MyMedR

A study on the use of abbreviations among doctors and nurses in the medical department of a tertiary hospital in Malaysia

Koh KC, Lau KM, Yusof SA, Mohamad AI, Shahabuddin FS, Ahmat NH, et al.

Med J Malaysia, 2015 Dec;70(6):334-40.

PMID: 26988205 MyJurnal

INTRODUCTION: Misinterpretation of abbreviations by healthcare professionals has been reported to compromise patient safety. This study was done to determine the prevalence of abbreviations usage among medical doctors and nurses and their ability to interpret commonly used abbreviations in medical practice.

METHODS: Seventy-seven medical doctors and eighty nurses answered a self-administered questionnaire designed to capture demographic data and information regarding abbreviation use in medical practice. Comparisons were made between doctors and nurses with regards to frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of medical errors due to misinterpretation of abbreviations; and their ability to correctly interpret commonly used abbreviations.

RESULTS: The use of abbreviations was highly prevalent among doctors and nurses. Time saving, avoidance of writing sentences in full and convenience, were the main reasons for using abbreviations. Doctors learned abbreviations from fellow doctors while nurses learned from fellow nurses and doctors. More doctors than nurses reported encountering abbreviations. Both groups reported no difficulties in interpreting abbreviations although nurses reported often resorting to guesswork. Both groups felt abbreviations were necessary and an acceptable part of work. Doctors outperformed nurses in correctly interpreting commonly used standard and non-standard abbreviations.

CONCLUSION: The use of standard and non-standard abbreviation in clinical practice by doctors and nurses was highly prevalent. Significant variability in interpretation of abbreviations exists between doctors and nurses.

Matched MeSH terms: Physicians

Breaking Bad News: An essential skill for doctors

Abdul Hafidz MI, Zainudin LD

Med J Malaysia, 2016 02;71(1):26-7.

PMID: 27130740

Breaking bad news is a process of delivering news, which may negatively affect a patient's view of the future, however is an essential skill for doctors. There are a multitude of benefits if doctors can execute this task well, and will improve the disease journey for the patient. There are several published models including the SPIKES and ABCDE models to help guide the doctor to break bad news effectively. This important skill can be taught through various methods but the most effective may be actually observing a session by senior clinicians.

Matched MeSH terms: Physicians*

Outcomes from the Malaysian Arm of The International Survey Informing Greater Insights in Opioid Dependence Treatment (INSIGHT) Project

George P

Med J Malaysia, 2015 Apr;70(2):117-24.

PMID: 26162395 MyJurnal

BACKGROUND: Opioid dependence (OD) is a chronic, relapsing condition representing a significant societal burden in Asia. Opioid maintenance treatment (OMT) in combination with psychosocial treatment is considered to be the most effective strategy to treat opioid dependence. In Malaysia, about 52,000 patients reported receiving OMT in December 2012.

OBJECTIVE: The International Survey Informing Greater Insights in Opioid Dependence Treatment (INSIGHT) project aimed to assess aspects of OMT access and quality of care by surveying patients and users with opioid dependence, and healthcare professionals treating opioid-dependent patients.

MATERIALS AND METHODS: Using a structured questionnaire, 50 patients who were currently receiving OMT (or had received OMT in the past 3 months) and 77 physicians were surveyed in Malaysia regarding the provision and quality of OMT.

RESULTS: Patients were predominately male and in their thirties. Nearly all patients (98%) reported currently receiving methadone liquid; almost half (48%) reported ever having received psychosocial counselling and only 14% had ever received buprenorphine-naloxone in the past. Most physicians reported they were treating their patients with OMT (77% on methadone and 15% on buprenorphine-naloxone), and 3% used psychosocial counselling alone. Although methadone maintenance doses were close to levels recommended by WHO guidelines, induction doses of methadone, and both induction and maintenance doses of buprenorphine were well below these levels in Malaysia.

CONCLUSIONS: The findings suggest that OMT implementation in Malaysia can be improved by providing patients with more education on treatment options, better access to available treatments, including abuse-deterrent formulations, and psychosocial support.

Matched MeSH terms: Physicians

Fulltext Upper respiratory tract infections: to what extent is the management evidence-based?

Teng CL, Nurjahan MI, Hashim NA, Punithambigai P, Leong KC, Mihat O

Med J Malaysia, 2003 Jun;58(2):159-66.

PMID: 14569735 MyJurnal

Over a 2-week period, the management of upper respiratory tract infection by 24 medical officers and medical assistants in Seremban District was studied. Each practitioner recorded clinical data and prescription for twenty consecutive patients using a structured questionnaire. The extent to which the practitioners used "predictive features" (fever, absence of cough, cervical adenopathy, enlarged tonsils and exudates on tonsils) in clinical decision-making was analysed. The mean antibiotic prescription rate was 28.7% (95% CI: 24.6%, 33.0%). The antibiotic prescription rate of medical officers and medical assistants were similar. Five features were independently associated with antibiotic prescription (phlegm, fever, cervical adenopathy, red throat and tonsillar exudates). Antibiotics were prescribed for 22.1% of patients with 0-1 predictive features. High prescribers were 5 times more likely to prescribe antibiotics in this group of patients than low prescribers. To a large extent the clinical decision-making of practitioners in this study was evidence based. However, they were unduly influenced by purulent manifestation (phlegm) and redness of throat. The antibiotic prescription rate in these government health clinics is potentially reducible by means of educational intervention.

Matched MeSH terms: Practice Patterns, Physicians'*

Fulltext How much should doctors tell their patients?

Abdul Hamid AK

Med J Malaysia, 2002 Jun;57(2):133-5.

PMID: 24326642

Matched MeSH terms: Physicians*

Providing protection for doctors

Hegan T

Med J Malaysia, 2003 Mar;58 Suppl A:141-5.

PMID: 14556362

Over the last decade the number of negligence cases brought against doctors, dentists and other healthcare professional has increased significantly in many countries around the world. In addition, the proliferation of the pathways of accountability in many countries means that doctors are feeling undervalued and vulnerable and are therefore seeking assistance and protection more than ever. The effect of a claim or complaint on a doctor can be devastating both personally and professionally. The relationship with the patient is damaged and an increase in defensive practice ultimately causes an increase in healthcare costs. Patient expectations have increased. Patients are more knowledgeable than they were five years ago and the demands on the professions are increasing daily. Unfortunately because of the long delays that are seen between an incident and a claim it is very difficult to predict what reserves are required in the future. We have seen a number of organisations pull out of the business over the last year and it highlights the importance of having an understanding of the needs of the professions and the ability to track trends in litigation in order to set appropriate subscription rates. Doctors and other healthcare professionals require more than just financial protection. They need support from their colleagues and assistance from experienced lawyers in order to help restore their confidence and ensure that they can continue to practice for the benefit of their patients in the future.

Matched MeSH terms: Physicians*

Fulltext Pre-operative investigations: yield and conformity to national guidelines

Juliana H, Lim TA, Inbasegaran K

Med J Malaysia, 2003 Mar;58(1):5-16.

PMID: 14556321

Routine ordering of pre-operative investigations yields a low true positive rate and is not cost effective. In this study, case notes of 251 adults who underwent elective surgery were reviewed. Pre-operative investigations were classified as 'indicated' or 'not indicated', based on the national guidelines. Only 56% of all tests done were indicated. The overall rates of expected and unexpected abnormal values from pre-operative blood investigations were 51.1% and 34.4% respectively. This study found that selective testing based on guidelines was beneficial. However, the results also suggest that the local guidelines need to be reviewed.

Matched MeSH terms: Practice Patterns, Physicians'/standards*; Practice Patterns, Physicians'/statistics & numerical data

Fulltext Demotivating factors among government doctors in Negeri Sembilan

Sararaks S, Jamaluddin R

Med J Malaysia, 1999 Sep;54(3):310-9.

PMID: 11045056

Motivation, especially on the relationship of remuneration of government doctors to it, has long been an issue of concern. This study sought to elucidate the demotivating factors in service and the perceived discrepancy in income. It was conducted amongst doctors serving in the Ministry of Health, Negeri Sembilan, using self-administered questionnaires. Factors considered demotivating were remuneration, workload and recognition given. Career development, promotion prospects, issues with superiors, resources and patient attitudes were other factors identified. On average, respondents expect an income of 1.63 times more than their current drawn salary and 87.2% cited rewards as a recommendation to improve their satisfaction in service. In-service training was desired by almost all. Though the medical profession has traditionally been viewed as altruistic in nature, doctors in service are voicing out their views and perception, and they should be heard.

Matched MeSH terms: Physicians/psychology*

Fulltext Specialty choices of male and female doctors in Malaysia

Zulkifli A, Rogayah J

Med J Malaysia, 1998 Dec;53(4):327-33.

PMID: 10971974

A survey of specialisation choices was conducted for two batches of medical officers applying to the local medical schools for specialisation in Malaysia. A total of 359 doctors responded, giving a response rate of 71%, with 169 male (44.4%) and 187 female (55.6%) respondents. Surgery ranked highest among the male doctors followed by orthopaedic surgery and internal medicine. Family medicine ranked highest among female doctors followed by public health and anaesthesiology. Among the other specialties, the male doctors preferred otorhinolaryngology while female doctors preferred Pathology. Both male and female doctors chose to be a clinical consultant in a general hospital as the first choice. They prefer to work in or near their hometowns.

Matched MeSH terms: Physicians*

Fulltext Palliative care for lung cancer patients in Penang Hospital

Hooi LN

Med J Malaysia, 2003 Mar;58(1):144-5; author reply 145.

PMID: 14556344

Matched MeSH terms: Practice Patterns, Physicians'*

Fulltext Job satisfaction of doctors in Negeri Sembilan

Sararaks S, Jamaluddin R

Med J Malaysia, 1997 Sep;52(3):257-63.

PMID: 10968095

A cross sectional study was carried out in Negeri Sembilan to identify factors associated with job satisfaction of doctors serving in Ministry of Health and their intentions to resign. All Ministry of Health doctors currently working in Negeri Sembilan were included in the study and data collection was done via a self-administered postal questionnaire. The response rate was 69.4%. Out of those who responded, only 31.3% had global job satisfaction, with the majority dissatisfied. Intention to resign was high among 32.7% of the respondents. Factors found to be significantly associated with job satisfaction were age, job designation, income, duration of service and intention to resign. Intention to resign was found to be significantly associated with ethnicity and income. From logistic regression, predictors of job satisfaction identified were age, place of first graduation, and satisfaction with status and autonomy, satisfaction with career development, satisfaction with workload and satisfaction with transfers. Predictors of intention to resign were race, income and global job satisfaction.

Matched MeSH terms: Physicians*

Fulltext A study of clinical questions in primary care

Fozi K, Teng CL, Krishnan R, Shajahan Y

Med J Malaysia, 2000 Dec;55(4):486-92.

PMID: 11221162

This is a prospective study of clinical questions generated in primary care consultations and a comparison of two approaches to answering those clinical questions. Twenty-one doctors in a university-based primary care clinic submitted 78 clinical questions arising from patient consultations during 24 clinic days (0.01 question per patient encounter). These doctors subsequently found answers to 40% of their questions but were satisfied with only 67% of these answers. The investigators were able to provide answers for 95% of the questions asked and the doctors rated these answers as satisfactory in 86% of instances. Answers obtained by investigators had significantly higher satisfaction score than those obtained by doctors' search (p = 0.002). The two main findings of this study are (1) almost all questions arising in clinic setting could be answered by intensive search; (2) answers found by intensive searches were judged to be more satisfactory than those found routinely by doctors. Provision of an information retrieval service in addition to training in the searching and appraisal of medical literature are possible solutions to the information needs of busy clinicians.

Study site: Primary Care Clinic,
University Hospital Kuala Lumpur i

Matched MeSH terms: Physicians, Family*

Fulltext Good clinical practice: issues and challenges

Merican MI

Med J Malaysia, 2000 Jun;55(2):159-63.

PMID: 19839142

Matched MeSH terms: Practice Patterns, Physicians'/standards*

Fulltext Practice patterns of some gynaecologists in Malaysia with regards to prophylactic oophorectomy and hormone replacement therapy

Ravindran J, Leow CH

Med J Malaysia, 1996 Dec;51(4):409-14.

PMID: 10968026

This study aimed to look at the prevailing practice patterns of gynaecologists with regards to prophylactic oophorectomy and usage of hormone replacement therapy. Questionnaires were sent to the first 200 gynaecologists listed in the membership list of the Obstetrical and Gynaecological Society of Malaysia. The response rate was 30%. The results showed that most gynaecologists would perform prophylactic oophorectomy after the age of 49 years. The result was equivocal for the ages between 45 to 49 years. Of those who retained the ovaries at the age of 45 to the menopause, 55% did so because the ovaries were still functional. Almost all gynaecologists would prescribe hormone replacement therapy (HRT) after oophorectomy and the most commonly prescribed form was the oral type. Thirty-five per cent of gynaecologists claimed that more than 80% of their patients were compliant to HRT. The reasons perceived for the poor compliance were mainly poor knowledge and misconception.

Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*

Fulltext Substance abuse and the doctor

Deva MP

Med J Malaysia, 1993 Jun;48(2):99-100.

PMID: 8350811

Matched MeSH terms: Physicians*

Fulltext Inhaler technique among doctors: a survey in Hospital USM

Riduan BA, Ismail Y

Med J Malaysia, 1993 Sep;48(3):269-72.

PMID: 8183137

A survey of inhaler technique using a placebo metered dose inhaler was performed among 41 house and medical officers from the Medical and Outpatient departments, Hospital USM. The majority (76%) of them had been taught at one time or another regarding inhaler technique. However, only 18 of them (48.9%) used the metered dose inhaler correctly. Medical officers currently in the Medical Department had the highest percentage of correct technique (75%); followed by medical officers in the Outpatient Department (57.1%). Among house officers, 30.8% demonstrated correct technique. The most common error was failure to hold their breath after inhaling the aerosol (53.7%).

Study site: Medical and Outpatient departments, Hospital USM.

Matched MeSH terms: Physicians*

Fulltext Drinking habits of Malaysians in general practice

Maniam T

Med J Malaysia, 1994 Dec;49(4):369-74.

PMID: 7674973

Five hundred and sixty-two consecutive attenders at an urban general practice were studied using the Consumption Index which has been successfully used in a general hospital sample. Seventy per cent of Chinese, 11% of Malays and 42% of Indians have used or are currently using alcohol-a vast majority of them were social drinkers. Among those who ever drank, 6% of Chinese and 22% of Malays drank more than 14 units per week. The hypotheses that more Indians used alcohol and used it more heavily were not supported in this urban sample. Possible explanations for these findings and the limitations of this study are discussed.

Matched MeSH terms: Physicians*

Fulltext How good are doctors as drug prescribers?

Rahman AR, Noor AR, Hassan Y

Med J Malaysia, 1994 Dec;49(4):364-8.

PMID: 7674972

The training of doctors in therapeutics has created interesting discussions internationally. A survey of senior hospital pharmacists currently practising throughout West Malaysia was embarked on during a recent postgraduate seminar. About sixty per cent said prescribing errors were common amongst doctors. Sixteen per cent of the prescribing errors were potentially serious. Most of the time errors were due to carelessness, lack of knowledge on drug action or a combination of both. Nearly 35% of prescribing errors were not acknowledged by doctors. Most doctors did not give reasons for not acknowledging pharmacists' intervention. About half (46.5%) of the respondents thought that doctors were not adequately trained in the use of drugs.

Matched MeSH terms: Physicians*

Fulltext A review of the management of 107 dizzy patients at the university hospital

Krishnan G

Med J Malaysia, 1994 Mar;49(1):44-8.

PMID: 8057990

The common investigations done were pure tone audiometry, electronystagmography, X-ray of the internal auditory meatus, CT-scan of the internal auditory meatus and X-ray of the cervical spine. After the examinations and investigations only 52 patients out of the 107 could be given any diagnosis. The most common diagnosis for the vertigo was Meniere's disease.

Matched MeSH terms: Practice Patterns, Physicians'

Fulltext Habits and attitudes of Malaysian military doctors towards smoking

Supramaniam V

Med J Malaysia, 1980 Mar;34(3):205-10.

PMID: 7412660

A postal questionnaire survey was carried out among military doctors during June to August 1979 on habits and attitudes to smoking. An 87% response rate was obtained. Smoking prevalence was found to be 50%. 45% of medical officers are heavy smokers. Age at starting influence the amount smoked. Service life had no influence on smoking habits. Attitudes to smoking vary between the different categories of doctors. The habits and attitudes indicate a mental revolution on the part of doctors is required prior to any anti-smoking programme as they have to be sufficiently motivated to lead the fight.

Matched MeSH terms: Physicians

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