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Fulltext Paediatric transoral robotic-assisted adenotonsillectomy: a new anaesthetic experience in Malaysia.

Zawiah Kassim, Fauziah Ahmad, Rusnaini Mustapha Kamar, Karis Misiran

Journal of Clinical and Health Sciences, 2019;4(2):91-96.
MyJurnal

Safety and feasibility of transoral robotic surgery (TORS) in adults for otolaryngology surgery,
mainly in the treatment of oropharyngeal carcinoma and obstructive sleep apnoea has already
been established several years ago. However, less is known with respect to the role and safety
of TORS for otolaryngology surgery in the paediatric age group and its description in the
literature is currently insufficient. As paediatric patients are unique in their anatomy, physiology
and pharmacological kinetic, special attention and consideration has to be applied when using
TORS, hence this increases the perioperative challenges. Herewith we present our experience
in anaesthetising a paediatric patient for TORS adenotonsillectomy which is the first not only
in our centre but in Malaysia. Our major obstacle was the limited airway access as the area of
concern was shared by the anaesthesiologist, surgeon and also the robotic system.
Haemodynamic stabilisation was a challenge compared to the conventional method as the
operative time increased due to robot docking time and the new surgical learning process. In
our opinion, the key point for the success of TORS adenotonsillectomy in paediatric patients is
good communication and teamwork between all personnel involved in the surgery.

Matched MeSH terms: Communication
Fulltext Barriers and facilitators to patient-centred care in pharmacy consultations: A qualitative study with Malaysian hospital pharmacists and patients

Ng YK, Mohamed Shah N, Loong LS, Pee LT, Chong WW

PLoS One, 2021;16(10):e0258249.
PMID: 34618863 DOI: 10.1371/journal.pone.0258249

BACKGROUND: Patient-centred care (PCC) has been suggested to provide benefits such as improved patient-healthcare provider communication and better disease self-management to patients. The practice of PCC should involve all healthcare professionals, including pharmacists who are well-positioned in providing pharmaceutical care to patients. However, a better understanding of the factors that can affect the practice of PCC in pharmacists' consultations is needed.
OBJECTIVE: To explore the perceptions of Malaysian hospital pharmacists and patients on the barriers and facilitators of a PCC approach in pharmacist consultations.
DESIGN: This study employed a qualitative, explorative semi-structured interview design.
SETTING AND PARTICIPANTS: Interviews were conducted with 17 patients and 18 pharmacists from three tertiary hospitals in Malaysia. The interviews were audiotaped and transcribed verbatim. Emerging themes were developed through a constant comparative approach and thematic analysis.
RESULTS: Three themes were identified in this study: (i) patient-related factors (knowledge, role expectations, and sociocultural characteristics), (ii) pharmacist-related factors (personalities and communication), and (iii) healthcare institutional and system-related factors (resources, continuity of care, and interprofessional collaboration). Pharmacists and patients mentioned that factors such as patients' knowledge and attitudes and pharmacists' personality traits and communication styles can affect patients' engagement in the consultation. Long waiting time and insufficient manpower were perceived as barriers to the practice of PCC. Continuity of care and interprofessional collaboration were viewed as crucial in providing supportive and tailored care to patients.
CONCLUSION: The study findings outlined the potential factors of PCC that may influence its implementation in pharmacist consultations. Strategic approaches can be undertaken by policymakers, healthcare institutions, and pharmacists themselves to address the identified barriers to more fully support the implementation of PCC in the pharmacy setting.

Matched MeSH terms: Communication
Moderating Role of Religiosity and the Determinants to Attitude, Willingness to Donate and Willingness to Communicate Posthumous Organ Donation Decisions among University Students in Pakistan

Umair S, Ho JA, Ng SSI, Basha NK

Omega (Westport), 2023 Nov;88(1):216-244.
PMID: 34505539 DOI: 10.1177/00302228211045170

Organ transplantation is considered an alternative treatment to save lives or to improve the quality of life and is a successful method for the treatment of patients with end-stage organ diseases. The main objective of the current study was to explore the determinants of the attitudes and willingness to communicate the posthumous organ donation decisions to the families. Questionnaires were used to test the hypothesized relationships. The results confirmed altruism, knowledge, empathy, and self-identity as the antecedents to attitude. We also found perceived behavioral control, moral norms, and attitude as significant antecedents to the willingness to donate organs after death. The results of the study also indicated that those who were willing to sign the donor card were also willing to communicate their decision to their families. Religiosity moderated the relationship between willingness to donate and signing the donor card, and it strengthened the relationship. The findings of this study would provide insight into the factors which can influence posthumous organ donation among university students in Pakistan.

Matched MeSH terms: Communication
Fulltext Inculcating collaborative practice among healthcare professionals: initiative from Hospital Universiti Malaysia Sabah

Jeanny John, Joanne Justin, Dainah Francis, Helen Benedict Lasimbang, Wendy Diana Shoesmith, Loo Jiann Lin, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):8-0.
MyJurnal

Introduction: Collaborative working culture is an important milestone to be inculcated in a hospital setting. In the process of preparation for the upcoming teaching hospital of Universiti Malaysia Sabah (HUMS), the organisational value of innovative, collaborative, compassionate, empowering, and sustainable needs to be inculcated to the both management and clinical staffs. The objective of this study was to assess the efficacy of a collaborative practise workshop in staff. Methods: A two days experiential learning workshop was conducted to deliver and inculcate the organisational value of HUMS to 32 existing and newly recruited healthcare professionals, which include doctor, nurses, assistant medical officer, dental assistant, pharmacist, and radiographer. The topics consisted of principles of collaborative practice, skill of validation, feedback-giving method, approach for value identification and goal setting, reflective practice, public communication during crisis, shared decision making, and organisational problem solving. Different delivery methods include round table discussion, role play, and group work were used. Innovative real time practice of giving feedback to the management was performed directly to the hospital chief executive officer and chief clinical officer. Results: Immediate feedback from the participants found that the candidates found the course was enriching and it helped them to develop an alternative perspective on how to get work done. The staffs expressed their idea, concern, and expectation more openly with the method learned using what they had learnt. The limitation included the challenge of transition from previous working culture to new environment without further supervision. Conclusions: Further systematic evaluation using more detailed assessment tool is needed to understand the long term efficiency and translatability of the learning outcomes into clinical practice once the hospital is ready.

Matched MeSH terms: Communication
Fulltext Peripheral intravenous canula (PIVC) assessment skills among pediatric nurses: audit-based approach study

Deena C T, Li Tsu Chong, Drina Dalie, Rose A Nain, Renie M Joanes, CheristyTumbil

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):4-0.
MyJurnal

Introduction: Peripheral Intravenous Cannula (PIVC) placement can cause undesirable effects, such as phlebitis. Poor PIVC care can irritate tunica intima layers of the superficial vein. The incidence of phlebitis had become a national nursing indicator, with a standard of less than 0.9%. The standard care of the patient with intravenous in- cludes a routine PIVC assessment. However, what the assessment should be based on remained unclear. The objec- tive of this study is to assess nurses’ skill in performing PIVC assessment. Methods: This is a descriptive study using an audit-based approach. It is conducted in a pediatric hospital. Nine pediatric wards were identified via stratified sampling methods. A total of 86 registered nurses consented to participate in this study. A validated research instru- ments (α = 0.83), PIVC Assessment Skill (PIVC-AS) checklist is used to audit nurses in performing PIVC assessment. PIVC-AS consists of nine audit criteria (AC), AC1: communication skill, AC2 until AC7: PIVC assessment skill, AC8: documentation skill and AC9: PIVC management. Results: Nurses communication skills to patient as in AC1 shows compliance rate of seventy six percent. The compliance rate can be explained that this study was done in the pedi- atric setting. Participants may skip this communication due to handling with a pediatric patient. More than eighty eight percent nurses comply with AC2 to AC6 which indicated their excellent skill in performing PIVC assessment every shift. However, in the AC7, only sixty seven percent comply to palpate PIVC area for any evidence of venous cord and warmth. Conclusion: This study concludes that communication between nurses and pediatric patients prior to PIVC assessment often missed out by nurses. The palpation techniques also not been carried out as compared to observation technique in pediatrics setting. Palpation technique is crucial to detect ‘warmth to touch’ because it differentiates between the early and medium stage of phlebitis.

Matched MeSH terms: Communication
Fulltext Unwed motherhood: the lived experience of teenage mothers in Malaysia

Fatimah Sham, Afiqah Ismail, Tuan Nor Ashikin Tuan Him, Salmi Razali, Eliyas S. Mohandas

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):31-0.
MyJurnal

Introduction: Teenage pregnancy is common and has become a key public health concern for all. This study aims to discover the meaning of lived experiences and to strategize in addressing the phenomenon from the previous or current unwed pregnant girls’ or young women’s perspective. Methods: A qualitative study was conducted among 10 girls or young women recruited during their stay at two shelters in Selangor but came from various state in Malay- sia; who have experienced becoming unwed mothers when they were between 10 to 19 years old. All participants gave informed consent. In-depth face-to-face interviews were conducted, audiotaped and transcribed. All quotes were encoded using Qualitative Data Analysis (QDA) Miner program. Data were analyzed using interpretative phe- nomenological analysis. Results: The themes emerged from the analyses; i) Trajectory of sexual activity, ii) struggles of motherhood to un-wed teenage mother. Most of these girls were pregnant due to consensual sexual intercourse although there were some refutes but their actions have led them for this to happen. They described how indirect relationship such as communication via telephone and the internet may have initiated the desire for sexual activity which led to a short first-time meeting and short term partnership, caused them to enact the sinful deed. They were overwhelmed with ambivalence feelings of wanting to terminate the pregnancy, abandon the newborn or to endure the journey of motherhood together with their ex-nuptial baby. Conclusion: The findings of this study showed that the strength of indirect relationship is able to evoke sexual desire that contributes to out-of-wedlock pregnancy. Max- imum support is needed from all; peers, parents, educators and the whole community structures.

Matched MeSH terms: Communication
Fulltext Improved Bacteriostatic and Anticorrosion Effects of Polycaprolactone/Chitosan Coated Magnesium via Incorporation of Zinc Oxide

Bakhsheshi-Rad HR, Hamzah E, Ying WS, Razzaghi M, Sharif S, Ismail AF, et al.

Materials (Basel), 2021 Apr 12;14(8).
PMID: 33921460 DOI: 10.3390/ma14081930

Magnesium has been recognized as a groundbreaking biodegradable biomaterial for implant applications, but its use is limited because it degrades too quickly in physiological solutions. This paper describes the research on the influence of polycaprolactone (PCL)/chitosan (CS)/zinc oxide (ZnO) composite coating (PCL/CS/ZnO) on the corrosion resistance and antibacterial activity of magnesium. The PCL/CS film presented a porous structure with thickness of about 40-50 μm, while after incorporation of ZnO into the PCL/CS, a homogenous film without pores and defects was attained. The ZnO embedded in PCL/CS enhanced corrosion resistance by preventing corrosive ions diffusion in the magnesium substrate. The corrosion, antibacterial, and cell interaction mechanism of the PCL/CS/ZnO composite coating is discussed in this study. In vitro cell culture revealed that the PCL/CS coating with low loaded ZnO significantly improved cytocompatibility, but coatings with high loaded ZnO were able to induce some cytotoxicity osteoblastic cells. It was also found that enhanced antibacterial activity of the PCL/CS/ZnO coating against both Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria, while less significant antibacterial activity was detected for uncoated Mg and PCL/CS coating. Based on the results, the PCL/CS coatings loaded with low ZnO content may be recommended as a candidate material for biodegradable Mg-based orthopedic implant applications.

Matched MeSH terms: Cell Communication
Hydroxychloroquine and Chloroquine in Prophylaxis and Treatment of COVID-19: What Is Known?

Shankar PR, Palaian S, Gulam SM

J Pharm Bioallied Sci, 2020 10 06;13(1):4-10.
PMID: 34084043 DOI: 10.4103/jpbs.JPBS_404_20

The corona virus disease-19 (COVID-19) pandemic has affected the entire world causing huge economic losses and considerable morbidity and mortality. Considering the explosive growth of the pandemic repurposing existing medicines may be cost-effective and may be approved for use in COVID-19 faster. Researchers and medical practitioners worldwide have explored the use of chloroquine and hydroxychloroquine, in few occasions combined with the macrolide antibiotic azithromycin, for COVID-19 treatment. These two drugs are economic and easily available, and hence gained attention as a potential option for COVID-19 management. As per the available evidence, the outcomes of treatments with these medications are conflicting from both the efficacy and safety (predominantly cardiac related) perspectives. Currently, multiple studies are underway to test the safety and efficacy of these medications and more results are expected in the near future. The retina, the endocrine system (with risk of hypoglycemia), the musculoskeletal system, the hematological system, and the neurological system may also be affected. The use of these drugs is contraindicated in patients with arrhythmias, known hypersensitivity, and in patients on amiodarone. In addition to the published literature, personal communication with doctors treating COVID-19 patients seems to suggest the drugs may be effective in reducing symptoms and hastening clinical recovery. The literature evidence is still equivocal and further results are awaited. There has been recent controversy including retraction of articles published in prestigious journals about these medicines. Their low cost, long history of use, and easy availability are positive factors with regard to use of these drugs in COVID-19.

Matched MeSH terms: Communication
Home and expatriate nurses' perceptions of job satisfaction: Qualitative findings

Almansour H, Gobbi M, Prichard J

Int Nurs Rev, 2021 May 27.
PMID: 34043818 DOI: 10.1111/inr.12699

AIM: This paper is part of a larger doctoral study that investigated the impact of nationality on the job satisfaction of nurses and their intentions to leave Saudi Arabian government hospitals. The paper aims to gain an understanding of the impact of expatriate status on nurses' perceptions, by comparing the factors that influence job satisfaction among Saudi nurses to those that affect nurses recruited from other countries.
BACKGROUND: Job satisfaction is a known predictor of nurse retention. Although there is a broad understanding of the factors that affect job satisfaction, little is known about how these vary between home and expatriate nurses working in countries which rely on a multicultural migrant workforce.
METHODS: A descriptive qualitative approach was taken, in which 26 semi-structured interviews were conducted with nurses selected from different nationalities, all of whom were working in Saudi Arabian hospitals. Eight participants were Saudi Arabian, six Filipino, four Indian, four South African, two Jordanian and two Malaysian.
FINDINGS: Five themes were identified that differentiated the perceptions of expatriates regarding their job satisfaction from those of the home nurses: separation from family, language and communication, fairness of remuneration, moving into the future and professionalism.
CONCLUSION: Focusing on the enhancement of job satisfaction experienced by expatriate nurses can result in a healthier work environment and greater retention of these nurses.
IMPLICATIONS FOR NURSING AND NURSING POLICY: To enhance nurse retention, policy makers in countries with migrant nurses should address their socio-economic needs. This includes providing both greater access to their dependent family members, and language lessons and cultural orientation to reduce linguistic and cultural challenges.

Matched MeSH terms: Communication
Attitudes of medical school deans toward interprofessional education in Western Pacific Region countries

Lee B, Celletti F, Makino T, Matsui H, Watanabe H

J Interprof Care, 2012 Nov;26(6):479-83.
PMID: 22830530 DOI: 10.3109/13561820.2012.706336

To examine the attitudes of medical school deans toward interprofessional education (IPE) and collaborative practice (CP), we conducted survey research in the Western Pacific Region. This regional survey was conducted as a collaborative research project with the World Health Organization. A survey was distributed to the medical school deans in Malaysia, the Philippines, Republic of Korea and Japan. Thirty-five surveys were returned from four countries. The survey demonstrated that many medical school deans have positive attitudes toward IPE and CP. However, respondents also reported that it is not easy to introduce interprofessional learning in their academic settings. It is suggested that collaboration between education systems and health systems is needed to introduce IPE in the academic setting. The possible role of international organizations is mentioned. This information helps to identify local efforts on which global health organizations and national governments can build.

Matched MeSH terms: Interdisciplinary Communication
Fulltext Gender differences in responses towards anti-smoking messages and policy implementation among future doctors in Malaysia

Yasin SM, Ismail N, Noor NM, Mohd Azman MS, Taib H, Jusop JM, et al.

Asian Pac J Cancer Prev, 2013;14(1):303-8.
PMID: 23534742

BACKGROUND: Medical students' views may provide some direction for future policy considerations.

AIM: The aim of this study was to assess gender differences in future doctors' receptiveness to currently implemented anti-smoking messages and the effectiveness of those messages.

MATERIALS AND METHODS: We administered a questionnaire to all students at a medical university in Malaysia, asking how frequently they noted anti- smoking policies, anti-smoking campaigns, and anti-smoking messages in schools. In addition, the questionnaire investigated most effective methods to convey these messages.

RESULTS: A total of 522 (59.7%) students responded. Students were least likely to approve of total bans on cigarettes and increasing the price of cigarettes, and most likely to approve of bans on use of cigarettes in public places and sales to individuals less than 16 years old. Approval of total bans on cigarettes was more common in female students than in males OR=0.39 (95%CI: 0.18- 0.86). Furthermore, compared to the female students, the male students thought that printed media; OR=2.32 (95%CI: 1.31-4.10), radio; OR=1.93 (95%CI: 1.15-3.22) and the internet; OR=1.96 (95%CI: 1.15-3.33) were very effective at delivering anti-smoking messages.

CONCLUSIONS: Gender differences existed in the future doctors' perception of the effectiveness of anti-smoking initiatives. Taking this gender difference into account may increase the receipt of anti-smoking messages in adolescents.

Matched MeSH terms: Persuasive Communication
Soft skills and dental education

Gonzalez MA, Abu Kasim NH, Naimie Z

Eur J Dent Educ, 2013 May;17(2):73-82.
PMID: 23574183 DOI: 10.1111/eje.12017

Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses the different soft skills, how they are taught and assessed and the issues that need to be addressed in their teaching and assessment. The use of the module by the Faculty of Dentistry, University of Malaya for development of soft skills for institutions of higher learning introduced by the Ministry of Higher Education, Malaysia.

Matched MeSH terms: Communication
Fulltext General Public Expectation from the Communication Process with their Healthcare Providers

Hassali M, Shafie A, Khan T

J Young Pharm, 2012 Jul;4(3):193-8.
PMID: 23112539 DOI: 10.4103/0975-1483.100028

The current study aimed to explore the public views and expectation about a successful communication process between the healthcare providers/physicians and patients in Penang Island, Malaysia. A cross-sectional study was conducted in Penang Island using a 14-item questionnaire. Statistical Package for Social Sciences (SPSS) software version 15.0(®) were used to analyze the collected data. A nonparametric statistics was applied; the Chi-square test was applied to measure the association among the variables. P-values less than 0.05 were considered statistically significant. A total of N (500) respondents have shown willingness to participate in the study with a response rate of 83.3%. The majority 319 (63.9%) have disclosed to communicate with their healthcare providers in the Malay language and about 401 (80.4%) of the respondents were found satisfied with the information provided by the physician. It was a common expectation by the most of the sample to focus more on the patient history before prescribing any medicine. Moreover, about 60.0% of the respondents expected that the healthcare providers must show patience to the patient's queries. The level of satisfaction with the information shared by the healthcare providers was higher among the respondents with a higher education level. Furthermore, patients with higher level of education expect that physician shouldwell understand their views and medical history to prescribe a better therapeutic regimen.

Matched MeSH terms: Communication
Fulltext Telepointer technology in telemedicine: a review

Abdul Karim R, Zakaria NF, Zulkifley MA, Mustafa MM, Sagap I, Md Latar NH

Biomed Eng Online, 2013;12:21.
PMID: 23496940 DOI: 10.1186/1475-925X-12-21

Telepointer is a powerful tool in the telemedicine system that enhances the effectiveness of long-distance communication. Telepointer has been tested in telemedicine, and has potential to a big influence in improving quality of health care, especially in the rural area. A telepointer system works by sending additional information in the form of gesture that can convey more accurate instruction or information. It leads to more effective communication, precise diagnosis, and better decision by means of discussion and consultation between the expert and the junior clinicians. However, there is no review paper yet on the state of the art of the telepointer in telemedicine. This paper is intended to give the readers an overview of recent advancement of telepointer technology as a support tool in telemedicine. There are four most popular modes of telepointer system, namely cursor, hand, laser and sketching pointer. The result shows that telepointer technology has a huge potential for wider acceptance in real life applications, there are needs for more improvement in the real time positioning accuracy. More results from actual test (real patient) need to be reported. We believe that by addressing these two issues, telepointer technology will be embraced widely by researchers and practitioners.

Matched MeSH terms: Communication
Fulltext Smoking beliefs and behavior among youth in Malaysia and Thailand

Parkinson CM, Hammond D, Fong GT, Borland R, Omar M, Sirirassamee B, et al.

Am J Health Behav, 2009 Jul-Aug;33(4):366-75.
PMID: 19182982

To characterize smoking beliefs among Thai and Malaysian youth and to examine associations with gender, antismoking media exposure, and smoking status.

Matched MeSH terms: Persuasive Communication
Stories and maps, images and archives: multimethod approach to the political ecology of native property rights and natural resource management in Sabah, Malaysia

Doolittle AA

Environ Manage, 2010 Jan;45(1):67-81.
PMID: 18506515 DOI: 10.1007/s00267-008-9144-0

The study of human-environmental relations is complex and by nature draws on theories and practices from multiple disciplines. There is no single research strategy or universal set of methods to which researchers must adhere. Particularly for scholars interested in a political ecology approach to understanding human-environmental relationships, very little has been written examining the details of "how to" design a project, develop appropriate methods, produce data, and, finally, integrate multiple forms of data into an analysis. A great deal of attention has been paid, appropriately, to the theoretical foundations of political ecology, and numerous scholarly articles and books have been published recently. But beyond Andrew Vayda's "progressive contextualization" and Piers Blaikie and Harold Brookfield's "chains of explanation," remarkably little is written that provides a research model to follow, modify, and expand. Perhaps one of the reasons for this gap in scholarship is that, as expected in interdisciplinary research, researchers use a variety of methods that are suitable (and perhaps unique) to the questions they are asking. To start a conversation on the methods available for researchers interested in adopting a political ecology perspective to human-environmental interactions, I use my own research project as a case study. This research is by no means flawless or inclusive of all possible methods, but by using the details of this particular research process as a case study I hope to provide insights into field research that will be valuable for future scholarship.

Matched MeSH terms: Interdisciplinary Communication
Fulltext Hearing impairment in the elderly

Loh KY, Elango S

Med J Malaysia, 2005 Oct;60(4):526-9; quiz 530.
PMID: 16570725

Hearing impairment is one of the most important health problems of the elderly above 60. Very often it leads to verbal communication difficulty and without treatment it can cause serious psychological and social complications such as depression and social isolation. Prebyscusis remains a leading cause of sensorineural deafness in the elderly. Elderly patient must be encouraged to seek proper hearing assessment if they face hearing difficulty. Active screening by health care workers and patient self-evaluation by answering a simple list of screening questions are possible for early detection and treatment of hearing loss in the elderly. Although hearing loss in the elderly may not have a cure, early rehabilitation helps to restore better quality of life if the problem is detected early.

Matched MeSH terms: Communication
Breast cancer management in middle-resource countries (MRCs): consensus statement from the Breast Health Global Initiative

Yip CH, Cazap E, Anderson BO, Bright KL, Caleffi M, Cardoso F, et al.

Breast, 2011 Apr;20 Suppl 2:S12-9.
PMID: 21388811 DOI: 10.1016/j.breast.2011.02.015

In middle resource countries (MRCs), cancer control programs are becoming a priority as the pattern of disease shifts from infectious diseases to non-communicable diseases such as breast cancer, the most common cancer among women in MRCs. The Middle Resource Scenarios Working Group of the BHGI 2010 Global Summit met to identify common issues and obstacles to breast cancer detection, diagnosis and treatment in MRCs. They concluded that breast cancer early detection programs continue to be important, should include clinical breast examination (CBE) with or without mammography, and should be coupled with active awareness programs. Mammographic screening is usually opportunistic and early detection programs are often hampered by logistical and financial problems, as well as socio-cultural barriers, despite improved public educational efforts. Although multidisciplinary services for treatment are available, geographical and economic limitations to these services can lead to an inequity in health care access. Without adequate health insurance coverage, limited personal finances can be a significant barrier to care for many patients. Despite the improved availability of services (surgery, pathology, radiology and radiotherapy), quality assurance programs remain a challenge. Better access to anticancer drugs is needed to improve outcomes, as are rehabilitation programs for survivors. Focused and sustained government health care financing in MRCs is needed to improve early detection and treatment of breast cancer.

Matched MeSH terms: Interdisciplinary Communication
Separation of prescribing and dispensing in Malaysia: a summary of arguments

Shafie AA, Hassali MA, Azhar S, See OG

Res Social Adm Pharm, 2012 May-Jun;8(3):258-62.
PMID: 21824823 DOI: 10.1016/j.sapharm.2011.06.002

The role of pharmacists has transformed significantly because of changes in pharmacists' training and population health demands. Within this context, community pharmacists are recognized as important health personnel for the provision of extended health services. Similarly, in Malaysia, the need to transform community pharmacy practice has been discussed by all interested parties; however, the transition has been slow due in part to the nonexistence of a dispensing separation policy between pharmacists and medical doctors in private community practices. For decades, medical doctors in private community practices have had the right to prescribe and dispense, thus diluting the role of community pharmacists because of overlapping roles. This article explores dispensing separation in Malaysia and, by taking into account the needs of health professionals and health care consumers, suggests a mechanism for how dispensing separation practice can be implemented.

Matched MeSH terms: Interdisciplinary Communication
Do patients' perceptions exceed their expectations in private healthcare settings?

Suki NM, Lian JC, Suki NM

Int J Health Care Qual Assur, 2011;24(1):42-56.
PMID: 21456497 DOI: 10.1108/09526861111098238

PURPOSE: The purpose of this paper is to investigate whether patients' perceptions exceed expectations when seeking treatment in private healthcare settings in the Klang Valley Region of Malaysia.
DESIGN/METHODOLOGY/APPROACH: A survey was conducted among 191 patients in the Klang Valley Region of Malaysia to measure service quality of the private healthcare setting in Malaysia using SERVQUAL 5 dimensions model by Parasuraman et al. and three additional dimensions of the human element, when it comes to rendering good healthcare services, i.e. courtesy, communication and understanding of customers.
FINDINGS: The results revealed that the customers' perceptions did not exceed their expectations, as they were dissatisfied with the level of healthcare services rendered by private healthcare settings in that they felt that the waiting time of more than an hour to receive the service was excessive and, when there was a problem, the healthcare provider did not provide a response fast enough.
RESEARCH LIMITATIONS/IMPLICATIONS: Only eight service quality dimensions were studied. The sample investigated is relatively small, where three private healthcare settings were selected.
PRACTICAL IMPLICATIONS: It is recommended that hospital management should look into highlighted areas for which patients have high expectations.
ORIGINALITY/VALUE: The paper adds to the existing body of research on healthcare service quality, particularly on patients' perceptions and expectations. Survey results should be useful for continuous quality improvement.

Matched MeSH terms: Communication

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