Introduction: Behavioural-based safety (BBS) programme is an accident prevention programme emphasized on the aspect of unsafe behaviour, which considerably new in Malaysia. The oil and gas industry is among the industries in Malaysia that has successfully implemented and sustaining the programme. The aim of this study is to measure and evaluate the effectiveness of BBS towards the safety performance in the oil and gas industry in Malaysia that certainly has owned an outstanding safety performance.
Methodology: A cross-sectional study using secondary data involving five indicators in the safety performance in the department of health, safety and environment (HSE) was performed at one of the oil and gas refinery companies in Malaysia. These indicators were chosen based on the frequency of its occurrence from January 2004 to December 2008.
Result: The results of the study show the presence of a significant difference in the incidence rates of near misses (p=0.008) and medical treatment cases (p=0.035) before and after the implementation of BBS and a very strong negative relationship (r=-0.885) between the incidence rates of near-misses and the rates of BBS observations done. However, analysis on unsafe behaviour does not show a significant reduction from 2006 to 2008. Instead, a significant reduction was seen on equipments failure from year 2006 to 2007 (p=0.021) and 2006 to 2008 (p=0.032).
Conclusion: The study has proven that the BBS is effective towards the reduction of the indicators in the safety performance, involving only the incidence rates of the nearmisses and the medical treatment cases. However, a very strong negative relationship only involves the incidence rate of near misses. A significant reduction was also seen on the occurrence of instrument failure, which is one of the root causes of near-misses. Although there is no significant reduction on thye unsafe behaviour, the reduction of equipment failure is expected to be related to the increase in the level of awareness and safe behaviour as a result of BBS implementation.
Background: Without any doubt, the combo of user ID and password are the most used authentication method in the computing and internet environment. However, due to the enormous number of accounts that require password authentication, users tend to develop bad habits in their password practices which in turn will put their account security at risk. With the increasing use of computing in health-care settings and the use of EMR in hospitals, such practices are a cause for concern.
Methods: This is a cross-sectional study using self-administered questionnaires, investigating the practice of the respondents in keeping their passwords secure. Respondents in this survey are the undergraduate students of Faculty of Medicine, Universiti Kebangsaan Malaysia.
Results: Among the findings are that 87.4% of the respondents used the same password for more than one account. If a user used the same password for several accounts, it might trigger a domino effect if any of the account passwords were compromised. A total of 98.9% of the respondents memorised their password only in their mind, without writing down the password anywhere. This may lead to using easily guessable passwords which may introduce additional security risk to their accounts. The majority of the respondents (96.6%) never or rarely change their passwords. The study also showed that 82.7% of the respondents used passwords which are 6-8 characters in length. Longer passwords are usually safer but harder to remember. The questionnaire also explored the users’ password combination style, whether they used numbers only or combination of numbers and alphabets or some other pattern. A total of 39.1% used letters only but 27.6% used combination of numbers only which is less secure. About 77% of the respondents used personal information such as their birthday date or a person’s name as part of their password.
Conclusions: This habit may make their password guessable to people who are close to them. In conclusion, most medical students are not practising safe password conduct and they should be educated on this. If not, patients’ data confidentiality may be compromised in the future due to such practices.
A cross-sectional study was undertaken to compare patients’ level of recall on verbal and written information about orthodontic treatment. Participants were the patients and parents attending the orthodontic screening clinic, Universiti Kebangsaan Malaysia (UKM). Participation was voluntary. Participants were placed into two groups. One group was given only written information in the form of an information leaflet, while another group was given only verbal information. The information content comprising of 13 items was based on the Patient Information Leaflet published by the British Orthodontic Society. Both groups received similar content of information in their preferred languages. Self administered close-ended questionnaire forms were given to the subjects after 15 minutes to assess the level of recall. The answers from both groups were compared. Data collected was analyzed using SPSS version 15.0. Chi-square test (p=0.05) was conducted to determine the effect of the method of information on the percentage of recall. A total of 79 subjects volunteered to participate in the study. There were more females than males. The majority were found to have achieved secondary level formal education. Comparison of each question item showed no significant difference between those who were provided with verbal or written information. Both groups showed a high proportion of correct responses. In conclusion, there was no difference in the patients’ level of recall whether the orthodontic patient was given verbal or written information.
Decision making in nursing is one of the most important skills nurses must apply and utilize in their nursing practice. The aim of this study was to determine the perception of clinical decision making ability among nursing students. A descriptive cross-sectional study was conducted in a tertiary hospital. A total of 54 nursing students were recruited using a modified version of Clinical Decision Making in Nursing Scale (CDMNS) adapted from Jenkins (1985). The findings showed good CDMNS score with mean and standard deviation of (124.24±12.713). The four sub-scales of CDMNS were: searching for alternative (33.24±4.821), canvassing (28.74±3.514), evaluation and re-evaluation (31.43±3.922), searching for information (30.83±4.765). Nineteen (35%) of the participants chose nursing as their first choice, whereas 35 participants (65%) did not. Thirthy seven (69%) participants were satisfied with their nursing competency, 17 (31%) were unsatisfied. There were significant differences between searching for alternatives, evaluation and re-evaluation, and nursing as their first choice (p=
Study site: Nursing students, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Effective management of cancer pain is often hampered by patients’ lack of knowledge regarding cancer pain management and other barriers related to ethnicity and religious beliefs. This cross sectional study was performed to determine the patient-related barriers to effective cancer pain management. One hundred patients receiving cancer pain management were studied. Inclusion criteria were: patients over the age of 18 years, able to communicate, with known diagnosis of cancer, experiencing persistent pain for the past two weeks. A modified version of the Barriers Questionnaire II (BQ-II) was used and a modified Brief Pain Inventory was used to assess the pain profile. Barriers such as, patient’s attitude and beliefs, communication skills and fear of side effects of pain medication were determined, given a score and the summation was recorded as the total patient related barriers score. Overall, 85% of respondents achieved more than 40% pain relief and the 72 of 100 patients reported low patient related barrier scores of 6 or less. Nevertheless, the main patient related barriers were: fear of tolerance to opioids (51%), ethnicity (p=0.003) and religious beliefs (p=0.002) which constituted the major components of the patient-related barriers score. Ethnicity and religious beliefs had significant influence on patient-related barriers score suggesting the need of further investigation into this area. In order to achieve a comprehensive view, other barriers to effective cancer pain management such as those related to the health systems and healthcare providers need to be assessed together.
A cross sectional study to measure the prevalence of domestic violence and the factors associated with it among women who seek treatment at Hospital Pontian Out Patient Department was carried out in September 1998 until April 1999. The study sample was chosen through systematic random sampling. A total of 370 women between 15 to 49 years were selected and the response rate was 100%. The Results show the one year prevalence rate of domestic violence was 16.8% and life- long prevalence of domestic violence was 35.1%. Studies shows significant difference between the prevalence of domestic violence by age, marital and working status, age at marriage, knowledge, attitude and action to be taken toward domestic violence. Percent of victim is higher among women less than 20 year old, single, still schooling, negative attitude and action towards abuse and less knowledge of place for seeking help. Factor that contribute significantly toward domestic violence among single women is the lack of positive action in dealing with violence and among married women are early marriage(<25 year), lack of positive action in dealing with violence and lack of moral support from husband and family.
Key words: prevalence of domestic violence, mangsa keganasan, associated factors, contributing factors
Study site: Outpatient clinic, Hospital Pontian, Johor, Malaysia
The study aims to evaluate students’ perceptions towards e-Learning Management System (e-LMS) in pharmacy education. A cross-sectional survey was conducted among all undergraduates enrolled at School of Pharmaceutical Sciences, Universiti Sains Malaysia. A pre-validated questionnaire consisting of two domains (demographic characteristics and students’ perception regarding the use of e-LMS) was used for data collection. Descriptive statistics were used to describe the demographic characteristics of the study respondents. Chi Square test was used to measure association between the study variables. All analysis was performed by using Predictive Analytical Software (PASW) v. 18. A total of 315 students completed the survey questionnaire with a response rate of 57.6%. Majority of the students (61.0%) accessed e-LMS to acquire lecture notes for their studies, followed by 53.3% have used e-LMS for the preparation of the assignments. Seventy eight percent of the respondents agreed that e-LMS is very useful and felt that e-LMS is making their studies easier. However, 50% of students claimed that poor network connection at the campus is a major barrier in accessing e-LMS. Moreover, 48% of the respondents disagreed that e-LMS should be taken into account as an assessment criterion for students’ grading. Students are found to be frequently engaged in using e-LMS and believed that online based learning is
enhancing their academic performances. Nevertheless, students still prefer hybrid teaching methodologies than choosing traditional system or e-learning as an alone entity.
Prevalence of visual impairment among students is increasing in trends especially in rural area. A cross sectional study was conducted among secondary school students in Taman PKNS Beranang, Selangor in March 2008 with the objective of determining the prevalence of visual acuity impairment and its influencing factors. A total of 77 secondary school students were interviewed using guided questionnaire. The prevalence of visual acuity impairment among the respondents was 25.0% and study found that being female and have been watching television at a distance of less than two meters were significantly associated with visual acuity impairment. In conclusion, the problem occurred maybe due to the students sit nearer to the television (
Background: The approach to the teaching of ethics and professionalism in the Faculty of Medicine (FM) of International Islamic University Malaysia (IIUM) is unique. A specifically designed package is incorporated designated as the Islamic Input into the Medical Programme (IIMP). The IIMP spans over the entire 5 years of the medical programme. In the Faculty of Allied Health Sciences (FAHS) students do not go through a similar Islamic Input module but exposed to ethical issues specific to health sciences. Method: The aim of this study is to assess the impact of the teaching of ethics through the IIMP. A cross-sectional study was conducted in medical and allied health sciences faculties of IIUM. In total 259 students volunteered and were allocated to 4 groups, Years 2 and 5 students of FM and Years 2 and 4 of FAHS. A set of questionnaire consisting of 20 vignettes related to medical ethics was distributed to all students. An independent t-test was used to compare the mean total scores between the groups. Results: A significant difference (p < 0.05) was seen between the mean total scores for the Year 2 and Year 5 students of FM; Year 2 students of FM and Year 2 students of FAHS; and between the Year 5 students of FM and Year 4 students of FAHS. Also there was significant difference between the two medical and allied health sciences groups as a whole. Discussion: This study suggests that the IIMP of the IIUM has a positive impact on the medical students when dealing with ethical issues. The Year 5 medical students were expected to have obtained a higher mean total score. The probable reason for the lower mean total score include the teaching-learning approach utilized which is mainly lecture with minimal small group approach. Also the allocation of marks for medical ethics in summative assessment in the IIUM medical curriculum is minimal compared to the core medical subjects which would have some influence on the weight given by students. Conclusion: The Medical Faculty of IIUM believes that the approach to the teaching of medical ethics by incorporating the Islamic Input module is effective, practical and relevant. However the teaching-learning method and the assessment will have to be re-addressed to achieve greater impact.
Objective: This study intended to determine the prevalence of anxiety and depressive symptoms and to compare their severities among rural residents based on their socio-demographic variables. Methods: A cross sectional study was conducted among 520 residents in East Coast Peninsular Malaysia who completed the Malay Hospital Anxiety and Depression Scale (HADS). Data were analyzed with SPSS 17.0, whereby descriptive statistics and nonparametric tests were utilised for scores comparison. Results: The prevalence of mild anxiety and depressive symptoms was at 12.90% and 11.30% respectively. Statistically significant associations between gender and monthly income with anxiety and depressive symptoms were observed (p < 0.01). Conclusion: Findings in our study indicated that the prevalence of anxiety and depressive symptoms among rural residents was low. Nevertheless, females and those with higher education (> PMR) background were comparatively more prone to these mood disorders. Healthcare professionals should be constantly alerted to these tendencies in the process of providing medical services especially in rural areas.
Objective: To investigate patient’s perceived satisfaction and adequacy of information given by doctors on prescribed drugs in an outpatient psychiatric setting.
Methods: The sampling was done consecutively with a target sample size of 200 patients. A simple questionnaire that was developed with 10 close-ended questions and yes or no answers was administered by the interviewing team. This questionnaire assessed patients' knowledge on prescribed medications and their perception on the adequacy of information given.
Results: More than 80% of the patients were informed regarding the reasons, timing to take medication(s), duration of drug treatment and type of prescribed drugs. Half of them were informed regarding the side effect profiles of their prescribed medications. Majority of them (80%) were satisfied with the information given despite only 49% of the patients being given adequate information on their medications.
Conclusion: Patients who are adequately informed about their medications are more significantly satisfied than those inadequately informed. (χ2=4.085, p<0.05).
Key words: perceived satisfaction, adequacy of information, prescribed psychotropic drug
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
This is a cross-sectional, two-year follow up study. The authors determined the varied presentations of delirium, dementia and other organic disorders to assess their mortality and outcome. They described the diagnosis of patients suffering from the psychiatric effects of those organic states and compared their symptom resolution and mortality between those with the acute and chronic varieties during their index hospitalization and again, 24 months later. Although mortality rates did not differ, patients with the acute syndrome had significantly better outcomes in terms of symptom resolution as compared to those with the chronic syndrome (p=0.001). Patients with symptom resolution upon discharge did not show statistically significant lower mortality rates.
Background: The weekly held clinical pathologic case conference popularly known as CPC provides an effective and regular educational media of collaborative learning for inter-disciplinary exchange of knowledge among the faculty members of an institution. CPC has been routinely practiced for the last two decades in School of medical Sciences (SMS) at Universiti Sains Malaysia (USM). An hour session primarily involves a case presentation hiding the diagnosis followed by discussion on differential diagnosis and floor interaction on interesting clinical cases. It also gives an opportunity to new teaching staff in the institution to experience an in-house practice of presenting the clinical cases; witch can readily be reproduced as a case report for publication. An effort to follow the original format of CPC is comprehended as an essential outcome of this study to keep up the sanctity of CPC as a case method of learning medicine in future. Methodology: A questionnaire-based survey was recently conducted to evaluate the weekly held CPC in SMS. It was a cross sectional survey in which a questionnaire comprising of 23 items was administered to a targeted population of faculty members of School of Medical Sciences. The items in questionnaire were grouped into 5 clusters. All respondents were adequately briefed through a letter addressing the objectives and importance of survey and its appraisal aiming to revamp the CPC guided by the out-come of study. Questionnaires were administered to 240 academic staff, covering > 80% of the target population of 294 faculty members. 159 (66.2%) members of sample population completed the questionnaires. Total non-responses were 81 (33.7%) and item non-responses were 320 (8.7%) Result: All the items in questionnaire were found significant (p 0.016) except those two items related to, observing a difference in preparing for a case presentation verses a formal CPC presentation and its promotion (p 0.556 and 0.197 respectively). It was also established that the major respondents were unaware of the original format of CPC (p 0.003) in which a presenter select and prepares a case, which is discussed with participating faculty members for its differential diagnoses. 51.6% faculty members did not follow the formal CPC format (p 0.016) in their presentations. A lack of awareness about the format of CPC was shown by (61.0%) faculty members (p 0.003). Conclusion : It was concluded that emphasis to discuss the differential diagnosis by a competent discussant was lacking, as presenters did not follow the formal CPC format. It was critically observed that a number of presentations made in this weekly program deviate from the original format adapted by SMS in USM. However, the out-come appraisal of this survey was the pledge shown by the majority faculty members to adapt the guidelines as a reverence to the formal CPC format.
Background: Faculty’s role as educators is over looked in clinical education, even though the teaching has a direct reflection of performance of clinical competence and professional development of graduating doctors. Two major problems of clinical education are the lack of uniform teaching and learning strategies in postgraduate as well as later years of undergraduate clinical teaching and the professional development of faculty in teaching in medical institutions. Objective: The survey has two major objectives. First objective was to know about the faculty response to a survey on teaching while trying to create awareness for teaching and research in teaching. The second objective was to know the faculty members’ understanding with principles of learning and teaching with strengths and weaknesses of respondents’ performance in clinical teaching on completing The Educator’s Self-Reflective Inventory (ESRI). Method: The ESRI was administered to approach 214 faculty members in SMS at USM. Appraisal of self-reflection inventory as medical teacher and personal development with respect to challenges, opportunities, innovations and need assessment of teaching were explored in response to 35 items grouped in 5 clusters through a questionnaire-based survey utilizing ESRI. Result: Statistical analysis of respondent’s data indicates a mixed response with lab-based disciplines 54.54% followed by surgical-based disciplines 50% and medical-based disciplines 30%. Individual discipline best response is received from Plastic Surgery and ORL-HNS (100%) and Hematology (77.77%). A result of individual item response in each cluster WAS also analyzed. Conclusion: The survey evaluated the faculty’s response to ESRI and concern shown to develop their abilities as teachers and researchers in clinical teaching. However, the initial response suggested the need for more survey to continue creating the awareness for faculty development and research in teaching. Conclusion drawn from analysis of each items in inventory is encouraging for teaching in medical education.
Objective: BigSib Students' Peer-Group Mentoring Programme was implemented as an innovative, interactive and integrated instructional method in the Universiti Sains Malaysia medical school curriculum designed to enhance and strengthen medical students training in soft skills and professional development. This study was conducted to evaluate first- and second-year medical students’ perceptions of and attitudes towards the Programme.
Methodology: A cross sectional study was carried on 314 medical students. Questionnaires assessing medical students' perceptions and attitudes towards the Programme were administered. Data were analysed by using SPSS version 12.
Results: 45.9 % of the students perceived the BigSib Students' Peer-Group Mentoring Programme as successful. More than 50% of the students are willing to participate in the Programme. About 60% of the students perceived it as an effective Programme in developing their soft skills and professionalism.
Conclusion: Medical students have positive attitudes toward the Programme and it is perceived as a successful and effective Programme in developing students' personal attributes. Similar peer-group mentoring programme may be considered relevant to be incorporated into the medical curriculum in the future.
Introduction : Nursing is an occupation associated with high risk of developing back pain due to their nature of work practices. The aim of this study was to determine the prevalence of back pain among nurses working in government health clinics and hospitals in Port Dickson and the factors associated with it.
Methods : A cross sectional study was conducted involving 126 nurses working in government health clinics and district hospital in Port Dickson. They were universally sampled. A selfadministered questionnaire, assessing personal and socio-demographic characteristics, back pain, work factors and psychosocial factors.
Results :The prevalence of back pain among nurses was 79.4% and factors that showed significant association were workplace (p=0.026) and carried heavy load (p=0.043).
Conclusion : Where one work and nature of work one does has been shown in this study to be important issues to be considered in helping to manage back pain related to work. It is also recommended that staff need to be encouraged to do exercise to strengthen the back muscles, increase spinal flexibility and blood circulation to the spine as well as need to be reminded regarding ergonomic adjustment at work.
Introduction : Studies on stress among diabetic patients with complications are not much conducted locally. In this study the researchers would like to find out the magnitude of the problem among the Malaysian.
Methodology : A cross- sectional study was conducted to determine the prevalence of stress and its associated factors among the diabetes mellitus patients with complications at Raja Perempuan Zainab II Hospital, Kota Bharu, Kelantan. The translated Personal Stress Inventory questionairse was used to measure the stress among the respondents.
Finding : The prevalence of stress was 36.8%. The study showed that the employment status of respondents has significant association with stress in which higher numbers of unemployed respondents were stressed as compared to the employed respondents. Other sociodemographic factors, namely duration of having diabetes mellitus and type of complications developed by the patients were not significant.
Conclusion : Once the poor and unemployed patients were diagnosed to have diabetes mellitus either with or without complication, the health staffs should refer them immediately to the relevant agencies for help. By doing so, these patients could be prevented from having stress later. Outreach programmes in the community should be carried out regularly for an early detection and treatment of chronic diseases including diabetes mellitus to prevent patients from developing any complication.
This cross-sectional study was carried out to identify A. actinomycetemcomitans and P. intermedia in the subgingival plaque of three ethnic groups (Malays, Chinese and Indians) in a selected group of adult Malaysians with advanced Chronic Periodontitis and to correlate these findings with their periodontal status. Thirty periodontally diseased adults were age, gender and ethnically matched with 30 healthy individuals. Clinical parameters were assessed for all. Subgingival plaque samples were collected for identification of A. actinomycetemcomitans and P. intermedia using polymerase chain reaction. Prevalence for P. intermedia (83.3%) was high and A. actinomycetemcomitans
(6.7%) low in the total subject population. P. intermedia and A. actinomycetemcomitans were more
prevalent in diseased (86.7%, 10% respectively) than in healthy (80%, 3.33% respectively) subjects. A. actinomycetemcomitans was detected in 15% Indians, 5% Malays but none of the Chinese subjects whereas P. intermedia was detected in 90% Malays, 85% Indians and 75% Chinese subjects. No significant association between presence of A. actinomycetemcomitans
and P. intermedia with race and periodontal disease status was found. Only A. actinomycetemcomitans had a significant association with clinical attachment level (CAL) (p < 0.05). In conclusion, in this small subject group, none of the pathogens were associated with race and periodontal disease status and only A. actinomycetemcomitans had a significant association with CAL.
The purpose of this study was to determine the quality of counter service at the Ministry of Health hospitals as perceived by patients. This was a cross sectional study using selfadrninistered questionnaires distributed to patients at the outpatient departments in all Ministry of Health Hospitals. By the end ofthe data collection period, 118 of 121 hospitals (total number of MOH Hospitals) participated with 93.2% response rate., The hospitals were divided into four categories, for the purpose of this study 1000 sample size were needed in each category, the number of sample size were obtained using Epi Info Program based on assumption that 30% Of patients were dissatisyded with the services provided and with a precision of 10%. In this study the quality were based on clarity and provision of services based on Client Charten deliverance of clear infomation by the healthcare personnel, priority treatment given to urgency of the cases, cleanliness of the facilities and teamwork among the staff This study revealed about 64% of patients perceived that the hospitals had provided quality services at the counter: Only about 11% of patients were not happy with the quality of the services given at the counter. The proportion of happy patients increased from the smaller to the bigger hospitals. In terms of delivering services according to the Client Charter; only about 15% said that service was not provided by the counter staff according to the Client’s Charter On the aspect of priority on the urgent cases, about 64% of the patients perceived that urgent cases were not seen immediately. About 64% of the respondents felt that the hospitah do provide quality services. Strategies should focus on the bigger hospitals because non conformance to quality occurs more frequently there. The post of Counter Supervisor should be created to ensure that quality services are delivered.
Study site: outpatient departments in all Ministry of Health Hospitals
Objective: This study assesses the impact of prescribed undergraduate psychiatry training program on medical students’ attitudes to psychiatry. It is hypothesized that training may cause positive attitude changes towards the discipline and status perceptions of the profession of psychiatry. Methods: A 23 item questionnaire was administered to 89 medical students before and after prescribed training in psychiatry as per the medical curriculum. Results: Participation in psychiatry training enhanced students’ belief that it is a rapidly expanding frontier of medicine and that psychiatry can be viewed as precise and scientific. Psychiatric referrals were seen as useful to medical and surgical patients. However there was less agreement that psychiatric treatment is helpful to most people. Support for choice of psychiatry as a career was less as students were more negatively influenced by family. Poor income prospects and perceived low status among other medical disciplines were also endorsed following the completion of training.Conclusion: There is a pressing need to revise the psychiatric training for medical students. A total attitude change is difficult to achieve and hence, the curriculum has to identify focal areas for emphasis. A multidisciplinary, bio-psychosocial model through liaison with other disciplines like medicine and surgery is a definite option. Psychiatrists have to be role models to alter the image of psychiatry among other medical professionals.