQ-12; mental health; productivity; Kedah; Malaysia
Acute appendicitis is one of the most common differential diagnoses for acute abdominal pain made by emergency doctors. Suspected cases require surgical referral for observation or definitive intervention to prevent complications. A high index of suspicion and good clinical skills with the aid of scoring systems allows early decision making, which includes optimal pain control. The objective of this study was to identify the pain score and is relationship to the cut-off points of the Alvarado scoring system so that justifies early surgical referral or discharge for suspected acute appendicitis from the Emergency Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a cross sectional study of acute abdominal pain from June 2007 to September 2008. All patients who fulfilled the criteria and consented to the study were assessed for Alvarado score, verbal numerical pain score (VNRS) and their subsequent management. Patients with an Alvarado score of ≥7 were likely to have acute appendicitis (80.1% sensitivity and 52.63% specificity) and those with the score of ≤3 were unlikely to have acute appendicitis. The median pain score was 7.00 (IQR: 5.00-8.50) but 72.5% did not receive any analgesia. There was no direct relationship between the pain score with Alvarado score. Oligoanalgesia in patients with acute appendicitis still exist in Emergency Department of UKMMC.
Health impact related to smoking is a critical public health predicament especially in pregnancy. However there is not much data available to describe the magnitude of the problem. Hence this study was conducted to determine the prevalence of smoking and its socioeconomic factors among antenatal mother and their opinion related to tobacco control measures. A cross sectional study was carried out involving newly registered antenatal mothers attending all government health clinics in Penang. Prevalence of ever smoking among antenatal mother is 1.4%, of which 42.4% is still smoking at first antenatal visit. It was found that single mothers are more likely to smoke (OR, 14.23: C12.52-53.27). It was also noted that spouse smoking (OR, 5,14: CI 1.95-17.09), primigravida (OR, 2.7: C1 1.3-5.62), age group less than 30 years old (OR, 2.41; CI 1.03-6.09) and living in urban area (OR, 2.33; CI 1.01 — 6.47) have a higher risk to indulge in smoking behaviour. Muslim OR 0.29; C1 0.14 - 0.60) and Malay (OR 0.22; CI 0.10 - 0.47) pregnant mothers are noted to be less likely to smoke as compared to non Muslim and non Malay. More than 85% of them agreed with the tobacco control measures regardless of their smoking status. Most of respondents agreed the influential people in community L;11T · such as medical personnel, teachers and parents should not smoke.
A cross-sectional study on helminthiasis among rural primary schoolchildren aged 9 to 10 years Bachok, Kelaritan was perfumed. A total of 680 schoolchildren participated in the study. Stool specimens were examined for the presence of the ova of Ascaris lumbricoides, Trichuris trichiura and hoolcwonn. The worm load was then measured using the modified Stoll`s volumetric dilution
technique. The overall prevalence of helminthiasis was 77 .2%. Trichuris trichiura were the commonest type of heminth noted - 66.8%, compared with Ascaris lumlrricoides (49.7%) and hookworm (1.8%). Mixed infections with Ascaris lumlyricoides and Trichuris trichiura was the commonest type of infection 249(41 .5%) . For Ascaris lumbncoides, 34.6% had mild and 5 I .3% had moderate worm load while for Trichurb trichiura, 66.5% had mild and 30.8 % had moderate worm load. Only 14.1% and 2.7% 4 of the schoolchildren had a heavy load of Ascaris lumlwicoides and Trichuris trichiura respectively. All the schookhildren with hookworm were only mildly infected. Targeted mass treatment for rural Mahysian schoolchildren is still essential, especially in areas where poverty and malnutrition are still prevalent.
Introduction: This study measured the health-related quality of life (HRQoL) among COPD patients attending outpatient clinic at Institute of Respiratory Medicine, Kuala Lumpur.
Materials and Methods: A cross sectional survey was conducted from November 2008 to January 2009 on 99 COPD patients. Subjects were interviewed through socio-demographic and health characteristics. The HRQoL was measured using the SF-36v2 questionnaires.
Results: Majority of the subjects were above 60 years (64.6%) with mean age of 64.10 ± 11.04 years, male (84.8%), Malays (49.5%), married (74.7%), primary educational level(57.6%), income level below RM1000 (39.4%), ex-smoker (64.6%), moderate COPD (40.4%), 1 to 5 years of illness (62.6%), presence of co-morbidities (65.7%) and satisfied with support from caregiver (48.5%). The total mean score for physical health component summary (PCS) was 41.64 ± 7.99 and mental health component summary (MCS) was 46.53 ± 13.21.
Conclusion: There were significant differences in PCS for different educational level (p<0.05) and socio-economic status (p<0.01). The MCS were signifi cantly different between ethnicity (p<0.05) and level of satisfaction with support from caregiver (p<0.01). This finding provides information that needed focus in
healthcare services.
KEYWORDS: COPD, health-related quality of life, Malaysia
Study site: outpatient clinic, Institute of Respiratory Medicine, Kuala Lumpur, Malaysia
Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital.
Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented.
Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039).
Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ICS combination.
KEYWORDS: Bronchial asthma, level of control, Asthma Control Test
Study site: Chest Clinic, Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
Device, Questionnaire & Scale: Asthma Control Test (ACT)