METHODOLOGY AND FINDINGS: We conducted a qualitative study using semi-structured interviews with 18 contraception users, 18 GPs and 9 pharmacists. The study took place in Galway, Republic of Ireland between June and September 2014. Thematic analysis was used to analyse the data. Overall, contraception users were more familiar with the OCP, and all the women interviewed began their prescription contraception journey using this method. All participants identified episodes of poor adherence throughout the reproductive life course. The identified barriers for use of LARCs were lack of information, misconceptions, lack of access and high cost. In contrast, GPs believed that adherence to the OCP was good and stated they were more likely to prescribe the OCP than other methods, as they were most familiar with this option. Barriers to prescribing LARCSs were time, cost to practice, training and deskilling. Pharmacists also believed that adherence to the OCP was generally good and that their role was limited to dispensing medication and providing information when asked.
DISCUSSION AND CONCLUSION: There are contrasting perspectives between contraception service providers and contraceptive users. Training for healthcare providers is required to support informed contraceptive choice and adherence. It is necessary to address the practice barriers of cost and lack of time, to promote better communication around adherence issues and prescription contraception options. There is a need for more easily-accessible public health information to promote awareness on all methods of prescription contraception.
OBJECTIVE: This study aims to assess pharmacists' KAP on FDI, their inter-association, as well as association with sociodemographic characteristics in Sabah, Malaysia.
METHODS & MATERIALS: A cross-sectional study was conducted from 1 to 31 May 2023, using online, self-administered Google Form questionnaire, involving 24 government hospitals and 113 government health clinics in Sabah.
RESULTS: A total of 273 (or 35.5%) out of 768 pharmacists responded. Over two-third were female and serving government hospitals (79.6%). Mean score of KAP were 72.5 ± 14.3%, 93.2 ± 8.3% and 56.0 ± 16.7%, respectively, reflected good attitude but moderate knowledge and practice. Knowledge gaps identified include common medications such as paracetamol and metformin.Additionally, 28.2% respondents reported lack of FDI coverage during undergraduate, while merely 17.2% have received formal training on FDI after started working. Although 89.0% respondents agree that informing patients about possible FDIs is their responsibility, only 35.9% of the respondents usually or always practiced this. Such discrepancy maybe attributed to insufficient pharmacists' knowledge on FDI, where pharmacists with good level of knowledge have almost 2 times higher odd for good level of practice, compared to those with poor/moderate knowledge (odds ratio, OR: 1.92; 95% CI 1.02-3.61; p = 0.040) in this study.
CONCLUSION: There are significant training gaps to be filled in. Pharmacist possessing good knowledge is a prerequisite for better pharmacy practice. Adequate education strategies covering FDI should be emphasised for all pharmacy undergraduates and practising pharmacists.
METHODS: This study comprises of three phases, namely (1) items selection phase, (2) pilot study phase, and (3) scale validation phase. During the first phase, the items were selected from items pools which gathered from previous suicide ideation/ attitude scales. Then the pilot study was carried out to examine the items for Yatt Suicide Attitude Scale (YSAS). Lastly, the Yatt Suicide Attitude Scale (YSAS) validation study was conducted with 219 university students.
RESULTS: Initial version of YSAS comprised 16 items and three components. After factor analysis, the questionnaire was reduced into only two components (Suicide Ideation and Suicide Attempt) with 5 items each. Both of the components obtained high reliability value (.89 and.86 respectively) and the questionnaire accounted for 67.84% of the total variance.
CONCLUSION: The analysis showed that YSAS has an acceptable reliability and validity for Malaysian population. Although these findings corroborate literature on development of suicide ideation assessment instrument for specific cultural context, there is a need to further examine its reliability with clinical population and general population of different cultural context in Malaysia.
OBJECTIVES: The current study aimed to assess student nurses' intentions to work with older people and to determine the predictors of working intentions among nursing students.
DESIGN: The study adopted a cross-sectional design.
SETTINGS: Multistage sampling was used to recruit nursing students from five states in Malaysia.
PARTICIPANTS: A total of 1462 nursing students from eleven nursing education institutions participated in this study.
METHODS: A self-administered questionnaire was used to collect data. This study is underpinned by the Theory of Planned Behaviour. The Intent to Work with Older People Scale and Kogan Attitudes Toward Old People Scale were used to assess nursing students' intentions and attitudes towards care of older people respectively. Researcher-developed instruments were used to assess subjective norms and perceived behavioural control among nursing students.
RESULTS: The present study found that nursing students in Malaysia demonstrated a moderate level of intention to work with older people, with a mean of 39.72 (±4.38). There were significant differences in effects of gender, ethnic group, academic level, type of nursing institution and setting of older person care clinical experience on intentions to work with older people. There was a moderate and positive relationship between attitudes towards older people and intentions to work with older people, as well as between perceived behavioural control and intentions to work with older people; it was found that r = 0.36 for both relationships. Attitudes, subjective norms and perceived behavioural control accounted for 19.7% of the variance in intentions to work with older people.
CONCLUSION: The primary findings of this national study revealed that Malaysian nursing students have a moderate level of intention to work with older people. It is imperative to develop educational interventions to nurture attitudes for caring and promote stronger intentions to work with older people.
METHOD: A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly.
RESULTS: Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public's attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration.
CONCLUSION: The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.
METHODS: This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSS® version 18.
RESULTS: Overall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional.
CONCLUSIONS: This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit.
OBJECTIVE: This qualitative study investigated the perceptions of CBR managers regarding the level of training in oral health care received by CBR workers, the current oral health care program for PWDs, and the barriers and enablers in providing oral health education, care, and services for PWDs in CBR centres.
METHODS: A semi-structured interview questionnaire and face-to-face in-depth interviews were conducted with CBR managers (n = 9) from 9 districts in Kuala Lumpur and Selangor, Malaysia, to seek their views on the focus topics. Audiorecorded interviews were transcribed verbatim, and transcripts were analysed in MAXQDA software. Qualitative data were analysed via thematic analysis.
RESULTS: Interview content analysis revealed 4 themes, 11 subthemes, and 13 codes. The 4 identified themes were oral health care education and training for CBR workers, oral health care programs and protocol for CBR trainees (PWDs), barriers and enablers to care.
CONCLUSION: In all CBR centres, CBR workers and PWDs receive an oral health presentation, training in oral health care, and are provided with treatment by a dentist assigned by the Ministry of Health. No specific programs, training or special courses were provided by the Department of Social Welfare. Several personal, professional, and social factors were identified as affecting the provision of oral health care to the PWDs.
CONCLUSIONS: Median perceived prevalence of counterfeit medicines was 10.00% but only 2.30% were aware of counterfeit medicine dispensing. Out of 343 pharmacists, 332 (96.79%) mentioned that action should be taken against those pharmacists knowingly dispensing counterfeit medicines and 338 (98.54%) stated that there should be strong law against counterfeit medicines.
DESIGN: A qualitative and quantitative research study.
METHODS: This study involved fourth-year medical undergraduates during their clinical posting in ophthalmology. One PAL session was conducted in each of the 4-week clinical postings. Peer tutors were selected during the first week and were briefed on PAL. Premultiple and postmultiple choice questions were distributed to PLs before and after each PAL session. One focus group discussion was conducted with PLs to explore their perception. Peer tutors were requested to give feedback in the form of structured Likert scale statements with 2 open-ended questions.
RESULTS: A total of 104 students, 6 PTs and 98 PLs, participated in this study. Both tutor and learner groups expressed positive attitudes toward PAL. Peer learners preferred having PAL in a clinical setting. There were some issues related with PAL that emerged from both groups. Success in PAL depends on the teaching ability of PTs.
CONCLUSIONS: Students have positive perceptions toward PAL. Most of the students believed PAL was beneficial to them.
PURPOSE: This study aimed to investigate the current practice and barriers to the transition of care (TOC) from the perspectives of adult surgeons.
METHODS: A cross-sectional study was conducted with purposive sampling of adult surgeons from different subspecialties. An online self-administered questionnaire was distributed.
RESULTS: There were 60 respondents. 62% of the respondents had experience managing referrals for continuation of care or complications in patients with congenital abnormalities. 38% of the respondents believed that TOC should be implemented when patients reached ages 17-18 years. 93% of the respondents agreed that a proper TOC model would greatly benefit patient care, and 97% asserted the need to develop TOC pathways in Malaysia. The absence of a proper guideline was the greatest barrier to a smooth TOC.
CONCLUSION: This study offered insights into the obstacles to TOC based on the perspectives and experiences of adult surgeons who participated. While not exhaustive, our study provided a better understanding of the challenges in developing the appropriate referral pathways for the continued care of these patients.
METHODS: A hospital-based prospective quasi-experimental pre-post intervention study was conducted from November 2023 to February 2024 among 346 healthcare professionals (medical doctors, pharmacists and nurses) practicing in King Saud Hospital (KSH), Unayzah, Saudi Arabia. The subjects were recruited using the convenience sampling method.An educational intervention workshop was conducted among the healthcare professionals. The KAP was assessed before and after the educational intervention using a content and face validated self-administered questionnaire. The statistical analyses were conducted using the Statistical Package for Social Sciences (SPSS). Wilcoxon Signed Rank Test was used to differentiate the mean response scores for knowledge, attitude, and practice domains, between pre and post intervention. Kruskal Wallis Test followed by Dunn's post hoc test was used to compare the mean response scores for knowledge, attitude and practice domains based on educational qualification and practicing experience for the pre and post-test period. The level of significance is determined at P
METHODS: A mixed-methods approach with quantitative and qualitative data was collected between September 2021 and November 2022. Implementer surveys were undertaken at pre- and post-intervention phases to understand the perceptions of low-intensity monitoring strategy. A sample of stroke care nurses were invited to participate in semi-structured interviews at an early stage of post-intervention. Qualitative data were analyzed deductively using the normalization process theory; quantitative data were tabulated.
RESULTS: Interviews with 21 nurses at 8 hospitals have shown low-intensity monitoring was well accepted as there were less time constraints and reduced workload for each patient. There were initial safety concerns over missing deteriorating patients and difficulties in changing established routines. Proper training, education, and communication, and changing the habits and culture of care, were key elements to successfully adopting the new monitoring care into routine practice. Similar results were found in the post-intervention survey (42 nurses from 13 hospitals). Nurses reported time being freed up to provide patient education (56%), daily living care (50%), early mobilization (26%), mood/cognition assessment (44%), and other aspects (i.e., communication, family support).
CONCLUSIONS: Low-intensity monitoring for patients with mild-to-moderate AIS, facilitated by appropriate education and organizational support, appears feasible and acceptable at US hospitals.
DESIGN: An online survey was disseminated through the British Academy of Audiology and ENT UK.
STUDY SAMPLE: A total of 191 hearing healthcare professionals responded to the survey.
RESULTS: Overall, while 63% of the respondents considered themselves to be adequately informed about APD, only 4% viewed themselves as very informed on the topic. Fewer than half of the respondents report screening (31%), diagnosing (14%), or managing (36%) cases of APD. For screening APD, professionals most commonly use auditory processing tests in adults and take case histories in children, whereas routine audiological procedures are the primary method for diagnosing APD in both adults and children. Although modifying the listening environment is a widely recommended management strategy for APD, half of the respondents indicated that a diagnosis of APD has no implications for patient management.
CONCLUSIONS: There is a critical need to promote APD-related training to ensure they can provide appropriate referrals and management.
METHODOLOGY: A qualitative, semi-structured interview, followed by a quantitative, questionnaire-based study, was carried out at the Shifa International Hospital (SIH; Islamabad, Pakistan). Discharge summaries of patients aged ≥ 60 years were collected to assess the prevalence of polypharmacy at SIH.
RESULTS: Discharge summaries of n = 350 patients were collected; 60.2% (n = 211) had comorbid conditions, and the co-occurrence of diabetes and hypertension were the most common. 37.8% (n = 132) were taking 8 or more medications. Eight (n = 8) hospital pharmacists participated in the qualitative study, and 4 major themes were identified in their perceptions regarding prescribing cascades. Fifty-two (n = 52) pharmacists were recruited in the quantitative phase. 86.5% (n = 45) of the participants reported long standing illness/chronic conditions; 67.3% (n = 35) noted the presence of comorbidities as a high risk, while 90.3% (n = 47) noted multiple prescribers, and 75.0% (n = 39) identified the ageing population as important risks factors for polypharmacy.
CONCLUSIONS: The current research may inform the role and responsibilities of hospital pharmacists in outpatient and inpatient departments, and in interprofessional care teams, in preventing and minimizing prescribing cascades.
OBJECTIVES: This aims to explore the knowledge, attitude, and practice (KAP) towards disaster medicine preparedness and readiness among community pharmacists in the United Arab Emirates (UAE).
METHOD: A cross-sectional study was conducted over the ten months among licensed community pharmacists who had three months' professional experience or more. Face-to-face interviews were carried out and a structured questionnaire was used for data collection. Logistic regression models were used to determine the factors influencing aboucine preparedness and readiness. SPSS Version 24 was used to analyze the data collected.
RESULTS: A total of 500 community pharmacists participated in the study. The average knowledge score was 25.6% with a 95% confidence interval (CI) of [21.7%, 29.4%]. Better knowledge scores were observed in the male gender (OR 2.43; 95% CI 1.05-3.72), participants aged ≥ 31 years old (OR 2.97; 95% CI 1.16-7.6), postgraduates (OR 4.36; 95% CI 2.6-7.3), participants from independent Pharmacies (OR 6.5; 95% CI 4.04-10.4 3), chief pharmacists (OR 3.1; 95% CI 1.86-5.07), participants with 16 years and more experience years (OR 2.42; 95% CI 1.063-5.522) and participants who graduated from regional/international universities (OR 5.92; 95% CI 2.65-13.2). Better attitude and practice about disaster medicine preparedness were observed in postgraduates (OR 2.54; 95% CI 1.26-pharmacists from independent pharmacies (OR 1.35; 95% CI 2.43-2,.66), and chief pharmacists (OR 1.26; 95% CI 1.17-1.35).
CONCLUSIONS: It's essential to provide a continuing education program using different educational strategies urgently needed to improve community pharmacy competencies (e.g. knowledge attitudes, and perceptions) to improve the skills and practices regarding disaster medicine preparedness and readiness.
OBJECTIVE: This study aimed to identify the differences in knowledge and attitude toward OSA between medical and dental practitioners working in North-Eastern Peninsular Malaysia.
METHODS: A comparative cross-sectional study was performed from February 2020 to February 2021. A total of fifty-two medical practitioners and fifty-two dental practitioners working at university-based outpatient clinics, government health clinics, and oral health clinics located in Kelantan State of Malaysia participated in the study, and data were collected by the structured questionnaire including sociodemographic inquiry and OSAKA questionnaire by non-probability stratified random sampling. The Mann-Whitney U test was used to compare knowledge and attitude scores between the two groups.
RESULTS: The mean age of the respondents was 34.6 years. The current study shows that 92.3% of medical doctors and 96.1% of dental doctors were able to correctly answer the question "Most of the patients with OSA snore" a significant finding in our study. Only 1% of medical professionals could answer seventeen questions correctly with a median score of 11, and only 1% of dental professionals could answer sixteen questions correctly with a median score of 9. None of them could provide an accurate answer to all the knowledge questions. Medical and dental practitioners exhibited different knowledge levels on OSA (z- statistics=-4.39, U = 827.00 with p < 0.05, and effect size, r = 0.61). However, no significant differences were found in total knowledge score by gender (p-value>0.05), ethnicity (p-value>0.05), total service years (p-value>0.05), and training attended. In addition, significant differences in attitude levels between medical and dental practitioners have been observed (z-statistics=-3.42, U = 725.00 with p < 0.05, and effect size, r = 0.47). Nevertheless, no significant differences have been seen in total attitude score by ethnicity (p-value > 0.05), total service years (p-value > 0.05), attending training on OSA (p-value > 0.05), and professional status (p-value > 0.05) except gender (p-value < 0.05).
CONCLUSION: A Significant difference is evident concerning knowledge and attitude toward OSA diagnosis and management between medical and dental practitioners working in North-Eastern Peninsular Malaysia. Medical practitioners in this study recorded a higher knowledge and attitude score compared to dental practitioners.
METHOD: This is a qualitative research design where focus group discussions among audiologists were held. The interview data were analyzed using reflexive thematic analysis to identify patterns and reconstruct meaning.
STUDY SAMPLE: Ten audiologists with at least 1 year of work experience in providing remote hearing aid adjustment services to adult patients were recruited.
RESULTS: Even though there has been an increased utilization of remote fine-tuning among audiologists in Malaysia due to the coronavirus disease 2019 pandemic, its use among audiologists remains limited at present. Five thematic areas were identified: "Adoption of Practice," "Challenges and Limitations," "Benefits and Opportunities," "Satisfaction," and "Recommendations for Improvement." The TedAP challenges (T-technical challenges: e-ease of use, d-digital competency; A-abuse of system, and P-physical examinations) have been identified under the "Challenges and Limitations" theme. Suggestions for improvement include integrating the applications and video calls on a common platform, assigning a "standby" trained audiologist, and incorporating remote fine-tuning into audiology education.
CONCLUSION: Challenges and limitations associated with the provision of tele-audiology have been documented based on the views and experiences of audiologists in Malaysia. Despite the barriers, audiologists acknowledged the benefits associated with remote systems and recommendations were provided to improve the services. The results of this study could contribute to the increase in the use of tele-audiology in Malaysia. This would be instrumental in developing further the audiology profession in terms of the adoption of tele-audiology and telehealth in Malaysia.