Production agriculture such as harvesting in oil palm plantation has been frequently associated with MSD and significant loss of productivities. This study tends to evaluate from the viewpoint of health, the association between self-reported prevalence of musculoskeletal disorders and productivities; the impact of musculoskeletal disorders on productivity. A cross-sectional study was conducted among 143 harvesters in oil palm plantation. A general questionnaire was used to collect socio-demographic background data while Nordic Musculoskeletal Questionnaire was used to determine the prevalence of MSD. Expressed in 4 different indicators; daily harvesting quantity, efficiency score, sick leave and presenteeism, the productivity data were analysed for association. There is significant association between reported acute prevalence of MSD (within 7 d) and productivity loss in terms of presenteeism (χ(2)=5.088; p<0.05) as well as quantity of daily harvest (χ(2)=7.406; p<0.01). Logistic regression adjusted for age, BMI and smoking indicate that harvesters with MSD (past seven days) were more likely to be engaged in presenteeism (OR=2.87 95% CI=1.34, 6.14) and had lower daily productivity (OR=2.09 95% CI=1.02, 4.29) compared to harvesters without MSD (past 7 d). This study reveals that oil palm harvesters suffering acute MSD (for the past week) were likely to be still present to work and produce half lesser than their healthy counterparts. Thus, further study with comprehensive surveillance strategy is essential in order to determine the urgency or need of appropriate intervention.
BACKGROUND: The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting.
OBJECTIVES: We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities.
METHODS: 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index.
RESULTS: During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections.
CONCLUSION: This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.
Introduction: Information on sick leave duration among employees with the first episode of acute coronary syndrome (ACS) throughout the world was limited. The aims of the study were to determine the sick leave duration and its predictive factors among employees diagnosed with the first episode of ACS. Methods: A cohort study was conduct- ed among employees who were admitted to the cardiology centre in the public hospitals in northeastern Malaysia. Data was collected using a designed proforma. The respondents were interviewed, and their medical records were reviewed on the second day of hospital admission. Information on sick leave duration was obtained from sick leave book in the wards. Multiple linear regression analysis was applied to determine the predictive factors for sick leave duration. Results: A total of 78 respondents participated in this study. The mean (SD) age of the respondents was
47.5 (7.31) year old. The majority were male (92.3%), married (94.9%) and had a low level of education (62.8%). The sick leave duration ranged from 4 to 180 days with the median (IqR) of 35.5 (32) days. The predictive factors for sick leave duration were smoking (Adjusted b=20.1, 95% CI: 7.4, 32.8), not attending cardiac rehabilitation after discharge (Adjusted b=19.9, 95% CI: 6.7, 33.6) and presence of complication during admission (Adjusted b=28.6, 95% CI: 15.1, 42.0). Conclusion: The sick leave duration was relatively low and being a smoker, having a complica- tion during admission and not attending cardiac rehabilitation after discharged predicts a longer sick leave duration.
Study design: A cross-sectional study among health care providers working at one hospital. Objective: To investigate the prevalence, the consequences and the risk factors associated with low back pain (LBP) among hospital staff. Materials and Methods: The study sample consisted of 931 health care providers who answered a pre-established questionnaire including 30 items in two languages. Results: The cumulative life-prevalence of LBP was 72.5% and the yearly prevalence was 56.9%. Chronic LBP prevalence was noted 5.1% of the cases. Treatment was sought in 34.1% of LBP sufferers and 7.3% required sick leave or absence from work due to LBP. Risk factors associated with LBP were professional categories, bad body posture, lifting objects or patients and the increased levels of lifting, levels of job satisfaction and stressful job demands. Conclusion: There was a high prevalence of LBP among hospital staff, resulting in significant medical and socio-professional consequences. Many risk factors were identified that would necessitate multidisciplinary involvement to reduce the LBP incidence and related costs.
Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees
particularly among those in security sector. The study aimed to determine the association between obesity with total
days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional
study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects
were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months
prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese,
39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7%
of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body
Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health
component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and
body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and
pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r
= 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence,
body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their
work attendance and quality of life.
INTRODUCTION: Cognitive dysfunction has been significantly associated with functional impairment in patients with major depressive disorder (MDD).
METHODS: This is a subgroup analysis of 211 Malaysian patients recruited from the multicountry, multicenter, cross-sectional Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Depression severity, cognitive dysfunction, and functional disability were assessed and compared with the overall CogDAD study population. Factors associated with functional disability were also evaluated in this Malaysian patient population.
RESULTS: Approximately half of the Malaysian patients were in their first depressive episode, with the majority being treated for mild-to-moderate depression. Furthermore, Malaysian patients experienced cognitive dysfunction, with self-reported Perceived Deficits Questionnaire (PDQ-D) scores falling within the third quartile of PDQ-D severity. Malaysian patients also reported functional disability evidenced by a mean total Sheehan Disability Scale (SDS) score of 11.47 ± 6.68, with the highest SDS score reported in the "Social Life/Leisure Activities" domain. Compared with the overall CogDAD study population, the Malaysian patient population had comparable patient demographics in terms of marital and working status; outcome scores for PHQ-9 (9-item Patient Health Questionnaire for self-reported depression severity), PDQ-D and SDS; and worst perceived cognitive dysfunction reported in the "Attention/Concentration" domain. Factors found to be significantly associated with functional disability were PDQ-D score, sick leave taken, and antidepressant treatment (P
Background Somatisation disorder (SD) has been reported as common in all ethnic groups, but the estimates of its prevalence have varied and the evidence for its associated factors has been inconsistent.
Purpose This study seeks to determine the prevalence of SD and its associated factors in multiethnic primary care clinic attenders.
Methods This cross-sectional study was on clinic attenders aged 18 years and above at three urban primary care clinics in Malaysia. The operational definition of SD was based on ICD-10 criteria for SD for research, frequent attendance, and excluded moderate to severe anxiety and depression. The instruments used were the ICD-10 symptom list, the Hospital Anxiety and Depression Scale, a semi-structured questionnaire, and SF-36.
Results We recruited 1,763 patients (response rate 63.8%). The mean age of respondents was 44.7±15.8 years, 807 (45.8%) were male; there were 35.3% Malay, 30.1% Chinese and 34.6% Indian. SD prevalence was 3.7%; the prevalence in Malay was 5.8%, Indian 3.0% and Chinese 2.1%. Significant associations were found between SD prevalence and ethnicity, family history of alcoholism, blue-collar workers and the physical component summary (PCS) score of SF-36. Multivariate analysis showed that SD predictors were Malay ethnicity (OR 2.7, 95% CI 1.6, 4.6), blue-collar worker (OR 2.0, 95% CI 1.2, 3.5) and impaired PCS score of SF-36 (OR 0.92, 95% CI 0.90, 0.95).
Conclusion The prevalence of SD was relatively uncommon with the stringent operational criteria used. SD preponderance in blue-collar workers may be attributable to secondary gain from getting sickness certificates and being paid for time off work.
Keywords Somatisation disorder . Associated factors . Primary care . Ethnic groups . Prevalence Questionnaire: ICD-10 symptom list; Hospital Anxiety Depression Scale; HADS; SF-36