Maternal Home-based Record (MHR) is a concise medical record that can be kept by the pregnant women for regular documentation throughout pregnancy stages. This study was done to assess the usage of the MHR among the pregnant women and its associated factors. A good MHR usage was assigned using mean value as cut-off point that has been agreed by an expert group from scoring system which incorporates usage elements in term of follow-up, information documentation, knowledge seeking, continuity of care and self-monitoring of pregnancy. A cross-sectional survey was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) and a total of 79 pregnant women who attended the antenatal clinic were recruited. A validated self-administered questionnaire was used. The questionnaire was newly developed in Bahasa Malaysia. Content validity and reliability test for internal consistency for the knowledge, satisfaction and usage scale was performed. The Cronbach’s Alpha value for each domain was 0.764, 0.716 and 0.877 respectively. The results showed that the prevalence of good MHR usage was 51.3%. There were significant association found between level of education (Adj OR=0.32, 95% CI 0.12, 0.85, p=0.023) and doctor as birth attendant in previous pregnancies (Adj OR= 2.54, 95% CI 1.97, 6.59, p=0.045) with good usage of MHR. There was a positive significant relationship between satisfaction level among the respondent and the level of the usage (p=0.01, r=0.377), whereby with every increase in 1 score in satisfaction level will increase the usage score by 0.4 (95% CI 0.2 to 0.7) units, p<0.01. Therefore, MHR is still relevant as antenatal care monitoring instruments and it is important to make an effort to improve patient satisfaction in using MHR. Health care providers can use this validated self-administered questionnaire to assess function of MHR to remain relevant to the pregnant women population in their locality.
Key words: Antenatal care, home-based maternal record, usage, satisfaction
Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma. The prevalence of asthma is increasing in most of countries, especially among children. The burden of severe asthma is considerable high in the Middle East courtiers including Iran. This study to investigate the effect of patients' knowledge about Inhaled Corticosteroids (ICS), attitude and health beliefs toward ICS, and behavioral intention to adhere to prescribed ICS in adult asthmatic patients in Yazd city, Iran. A cross sectional study was conducted from August 2008 to January 2009 in three private allergy and asthma clinics, located in Yazd city of Iran, using Structured face to face interviews using a questionnaire by the researcher. The results showed that the majority of patients (55.5%) were not adherent to their prescribed ICS. Patients’ knowledge toward ICS did not have effect on medication adherence behavior, while patients with positive attitude toward ICS were better adherent with their medication. Linear regression model identifies intention to comply with treatment and positive attitude toward ICS as predictors for adherence behavior. This study shows the relationship between medications beliefs, attitude, behavioral intention, and medication adherence. A better understanding of patient's medication beliefs, and attitude and their effect on compliance may help health care system to promote adherence.
Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
The leading cause of mortality in Malaysia is coronary heart disease (CHD). Several cardiovascular (CVD) risk factors contribute to this problem and smoking is one of the main modifiable risk factor. Most of the patients started smoking early during youth period. This study aimed to determine the association and to predict the cigarette smoking and cardiovascular risk factors among the male youth. A cross sectional study was conducted by self-administered data sheets, physical examinations: blood pressure measurement and body mass index calculation, blood taking procedure for blood glucose, total cholesterol and HDL-C levels. The results showed that the glycemic status was significantly associated with smoking status (p=0.048) however, there was no significant association for smokers and risk of developing diabetes mellitus compared to non smokers although smokers had higher odd ratio (OR: 4.33; 95%CI: 0.900-20.811) (p=0.068). Interestingly, for daily exposure of smoking, those who smoke 5 cigarette and less was significantly associated with high systolic blood pressure (p = 0.036) and smoking showed protective trend against systolic hypertension (OR: 0.57; 95% CI: 0.266-1.230), however, it was not significant (p=0.152). In conclusion, smoking among youth and its association with the cardiovascular risk factor should be addressed tactfully and early screening should be promptly done among the smoking youth for early prevention.
The population with normal body mass index (BMI) but with abdominal obesity are most of the time the ‘neglected’ population in terms of health interventions. The aim of this study is to study the prevalence of abdominal obesity and to explore the factors causing abdominal obesity by using waist circumference (WC) measurement. A cross sectional study was conducted among a group of respondents in Tanjung Karang, Selangor, Malaysia from January until June 2010, among those aged 18 years old and above, to explore the demographic (gender and ethnics), lifestyle factors (physical activity, carbohydrate intake and smoking status) and measurement of body weight, height and waist circumference. A total of 629 subjects with normal BMI were studied. The prevalence of abdominal obesity was 36.1% based on WC (40.0% males and 70.0% females). The predictor model revealed that being non-Malay (aOR = 2.1; 95% CI: 1.35-3.20) and being female (aOR = 3.6; 95% CI: 2.51-5.06) were the associated factors of having abdominal obesity in normal BMI population. In conclusion, females and non-Malay were factors that were found to be associated with abdominal obesity in normal BMI population. This is important in targeting this vulnerable population with risk factors that can develop non communicable diseases for early interventions.
Pregnant women are at higher risk of transmitting the infections to their foetus. This prompted the “Prevention of Mother to Child Transmission (PMTCT) Program” in Malaysia since 1998. The objective of this cross sectional study was to determine the knowledge, attitude and practice (KAP) of pregnant mothers in the west of Sabah towards HIV/AIDS and its influencing factors. Data were obtained through self administered questionnaires. Results showed that only 32.2% of the
respondents have good knowledge compared to 67.8% who had poor knowledge (p
Leisure involvement is an essential element in the daily life of the elderly people. Little is known, however, about the perceived leisure constraints among them, especially among the increasing elderly population in Malaysia. This study aims to explore constraints perceived by the elderly that prevent them from actively involved in leisure. In depth interviews were conducted, involving a total of 20 elderly aged 60 years and above with stratification by background characteristics. Each interview was conducted for an average of 15 to 30 minutes and discontinued when a saturation point was achieved. They were purposively selected from two health clinics located in two different districts in the state of Selangor, representing an urban and a rural area. Elderly participation in leisure activities was constrained by many factors. These factors can be divided into individual, family and community factors such as increasing age and related physical deterioration , education level, health status and the existence of chronic illness, absence of family member or friends to perform the activity together and non-conducive environment. The constraints should be endorsed and acknowledged by the relevant agencies and authorities in order to facilitate effective implementation of related policies, strategies and programmes to improve the health of the elderly people. These include the provision of appropriate services and facilities to cater senior citizens from various health and demographic perspectives.
With economic growth and significant technological advances in the health sector, many countries have developed aggregate outcomes in terms of both health services and individual well-being. Life expectancy has seen a remarkable increase of more than fifty per cent between 1950 and 2009. Achievement is uneven, however, and some groups are better able to access health services than others. In our review, we explore the need and how to maximize health equity, efficiency and effectiveness. Methodology is the review and web surfing on public health, social science, humanity and development literature. The increasing gap in health inequality, however, calls for further reform of the health system to achieve both equity and efficiency. Health is essential for survival and human capability. Good health enables people to participate in society. A new approach to efficient and cost-effective health service provision is community participation in health development. Participation can increase the skills and knowledge of local people, thus providing opportunities to improve their lives (empowerment). Analysis suggests four functional changes to achieve equity and efficiency in maximizing health outputs: reforms targeting universal coverage to achieve universal access to health; people-centred service delivery through concentrating on health services based on need; public policy change targeting integrated and multi-system health planning; and collective health system and community response to achieve health for all.
There is high expectation from the population on part of the healthcare providers. These include; skilful and timely medication administration; and knowledge, honesty, listening skills, availability and professional attitude. The aim of this paper is to evaluate the expectation of population with regards to the healthcare providers in Turkey. A cross- sectional study was conducted in Turkey, including both rural and urban population, carried out from October 2011 till January 2012. A total of 540 household heads were selected using multistage random sampling technique. Data was collected using modified self-administered 16-items QUOTE (Quality of Care Through the Patients’ Eyes) questionnaire. The questionnaire measures communication/ accessibility, organizational skills and professional skills. The response rate was (77.1%) and data was analyzed by using SPSS version 16.0. All the aspects measured using QUOTE questionnaire were found to be important by the majority of respondents, but with varying degrees of priority. The quality aspects related to the professional skills of physicians was ranked first followed by communication/ accessibility and last but not the least is the organizational skills of health care providers. This study explored the Turkish people priorities and expectations regarding healthcare providers. The public priorities and expectation were different across population. This may reflect the need to understand people's expectations before providing the services to avoid complaints that may occur after the services have been rendered.
The Use of Complementary and alternative medicine (CAM) is a common phenomenon among women with breast cancer in Malaysia. This study examines the prevalence, types, influencing factors and source of information regarding CAM among women with breast cancer, using a cross sectional research design. A purposive sampling was used to recruit 103 women with breast cancer who were attending follow up care at the Radiotherapy and Oncology unit of Universiti Kebangsaan Malaysia Medical Centre. Data was gathered through the use of self–administered questionnaires. Ninety one women identified themselves as CAM users while twelve were non users. Among the CAM users, 57(62.6%) were Malays, 27(29.7%) Chinese and 7(7.7%) Indians. The common types of CAM used were vitamins, nutritional supplements and traditional medicines (TM). CAM was used more frequently upon diagnosis (63.7%) and after completion of conventional treatment (97.8%). With regard to decision-making, most of the women (62.6%) did not make the decision to use CAM and were mostly influenced by their husband and mother (67%). Mother (71.4%), husband (67%), and relatives (56%) were the main sources of information and all values showed significant association with CAM use (p
This was a pilot study comparing the success between early versus late external cephalic version (ECV) involving primigravidae with singleton breech pregnancy. They were randomised into early (34–36 weeks) and late (37-40 weeks) ECV groups. A total of 44 women were initially randomised into 22 women for each group. The overall ECV success rate was acceptable in both groups although insignificantly higher in the late ECV group (55.6% versus 46.7%, p= 0.732.) Caesarean
section in the early ECV group was higher (80% versus 72.2%). Early ECV group had women with higher BMI (29.5 versus 26.8 kg/m2, p=0.107), anterior placentation (60% versus 38.9%) and extended breech presentation (55.6% versus 44.4%; p= 0.296). In conclusion, early ECV in primigravidae showed no better success rate than late ECV. Maternal obesity, anterior placentation and extended breech presentation should alert to failure risk.
A cross-sectional study was conducted in two hospitals in Hargeisa city to determine the job and organizational stress among nurses and doctors in ICU and its influencing factors. A universal sampling method was carried out and one hundred and twenty questionnaires were distributed among nurses and doctors working in intensive care units of two hospitals on different shift duties; morning, afternoon, night and rotation shifts. The response rate was 83.3%. Regression analysis showed that approximately 88% (adjusted R square = 0.889) of the variation in stress mean score was explained by the background variables. Experience, role overload, physical environment and marital status were significant predictors.
The study aimed to explore the perceptions towards health promotion activities among population of Penang Island,
Malaysia. The study was designed as a questionnaire based cross sectional analysis. General public from the district of
Jelutong, located in the state of Penang, Malaysia was conveniently approached for the study. Descriptive statistics
were used to ascertain demographic characteristics where as inferential statistics were employed to measure the
extent of association among study variables. Out of 480 respondents, a response rate of 82.7% was achieved. The study
cohort was dominated by females (63.0%) and majority of the participants belonged to Malay ethnicity (88.1%). One
hundred and seventy two (43.3%) never attended a health promotional campaign and mentioned lack of time and
transport as potential barriers. Among those who attended such activities, one third was satisfied with the benefits of
health campaigns. Approximately 90% of the participants demanded accessible locations, common language as mode of
communication and complete medical checkups with professional advice at health promotional campaigns. General
public can encouraged to participate in the health promotion activities by considering their priorities before designing
a health promotion program. This will help in targeting and achieving the goal “health for all”.
Surprisingly little was known about the importance of touch in life which was placed at a lower emphasis than the rest-namely visual, auditory, olfactory sense and etc. This writing aimed to decipher the significances of interpersonal touch, its culture, practices, barriers and challenges, which were then conveyed to the public as a form of health promotion. Methodology includes narrative review where the suitable literatures used were searched using ScienceDirect database under the keywords of “Interpersonal Touch”, “Oxytocin” and “Touch”. In this review, we have highlighted some of the most critical points which should have been promoted to the public. For example, touch satisfies individual psychosomatic and psychosocial needs. It forms a non-verbal communication culture which interacts about emotions, trust, compliance and more. Furthermore, it has been linked to the secretion of multifunctional bioactive chemical-oxytocin which was well-known in its therapeutic advantages for a wide range of commonest chronic diseases and social ills. Although some dysfunctional consequences may be resulted, incorporating genuine interpersonal touch into today’s efforts is undeniably viewed as a good option in solving many social problems.
Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the deadline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%.This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100,000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.
Kajian sero»prevalens dijalankan untuk menentukan prevalens kes Hepatitis A dan ciri-ciri demografinya di Kampung Pangsoon, Kampung Padang dan Kampung Lubuk Kelubi, di Mukim Hulu Langat, pada 15 dan 16 Mac 2003. Sebanyak 1643 sampel telah diperiksa dan didapati 995 kes (60.6%) telah terdeclah tehadap jangkitan Hepatitis A iaitu sebanyak 327 kes di Kampung Pangsoon, 400 kes, Kampung Padang dan 268 kes di Kampung Lubuk Kelubi. Majoriti kes adalah perempuan 545 kes (54 .7%), etnik Melayu 752 kes (75 .6%) , berusia kurang daripada 40 tahun (65%) dengan min umurnya 25 .4 tahun ( SP 1 9) dan tahap pendidikan di peringkat sekolah rendah. Kes di kalangan Orang Asli pula sebanyak 231 kes (23 .2%) . Lebih kurartg 40.3% kes telah bekerja, dengan pendapatan kurang daripada RM1000 sebulan. Majoriti kes mempunyai tandas sempurna 92Z( 95.4% ), sistem air limbah 846( 91 .2%), bekalan air seharrtat 930(96.4%) dan sistem lubang sampah 426( 44.6%) . Terdapat perbezaan yang bererti (p
Iodine is an essential micronutrient for normal physical and mental development. Iodine deficiency is endemic in 130 countries worldwide, including Malaysia. This is a cross-sectional study done to determine the prevalence and risk factors of iodine dejiciency among 342 rural mothers attending antenatal clinics in Bachok, Kelantan. A self-adrninistered questionnaire on the knowledge, attitudes, practices and other risk factors relating to iodine deficiency was done. Physical examination for thyroid enlargement was carried out and urine samples were taken for urine iodine determination. The prevalence of iodine deficiency based on urine iodine Q level of less than 100 mcg/l was 63.0 % (95% CI: 57.8, 68.2). The mean urinary iodine level was 87.3 mcg/l with a median of 78.0 mcg/l. However, the goiter prevalence was only 9.4%. The total mean scores of knowledge, attitudes and practices were generally low at 58.6 (SD 7.9), 52.9 (SD 7.9) and 42.9 (SD 10.9) respectively. Logistic regression analysis found that a smoking husband is a risk for iodine deficiency (OR=2.0). In conclusion, iodine deficiency disorders among rural antenatal mothers were still prevalent in Bachok. Their level of knowledge on the causes, effects, prevention and clinical presentations of Q iodine deficiency disorders were poor. In addition, having a husband who is a smoker increases the risk of the antenatal mothers developing iodine denciency.
Study site: Antenatal clinic (klinik kesihatan), Bachok, Kelantan, Malaysia
Cancer of uterine cervix is one of the most common cancers among women worldwide, second only to breast cancer in incidence and mortality. Industrialized countries have dramatically reduced the incidence of mortality from cervical cancer in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (pap) smears. The main objective of the study was to determine the relationship between socio-demography, knowledge, attitude and practice regarding pap smear screening among female patients in Hospital Teluk Intan. There was statistically significant association between level of knowledge and practice (p
On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.
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.