Displaying publications 221 - 240 of 636 in total

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  1. Enhancing knowledge, attitude, and perceptions towards fall prevention among older adults: a pharmacist-led intervention in a primary healthcare clinic, Gemas, Malaysia
    Manirajan P, Sivanandy P, Ingle PV
    BMC Geriatr, 2024 Apr 02;24(1):309.
    PMID: 38566052 DOI: 10.1186/s12877-024-04930-5
    BACKGROUND: Falls and fall-related injuries are very common among older adults, and the risk of falls increases with the aging process. The lack of awareness of falls and fall-related injuries among older adults can contribute to an increasing risk of falls. Hence, a study was carried out to improve the knowledge, attitude, and perception of falls and fractures among older adults in a primary care setting in Gemas, a rural area of the Selangor state of Malaysia.

    METHOD: A structured educational intervention was provided to older adults who visited the primary care setting in Gemas and provided written informed consent to participate in the study. A total of 310 older adult patients was included in the study using a convenience sampling technique.

    RESULTS: Before the intervention, 74.84% of the respondents (n = 232) agreed that falls and related fractures are the leading causes of hospital admission among older adults. In post-intervention, the number of respondents who agreed with this statement increased to 257 (82.91%). At baseline, 28 respondents (9.03%) had poor knowledge, 160 respondents (51.61%) had average knowledge levels, and 122 respondents (39.35%) had good knowledge. In post-intervention, respondents with poor and average knowledge reduced to 1.93% (n = 6) and 29.35% (n = 91) respectively. A majority of respondents' knowledge levels improved significantly after the intervention (n = 213; 68.71%). About eight respondents (2.58%) had a negative perception of falls. In post-intervention, the percentage reduced to 0.65% as only two respondents had a negative perception. A total of 32 types of fall-risk-increasing drugs (FRIDs) have been prescribed to the respondents. A strong correlation (r = 0.89) between pre- and post-intervention knowledge was shown among the respondents. Paired t-test analysis showed a statistically significant difference.

    CONCLUSION: The pharmacist-led educational intervention significantly improved the knowledge, attitude, and perception of falls among older adults. More structured and periodical intervention programmes are warranted to reduce the risk of falls and fractures among older adults.

    Matched MeSH terms: Primary Health Care
  2. Enhancing Sustainability in Healthcare Delivery-A Challenge to the New Malaysia
    Ahmad D
    Malays J Med Sci, 2019 Jan;26(1):1-4.
    PMID: 30914889 DOI: 10.21315/mjms2019.26.1.1
    There have been substantial improvements in the health indicators since Malaysia achieved independence. These were accomplished through strong primary healthcare services addressing maternal and paediatric health, as well as the successful control of communicable diseases. The rate of decline in the mortality statistics has been at a virtual standstill, or at best, almost plateaued since 2000. However, with the plethora of national health issues at both the policy and delivery levels, we cannot continue on with 'business as usual'. Therefore, we must strategise effective and practical approaches to a renewed and revamped national healthcare services for a modern 'New Malaysia' that are compatible with our quest toward the status of a 'truly developed' nation.
    Matched MeSH terms: Primary Health Care
  3. Factors associated with anxiety among elderly hypertensive in primary care setting
    Ismail Z, Mohamad M, Isa MR, Fadzil MA, Yassin SM, Ma KT, et al.
    J Ment Health, 2015 Feb;24(1):29-32.
    PMID: 25358109 DOI: 10.3109/09638237.2014.971148
    BACKGROUND: There is increasing evidence showing that anxiety is associated with morbidity in the older age group. Factors contributing to anxiety may vary among different diseases and settings.
    AIMS: The aim of this study was to determine the factors associated with anxiety symptoms among elderly hypertensive at the primary care level.
    METHODS: A cross-sectional study and face-to-face interviews using Hospital Anxiety and Depression Scale (HADS) were conducted among elderly hypertensive.
    RESULTS: The mean (SD) age of subjects was 68.8 (6.76) years and comprised of 49.5% and 50.5% of males and females, respectively. The majority of respondents were Malays (76.1%), followed by Chinese (14.3%), and Indians (9.5%). The mean (SD) duration of hypertension was 8.44 (7.29) years and the prevalence of anxiety symptoms was 13.3% (95% CI: 9.9, 16.7). Multiple logistic regression analysis showed that elderly hypertensive with a past history of stroke (adjusted OR: 4.472; 95% CI: 1.754, 11.405; p = 0.002) and depression (adjusted OR: 3.715; 95% CI: 2.009, 6.872; p care
    Matched MeSH terms: Primary Health Care*
  4. Fulltext Addressing non-communicable diseases in Malaysia: an integrative process of systems and community
    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. Fulltext Role of primary care providers in dengue prevention and control in the community
    Ang KT, Rohani I, Look CH
    Med J Malaysia, 2010 Mar;65(1):58-62.
    PMID: 21265251 MyJurnal
    Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.
    Matched MeSH terms: Primary Health Care*
  6. Fulltext Text messaging reminders to reduce non-attendance in chronic disease follow-up: a clinical trial
    Liew SM, Tong SF, Lee VK, Ng CJ, Leong KC, Teng CL
    Br J Gen Pract, 2009 Dec;59(569):916-20.
    PMID: 19712544 DOI: 10.3399/bjgp09X472250
    Non-attendance results in administrative problems and disruption in patient care. Several interventions have been used to reduce non-attendance, with varying degree of success. A relatively new intervention, text messaging, has been shown to be as effective as telephone reminders in reducing non-attendance. However, no study has looked specifically at using text messaging reminders to reduce non-attendance in chronic disease care.
    Matched MeSH terms: Primary Health Care/statistics & numerical data*
  7. A comparison of human elements and nonhuman elements in private health care settings: customers' perceptions and expectations
    Mohd Suki N, Chwee Lian JC, Suki NM
    J Hosp Mark Public Relations, 2009;19(2):113-28.
    PMID: 19827322 DOI: 10.1080/15390940903041567
    In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers' perceptions and determine whether they are meeting customers' expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions-courtesy, communication, and understanding of customers of the human element-when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.
    Matched MeSH terms: Primary Health Care/standards*
  8. Fulltext A primary care experience of open access to exercise stress test
    Ng CJ, Khoo EM
    Med J Malaysia, 2007 Aug;62(3):241-4.
    PMID: 18246916 MyJurnal
    This study described the practice profile of an open access exercise stress test (EST) service to the primary care physicians at a teaching hospital in 2000. We performed a retrospective review of all ESTs ordered and conducted by the primary care physicians. A total of 145 ESTs were conducted, of which 80.7% were referred for assessment of chest pain. Proportions of positive, negative, uninterpretable and inconclusive ESTs were: 22.1%, 52.8%, 18.1% and 6.9%. Typical chest pain was independently associated with a positive EST in this study (p = 0.008, OR 5.50, 95% CI 1.56-19.37). Although referral to the open access EST service seemed appropriate, there is a need to reduce the number of uninterpretable and inconclusive results.
    Matched MeSH terms: Primary Health Care*
  9. Learning medical ethics in a primary care clinic
    Loh KY, Nalliah S
    Med Educ, 2008 Nov;42(11):1127-8.
    PMID: 18991988 DOI: 10.1111/j.1365-2923.2008.03217.x
    Matched MeSH terms: Primary Health Care*
  10. Fulltext Pain morbidity in primary care - preliminary observations from two different primary care settings
    Zailinawati AH, Teng CL, Kamil MA, Achike FI, Koh CN
    Med J Malaysia, 2006 Jun;61(2):162-7.
    PMID: 16898306 MyJurnal
    The prevalence of pain complaints as a reason for patient-doctor encounters in the local primary care setting is unknown. We performed a cross-sectional survey of such encounters in one public primary care clinic (KK) and 17 general practice clinics (GP), from the city of Seremban, Negeri Sembilan, Malaysia. Reasons for visits were recorded by doctors in KK and medical students in GP using a structured questionnaire. Morbidity data was coded using the International Classification of Primary Care (ICPC-2). A total of 2234 encounters were recorded (80.9% from KK, 19.1% from GP). The overall prevalence of pain complaints was 31.9% with a significant difference between the two cohorts (KK 28.7% and GP 45.2%, p<0.001). Musculoskeletal pain complaints were more common in KK than GP (40.9% versus 29.7%, p<0.05). Of the 3 main ethnic groups in Malaysia (Malay, Chinese and Indian) the Indian patients at KK had the highest prevalence of pain complaints and the Chinese at the GP had the lowest. Thus pain was a common complaint in the two different primary care settings studied. Some of the differences observed are probably due to the differences in the healthcare seeking behaviour of patients consulting at these two settings as well as differences in the payment systems.
    Matched MeSH terms: Primary Health Care/methods*
  11. Fulltext Emotional and behavioral problems among adolescent smokers and their help-seeking behavior
    Muthupalaniappen L, Omar J, Omar K, Iryani T, Hamid SN
    Southeast Asian J. Trop. Med. Public Health, 2012 Sep;43(5):1273-9.
    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
  12. Fulltext Primary care doctors' perceptions towards evidence-based medicine in Melaka State: a questionnaire study
    Chan GC, Teng CL
    Med J Malaysia, 2005 Jun;60(2):130-3.
    PMID: 16114151
    A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.
    Matched MeSH terms: Primary Health Care/standards
  13. Fulltext A nationwide survey of public healthcare providers' impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments
    Chew BH, Cheong AT, Ismail M, Hamzah Z, A-Rashid MR, Md-Yasin M, et al.
    BMJ Open, 2016 Jan 07;6(1):e009375.
    PMID: 26743703 DOI: 10.1136/bmjopen-2015-009375
    OBJECTIVE: To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.
    DESIGN: Cross-sectional study.
    SETTING: This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS).
    PARTICIPANTS: PHCPs from three categories of health facility: hospitals, health clinics and health offices.
    MAIN OUTCOME MEASURES: Qualitative analyses of written comments of respondents' general impression of FMSs.
    RESULTS: The participants' response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices.
    CONCLUSIONS: FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation.
    Study site: Klinik Kesihatan, Hospitals, Malaysia
    Matched MeSH terms: Primary Health Care*
  14. Fulltext Personal continuity of care in a university-based primary care practice: impact on blood pressure control
    Hanafi NS, Abdullah A, Lee PY, Liew SM, Chia YC, Khoo EM
    PLoS One, 2015;10(7):e0134030.
    PMID: 26214304 DOI: 10.1371/journal.pone.0134030
    Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.

    Study site: Primary care clinic, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Primary Health Care*
  15. Fulltext Appropriateness of medical admissions from a Malaysian public primary care clinic
    Chan SC
    Med J Malaysia, 1999 Sep;54(3):329-37.
    PMID: 11045059
    Appropriateness of medical admissions from a Malaysian public primary care clinic (Outpatient Department, Hospital Ipoh) was assessed by two physicians using a modified appropriateness evaluation protocol. Of 122 admissions between 16/6/96 and 15/7/96, 107 records (88%) could be traced from the records office. Eighty percent (86/107) were found to be appropriate and 20% (21/107) inappropriate admissions. Inappropriate admissions included admissions to the wrong discipline and patients who could be investigated and stabilised as outpatients or could be referred to specialist clinics. Protocols, provisions for urgent referrals and medical updates for doctors are recommended.

    Study site: Outpatient Department, Hospital Ipoh
    Matched MeSH terms: Primary Health Care*
  16. Primary health care for the children of Sarawak
    Benster R, Stanton J
    Br J Hosp Med, 1989 Dec;42(6):488-90.
    PMID: 2611474
    Rosalind Benster and Judith Stanton went to Sarawak to study child health care. Their aim was to highlight areas of most need so that the tiny health budget could be channelled in the relevant directions. They found cultural and environmental differences to account for significant differences in the nutritional status of children from different tribes. They suggest remedies to this situation.
    Matched MeSH terms: Primary Health Care/standards*
  17. Adopting the primary health care approach in malaria control in Malaysia: lessons in community participation
    Riji HM
    Southeast Asian J. Trop. Med. Public Health, 1992;23 Suppl 1:18-22.
    PMID: 1341838
    The Primary Health Care approach in Malaysia was first tried out in Sarawak, East Malaysia in 1982. In 1984, the Vector Borne Disease Control Program, Kelantan decided to adopt the Primary Health Care approach as an additional strategy in its effort to control malaria in the state, which then experienced an increase in malaria cases. Much effort was directed at creating the awareness and stimulating the interest of health staff and communities to adopt the strategy. Kelantan was made the model state. The paper gives an outline of the process involved and some characteristics of PHC workers. A study was carried out among health workers, community members and health staff on their knowledge and involvement in PHC in three states, including Kelantan. In view of the overall success of this approach, and the weaknesses which have been identified possible solutions have been suggested and should be acted upon.
    Matched MeSH terms: Primary Health Care/methods*
  18. Fulltext International classification of primary care
    Bentsen BG
    Scand J Prim Health Care, 1986 Feb;4(1):43-50.
    PMID: 3961309 DOI: 10.3109/02813438609013970
    "Health for all by year 2000" was the subject of the WHO Conference at Alma-Ata in 1978. It was evident that good primary care was a requirement to reach this goal. However, knowledge about this was scanty, and the instrument, an acceptable classification for analyses of primary care, was lacking. Since 1978 a WHO Working Party on Classifications of Primary Care has been working on a Reason for Encounter Classification. A RFEC test form was produced. In 1983 a feasibility study was conducted in nine countries: Australia, Barbados, Brazil, Hungary, Malaysia, The Netherlands, Norway, the Philippines, and the USA. The results of this were changing the original proposal very much. In addition, the WONCA/WHO Classification of Health Problems in Primary Care was included in the final version. In 1984 this final version was accepted by WONCA Classification Committee. This is called ICPC = The International Classification of Primary Care. ICPC is biaxial with the chapters of organ/organ systems along the one axis, in addition of three chapters: General, Mental, and Social problems. The other axis comprises seven components: Complaints, Process and Diagnosis. An alphanumeric code is used. The feasibility study of RFEC comprised ten test sites, and 138 primary care professionals recorded a total of 100 452 reasons for encounter. The English version of the RFEC was translated into five other languages, and these versions were used during the study. ICPC is a comprehensive, simple and practicable classification which can be used in medical records and in different areas of primary care research.
    Matched MeSH terms: Primary Health Care/trends*
  19. Child-to-Child programme in Malaysia
    Kasim MS, Abraham S
    Southeast Asian J. Trop. Med. Public Health, 1982 Sep;13(3):459-63.
    PMID: 7163857
    Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.
    Matched MeSH terms: Primary Health Care*
  20. Primary health care among the Iban of Sarawak
    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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