DESIGN: Cross-sectional, cross national.
SETTING: Multi-centre, primary care clinics Malaysia and Singapore.
PARTICIPANTS: 1123 adults with hypertension enrolled and analysed.
PRIMARY AND SECONDARY OUTCOME MEASURES: Comparison between sociodemography, disease characteristics and the mean scores of HTN-SCP domains (behaviour, motivation and self-efficacy) and the factors influencing hypertension self-care.
RESULTS: 1123 adults with hypertension attending primary care clinics in Malaysia and Singapore were involved. The participants' mean age was 63.6 years (SD 9.7) in Singapore and 60.4 (SD 9.1) in Malaysia. Most of the participants in Singapore had tertiary education (22.3%) compared with Malaysia (13.0%), p<0.001. A higher proportion of participants from Singapore had controlled blood pressure (74.6%) compared with Malaysia (33.8%), p<0.001. The mean total score of HTN-SCP was significantly higher among Singapore participants compared with Malaysia participants 190 (SD 28) versus 184 (SD 23) (p<0.001). Similarly, the mean score for motivation domain 67 (SD 10) versus 65 (SD 9), followed by self-efficacy score 65 (SD 11) versus 62 (SD 9) and behaviour score (58 SD 9 vs 56 SD 9) were higher among Singapore participants. In both countries, the factors which influenced higher HTN-SCP mean scores across all domains were being Indian and had tertiary education.
CONCLUSIONS: The study population in Singapore had a higher HTN-SCP mean score compared with Malaysia. The common factors influencing higher HTN-SCP mean scores at both study sites were ethnicity and level of education. Future intervention to improve self-care among people with hypertension may need to be tailored to their behaviour, motivation and self-efficacy levels.
METHODS: A semistructured interview study was conducted among 17 patients and 18 pharmacists in three tertiary hospitals in Malaysia. All interviews were audiotaped and transcribed verbatim. Themes were developed using a constant comparison approach and thematic analysis.
RESULTS: Five main themes emerged from the data, namely, achieving mutual understanding, recognizing individuality, communication style, information giving, and medication decision making. For both pharmacists and patients, a PCC consultation should promote mutual understanding and non-judgmental discussions. Communication was an important element to bridge the gap between patients' and pharmacists' expectations. Patients emphasized the importance of emotional aspects of the consultation, while pharmacists emphasized the importance of evidence-based information to support patient engagement and information needs.
CONCLUSIONS: Comparison of pharmacists' and patients' views provided insight towards important aspects of PCC in pharmacist-patient consultations. It was suggested that PCC is not a one-sided approach but rather a patient-provider collaboration to optimize the consultation. Further research can be done to improve the integration of PCC in the local health care context, including pharmacist consultations.
METHODS: The norm-referenced method of standard setting was applied to the real scores of 40 final-year dental students on a multiple-choice question (MCQ), a short answer question (SAQ), and an objective structured clinical examination (OSCE). A panel of 10 judges set the standard using the modified-Angoff method for the same paper in one sitting. One judge set the passing score of 10 OSCE questions after 2 weeks. A comparison of the grades and pass/fail rates derived from the absolute standard, norm-referenced, and modified-Angoff methods was made. The intra-rater and inter-rater reliabilities of the modified-Angoff method were assessed.
RESULTS: The passing rate for the absolute standard was 100% (40/40), for the norm-referenced method it was 62.5% (25/40), and for the modified-Angoff method it was 80% (32/40). The modified-Angoff method had good inter-rater reliability of 0.876 and excellent test-retest reliability of 0.941.
CONCLUSION: There were significant differences in the outcomes of these three standard-setting methods, as shown by the difference in the proportion of candidates who passed and failed the assessment. The modified-Angoff method was found to have good reliability for use with a professional qualifying dental examination.