The objective of the study is to investigate the extent of preventive and promotive health care in the ambulatory management of paediatric gastroenteritis in an incompletely immunised child using the simulated patient methodology. Only 44% of doctors explained to the fathers the nature of their child's ailment. 75% of clinicians prescribed oral rehydration solution but only 4% met the Gold Standard. The questionnaire survey showed that doctors rated immunisation as a very important health message to disseminate to all parents. But only 3% of doctors in the study advised parents to complete each child's immunisation once he is well. The extent of preventive and promotive health care in ambulatory paediatric practice in the Klang Valley is very low. (Copied from article).
A questionnaire survey to study the smoking habits and attitudes toward smoking among secondary school teachers in Kelantan, Malaysia was conducted between July and September 1992. Questionnaires were sent to 5,112 teachers through their respective headmasters. Sixty-three percent (3,208 teachers; 61% males, 39% females) responded satisfactorily. Overall, 625 teachers (20%) were current smokers, 141 (4%) were occasional smokers, 317 (10%) were ex-smokers and 2,123 (67%) had never smoked. Only six (0.8%) of the 766 regular and occasional smokers were females. The rates of smoking among parents and siblings of smokers were higher than parents and siblings of non-smokers. Seventy-four percent of the smoking teachers admitted to smoking in the school premises. The teachers' attitudes about the health effects of smoking were statistically different between smokers and non-smokers. However, both smoking and non-smoking teachers had similar views regarding methods to control the smoking habit which included banning cigarette sales, putting a halt to the tobacco industry and banning cigarette advertisements.
The purpose of this study is to explore the types of problem students that clinical teachers encounter in clinical settings. A questionnaire developed by the Association of American Medical Colleges that lists a variety of types of problem students was completed by 466 clinicians at the University of Washington School of Medicine (UWSOM) and 98 Malaysian clinicians from Universiti Kebangsaan Malaysia (UKM) and Universiti Sains Malaysia (USM). In addition, 120 medical students from UKM completed a slightly modified version of this questionnaire. Both the faculty and student questionnaires asked the respondent to identify the frequency of a given problem type. The faculty was also asked to estimate how difficult it was to evaluate a specific problem. In general, there was strong agreement among the North American and Malaysian faculty on the frequency and difficulty of the 24 types of problem students listed. There were some notable differences, such as Malaysian teachers perceiving the "shy" student more frequently than their North American counterparts who rated the student with deficits in knowledge more frequently. However, the overall similarity in the rankings suggest that clinical teachers face similar types of problems, independent of cultural differences and institutional differences.
Questionnaires (4000) on experience of menopausal symptoms in Singaporean women aged 40-55 were distributed by students. In total, 524 envelopes were returned (13.1%) and of these 420 were analyzed. Of these, 366 were classified as either pre-, peri- or postmenopausal on the basis of their menstrual patterns. Menopausal symptoms in this sample of Singaporean women were, in general, similar to those experienced in the West though the prevalence was low compared to European studies. No significant differences in individual symptoms were found between the 3 groups but, taken together, symptoms were significantly highest in the perimenopausal and lowest in the other menopausal groups. In the postmenopausal group 50% had been menopausal for at least 1 year at 50.5 years.
One hundred and eighty-three patients undergoing surgery were interviewed twenty-four hours following surgery to assess the quality of pain relief they received in the immediate postoperative period. Interviews were conducted using a standard questionnaire for all patients. They were asked to (1) rate the quality of pain relief they obtained on a Visual Pain Analogue Scale (VPAS-0 being no pain and 10 being the worst imaginable pain); (2) state whether they were happy and satisfied with the pain relief they received; (3) if dissatisfied, they were asked to give their reasons. 37.7% (69 patients) had moderate to severe pain--pain score greater than 6 on the VPAS. Most of these patients had undergone abdominal or major orthopaedic surgery. 32.7% (60 patients) were unhappy with their postoperative pain control. The main reasons for complaint from the patients were that analgesic injections were either not given promptly or were not given at all. The survey also highlighted the inadequate under-administration of narcotic injections in the postoperative period despite orders being written up. It showed there is an urgent need for setting up an Acute Pain Service for better postoperative pain control. An anaesthesiology based Acute Pain Service was started in October 1992.
A questionnaire survey was conducted to examine the attitudes of Malaysian dentists toward patient education and preventive dentistry and the level of preventive care adopted in Malaysian dental practice. An adjusted response rate of 73.1% was obtained. Generally the Malaysian dentists had positive attitudes towards patient education and preventive dentistry including fluoridation. However, a sizable proportion of them considered that preventive measures were no challenge for the dentist. The common preventive measures given to patients were scaling, dental health education, prophylaxis and instruction in correct brushing and flossing in as much as 40 to 50 percent of the queried dentist claimed that these preventive items were provided to most or all of their new patients. In spite of the fact that the majority of the dentists had good knowledge about the application and effects of sealants only about 41 percent of the dentists claimed to have used sealants. More dentists in the private sector reportedly having done so. Also many Malaysian dentists (18.5%) did not use leaded protection for any of their new patients when taking radiographs.
Observational and survey methodologies were used to probe human behavioral factors influencing the use of insecticide-impregnated bednets to control malaria in rural Sabah, Malaysia. One aim was to investigate why a field trial of such nets in an interior area yielded disappointing results. A second aim was to gather baseline data prior to a field trial proposed for a coastal area. Interior villagers reported a significantly higher net usage rate than that observed directly, suggesting that subject self-reports need to be validated in some way. The poor results of the interior field trial appeared related to reluctance to regularly use nets, which were not in wide use previously. Prospects for reducing malaria transmission through bednets appeared better for the coastal area since nearly half of observed villagers were sleeping in them. However, significantly more coastal than interior villagers were observed watching television at night, an activity that may increase malaria risk by keeping villagers awake and out of bednets.
A questionnaire survey on smoking was conducted among 395 medical students (40% males, 60% females) at the School of Medical Sciences, University Sains Malaysia at Kubang Kerian, Kelantan. Thirty-five students (9%), all of them males, were current smokers. Twenty-eight percent of the smokers smoked more than ten cigarettes per day and 88% began smoking before entering the medical school. Social influence and cigarette advertisements were the main reasons given for starting smoking. Both smokers and nonsmokers were adequately informed of the common adverse effects of smoking. Ninety percent of smokers had tried to give up smoking but failed. Among the ex-smokers and nonsmokers, the main reasons given for not smoking was that smoking was useless. Among the female students, one-third felt that cigarette smoking was socially unacceptable among females. This was one of the three main reasons for not smoking. Very few of the students (4.6%) considered that doctors' advice would play an important role in smoking prevention.
This study examines the usefulness of the "CAGE", (which is an acronym for "cut down", "annoyed", "guilty" and "eye-opener"), a 4-question screening test to identify excessive drinkers among Malaysian inpatients. The CAGE questionnaire after translation and back translation was administered to all inpatients in the General Hospital, Kuala Lumpur. The author interviewed 'blindly' all who score positive on the CAGE score and 10% of all negatives using the DSM III interview schedule for alcohol abuse dependence. The results show that the CAGE performs best at a cut-off point of 2 and above, with a sensitivity of 92%, specificity of 62%, positive predictive values of 38% and Kappa (K) of 0.37 with a DSM III R diagnosis for alcohol abuse/dependence. The poor agreement with a DSM III diagnosis indicates that the CAGE is not useful in the Malaysian population. Reasons suggested for this are: cultural factors in the Malaysian population resulting in the overrating of the question of 'guilt' by Muslims and translations into the local languages which are only the closest approximations.
This cross sectional study explored the health problems and health needs in the local Chinese community in Glasgow. Several data collection methods have been used in this study, including face-to-face and telephone structured interviews, postal and hand delivered questionnaires. A total of 800 questionnaires were processed, and 493 were completed, giving an overall response rate 61.6%. The results from the present survey indicated that the health status of Chinese residents in Glasgow is poorer than that of the local population. The most important findings of the study is that the Chinese community in Glasgow underuse health services, and unmet health needs exist in the community. The main barrier to effective use of present health services and benefit from the health promotion and health education programmes is language difficulties. Following discussion with the local community, options for improving the health services for the Chinese community in Glasgow were obtained. The findings of the study have implications for health service purchaser/providers of health care to the Chinese population generally in Scotland.
A questionnaire survey on cross-infection control was conducted among 1371 professionally trained dentists whose names appeared in the Malaysian Government Gazette of 1990. A 73.1 percent response rate was obtained. About 13 percent of the dentists routinely did not wear gloves during treatment of patients as opposed to 54 percent who routinely did. About 83 percent and 52 percent of dentists wore a mask and eyewear or glasses respectively when carrying out dental procedures. About 93 percent of dentists would use a new sterile needle for each patient and about 40 percent would wipe working surfaces with disinfectant after each patient. The practice of sterilizing handpieces was found to be uncommon as opposed to the sterilization of hand instruments. Variations were observed in some of the infection control measures by gender, seniority in service and employment status. More than one-third of the respondents had experienced puncture wounds during the last month prior to the survey.
This study deals with personality variables of medical students in relation to their academic success in the preclinical stage. One hundred and one students completed the 16PF Questionnaire at the beginning of their medical course and the scores were analysed in relation to their marks obtained at the end of the 2-year preclinical stage. This study shows that the 16PF Questionnaire can be a useful instrument for identifying personality variables in candidates who are likely to have academic problems and those who are likely to do well in the preclinical stage of a medical course. Students of urban origin and the eldest in the family performed better in their preclinical years. Performance was not related to sex, ethnic group, family size of entrance qualification into medicine. Personality variables of being enthusiastic, venturesome, self-opinionated, imaginative, experimenting, resourceful and driven correlate positively with performance, whereas being self-assured has negative correlation. Problem students were more reserved, emotionally less stable and more apprehensive than non-problem students.
OBJECTIVE: This study examines the extent to which preventive and promotive advice is integrated into the clinical practice of doctors.
STUDY DESIGN: Using a cross-sectional descriptive survey design, the study compares the performance of doctors in giving healthy lifestyle advice for five clinical conditions, their perceived practice and their rating on the importance of disseminating selected key lifestyle messages.
DATA EXTRACTION METHODS: A total of 28 volunteers were trained to simulate the five clinical conditions which required related health advice and to rate the doctors' performance with the use of a prepared checklist. Simulated patient ratings of 343 doctor-patient encounters provided the data on doctors' health promotion efforts for the selected clinical conditions. A post-visit self-administered questionnaire survey of a sub-sample of 100 doctors gave an insight into their opinions and perceived practice.
PRINCIPAL FINDINGS: Only in 49% of the instances was a health promotion message given. The doctors' encouraging interest in health education and health promotion and their positive perceptions of their volume of healthy lifestyle counselling were not borne out in actual clinical practice.
CONCLUSIONS: The results indicate that the extent of preventive and promotive health education in both the public and private health sectors is unacceptably low. The matter needs to be addressed through training programmes as well as the formulation of clear health promotion priorities and strategies in Malaysia.
Given the magnitude of drug addiction in Malaysia, the government has given top priority to this issue. It is timely that an assessment of knowledge, attitudes and perceptions related to drug abuse and drug dependents among the general public be carried out. Thus, a nationwide survey was undertaken. A representative sample of 2,591 respondents aged 13 years and above from households were surveyed throughout the 11 states and the Federal Territory of Kuala Lumpur in Peninsula Malaysia. The results revealed that the respondents are moderately knowledgeable on drug abuse, especially information pertaining to treatment, rehabilitation and aftercare services, including education to families against drug abuse. The public possess a negative attitude towards drug dependents. Majority felt that drug addicts do not have the will power to rid themselves of drugs and they also lack a supportive family network system. Many believe that the most vulnerable group are the adolescents. Respondents were aware of the type of drugs commonly abused, although they failed to realise their long-term effects. Respondents do not attribute low education, large family and marginal income to the background of drug dependents. The findings showed gaps and misconceptions in terms of knowledge, attitudes and perceptions of the public. Accurate knowledge on, and right attitudes and perceptions towards drug related issues would certainly benefit the public in timely prevention of drug abuse.
The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.
The objective of this paper is to assess the perception of bodyweight status among the office workers in two government departments in Kuala Lumpur. A total of 385 Malay workers aged between 18 to 55 years were randomly selected from the Prime Minister’s Department and the Ministry of National Unity and Community Development. The weights and heights of all subjects were measured and their Body Mass Index (BMI) determined. In this study, obesity is defined as individuals having ï‚³ï€ 25 kg/rn 2 . A questionnaire was prepared to obtained information on socioeconomic status, health aspects, dietary intakes, activity levels and perception on bodyweight status. The study revealed a high prevalence of obesity (38.1 %) and among the obese subjects, 21.7 % perceived themselves as having normal weight. The normal weight and underweight subjects perceived themselves as obese (33.5 % and 6.3 % respectively). A small percentage (5.7 %) of the obese individuals who perceived themselves as obese did not wish to lose weight. In contrast, 9.7 % of the normal weight subjects who perceived themselves as having normal weight wanted to lose weight. A third person’s perception on the subjects’ bodyweight status is significantly associated with the subjects’ bodyweight status (P
A postal questionnaire concerning the Malaysian dentists' attitudes towards their patients yielded a 73.1% response rate. The results of this study indicated that a majority of dentists felt that patients had more negative than positive attributes. Private practitioners attributed more negative traits to their patients than their public sector colleaques. About 88% of dentists indicated that the most negative patient attribute was fear of pain. Fear of pain was perceived to be stronger than fear of the dentist (62.2%). likewise the patients' inability to seek treatment soon enough (78.4%), to come for regular check-up (72.7%) and to follow advice on personal oral hygiene(70.1%) were worrisome.
A 73.1 percent response rate was obtained in a postal questionnaire survey conducted among Malaysian dentists to assess their attitudes and needs for continuing dental education. It appeared that on an average the Malaysian dentist spent very little time on continuing education,reading journals and participation in professional dental meetings.The need for continuing education was strongly evident as almost all dentists indicated that such activities be further developed in Malaysia. Crown and Bridgework, Oral Surgery and Orthodontic appeared to be areas in which more continuing education were required.
The aim of the article is to report on the perception of utilizers of government dental services towards the preservation of natural teeth for life and relate it to their past utilization pattern and the associated demographic factors. All patients aged 15 years and over attending ten randomly selected government dental clinics in Selangor, Wilayah Persekutuan and Negri Sembilan during the study period of thirty non consecutive outpatients days were interviewed and examined clinically. Five-hundred and fifty subjects were included in the survey. It was found that the majority of respondents (63%)have a.rather pessimistic perception of their ability to preserve natural teeth for life and most have a very poor past utilization behaviour (90%).The most pessimistic and worst utilization behaviour was reported by the Malay ethnic group, the least formally educated and the lowest income group (p O.O1).It is postulated that one of the main reason for this trend among Malay respondents could be due to their lower educational and income status, rather than cultural influences. Further research into the influence of culture on the utilization pattern of the Malays is therefore recommended.