This survey was done to determine the knowledge, attitude and practice of preventive measures concerning Severe Acute Respiratory Syndrome (SARS) among Alor Gajah town community. The purpose of this study was to determine the knowledge level of SARS, to know their attitude towards SARS and health information provided, to know which sources that provide the best infomation about SARS and to identify the expectations and preferences of population on gaining health infomation. A cross-sectional study involving respondents age 18 and above staying in Alor Gajah town was done. The respondents were assessed using questionnaires comprising of 25 questions. A total 180 respondents had answered the questionnaire. All of them were aware of SARS with 93 .3% with high scores in the knowledge level. Furthermore, 9l .7% of respondents had high scores in their attitude towards SARS. About 98.9% of respondent got their information regarding SARS from television, and 83.9% of them believed the information given. Firty four percent choose television as the best method to convey information concerning SARS or other new emerging diseases. The knowledge and attitude of the respondents concerning SARS were good.
A cross sectional study was conducted to determine the perception of Hospital Directors in performing clinical duties. This was done through a postal survey which was conducted covering all public hospitals in Malaysia. The majority of Hospital Directors had read the circular at the time of the study and agreed to do clinical work besides managerial duties. Before the issuance of the directive, the majority of those directors were already doing some clinical work. However they disagreed that by doing clinical work they could help overcome the problem of shortage of doctors. They agreed that the duration of 10 hours per week is suitable to do clinical duties. In term of confidence in giving curative treatment, the Hospital Directors especially those from district hospitals without specialists were confident in giving curative care to individuals. As for the clinicians, the majority felt that the implementation of the directive for Hospital Directors to do clinical work will not disrupt the clinicians' routine duties.
Study site: University Malaya, Universiti Kebangsaan Malaysia; Hospital Kuala Lumpur, Malaysia
A cross·sectional study was done to determine the capacity of Public Health Inspectors in Selangor using a seh administered questionnaire and universal sampling, to determine the enforcement of public health legislation and its influencing factors. A total of 99 respondents from the District Health Offices and 100 respondents from the Local Health Departments participated. The level of enforcement is generally low in all the units except for the Food Unit and Sanitary and Hygiene Units. Factors influencing enforcement of Public Health Legislations are the unit where the respondents worlc and the length of service with the unit. Further analysis using multiple logistic regression, found that respondents from the Food Unit (OR ZZ; 95% C1: 7 .9-58.9 ) , being in the
U8 category (OR 5; 95% C1: l.4» 17.6), service offour years and above in the same unit (OR 6; 95% C1: 2.2»13.8) , received service rewards (OR 3; 95% C1 : 1.2· 6.9); low exposure to bribery (OR 46; 95% C1: 2.3·100.0) and offered bribes while on the field (OR 3; 95% C1: 1.02» 4.8) have higher kvel enforcement performance. Attention must be given to the enforcement organization with respect to duration of service, service awards and monitoring of bribes exposure to help develop the enforcement of public health legislations.
A cross sectional study was conducted in Kelantan state with the objectives to determine the prevalence of smoking in 2004 and to determine the relationship between smoking and age, sex, educational level, family and peer influence. All residents aged 15 years and above from all the selected households were included in this study. A standardized pre-tested structured questionnaire was used in this study. Out of 1025 respondents interviewed the prevalence of ever and current smokers was 34% and 25.1% respectively.The prevalence of ever smokers and current smokers was significantly higher In males as compared to females (p.<0.001). The mean initiation age for the males current smokers was 10.4 (95% CI = 19.4, 21.5) years with a range from 7 to 66 years. For the females the mean initiation age was 31 (95% Cl =26.8, 35.2) years with a range from 15 to 64 years. The difference between the mean initiation age between male and female smokers was statistically significant (p<0.0001). The overall mean duration of smoking was 23.9 years with a median of 23 years. It ranged from less than 1 year to 66 years. There was no significant difference between the mean duration of smoking between male and females current smokers (p =0.59). There was a significant association between current smoking status and education level (p<0.01 ) and between smoking and peer influence (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. In conclusion the prevalence of smoking in Kelantan state in 2004 is lower than the reported prevalence in 1996. However, it is still very high especially in the males.
Key words: Smoking, peer influence, Kelantan
The National Health Morbidity Survey 1996 showed only 34.2% of women aged 20 years and above had done breast self examination (BSE). This data showed the practice of BSE is still low despite of various awareness programmes and activities carried out. A cross sectional study through Systematic Random Sampling was done at Out Patient Department, Kuantan Health Office to know the knowledge and practice of BSE among women aged 20~60 years. The results showed 94.9% respondents had received information about BSE, however only 31.6% knew the appropriate time to do BSE, 14.7% knew the purpose of doing at that time and only 29.9% knew how frequent they should do BSE. 74% of respondents did BSE, however 70.2% of them did not do monthly and 67.2% did not do at the suggested time. There was an association between the practice of BSE with the knowledge and sociodemographic characteristics i.e. educational level, income, ethnic group and marital status.
Key word: Breast self-examination, breast cancer, Kuantan.
Study site: Klinik Kesihatan, Kuantan, Pahang, Malaysia
A cross—sectional study conducted in the fasting month of Ramadan targeting muslim males assessed their religious beliefs in relation to smoking and their intentions t0 quit smoking in Ramadan. It was found that there law; is a strong association between their perceptions on the religious ruling of smoking as haram (prohibited) in relation to their smoking status. Among the non smokers and ex smokers, 87.8% and 73.6% respectively accept the ruling on smoking as prohibitea'(haram), while only 31.6% of smokers accept smoking as prohibited. Among the smokers, 97.7% smoke a lesser number of cigarettes during Ramadan, while 96.7% of them felt that it is easier to quit during the fasting month. The findings suggest that the religious department needs to provide more information and education to the Muslim population as to the reasons of the ruling on smoking as haram(prohibited) on religious grounds . It was also found that the majority felt it is easier to quit during quit smoking programmes can be emphasized and carried out on a bigger scale during fasting months in the future.
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
The objective of this pilot cross-sectional study was to assess effcacy of training dental officers (DO) and nurses (DN) in the Index of Orthodontic Treatment Need (IOTN). A conventional training method of lectures, manual; and md5,0n* exettise was used for bath Lest groups. 30 study models in all grades in the Aesthetic component (AC) and dental health component (DHC) were graded by 27 subjects (13 DO, 14 DN) after training. Results were cnrrlparedfor agreement with an exper; group, Kappa statistic: was used to assess strength in agreement in correct grouping of AC and DHC in the Categorie; gf treatment need, Wilcoxon Rank sum test was used to compare mean kappa and % 0 correct res ames in the test. Spearman rank correlation was used to test association of 11g experience with mean kappa values. There was ‘m0demte’ agreement in correct groupingfor ojjqcers in AC (K=O.5l) and DHC (K`=O.4l); Cmd 'fair’ j‘0'f TluTS€S in AC (K=O.40) and DHC (K:O,34). There was no significant difference between groups. Subjects were better at identifying cases with definite need than little/ borderline need for treatment. There was more inaccurate grading in DHC Gmde+qualifier for both groups (p
A cross»sectional study using self administered questionnaires on sociodemographic and service factors influencing locum practice was undertaken among all Government medical officers in Negeri Sembilan and Malacca for 8 months from 2 7 April 1999 to 9. l January ZOOO. Universally chosen samples were made of 335 Government medical officers from both the 'Public Health Division' and ”Hospital Division' and from 154 who responded, only 147 samples were chosen and analysed in the study. Results revealed that locum were still being practised by 51 .9% of male Government medical officers, 41 .0% of Government medical ofhcers aged less than 30 years, 43.4% of Government medical officers who had served less than 5 years and 55.6% of Government medical officers who had earned nett income less than RM 1 000. Meanwhile, 80.9% of Government medical officers who had earned gross income more than RM 5 OOO did not practice locum during the study. Logistic Regression analysis then revealed that locum practice among Government medical ofhcers can positively be influenced by gender (male) , Malay ethnic, service duration of less than 5 years, practice in the 'Public Health Divisionl and nett income of less than RM 1 OOO (p
A cross sectional survey was conducted in Kampung Datuk Kerarnat, an urbanized residential area in Kuala Lumpur from August to November ZOO5 to assess knowledge, attitude and preventive practices on dengue among its residents. A two stage sampling strategy was used to select survey household. An adult aged at least 21 years old was identified from each selected household and interviewed using a standardized questionnaire. Data was collected on demographics, dengue related KAP and house-types. Knowledge, attitude and practice were assessed using a scoring system. Each appropriate answer was given a point and the points for each section of the questionnaire were totalled. Knowledge was assessed as ‘good' or ‘moderate to poor’ based on arbitrary cut-off point. Out of 133 respondents interviewed, 78.2% were able to identify at least one clinical sign of dengue, 73% knew that dengue fever was caused by the bite of dengue infected Aedes mosquitoes, 71 % correctly identified breeding sites, 69.2% correctly identified the Aedes mosquito and 42% correctly reported biting times ofthe mosquito vector. Overall, knowledge
was categorized as poor, attitude was good and dengue control and prevention practices was moderately poor. There was a weak but significant positive correlation between knowledge and practice (r=0.271, p=0.002) but there was no significant correlation between attitude with practice and between attitude with knowledge (p>0.05) . The results suggested that inspite of good attitude l
on dengue fever, it did not correlate with good practices and good knowledge in dengue prevention. We conclude that there is a need to increase health promotion activities to increase knowledge which forms the basis for preventive practices as part of the strategy to control dengue. Preventive strategies are the only means of controlling the disease.
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
Client satisfaction upon health services is important for public especially for those who have to undergo treatment for tuberculosis (TB) noted for its difficult regime. The purpose of this study is to measure client dissatisfaction level towards TB treatment & services among TB patients in government outpatient health services and the factors that influenced it. This study was carried out in all the districts of West Coast Division of Sabah. It was conducted from June 2002 to November 2002. Study design is cross-sectional, with population samples taken on those who are currently receiving outpatient TB treatment in government health facilities. Questionnaires forms were used as study tool and filled by either by respondent or through the help of trained interviewer. The outcome is based on the total score obtained through Likert scales to determine the proportion of dissatisfied group from the respondents. A total of 488 patients took part in this study. Results of study showed overall percentage of 31.8% dissatisfaction level towards TB
treatment & services, while dissatisfaction towards TB treatment and upon health services alone were 54.3% and 24.0% respectively. The predictive factors for client dissatisfaction towards TB treatment and services are those without education, longer waiting time and have opinion of insufficient number of health staff.
Key words: Tuberculosis, client satisfaction, TB treatment, services, Sabah.
Study site: Outpatient clinics, hospitals, Sabah, Malaysia
Risks of transfusion increase with the increase in the number and volume of transfusions occurring in hospitals year after year. Knowledge and practice of the nurses on proper transfusion techniques and risk reduction procedures should always be updated to ensure that transfusions are safely carried out. The study was done to determine the levels of knowledge and practice of trained nurses regarding blood transfusion in a general hospital. The study is a cross-sectional survey using a questionnaire, distributed to all staff nurses in the medical-based wards and intensive care unit (ICU) in the hospital. The total score were added for each category of knowledge and practice. Ninety one percent of the total population of staff nurses in medical based wards anti ICU were recruited into the study. A score of 80% or more in the knowledge and score of IOO% is required for practice to consider it as a pass, The outcome of the study showed that no one respondent in the study has achieved the required level, with regard to neither knowledge nor practice. The mean knowledge score was 54.8 with SD. of 9,9; while the mean practice score was 63 .8 with S.D. of 1.4. It was found that there was no rehtionship between knowledge score, nor practice score with the clinical postings (place of work) , work experience, and nursing qualification. This survey had indicated probkms faced by the nursing population in the hospital studied that there was a need to improve knowledge and practice levels with regards to blood transfusion procedure. It is crucial that updated information concerning transfusions be communicated to these nurses since they were the ones who carry out the procedures whilst continuously observing the patients during transfusion.
A cross sectional survey on the assessment of coronary heart disease risks was conducted on a group of security guards in a public university. The objectives were to assess the risk of coronary heart disease (CHD) among the security staff and to provide advice on CHD prevention and practice of a healthy lifestyle. A face»t0»face questionnaire was used to conduct the survey. The main outcome measure was the coronary heart disease (CHD) risk score estimates. The handings showed that 61 participants ( 5 3 .0%) have very high CHD risk factors, while the rest, 38.3% and 8.7% have moderate and low CHD risk factors respectively. With increasing age, there is an increase in total risk score among the target groups. The percentage increases almost 2-fold between the 21-30 and the 31-40 age groups. Majority of the security staff had high CHD risk factors and more efforts and preventive measures must be taken to overcome this situation. Personalised advice was given to participants based on their CHD risks estimates.
Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.
Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.
Method: A cross- sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.
Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001) . Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.
Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.
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.
Introduction: Undergraduate medical education should be broad-based, holistic, integrated and should promote a framework for the development of higher order cognitive skills like communication, professionalism and teamwork to prepare the student for a life-long challenging medical career. Recent calls for a competency-based medical education require, in addition, competency in clinical and procedural skills prior to graduation. This study investigates how often opportunities exist for medical students to perform four common ward procedures prior to graduation.
Method: A prospective cross-sectional study to assess the opportunities a medical student have in performing four common ward procedures, comprising intravenous cannulation, nasogastric tube insertion, urinary catheterisation and chest tube insertion, in a State General hospital in Malaysia was done.
Results: A medical student has sufficient opportunity to perform only intravenous cannulation prior to graduation. He has a remote chance to insert a urinary catheter and is unlikely to have the opportunity to insert a nasogastric tube or insert a chest tube prior to graduation.
Conclusion: Although competency in clinical skills and procedural skills prior to graduation are desirable, this is increasingly difficult to achieve due to shortage of clinical material, teachers to supervise, the large numbers of medical students and house officers, the short time spent on the main disciplines and the failure of many universities to invest heavily in skills laboratories staffed by full time clinicians. The calls to introduce competency-based medical education in undergraduate medical education, particularly in procedural competence, should take into account the challenges in delivery and the realities in the hospitals today. This is necessary to avoid demoralising students who are unable to achieve their quota of procedures through no fault of theirs.
Keywords: procedural competency, medical education, Malaysia
Background: This cross sectional study was done to identify the areas of lack of knowledge, practice and awareness of students about the effective use of personal protective equipment (PPE).
Methods: A total of 40 students were selected when they were posted to the accident and emergency unit (A&E) in Seremban Hospital; all of them answered a questionnaire and were observed unaware on the effective use of PPE in the A&E.
Results: We found that 17.5% of students were unaware of the right technique of removing the gloves after a procedure and 25% of students were unaware of safety of hand washing. During invasive procedures, 12.5 % of students did not wash their hands before invasive procedures, 65% did not wear aprons and 57.5% did not wear masks. During non- invasive procedures more than 25% of students did not wash hands before or after the procedures.
Conclusion: There is still significant lack of knowledge in students about the effective use of PPE that needs to be addressed.
Keywords: PPE, Personal protective equipment, effective practice of PPE, A&E
Background: The International Medical University (IMU) has an outcome-based curriculum defined by eight major curriculum outcome domains.The attributes, qualities and competencies expected of a health care professional form the basis for these outcome domains. Community service is an effective curriculum delivery tool widely practised by medical universities around the world. We present the results of a survey among IMU students to explore the effectiveness of community service as a curriculum delivery tool in enabling activities defined within the major curriculum outcome domains of IMU.
Methods: A self-administered 6-point Likert scale questionnaire was used to survey student participants of 20 community service events held in a rural village between 2007–2012. The survey tool included questions on demographic data as well as the perception of the students on whether participation in the events enabled them to experience activities defined under the eight major curriculum outcome domains of IMU.The one sample Student t-test was used to test for statistical significance while regression analysis was done to look for significant predictors.
Results: A total of 255 students were surveyed, of which 229 (90.5%) were medical students while the rest were nursing students. Most of the students were in the 3rd (48.2%) and 4th (43.8%) year of their studies and have completed the surgery, internal medicine and family medicine posting. Six out of the 8 curriculum outcomes domains were achieved through participation in the community service programme.
Conclusion: Community service is an effective curriculum delivery tool for the outcome-based curriculum of IMU where activities defined in six out of eight outcome domains were achieved.
Jellyfish stings are the most frequently reported marine animal envenomation worldwide. However, data on jellyfish sting from Malaysia remains obscure due to inadequate research.