Stigmatising attitudes towards mental illness may improve with clinical exposure during medical school training. Attitudes of 48 fourth year medical students in Universiti Kebangsaan Malaysia were assessed before and after their compulsory attachment in Psychiatry, using the Attitude Towards Psychiatry-30 (ATP) and the Attitude towards Mental Illness (AMI) questionnaires. ATP scores improved significantly with training (104.8 and 114.4, pre- and post-attachment respectively) as did AMI scores (63.4 and 68.1 respectively). Both improvements were statistically significant. (ATP: z = 4.55, p < 0.0005) (AMI: z = 3.75, p < 0.0005). Attitudes towards mental illness appeared to have become more favourable with clinical training in psychiatry.
Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students' attitudes toward abortion education and presents a case for including abortion education in medical schools.
A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.
"Occupational MDR-TB" … "XDR-TB" … "Treatment-induced hearing loss": 3 life-changing messages imparted over the phone. Three personal accounts are shared highlighting the false belief held by many healthcare workers (HCWs) and students in low-resource settings-that they are immune to tuberculosis despite high levels of occupational tuberculosis exposure. This misconception reflects a lack of awareness of tuberculosis transmission and disease risk, compounded by the absence of accurate occupational tuberculosis estimates. As the global problem of drug-resistant (DR) tuberculosis evolves, HCWs are increasingly infected and suffer considerable morbidity and mortality from occupational DR tuberculosis disease. Similarly, healthcare students are emerging as a vulnerable and unprotected group. There is an urgent need for improved detection, vaccines, preventive therapy, treatment, and support for affected HCWs and those they care for, as well as destigmatization of all forms of tuberculosis. Finally, efforts to protect HCWs and prevent DR tuberculosis transmission by universal implementation of tuberculosis infection control measures should be prioritized.
Dental amalgam in fillings exposes workers to mercury. The exposure to mercury was investigated among 1871 dental health care workers. The aim of the study was to evaluate the risk of mercury exposure among dental compared to nondental health care workers and to determine other risk factors for mercury exposure. Respondents answered questionnaires to obtain demographic, personal, professional, and workplace information and were examined for their own amalgam fillings. Chronic mercury exposure was assessed through urinary mercury levels. In total, 1409 dental and 462 nondental health care workers participated in the study. Median urine mercury levels for dental and nondental health care workers were 2.75 μg/L (interquartile range [IQR] = 3.0175) and 2.66 μg/L (IQR = 3.04) respectively. For mercury exposure, there were no significant risk factor found among the workers involved within the dental care. The Mann-Whitney test showed that urine mercury levels were significantly different between respondents who eat seafood more than 5 times per week compared to those who eat it less frequently or not at all (p = 0.003). The urinary mercury levels indicated significant difference between dental workers in their practice using squeeze cloths (Mann-Whitney test, p = 0.03). Multiple logistic regression showed that only the usage of cosmetic products that might contain mercury was found to be significantly associated with the urinary mercury levels (odds ratio [OR] = 15.237; CI: 3.612-64.276). Therefore, mean urinary mercury levels of health care workers were low. Exposure to dental amalgam is not associated with high mercury exposure. However, usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.
IMPLICATIONS: Exposure to the high levels of mercury from dental amalgam can lead to serious health effects among the dental health care workers. Nationwide chronic mercury exposure among dental personnel was assessed through urinary mercury levels. Findings suggest low urinary mercury levels of these health care workers. Exposure to dental amalgam is not associated with high mercury exposure. However, the usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.
Matched MeSH terms: Health Personnel/statistics & numerical data
Electronic medical records (EMRs) have been proven to be effective tools for improving the safety and quality of healthcare despite their relatively low usage rate in hospitals. The long-term development by EMRs depends on the continued use of healthcare professionals. In this study, technology continuance theory (TCT) was used to evaluate the short-term and long-term continuance acceptance of EMRs among healthcare professionals. Data were gathered by surveying 195 medical professionals in Iran. The data were analyzed using the partial least squares (PLS) technique. The analysis showed that the TCT provided a deep understanding of user continuance intention toward EMRs. In addition, the findings illustrated that the determinants of continuance intention vary between short-term and long-term users. The theoretical and practical implications of the study are discussed.
BACKGROUND: Establishing and promoting connections between health researchers and health professional clinicians may help translate research evidence to clinical practice. Social media may have the capacity to enhance these connections.
OBJECTIVE: The aim of this study was to explore health researchers' and clinicians' current use of social media and their beliefs and attitudes towards the use of social media for communicating research evidence.
METHODS: This study used a mixed-methods approach to obtain qualitative and quantitative data. Participation was open to health researchers and clinicians. Data regarding demographic details, current use of social media, and beliefs and attitudes towards the use of social media for professional purposes were obtained through an anonymous Web-based survey. The survey was distributed via email to research centers, educational and clinical institutions, and health professional associations in Australia, India, and Malaysia. Consenting participants were stratified by country and role and selected at random for semistructured telephone interviews to explore themes arising from the survey.
RESULTS: A total of 856 participants completed the questionnaire with 125 participants declining to participate, resulting in a response rate of 87.3%. 69 interviews were conducted with participants from Australia, India, and Malaysia. Social media was used for recreation by 89.2% (749/840) of participants and for professional purposes by 80.0% (682/852) of participants. Significant associations were found between frequency of professional social media use and age, gender, country of residence, and graduate status. Over a quarter (26.9%, 229/852) of participants used social media for obtaining research evidence, and 15.0% (128/852) of participants used social media for disseminating research evidence. Most participants (95.9%, 810/845) felt there was a role for social media in disseminating or obtaining research evidence. Over half of the participants (449/842, 53.3%) felt they had a need for training in the use of social media for professional development. A key barrier to the professional use of social media was concerns regarding trustworthiness of information.
CONCLUSIONS: A large majority of health researchers and clinicians use social media in recreational and professional contexts. Social media is less frequently used for communication of research evidence. Training in the use of social media for professional development and methods to improve the trustworthiness of information obtained via social media may enhance the utility of social media for communicating research evidence. Future studies should investigate the efficacy of social media in translating research evidence to clinical practice.
KEYWORDS: communication; eLearning; evidence-based medicine; social media
INTRODUCTION: Malaysia has experienced a significant expansion of dental schools over the past decade. Research into students' motivation may inform recruitment and retention of the future dental workforce. The objectives of this study were to explore students' motivation to study dentistry and whether that motivation varied by students' and school characteristics.
METHODS: All 530 final-year students in 11 dental schools (6 public and 5 private) in Malaysia were invited to participate at the end of 2013. The self-administered questionnaire, developed at King's College London, collected information on students' motivation to study dentistry and demographic background. Responses on students' motivation were collected using five-point ordinal scales. Confirmatory factor analysis (CFA) was used to evaluate the underlying structure of students' motivation to study dentistry. Multivariate analysis of variance (MANOVA) was used to compare factor scores for overall motivation and sub-domains by students' and school characteristics.
RESULTS: Three hundred and fifty-six final-year students in eight schools (all public and two private) participated in the survey, representing an 83% response rate for these schools and 67% of all final-year students nationally. The majority of participants were 24 years old (47%), female (70%), Malay (56%) and from middle-income families (41%) and public schools (78%). CFA supported a model with five first-order factors (professional job, healthcare and people, academic, careers advising and family and friends) which were linked to a single second-order factor representing overall students' motivation. Academic factors and healthcare and people had the highest standardized factor loadings (0.90 and 0.71, respectively), suggesting they were the main motivation to study dentistry. MANOVA showed that students from private schools had higher scores for healthcare and people than those in public schools whereas Malay students had lower scores for family and friends than those from minority ethnic groups. No differences were found by age, sex, family income and school type.
CONCLUSION: Using CFA, this study shows that academic factors were the main motivation to study dentistry in this group of Malaysian students. There were also variations in students' motivation by students' ethnicity and school sector but not by other factors.
Breast cancer is the most common cancer among women in Malaysia. Therefore, it is highly important for the public to be educated on breast cancer and to know the steps to detect it early on. Healthcare providers are in the prime position to provide such education to the public due to their high knowledge regarding health and their roles in healthcare. The present systematic review involved studies conducted in recent years to analyze the knowledge, attitudes and behavior of Malaysian healthcare providers regarding breast cancer, in attempts to obtain an overall picture of how well equipped our healthcare providers are to provide optimal breast cancer education, and to see their perceptions and actual involvement in said education. The systematic review was conducted via a primary search of various databases and journal websites, and a secondary search of references used by eligible studies. Criteria for eligibility included being published from the year 2008 till present, being conducted in Malaysia, and being written in the English language. A total of two studies were eligible for this review. Findings show that Malaysian future and current healthcare providers have moderate knowledge on breast cancer, have a positive towards involvement of breast cancer education, but have poor actual involvement.
BACKGROUND: Knowledge, perceptions and prescribing behaviour are key to antibiotic prescribing. The aim of this paper is to systematically review this.
METHOD: An extensive literature search from 1990 to 2014.
RESULTS: Nineteen articles were included; eight in ambulatory care, seven in hospital settings and four in both, across all countries. Physicians still have inadequate knowledge and misconceptions about antibiotic prescribing. Moreover, some physicians, although aware that antibiotics are of limited benefit in some conditions, still prescribed them. Several factors influenced prescribing, including patients' expectations, severity and duration of infections, uncertainty over diagnosis, potentially losing patients and influence of pharmaceutical companies. Pocket-sized guidelines seen as an important source of information for physicians.
CONCLUSION: Inadequate knowledge of prescribing is prevalent among physicians. However, many physicians were interested in improving their antibiotic prescribing. Multifaceted interventions targeting all key stakeholders, including patients, are needed to improve future antibiotic prescribing.
KEYWORDS: antibiotics; irrational use of medicines; patients; physicians; prescribing behaviour; resistance; systematic reviews
Health care workers have been reported to constitute one of the few high-risk groups related to IgE-mediated hypersensitivity associated with the use of latex products. This paper describes the first ever study of prevalence carried out in Malaysia among these workers. One hundred and thirty health care personnel from Hospital Kuala Lumpur were skin tested. Extracts used were prepared from seven different brands of natural rubber latex gloves with varying levels of extractable protein (EPRRIM). Out of the 130 volunteers, 4 (3.1%) had positive skin test to latex with extracts with high levels of EPRRIM (> 0.7 mg/g). The prevalence among the Malaysian health care workers can be considered to be low in comparison to that of some consumer countries as the USA which reported a prevalence of as high as 16.9%.
Matched MeSH terms: Health Personnel/statistics & numerical data*
One of the main reasons for poor response in organ donation is the lack of positive attitudes and knowledge present in health care professionals. Definite legislation, policies and programmes dealing with brain death and cadaveric organ transplantation have shown some favourable results in terms of increasing donor rates. These programmes are mainly Western based; therefore adopting such programmes to be used locally may not be adequate or proper. To address this issue, we decided to carry out a questionnaire in two tertiary hospitals in Malaysia, one with a well establish brain death and cadaveric organ transplantation programme and one with none.
A postal questionnaire survey concerning dentists' attitudes toward auxiliaries in Malaysia resulted in a 73.1 per cent response rate. The result of the study indicates that whilst the majority of the dentists agreed that dental auxiliaries usually increase productivity and permit the dentists to devote more time for more challenging tasks, a majority felt uncomfortable to be held accountable for the performance of auxiliaries. A majority of the dentists agreed that dental auxiliaries work best under direct supervision. The perceived value of the auxiliaries was more positive among public sector dentists as compared to private practitioners. Almost three-quarters of the dentists were positive towards legalising properly trained auxiliaries to work in private practice performing mainly preventive procedures. The implications of these findings relative to existing regulations, mode of practice and the future prospect in the delivery of oral health care are discussed.
The author reflects on 24 years of involvement in WHO activities, and their effect on her own life and on the maternal and child health services in Malaysia.
A postal survey of 730 Malaysian dental practitioners was undertaken to assess their awareness and acceptance of the plasma derived hepatitis B vaccine. Only 32% of the 325 practitioners who responded had been vaccinated, 41% intended to be and 15% categorically refused vaccination. The main reservations about vaccine acceptance were fear of side effects including AIDS, cost of the vaccine and lack of information. Vaccine efficacy was not confirmed by serology in two-thirds of the vaccinees and two-fifths of the respondents were unaware that 5% of the vaccinees do not develop a successful antibody response after vaccination. Seventy-eight percent of dentists believed that their risk of contracting hepatitis B was high or very high while 71% recalled having received needle stick injuries in the 3 yr prior to the survey. Only 13% of respondents were aware of delta hepatitis while 63% were aware of non-A non-B hepatitis. The survey has highlighted the need for dissemination of information on hepatitis B vaccine among dentists in Malayasia.
This paper draws upon findings from an ethnographic study of psychiatric service users in a psychiatric institution in Sarawak, East Malaysia. Findings focus primarily on the accounts of nursing staff in relation to attitudes towards psychiatric work and patients. These indicate that despite a rhetoric of decentralized services, a custodial 'asylum' model continues to influence the care of patients at many levels. Negative professional attitudes towards patients lead to issues of both moral and physical containment. However, an associated attitude of stigma and prejudice towards mental illness impacts upon how attractive a career in psychiatric nursing is perceived to be by respondents, subject to gender differentials.