The Oral Health Division, Ministry of Health in Malaysia piloted clinical pathways (cpath) in primary care in early 2003. This study investigated the knowledge, perception of cpaths and barriers faced by the clinicians involved in the pilot project. Self-administered questionnaires were sent to the clinicians (n=191). Dentists (67.9%) and dental nurses (70.6%) had good overall knowledge of cpaths. The majority of the clinicians (67.9% to 95.6%) perceived cpath positively in all areas. Only 9.2% of dentists encountered difficulties in using cpath forms compared to 28.4% of dental nurses. A higher proportion of dental nurses (73.5%) compared to dentists (64.8%) were willing to continue using cpath. The majority of dentists (76.7%) and dental nurses (73.1%) were willing to participate in future development of cpaths. Overall, there was evidence of managerial support for the pilot project. A follow-up of the pilot project was somewhat lacking as less than half (43.3%) of the clinicians reported that the state coordinator obtained feedback from them. The findings auger well for the future implementation of cpath should the Oral Health Division decide to adopt cpath routinely in the public oral health care service.
Recent years have witnessed unprecedented changes in the design and demands of work, and the emergence of job stress as a major concern. The aim of the study was to determine the psychosocial problems in relation to nature of work among female nurses at Hospital Selayang. The study was a cross-sectional study and the study population comprised of female nurses who are currently working at Hospital Selayang. A total of 393 study subjects were randomly selected and each respondent has been given a set of complete validated self-administrated Copenhagen Psychosocial Questionnaire. The result showed that the prevalence of having psychosocial problems was 24.9%. It is show that married nurses with more than three children has 3.54 (95%CI: 1.81-6.94) higher risks to have the problems compared to those with 3 or less children. Shiftwork nurses have 1.74 (95%CI: 1.01-2.99) more risk to have psychosocial problems compared to those who are not doing shiftwork. From the crude odds ratio, nurses who have served the service for more than seven years, there was 1.53 times more risk (95%CI: 0.89-2.63) to have psychosocial problems compared to those who only have service of seven years or less. From multivariate analysis, the risk of having psychosocial problems among nurses who are doing shiftwork found to be two times greater than those who are not doing shiftwork (OR=2.15; 95%CI: 1.12- 4.11) . Psychosocial problems in relation to nature of work among nurses at Hospital Selayang are higher among nurses who are doing shdtwork. The hospital management needs to overcome the problems and organizing the mental health programs among workers.
Underlying causes of most nutrition related problems are diverse, including biological, social, cultural, and economic factors. Qualitative approaches complement quantitative methods in identifying the underlying meanings and patterns of relationships involved in managing malnutrition. This study examined perceptions regarding malnutrition among health workers from 7 clinics (community and health clinics) in Tumpat, Kelantan. A total of 18 nurses and 2 doctors, who were involved in monitoring child health and nutrition, were included in the study. These health workers were interviewed using a semi-structured questionnaire adapted from Sastry's framework on malnutrition (Sastry, 1996). The questionnaire included biological, behavioral and environmental factors that influence child health and nutrition. All the health workers perceived that mothers/caregivers play the main role in improving the health of malnourished children. The quality of childcare was rated as moderately satisfactory by the health workers. Most of the affected families who were given the Food Baskets did not fully use all the items for the malnourished child. Child feeding practice was based on the needs of the whole family rather than according to the target child's needs. Most of the mothers preferred processed cereals than rice porridge because the former is easier to prepare for the child. Although they were from a low socioeconomic background, most of the mothers were not earning additional income for the family. The qualitative methodology provided information that can be used as a basis for the designing of quantitative questionnaires to assess malnutrition among children. The induction characteristic of qualitative methods was used to gain an understanding of the underlying reasons or phenomena such as behaviours that are directly observable.
Study site: Klinik kesihatan, Tumpat, Kelantan, Malaysia
This paper highlights the role of women from the Royal Australian Army Nursing Corps who served in the Malayan Emergency. The British administrators of Malaya declared an Emergency in 1948 in response to threats posed by Chinese Communist Terrorists. Australia was slow to support Britain, but in 1955 Australian ground troops, accompanied by six Army nurses were deployed to Malaya. The nurses worked in British Military Hospitals, continuing the traditions of their antecedents; yet their contributions remain hidden from view. The exact number of Australian nurses who served in the Emergency is unknown, because of the poor record-keeping of the Southeast Asian conflicts. However, it is estimated that 33 Australian Army nurses served in Malaya from 1955, with some continuing their service into the early 1960s. The experiences of four of these nurses are revealed in this paper: they are no longer invisible partners.
Sharps injury among health care workers in HUKM has received serious attention lately due to the possible transmission of diseases like HIV, Hepatits B and Hepatitis C, which can cause serious consequences for the victim. The aim of the study was to gain a deeper understanding of the emotional problems experienced by health care workers who had incurred a sharps injury and the coping strategies adopted by them to overcome the problem. A 28 item semi-structured questionnaire was designed by the supervisors and the researcher as there was no existing questionnaire to be adopted, as no research had been carried out in this area prior to this. The target group consisted of 64 health care workers of different categories working in HUKM. Data was collected over a period of five months from November 2000 to March 2001. The results of the study revealed that the most frequently injured were the staff nurses, nearly 90% of whom were emotionally upset and were worried that they might contract a disease. There was no significant difference in the emotional stress experienced by the different categories of the health care workers, all were equally upset about the injury but each category of staff adopted different methods to overcome the tragedy. Open comments and opinions about prevention and the management of the sharps injury in HUKM as given by the respondents here are taken into account. Several views given by the participants were explored and discussed. Finally, several implications for nursing and recommendations have been presented.
Study site: Wards and the general operating theatres in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Clinical psychology is a specialised field of professional psychology that is much needed with regards to the treatment of mental disorders, behaviour problems and learning difficulties. The field of clinical psychology has been integrated into the health system, especially the mental health and education system, in many western countries. In Malaysia, clinical psychology is still a new concept and has yet to be accepted into the medical and health systems in Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 59-6660 general. This preliminary study looks at the awareness of 199 medical and health sciences professional with regards to clinical psychology. Results of this survey found that only 13.6% of the respondents demonstrated basic knowledge of what clinical psychology is. The awareness of clinical psychology as a clinical profession, and its benefits within the health system is still very much lacking among medical and health sciences professionals. The need to improve awareness of clinical psychology as a clinical profession as well as a health science discipline is very important as clinical psychology services are able to contribute to more holistic treatment of health problems in Malaysia.Implications of this study includes the need for the awareness of clinical psychology to be improved.
The working environment of intensive care unit (ICU) nurses is a constant source of stress. Researchers have described ICU as a stressful environment because of the complex nature of patients’ health problems requiring an extensive use of very sophisticated technology. This study aimed to identify the prevalence of stress among staff nurses working in ICU, Hospital Universiti Kebangsaan Malaysia (HUKM), factors influencing stress and to explore the symptoms of stress experienced. This descriptive study was conducted on 67 staff nurses working in ICU, HUKM. Data was collected using self-administered questionnaires. The questionnaires included sections on socio-demographic data, factors influencing stress and symptoms of stress experienced. Data was analyzed using frequency and percentage. The Chi square test was used to examine the relationship between socio-demographic data and factors influencing stress. Findings indicated that stress symptoms were experienced by 100 per cent (n =67) of staff nurses Knowledge, working experience, critically ill patients, and environmental factors were one of the many factors contributing to the stress experienced by the ICU nurses in HUKM. Nurses working in ICU, HUKM are found to have a high level of stress. Recommendations like encouraging ICU nurses to take up post basic ICU courses and increasing the nurses quota can reduce the prevalence of stress among ICU nurses. Hospital management has an important role to play in reducing the stress levels of nurses working in ICU as stress has an effect on job performance and quality of nursing care.
OBJECTIVE:This study sought to identify and evaluate approaches used to attract internationally trained nurses from traditional and non-traditional countries and incentives employed to retain them in small rural hospitals in Gippsland, Victoria.
DESIGN: An exploratory descriptive design.
SETTING: Small rural hospitals in Gippsland, Victoria.
PARTICIPANTS: Hospital staff responsible for recruitment of nurses and overseas trained nurses from traditional and non-traditional sources (e.g. England, Scotland, India, Zimbabwe, Holland, Singapore, Malaysia).
RESULTS AND CONCLUSION: Recruitment of married overseas trained nurses is more sustainable than that of single registered nurses, however, the process of recruitment for the hospital and potential employees is costly. Rural hospitality diffuses some of these expenses by the employing hospitals providing emergency accommodation and necessary furnishings. Cultural differences and dissonance regarding practice create barriers for some of the overseas trained nurses to move towards a more sanguine position. On the positive side, single overseas registered nurses use the opportunity to work in rural Australian hospitals as an effective working holiday that promotes employment in larger, more specialized hospitals. Overall both the registered nurses and the employees believe the experience to be beneficial rather than detrimental.
Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia.
Introduction: To determine association between occupational stress and personality characteristics among nurses at Maternal and Child Health Clinic in the state of Malacca, emphasizing on type of personality and personal perception of stress.
Methods : A cross sectional study was conducted among 152 nurses of Maternal and Child Health Clinics in Malacca using self administered questionnaires and selected via multistage sampling.
Results : This study showed that a total of 28.3% of the nurses were found to be stressed. Almost half (41.2%) of those who perceived that they were stressed were likely to be really stressed (p = 0.004). Therefore those who perceived themselves to be stressed should be referred for stress evaluation and further management if necessary. However selfperception of stress cannot be used as a screening tool for stress due to its lack of sensitivity (56.8%) and poor Positive Predictive Value (41.2%). Majority of the nurses were of Guardians Personality Type (98%) and 72.4% of them had extrovert trait. However there were no significant associations between stress with personality type or characteristic, most probably due to the preponderance of one personality type or characteristic. Other studied variables such as socio-demographic factors (age, gender, ethnicity, religion, marital status, educational level, body mass index, type of work place, position, duration of service and poverty level) and social factors (placement, chronic medical illness, chronic care taker, smoking status and alcohol drinker) were suggestive of an association between them and stress but were not statistically significant.
Conclusion : There is no association between occupational stress and personal characteristics among nurses in Malacca.
Introduction : Nursing is an occupation associated with high risk of developing back pain due to their nature of work practices. The aim of this study was to determine the prevalence of back pain among nurses working in government health clinics and hospitals in Port Dickson and the factors associated with it.
Methods : A cross sectional study was conducted involving 126 nurses working in government health clinics and district hospital in Port Dickson. They were universally sampled. A selfadministered questionnaire, assessing personal and socio-demographic characteristics, back pain, work factors and psychosocial factors.
Results :The prevalence of back pain among nurses was 79.4% and factors that showed significant association were workplace (p=0.026) and carried heavy load (p=0.043).
Conclusion : Where one work and nature of work one does has been shown in this study to be important issues to be considered in helping to manage back pain related to work. It is also recommended that staff need to be encouraged to do exercise to strengthen the back muscles, increase spinal flexibility and blood circulation to the spine as well as need to be reminded regarding ergonomic adjustment at work.
Introduction : AIDS stigma and incorrect HIV/AIDS information among health care workers will influence the quality of care received by persons living with HIV/AIDS (PLHA). A cross-sectional study was conducted amongst nurses in the Hospital University Kebangsaan Malaysia (HUKM) with the objective of determining their knowledge and attitudes regarding HIV/AIDS and Universal Precautions (UP).
Methods : A total of 450 female nurses were recruited in this study and data were collected via a self-administered questionnaire.
Results : A total of 393 female nurses had completed the questionnaires and majority of them were Malays (95.4%) with mean age of 28.4±3.9 years old. The mean duration of work in the hospital was 6.2±3.6 years. The study results showed a satisfactory level of good knowledge among nurses (69%) and this is statistically significant (p
The objective of this study was to determine the prevalence of sleep disturbance with work characteristics among nurses in the Melaka Hospital, Malacca, Malaysia. This was a cross sectional study conducted in Melaka Hospital. Universal sampling was conducted and a Malay version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire was used in data collection. Socio-demographic characteristics such as age, marital status, number of children and work characteristics such as type of work schedule and duration were also enquired. Factors associated with poor sleep quality were compared between those nurses with good sleep quality by using logistic regression. There were 607 nurses who completed the questionnaire with a response rate of 73.1%. There was a moderate prevalence (57.8%) of poor sleep quality (PSQI > 5) in all study subjects. The prevalence of sleep disturbance was more widespread among nurses who worked shifts (62.0%) compared to non-shift working nurses (41.5%) p
Caring practice is one of the three core values of Corporate Culture of Ministry of Health Malaysia, initiated in 1991. A cross sectional study was conducted to determine the extent of hospital healthcare personnel practicing the element of caring. Self-administered questionnaires were mailed to all staff working in public hospitals followed by reminder letters and telephone calls. A total of 37,267 responded out of 69,385 personnel working in the hospitals with a response rate of 53.7%. Results showed that about half of the respondents perceived that they practice caring value of the corporate culture (49.5%) and only 33.3% perceived that their colleagues practiced it. The practice of caring value was highest among clinical specialists (65.4%) and lowest among the clerks (22.1%). Nurses perceived that 40.4% of their colleagues practiced caring values while the clerks perceived only 17.0% of their colleagues practice it. In conclusion, caring value is not being well practiced by healthcare staff especially among the support staff. There is a need for further research to study the reasons for poor caring practice by healthcare personnel and develop strategies to improve the situation.
Patient education has been considered as an integral component of care for patient after myocardial infarction. Post myocardial infarction patients require information and knowledge related to their conditions to reduce anxiety and aid recovery. The objective of this study was to identify nurses’ perception on information needs of post MI patients of UKMMC. A cross sectional study using Cardiac Patient Learning Needs Inventory (CPLNI) adopted from Timmins and Kalizer (2002) was used. It comprises seven cate-gories: related to anatomy and physiology, psychological factor, life style factor, medi-cation information, dietary information, physical activity, and symptom management. This study was conducted in coronary care unit (CCU), coronary rehabilitation ward (CRW), medical ward 1 and medical ward 2 from January 2007 to March 2007. 56 res-pondents (96%) who fulfilled the inclusion criteria were recruited in this study. Results showed that CCU and CRW respondents ranked symptom management as their first ranking followed by medication, life style factor, anatomy and physiology, dietary in-formation, physical activity and psychological factor. However, respondents in Medical Ward 1 and 2 reported and ranked medication information as their top priorities fol-lowed by symptom management, psychological factors, dietary information, physical activity, anatomy and physiology and life style factor. There were significant differ-ences between ward nurses’ responses with their perception related to anatomy and physiology, psychology factor, life style factor, physical activity, and symptom man-agement with p value
This study aimed to determine the rates of non-adherence to standard steps of medication administration and medication administration errors committed by registered nurses in a neonatal intensive care unit before and after intervention.
Changes to the nursing profession over recent decades have provoked an increasing migration of nursing education into the tertiary sector. For nurses who live and work in developing nations, such as Malaysia, opportunities for further study might be limited, particularly for those located in more remote regions. This paper reports on a research study of registered nurses who undertook baccalaureate degree studies in off-campus mode in Malaysian Borneo. A grounded theory methodology was employed in this research, which is part of a larger study into the nature and outcomes of change experienced as a result of postregistration degree studies. This paper explores the reasons why nurses in this location enrolled in one such course and the extent to which completion of their studies addressed their motivational goals. The findings indicate that the experience of learning and acquisition of knowledge was well beyond what was expected, resulting in a sense of achievement that was similarly unanticipated.
Medication error is defined as any preventable event that might cause or lead to an inappropriate use or harming of the patient. Such events could be due to compounding, dispensing, distribution, administration and monitoring. The aim of the present study was to determine the nurses' perception on medication error that were related directly or indirectly to the process of administration of drugs. MATERIALS AND METHODS. This was a descriptive cross sectional study conducted on 92 staff nurses working in the selected wards in one of the hospitals in East Malaysia. Data was obtained through structured questionnaires. RESULTS. Analysis of data was done through SPSS program for descriptive inferential statistics. Out of a total of 92 subjects, sixty-eight (73.9%) indicated medication error occurred because the nurses were tired and exhausted. Seventy nine subjects (85.9%) believed that any medication error should be reported to the doctors; another 74 (80.2%) knew that their colleagues committed medication error and 52 (56.5%) did not report the case. Forty eight (52.17%) subjects committed medication error at least once throughout their life. Of the 48 committed medication, 45 (93.75%) nurses believed that the error committed was not serious; while 39 (81.25%) believed the error occurred during the 1st 5 years of their working experience.
Introduction : Major flooding that occurred in Segamat District at the end of 2006 and early 2007 was a natural disaster that has left impact on physical and mental well-being of the victims. The aim of this study is to see the impact of the major flooding to the mental health of the health staff in Segamat District.
Methodology : Cross sectional study was conducted among Segamat health staffs who were involved in the major floods. Structured questionnaire was used to assess the mental health status of the victims. Result : There were 119 health staffs from the district health office, Hospital Segamat, dental clinic and Community Nursing School were interviewed in this study. A total of 6.7% respondents claimed to have stress related symptoms with women were more effected than men. Nurses and married respondents were found to be more stressful in this study.
Conclusion : Based on findings, therefore, top management has to pay more attention to the welfare of the health staff, directly or indirectly, in particular on the psychological aspect. By giving emphasis on continuous in-service training and counseling as well as other relevant support, stress-related symptoms could be minimized which in turn lead to higher individual productivity.
Drug administration is an integral part of nurses role in nursing practice. In relation to their diverse roles, nurses are required to have adequate knowledge and good practice. The purpose of this study is to examine the level of knowledge, attitude and practice of nurses in the medical wards administering oral medication and to assess whether nurse’s knowledge, attitude and practice is associated with working experience and professional education (post basic training). A cross-sectional study was conducted on forty (40) nurses working in the Medical wards in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Questionnaires were used to measure the level of knowledge and attitude of nurses and a direct observation technique with checklist to record the practice of nurses. The mean score for knowledge (13.8), attitude (16.4) and practice (10.7) were all within average distribution. No significant difference was found between knowledge and practice of nurses with working experience and post basic training. However, the influence of working experience on attitude of nurses in serving oral medication was found to be significant (p= 0.045). Nurses in medical ward, Universiti Kebangsaan Malaysia Medical Centre, were found to possess an average level of knowledge and attitude in administering oral medication. In addition, this study suggest that work experience of nurses has no influence on knowledge gain and good practice in administering oral medication..