Displaying publications 21 - 40 of 50 in total

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  1. Ibrahim Alzamel LG, Abdullah KL, Chong MC, Chua YP
    J Egypt Public Health Assoc, 2020 Aug 14;95(1):20.
    PMID: 32813099 DOI: 10.1186/s42506-020-00048-9
    BACKGROUND: Understanding the factors influencing nurses' turnover intention, particularly the work life quality and commitment to organization, is important to all countries suffering from nursing shortage. The study aims to determine the mediating role of commitment to organization on work life quality and its relationship with turnover intention among Malaysian nurses.

    METHODS: A descriptive cross-sectional design, using a self-report survey was conducted on 430 nurses from a teaching hospital from February to April 2019. A structural equation model version 3 was used for testing study hypotheses.

    RESULTS: The mediating effect (indirect effect) of organizational commitment on the relationship between work life quality and turnover intention (QWL→OC→IT) was negative with path coefficient - 0.234, whereas the direct effect of work life quality on turnover intention (QWL→IT) was negative with smaller path coefficient - 0.228. This means that the relationship between work life quality and turnover intention was partially mediated by the organizational commitment (P < 0.001).

    CONCLUSION: Organizational commitment has a negative partial mediating effect between work life quality of nurses and intention of turnover in teaching hospitals where the organizational commitment significantly reduced the nurses' intention to leave. The study findings can guide nursing managers to be carefully attended to the levels of nurses' commitment to their organization.

  2. Isa RM, Chong MC, Lee WL, Iqbal T, Mansor M, Zainudin AA, et al.
    Saudi Med J, 2023 Dec;44(12):1290-1294.
    PMID: 38016754 DOI: 10.15537/smj.2023.44.12.202320029
    OBJECTIVES: To describe the development of a webpage based on the Intervention Mapping (IM) protocol and usability testing of the Diabetic Retinopathy Health Education Profram (DRHEP).

    METHODS: The mixed methods pilot feasibility study was carried out between April and September 2021, involving 16 patients with type 2 diabetes mellitus and 5 experts. The usability score was rated according to the System Usability Scale (SUS).

    RESULTS: The average SUS score by the experts was 88. The patients gave a higher score of 85 for SUS, with 58 as the lowest. The average SUS score was 72. The findings indicate that the webpage is acceptable, good, and highly usable for users.

    CONCLUSION: The outcomes of this study signify the relationship between effective health applications and how their design might hamper their effectiveness in changing patients' behavior.

  3. Jamaludin TSS, Zakaria MA, Saidi S, Chong MC
    MyJurnal
    Objective: As the incidence of emergencies has steadily increased in recent years, it is important to en-sure that individuals, including university students, are adequately trained to deal with such events. This study aimed to assess the level of knowledge and awareness of, and attitudes towards, first aid among IIUM Kuantan campus students.

    Method: A quantitative cross-sectional survey with stratified random sam-pling study was conducted among 348 students at the International Islamic University Malaysia (IIUM) Kuantan. Data were collected using a self-administered questionnaire which was adapted from Hong Kong Red Cross. The questionnaire was available in both English and the Malay language.

    Results: A total of 42.8% participants had a moderate level of first aid knowledge. However, 90.8% participants had aware-ness of and a positive attitude towards first aid knowledge. On the other hand, 55.4% of study participants had not experienced taking first aid courses and they had little knowledge of this. There were significant associations between gender, Kulliyyah or faculty, year of study, and first aid training experience, and the level of first aid knowledge based on a one-way ANOVA test with p-values of < 0.05 representing statistical significance.

    Conclusion: The findings indicate that most health sciences university students have good awareness and attitudes towards first aid. Nevertheless, implementation of regular educational programs with structured modules may be able to improve their knowledge of first aid practices and skills.
  4. Krishnasamy K, Tang LY, Chong MC, Lau PC, Chinna K
    Clin J Oncol Nurs, 2017 02 01;21(1):E23-E29.
    PMID: 28107326 DOI: 10.1188/17.CJON.E23-E29
    BACKGROUND: Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences.
    OBJECTIVES: The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer.
    METHODS: Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories.
    FINDINGS: A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.
    KEYWORDS: malnutrition; nutrition status; nutritional assessment; risk factor
  5. Lee WL, DeWitt D, Chui PL, Sahibudeen AKS, Nurumal MS, Chinna K, et al.
    J Gerontol Nurs, 2021 Mar 01;47(3):23-28.
    PMID: 33626161 DOI: 10.3928/00989134-20210209-04
    The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23-28.].
  6. Li Tee CC, Chong MC, Sundar V, Chok CL, Md Razali MR, Yeo WK, et al.
    Eur J Sport Sci, 2023 Aug;23(8):1581-1590.
    PMID: 35912915 DOI: 10.1080/17461391.2022.2109066
    Acute physiological, perceptual and biomechanical consequences of manipulating both exercise intensity and hypoxic exposure during treadmill running were determined. On separate days, eleven trained individuals ran for 45 s (separated by 135 s of rest) on an instrumented treadmill at seven running speeds (8, 10, 12, 14, 16, 18 and 20 km.h-1) in normoxia (NM, FiO2 = 20.9%), moderate hypoxia (MH, FiO2 = 16.1%), high hypoxia (HH, FiO2 = 14.1%) and severe hypoxia (SH, FiO2 = 13.0%). Running mechanics were collected over 20 consecutive steps (i.e. after running ∼25 s), with concurrent assessment of physiological (heart rate and arterial oxygen saturation) and perceptual (overall perceived discomfort, difficulty breathing and leg discomfort) responses. Two-way repeated-measures ANOVA (seven speeds × four conditions) were used. There was a speed × condition interaction for heart rate (p = 0.045, ηp2 = 0.22), with lower values in NM, MH and HH compared to SH at 8 km.h-1 (125 ± 12, 125 ± 11, 128 ± 12 vs 132 ± 10 b.min-1). Overall perceived discomfort (8 and 16 km.h-1; p = 0.019 and p = 0.007, ηp2  = 0.21, respectively) and perceived difficulty breathing (all speeds; p = 0.023, ηp2  = 0.37) were greater in SH compared to MH, whereas leg discomfort was not influenced by hypoxic exposure. Minimal difference was observed in the twelve kinetics/kinematics variables with hypoxia (p > 0.122; ηp2 = 0.19). Running at slower speeds in combination with severe hypoxia elevates physiological and perceptual responses without a corresponding increase in ground reaction forces.Highlights The extent to which manipulating hypoxia severity (between normoxia and severe hypoxia) and running speed (from 8 to 20 km.h-1) influence acute physiological and perceptual responses, as well as kinetic and kinematic adjustments during treadmill running was determined.Running at slower speeds in combination with severe hypoxia elevates heart rate, while this effect was not apparent at faster speeds.Arterial oxygen saturation was increasingly lower as running speed and hypoxic severity increased.Overall perceived discomfort (8 and 16 km.h-1) and perceived difficulty breathing (all speeds) were lower in moderate hypoxia than in severe hypoxia, whereas leg discomfort remained unchanged with hypoxic exposure.
  7. Li X, Che CC, Li Y, Wang L, Chong MC
    BMC Nurs, 2023 Sep 12;22(1):312.
    PMID: 37700282 DOI: 10.1186/s12912-023-01473-9
    BACKGROUND: Studies have shown that second-victim experiences could increase risks of the compassion fatigue while support from individuals and organisations is most often protection. However, the risk for poor compassion satisfaction and increased compassion fatigue in nurses aroused by adverse events remains an underestimated problem, meanwhile, litter known about the role of positive and negative coping styles among nurses suffering from adverse events. This study aims to investigate the effect of second-victim experiences on the professional quality of life among nurses and to determine the mediating role of coping styles in the relationship between second-victim experiences and professional quality of life.

    METHODS: Multistage sampling was used to recruit registered nurses from Hunan province in China. Registered nurses who identified themselves as experiencing adverse events from nine tertiary hospitals were included in this study. Participants were recruited to complete a survey on the second victim experience and support tool, the simplified coping style questionnaire, and the professional quality of life scale. The stress coping theory was used to develop the framework in this study. The structural equation modelling approach was used for conducting the mediating effects analysis via IBM SPSS Statistics 26.0 and Mplus 8.3.

    RESULTS: In total, 67% (n = 899) of nurses reported a second victim experience during their careers. In a bivariate analysis, both second-victims experiences and coping styles were significantly associated with their professional quality of life. The results showed that the effects of second victim experiences on their professional quality of life were fully mediated by coping styles. A total of 10 significantly indirect pathways were estimated, ranging from -0.243 to 0.173.

    CONCLUSIONS: Second-victim experiences are common among nurses in this study. Since the mediating effects of coping styles were clarified in this study, it is imperative to promote the perception of negative coping styles and encourage nurses to adopt more positive coping styles with adequate support systems.

  8. Liao SJ, Chong MC, Tan MP, Chua YP
    Geriatr Nurs, 2018 08 31;40(2):154-159.
    PMID: 30173939 DOI: 10.1016/j.gerinurse.2018.08.001
    Depression leads to a poorer quality of life (QOL) which is a determinant of healthy ageing. Cost-effective solutions for enhancing QOL in the older population are much needed in China, with its rapidly ageing population. We conducted a randomized controlled trial involving 112 community-dwelling older participants with mild to moderate depression, to evaluate the effect of Tai Chi with music on QOL (57 in intervention group, 55 in control group). WHO Quality of Life-BREF was used to measure QOL at baseline and at every month for three months. Following the adjustments for sociodemographic data, the effect of intervention on QOL was assured (F = 25.145, P 
  9. Liao SJ, Tan MP, Chong MC, Chua YP
    Issues Ment Health Nurs, 2018 May;39(5):398-402.
    PMID: 29436896 DOI: 10.1080/01612840.2017.1417519
    BACKGROUND: The effectiveness of pharmacological treatment may be limited in older persons. Several studies using Tai Chi or music therapy separately confirmed positive effects in the reduction of depressive symptoms. We conducted a cluster randomized controlled trial to evaluate the possible synergistic effect of combined music and Tai Chi on depressive symptoms.

    METHODS: One hundred and seven older adults with mild to moderate depressive symptoms were recruited from Ya'an city. Fifty-five participants were cluster randomized to combined music and Tai Chi group for three months, while the other fifty-two individuals were randomized to the control group that entailed routine health education delivered monthly by community nurses. The primary outcome of depressive symptoms was measured with the Geriatric Depression Scale (GDS) at baseline and monthly for three months.

    RESULTS: At three-month follow-up, a statistically significant improvement in depressive symptoms was found in the intervention group compared with control group (F(3,315) = 69.661, P < 0.001). Following adjustments for socio-demographic data, the true effect of intervention on depressive symptoms was significant (F = 41.725, P < 0.01, ηp2 = 0.574).

    CONCLUSIONS: Combined music and Tai Chi reduced depressive symptoms among community-dwelling older persons. This represents an economically viable solution to the management of depression in highly populous developing nations.

  10. Liu Y, Han Y, Xiong L, Ma Q, Mei L, Chong MC, et al.
    Work, 2023 Jun 24.
    PMID: 37393480 DOI: 10.3233/WOR-230022
    BACKGROUND: Adaption to clinical work during the internship can induce several stressors among medical students, especially in the context of the coronavirus disease 2019 (COVID-19) pandemic. Particularly, job stress could be linked to the development of psychological traits and the formation of the professional identity of medical interns.

    OBJECTIVE: This study aimed to explore the relationship between job stress, psychological capital, and professional identity through a mediation analysis of Chinese medical interns.

    METHODS: A descriptive cross-sectional study was conducted in 30 hospitals and clinics in China from June 2021 to March 2022. A total of 665 medical interns filled out questionnaires related to demographic questions, psychological capital, job stress, and professional identity. Data analysis was executed using the IBM SPSS version 22.0 software and its add-in PROCESS Windows version 4.0.

    RESULTS: The findings indicated a statistically significant mediating effect of psychological capital between job stress and professional identity. Job stress and job stress combined with psychological capital accounted for 5.3% and 37.9%, respectively, of the variance in professional identity. The bootstrapping method corroborated the significance of the indirect effect of job stress through psychological capital (95% bootstrap CI = -4.7921, -2.4345).

    CONCLUSION: The current findings underscore the need for increased attention on improving the psychological capital of medical interns.

  11. Liu Y, Che CC, Hamdan M, Chong MC
    Midwifery, 2024 Apr 22;134:104002.
    PMID: 38669756 DOI: 10.1016/j.midw.2024.104002
    BACKGROUND: The empowerment of pregnant women is a meaningful strategy that profoundly impacts the health of women and their children. Despite a significant increase in the empowerment of pregnant women and its measurement, little attention was given to a consensus on the selection and application of assessment instruments used for pregnant women.

    OBJECTIVE: To identify the available assessment instruments for measuring the empowerment of pregnant women and to describe the appraisal content and their psychometric properties.

    METHODS: We searched nine bibliographic databases for original studies that focus on the measurement of empowerment in pregnant women. Arksey and O'Malley's methodology and PRISMA-ScR were selected to guide the implementation of this scoping review. The COSMIN criteria was employed to assess the methodological quality and the quality of psychometric properties.

    RESULTS: A total of 23 studies were included and 13 instruments were extracted. Given comprehensive considerations, Kameda's prenatal empowerment scale may be deemed suitable. The included instruments comprehensively measured the attributes of empowerment, with a particular focus on facilitating women's choice and decision-making. Except for the four most recent self-designed questionnaires, the remaining instruments had been tested for reliability and/or validity.

    CONCLUSION: There were heterogeneous results regarding the included instruments' appraisal content and psychometric properties. Future studies focusing on the development or validation of measurement instruments should be guided by influential and identical standards.

  12. Maniam R, Tan MP, Chong MC
    Patient Educ Couns, 2021 Sep 29.
    PMID: 34625322 DOI: 10.1016/j.pec.2021.09.026
    OBJECTIVE: End-of-life care is often overlooked in the dialysis unit despite high mortality rates. This study aimed to understand the diverse subjectivity of opinions on end-of-life care preferences, feelings, needs, value and goals in life among a haemodialysis population.

    METHODS: The Q methodology was used where 37 opinion statements were ranked in order of importance in a unimodal shaped grid. Results were explored using the Centroids factor extraction and Varimax rotation.

    RESULTS: Four-three persons living with haemodialysis, mean age± SD= 56.58 ± 10.22 years, participated in the study. Five-factors were identified: living in the present, family preference, self preservation, power vs. control and autonomy in decision making, loaded by eleven, four, four, three and three participants with 16 individuals not loading significantly and two were confounded. Preferences for remaining positive in the face of illness through a healthy lifestyle and preserving relationships and autonomy were demonstrated.

    CONCLUSIONS: End-of-life discussions are potentially inhibited by preferences to live for the present which should be explored in future studies.

    PRACTICE IMPLICATION: Statement sets may be used to help facilitate end-of-life discussions through identification of opinion groups. Establishing preferences may guide identification of those willing to initiate discussions.

  13. Mansor M, Chong MC, Chui PL, Hamdan M, Lim CC
    Psychol Health Med, 2023 Jul;28(6):1549-1561.
    PMID: 36120729 DOI: 10.1080/13548506.2022.2124288
    This scoping review describes the research-based mindfulness intervention on anxiety, distress, and depression. The search strategy retrieved articles published in English from 2014 to 2019 and were retrieved across Scopus, Web of Science, Science Direct, CINAHL, and Google Scholar. The PRISMA-Scr checklist is a tool to evaluate the quality of the articles. The selection criteria initially included all original articles in English, with 1,527 that were related to mindfulness intervention for anxiety, distress, and depression. A total of 490 full texts were retrieved, and after the abstracts were reviewed, 124 full-text articles were included for eligibility, and the final eight studies were determined. The articles were reviewed and screened for relevance to mindfulness intervention in reducing anxiety, distress, and depression among those with chronic diseases. The results have shown that mindfulness intervention reduces anxiety, distress, and depression among patients with chronic diseases. The review contributes further insight into the fact that mindfulness intervention is also appropriate for other conditions to facilitate reducing psychological symptoms.
  14. Mansor M, Chong MC, Chui PL, Hamdan M, Basha MAMK
    Saudi Med J, 2023 Sep;44(9):933-939.
    PMID: 37717967 DOI: 10.15537/smj.2023.44.9.20230228
    OBJECTIVES: To validate and determine the psychometric properties of the Malay version of the endometriosis health profile-30 (EHP-30) by confirmatory factor analysis.

    METHODS: A cross-sectional study was carried out in the main city of Malaysia at a tertiary teaching hospital between January to April 2021. A total of 218 women diagnosed with endometriosis symptoms were recruited using the universal sampling method to answer the questionnaire.

    RESULTS: The revised Malay version of the EHP-30 with 28 items demonstrated that the factor loading of the 28 items had an acceptable value range between 0.60-0.90. The model fit was acceptable after the inclusion of 28 items correlated errors of the root mean square of error approximation: 0.072, 90% confidence interval: [0.065-0.080], comparative fit index (0.939), Tucker-Lewis index (0.932), and Chi-square/degrees of Freedom (2.135). The Cronbach's alpha ranged from 0.89-0.97. Concurrent validity for the composite reliability was between 0.88-0.96, while the average variance extracted was between 0.65-0.74.

    CONCLUSION: This revised Malay version of the EHP-30 is a reliable and valid tool that can be used for the next study.

  15. Mong I, Ramoo V, Ponnampalavanar S, Chong MC, Wan Nawawi WNF
    J Clin Nurs, 2022 Jan;31(1-2):209-219.
    PMID: 34105196 DOI: 10.1111/jocn.15899
    BACKGROUND: Healthcare-associated infection (HAI) is one of the major threats to patients' safety besides being among the principal causes of patient morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) is reported to be the most common HAI worldwide. CAUTI can be prevented with appropriate practice and care by healthcare personnel, especially nurses, who play the main role in urinary catheter care. Nurses' knowledge and attitude are considered to be important factors that influence their practice.

    OBJECTIVES: To assess nurses' level of knowledge, attitude and perceived practice regarding CAUTI and its preventive measures.

    METHODS: A cross-sectional design was adopted, and a self-administered questionnaire was used to collect data. Nurses from the medical and surgical inpatient wards of a tertiary teaching hospital in Malaysia were recruited in two stages using the stratified and simple random sampling methods. A total of 301 nurses participated. Descriptive analysis, an independent t test, ANOVA and hierarchical multiple regression were employed to analyse the data using SPSS software version 25. In addition, a STROBE checklist was used to report the results of this study.

    RESULTS: Nurses were found to have good knowledge, a positive attitude and good perceived practice regarding CAUTI prevention. Nurses aged above 30 and who had more than ten years of experience reported higher knowledge levels. Knowledge was found to be positively correlated with attitude and perceived practice; however, attitude explained a higher variance in perceived practice of CAUTI prevention compared with knowledge.

    CONCLUSION: Attitude was found to have a higher significant influence on perceived practice in this study. Educators need to emphasise the inculcation of a positive attitude among nurses rather than just knowledge for CAUTI prevention. Since this study assessed perceived practice, examining nurses' actual practice and its impact on patient outcomes is recommended in future studies.

  16. Nelwati, Abdullah KL, Chong MC, McKenna L
    J Prof Nurs, 2020 03 19;36(6):477-483.
    PMID: 33308543 DOI: 10.1016/j.profnurs.2020.03.008
    BACKGROUND: Peer learning has enabled undergraduate nursing students to develop competence and clinical skills. It is rare to find quantitative studies examining the effect of peer learning on professional competence development among undergraduate nursing students comprehensively.

    OBJECTIVE: To examine the effect of peer learning on professional competence development among Indonesian undergraduate nursing students.

    DESIGN: A quasi-experimental study with non-equivalent control group pre-test post-test design.

    PARTICIPANTS: Convenience sampling was used to recruit participants. Seventy-five students completed the study (37 in the intervention group and 38 in the control group).

    METHODS: The intervention group received the peer learning program, while the control group received conventional learning during clinical practice. The Nurse Professional Competence (NPC) was used to collect data at pre-test and post-test measurement. Data were analysed using descriptive and inferential statistics.

    RESULTS: Professional competence had significantly increased in the intervention group. A significant interaction effect of time (pre-test and post-test) and group on professional competence development was also found. The effect of peer learning on professional competence development was significantly greater than the conventional method.

    CONCLUSION: Peer learning was demonstrated as an innovative learning method to develop professional competence during clinical practice among Indonesian undergraduate nursing students. It is recommended for nurse educators to consider implementing peer learning during clinical education.

  17. Nelwati, Abdullah KL, Chong MC
    Nurse Educ Pract, 2019 Nov;41:102648.
    PMID: 31707147 DOI: 10.1016/j.nepr.2019.102648
    BACKGROUND: Undergraduate nursing students are required to acquire professional values during professional nurse education to provide safe and high quality patient care. However, there was no documentation in professional values among Indonesian undergraduate nursing students and the factors influencing its development.

    PURPOSE: The purpose of this study was to determine professional values among Indonesian undergraduate nursing students and examine the relationship between students' demographic factors and professional values.

    DESIGN: A cross-sectional study using convenience sampling was applied to recruit 391 Indonesian undergraduate nursing students. The 26 items of Nurses Professional Values Scale Revision (NPVS-R) with five dimensions was employed to collect data. Descriptive and inferential statistics, independent samples t-test were applied to analyse and interpret data.

    RESULTS: The result showed that the total score of nurse professional values was high (95.80 ± 12.93). The most important professional value dimension was caring, while activism was the least important values. The NPVS-R total score had a significant association with length of professional clinical practice of the students (p 

  18. Noviani W, Chong MC, Tang LY
    Heliyon, 2023 Mar;9(3):e13433.
    PMID: 36895334 DOI: 10.1016/j.heliyon.2023.e13433
    BACKGROUND: Professional socialization could support competency achievement and assist the transition phase. It is rare to find quantitative studies examining the effects of professional socialization for nursing students (NS).

    OBJECTIVES: To investigate the effects of a socialization in professional reality integration for nursing student transition (SPRINT) to improve the professional competence of undergraduate NS in Indonesia.

    DESIGN: A quasi-experimental study non-equivalent control group pre-test post-test design was conducted using convenience sampling.

    PARTICIPANTS: One hundred twenty NS (60 participants in the experimental group and 60 participants in the control group) from two nursing departments in private universities in Indonesia.

    METHODS: The SPRINT educational intervention consisted of professional socialization training using several learning methods and activities. Meanwhile, the control group received conventional socialization. The Nurse Professional Competence short-form (NPC-SF) scale was evaluated prior to the participants' internship program, lasting from 6 to 12 weeks after clinical education in both groups.

    RESULTS: SPRINT intervention significantly increased overall professional competence scores of the experimental groups higher than the control group. By comparing the mean scores in three times measurement, the six competency areas mean score increased significantly for the experimental group while, for the control only three areas of competence increased in twelve week post-test.

    CONCLUSION: A "SPRINT" as an innovative educational program developed in collaboration with academia, clinical preceptors, could improve professional competence. It is recommended to implement SPRINT program to assist the smooth transition from academic into clinical education.

  19. Omar Daw Hussin E, Wong LP, Chong MC, Subramanian P
    J Clin Nurs, 2018 Feb;27(3-4):e688-e702.
    PMID: 29076190 DOI: 10.1111/jocn.14130
    AIMS AND OBJECTIVES: To examine nurses' perceptions of barriers to and facilitators of end-of-life care, as well as their association with the quality of end-of-life care.

    BACKGROUND: Often, dying patients and their families receive their care from general nurses. The quality of end-of-life care in hospital wards is inadequate.

    METHOD: A self-administered questionnaire was completed by 553 nurses working in a tertiary teaching hospital in Malaysia.

    RESULTS: The barrier with the highest mean score was "dealing with distressed family members." The facilitator with the highest mean score was "providing a peaceful and dignified bedside scene for the family once the patient has died." With regard to barrier and facilitator categories, the barrier category with the highest total mean score was patient-related barriers and the facilitator category with the highest total mean score concerned facilitators related to healthcare professionals. In the multivariate analysis, age, patient family-related barriers and healthcare professional-related facilitators significantly predict the quality of end-of-life care.

    CONCLUSION: The results of this study suggest that there is an urgent need to overcome barriers related to the patient and family members that hinder the quality of care provided for dying patients, as well as to enhance and implement the facilitators related to healthcare providers. In addition, there is also a need to enhance the quality of end-of-life care provided by younger nurses through end-of-life care courses and training.

    RELEVANCE TO CLINICAL PRACTICE: Helping nurses overcome barriers and implement facilitators may lead to enhanced quality of care provided for dying patients.

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