METHODS: Bone procurement workshop was held for 2 days for doctors and paramedics. The knowledge on bone procurement was evaluated in pre- and post-assessments by answering self administration questionnaire before and after the workshop, respectively.
RESULTS: A total of 50 participants comprised of doctors and paramedics attended the workshop however only 15 (55.6%) doctors and 12 (44.4%) paramedics completed the assessments. Overall, the mean total score for the post-assessment (61.4%) was significantly higher (p
METHODS: As a quasi-experimental design with a control group and pre-tests., we examined 1,598 medical records of T2DM subjects in six healthcare facilities in the state of Pahang, Malaysia. In all study sites, there was a pre and post-intervention assessment of the percentage of appropriate statin therapy prescribing that complied with the clinical guidelines with no potential safety issues. The intervention was an academic detailing program offered to the health care providers in three study sites, while the other three sites served as the control group. A comparison of the overall percentage of appropriate statin therapy prescribing before and after the academic detailing was performed in all intervention and control sites.
RESULTS: Overall, 797 medical records were examined in the pre-intervention phase, and 801 records were evaluated in the post-intervention phase. The academic detailing program was associated with a statistically significant difference in the proportion of appropriate statin therapy prescribing between the post-intervention phase compared to the pre-intervention phase (n = 246, 61.7% versus n = 188, 47.1%), p = 0.001. Whereas, the appropriate statin therapy prescribing in the control study sites experienced a modest change from 53.8% (214/398) to 56.7% (228/402), p = 0.220. The academic detailing showed significant increases in the proportions of appropriate statin therapy prescribing in both hospital and primary care settings.
CONCLUSIONS: The academic detailing program was found to be significantly associated with a positive impact on the overall statin therapy prescribing among patients with T2DM in Malaysian hospital and primary care settings.
METHODS: This cross-sectional study was conducted from July to October 2016. All the 140 doctors in 12 public primary care clinics in Kuala Lumpur were invited to participate in this study. However, only 122 doctors (females, 82.8%) completed the self-administered questionnaire that assessed their demography, clinical experience, SCI practice and its barriers, self-efficacy in delivering and knowledge on smoking and SCI.
RESULTS: Only 42.6% of the doctors had good SCI practice. Almost all doctors assessed the smoking status of their patients (98.4%) and advised them to quit (98.4%). However, lesser proportions of the doctors followed up the practice of patients (50.0%), taught smokers on various methods of quit smoking (46.70%) and discussed about the barriers and resources to quit prior to the quit date (27.9%). Less than one-fourth of the doctors were confident in providing SCI. Although 69.7% had previous training in SCI, many felt they had inadequate knowledge (56.6%) and skills (47.5%). Only 11.5% of doctors thought their previous training was enough. Having higher level of knowledge on smoking and SCI was significantly associated with good SCI practice [adjusted Odds Ratio (95% Confidence Intervals): 1.21 (1.02, 1.43), p=0.026].
CONCLUSION: The SCI practiced by the primary care doctors in this study was sub-standard, particularly in assisting smokers to quit and arranging follow up. Low self-efficacy in providing SCI was also common. These inadequacies may be due to poor knowledge and skills, which needs to be improved through effective clinical training.
OBJECTIVE: This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required.
METHODS: For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field.
RESULTS: We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics.
CONCLUSIONS: Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era.
Objectives: We aimed to systematically produce empirical evidence on the WPV against health care workers in Africa through the review of relevant literature.
Method: We sourced for evidence through the following databases: PubMed, Science direct and Scopus from 30th November to 31st December 2019 as well as the reference list of the studies included. A total of 22 peer reviewed articles were included in the review (8065 respondents). Quality appraisal of the included studies was assessed using critical appraisal tools for cross-sectional studies.
Result: Across the studies, diverse but high prevalence of WPV ranging from 9% to 100% was reported with the highest in South Africa (54%-100%) and Egypt (59.7%-86.1%). The common types were verbal, physical, sexual harassment and psychological violence. The correlates of WPV reported were gender, age, shift duty, emergency unit, psychiatric unit, nursing, marital status and others. Various impacts were reported including psychological impacts and desire to quit nursing. Patients and their relatives, the coworkers and supervisors were the mostly reported perpetrators of violence. Doctors were mostly implicated in the sexual violence against nurses. Policy on violence and management strategies were non-existent across the studies.
Conclusion: High prevalence of WPV against healthcare workers exists in Africa but there is still paucity of research on the subject matter. However, urgent measures like policy formulation and others must be taken to address the WPV as to avert the impact on the healthcare system.
OBJECTIVE: The objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians.
METHODS: We used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum.
RESULTS: Based on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (P
Methods: The questionnaire contained items on the socio-demographic characteristics, medical condition, quality of life (QOL), nutritional status, functional capacity, and depression status. The forward and backward translation processes of the original English language version of the questionnaire were undertaken by three independent linguistic translators, while its content was validated by an expert team consisting of seven geriatricians, physicians, dietitian, and lecturers. The Malay version of the questionnaire was tested for face validity in 10 older adult patients over 65 years of age. The internal consistency reliability and construct validity were evaluated among 166 older adult patients (mean age, 71.0 years; 73.5% male). The questionnaire was administered through face-to-face interviews with the patients. Minor amendments were made after the content and face validity tests.
Results: The internal consistency reliability was good, as the Cronbach's alpha for most of the scales surpassed 0.70, ranging from 0.70 to 0.98, with only one exception (Mini Nutritional Assessment Short-Form, Cronbach's alpha=0.62). The factor loadings for all scales were satisfactory (>0.40), ranging from 0.45 to 0.90.
Conclusion: The Malay-version CGA showed evidence of satisfactory internal consistency reliability and construct validity in Malaysian geriatric patients.
METHODS: Survey forms were sent to contact lens fitters around the world, every year for 20 consecutive years (2000 to 2019). Practitioners were asked to record data relating to the first 10 contact lens fits or refits performed after receiving the survey. Data were analysed for those countries reporting ≥ 1,000 contact lens fits during this period.
RESULTS: A total of 369,209 contact lens fits were recorded from 40 eligible countries, comprising 2,309 scleral lens fits and 366,900 other (non-scleral) lens fits. Overall scleral lenses represented 0.76 per cent of all contact lens fits with significant differences between countries (p
METHODS: The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study.
RESULTS: One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge.
CONCLUSIONS: The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes.
TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016.
DESIGN: Qualitative study with a quantitative component.
SETTING: Pediatric and adolescent gynecology unit at Universiti Kebangsaan Malaysia Medical Centre, Malaysia.
PARTICIPANTS: Twelve women with MRKH.
INTERVENTIONS: Face-to-face interview and short questionnaire.
MAIN OUTCOME MEASURES: Thematic analysis was used to understand participants' experiences.
RESULTS: There were 7 themes identified: (1) delayed diagnoses; (2) doctors' roles and attitudes; (3) gender identity; (4) family and society's response; (5) reaction toward infertility; (6) managing sexual intimacy; and (7) coping mechanisms. Several participants consulted their physicians regarding their primary amenorrhea at an opportunistic setting. When they were referred to the gynecologists, they were dismayed at the lack of information given. The term, "MRKH" plays an important role to ease information-seeking. Participants felt that the doctors were insensitive toward them. Mental illness is a significant complication of MRKH. All participants acknowledged that infertility was the hardest part of the condition. The importance of blood lineage affects their outlook on childbearing options. Some were afraid of sexual intimacy and worried that they would not be able to satisfy their partners. Participants gained support and bonded with their counterparts in the MRKH support group.
CONCLUSION: A multidisciplinary approach including medical, psychological, and social support is essential for the management of MRKH. Adequate information and sexual education plays the utmost importance in preventing social-related complications of MRKH.
METHODS: This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach.
RESULTS: A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs.
CONCLUSION: Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients' attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.
METHODS: Nine AD experts from South and East Asia and one from Europe developed the algorithm based upon treatment guidelines, relevant literature and local treatment practices. The algorithm outlines current best practice for the use of emollients, topical corticosteroids (TCS) and topical calcineurin inhibitors (TCI), with the intention of simplifying the treatment regimen of mild-to-moderate AD in South and East Asia.
RESULTS: Patients with AD should bathe and cleanse affected skin to remove crusts and scales daily. Emollients should also be applied daily as a maintenance treatment. When selecting appropriate topical anti-inflammatory treatment for AD flares, several factors should be taken into consideration, including the patient's age, attitude to treatment options and site of AD lesions. Given the concerns regarding the risk of skin atrophy with use of TCS, a TCI should be used to treat AD lesions in sensitive skin areas: pimecrolimus is recommended for mild-to-moderate AD in these locations, while tacrolimus should be considered for moderate and severe cases. Either pimecrolimus or tacrolimus is recommended for flares in other, non-sensitive body locations. A proactive or intermittent maintenance treatment strategy involving regular emollient use and twice-weekly application of a TCI to previously affected areas is encouraged to reduce the risk of flares.
CONCLUSIONS: The algorithm proposed here is intended to simplify the topical treatment of mild-to-moderate AD in daily practice in South and East Asian countries.
METHODS: A cross-sectional questionnaire-based survey was employed, and a convenience sampling was opted to collect the data among physicians, pharmacists and nurses working in tertiary care public hospitals of Lahore, Pakistan from September 2018 to January 2019.
RESULTS: Of the 384 questionnaires distributed, 346 health care professionals responded to the questionnaire (90.10% response rate). Most participants had good knowledge about ADR reporting, but pharmacist had comparatively better knowledge than other HCPs regarding ADR (89.18%) pharmacovigilance system (81.08%), its centres (72.97%) and function (91.89%). Most of the participants exhibited positive attitude regarding ADR reporting, such as 49.1% of physicians (P
METHOD: A validated questionnaire (Cronbach's alpha 0.71) was used to collect data from HCPs in two CCHF endemic metropolitan cities of Pakistan by employing a cross-sectional study design. For data analysis percentages, chi-square test and Spearman correlation were applied by using SPSS version 22.
RESULTS: Of the 478 participants, 56% (n = 268) were physicians, 37.4% (n = 179) were nurses, and 6.5% (n = 31) were pharmacists. The proportion of HCPs with good knowledge, attitude, and perception scores was 54.3%, 81, and 69%, respectively. Being a physician, having more work experience, having a higher age, working in tertiary care settings, were key factors for higher knowledge (p