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Medical students' attitudes toward people with dementia: an international investigation

Tullo ES, Young TJ

Int Psychogeriatr, 2014 Jan;26(1):165-71.
PMID: 24135153 DOI: 10.1017/S1041610213001737

BACKGROUND: The changing demographics of societies mean that medical students worldwide must be sufficiently prepared to care competently for patients with dementia through development of appropriate knowledge, skills, and attitudes. No previous research had explored undergraduate medical students' attitudes toward people with dementia.
METHODS: An adapted version of the Approaches to Dementia Questionnaire (ADQ) was completed by 501 medical undergraduates in years 1, 3, and 5 of their degree programs in the UK and Malaysia. Non-parametric statistical analysis focused on any differences between year groups and geographical locations.
RESULTS: The mean ADQ response indicated a generally positive attitude across the sample, comparable with other healthcare professionals previously surveyed. Year 3 and year 5 students expressed significantly more positive attitudes than year 1 students. Year 1 students based in the UK expressed significantly more positive attitudes than year 1 student based in Malaysia, but there were no significant differences between year 3 students based in different locations.
CONCLUSION: The more positive attitudes found amongst year 3 and year 5 students compared to year 1 may be a result of teaching emphasizing a person-centered approach. The differences between entry-level students from Malaysia and the UK may reflect variance in cultural norms and expectations, or the ADQ's "Western" origin. Medical schools aiming to equip students with dementia-specific skills and knowledge can draw on the generally positive attitudes found in this study.

Matched MeSH terms: Attitude of Health Personnel*
'They treat you like you are not a human being': maltreatment during labour and delivery in rural northern Ghana

Moyer CA, Adongo PB, Aborigo RA, Hodgson A, Engmann CM

Midwifery, 2014 Feb;30(2):262-8.
PMID: 23790959 DOI: 10.1016/j.midw.2013.05.006

to explore community and health-care provider attitudes towards maltreatment during delivery in rural northern Ghana, and compare findings against The White Ribbon Alliance's seven fundamental rights of childbearing women.

Matched MeSH terms: Attitude of Health Personnel*
Knowledge attitude and perception of dispensing doctors regarding generic medicines in Karachi, Pakistan: a qualitative study

Jamshed SQ, Hassali MA, Ibrahim MI, Babar ZU

J Pak Med Assoc, 2011 Jan;61(1):80-3.
PMID: 22368910
Matched MeSH terms: Attitude of Health Personnel*
Fulltext Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

Minas H, Zamzam R, Midin M, Cohen A

BMC Public Health, 2011;11:317.
PMID: 21569613 DOI: 10.1186/1471-2458-11-317

The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes.

Matched MeSH terms: Attitude of Health Personnel*
Student, tutor and staff nurse perceptions of the clinical learning environment

Chuan OL, Barnett T

Nurse Educ Pract, 2012 Jul;12(4):192-7.
PMID: 22277167 DOI: 10.1016/j.nepr.2012.01.003

The aim of this exploratory study was to describe and compare student nurses (n=142), staff nurses (n=54) and nurse tutors (n=8) perceptions of the clinical learning environment (CLE), and to identify factors that enhanced or inhibited student learning. The setting was a private hospital in Penang, Malaysia. Data were collected using a structured, self-administered questionnaire that consisted of six a priori subscales. Principal component analysis supported a six factor solution and a reduction in the number of items from 44 to 34. Participants' overall perception of the CLE was positive, though there were significant differences in 5 of the 6 subscales between the three groups. For students and their tutors, the most positive component of the CLE was 'supervision by clinical instructors'. Staff nurses reported more favourably on the learner friendliness of the CLE than did students or tutors. Factors that enhanced student learning included students' and staff nurses' attitude towards student learning, variety of clinical opportunities, sufficient equipment, and adequate time to perform procedures. Factors that hindered student learning were: overload of students in the clinical unit, busy wards, and students being treated as workers.

Matched MeSH terms: Attitude of Health Personnel*
Understanding the need of health care providers for teleconsultation and technological attributes in relation to the acceptance of teleconsultation in Malaysia: a mixed methods study

Maarop N, Win KT

J Med Syst, 2012 Oct;36(5):2881-92.
PMID: 21826500 DOI: 10.1007/s10916-011-9766-2

The aim of this study was to explore the importance of service need along with perceived technology attributes in potentially influence the acceptance of teleconsultation. The study was conducted based on the concurrent triangulation design involving qualitative and quantitative study methods. These entailed interviews with key informants and questionnaires survey of health care providers who practiced in the participating hospitals in Malaysia. Thematic analysis involving iterative coding was conducted on qualitative data. Scale reliability test and hypothesis testing procedures were performed on quantitative data. Subsequently, both data were merged, compared and interpreted. In particular, this study utilized a qualitative priority such that a superior emphasis was placed on the qualitative method to demonstrate an overall understanding. Based on the responses of 20 key informants, there was a significant need for teleconsultation as a tool to extend health services to patients under constrained resources and critical conditions. Apparently, the latest attributes of teleconsultation technology have generally met users' expectation but rather perceived as supportive facets in encouraging the usage. Concurrently, based on the survey engaging 72 health care providers, teleconsultation acceptance was statistically proven to be strongly associated with service need and not originated exclusively from the technological attributes. Additionally, the results of this study can be used to promote teleconsultation as an effective means in delivering better health services. Thus, the categories emerged from this study may be further revised and examined for explaining the acceptance of teleconsultation technology in other relevant contexts.

Matched MeSH terms: Attitude of Health Personnel*
University of Malaya dental students' attitudes towards communication skills learning: implications for dental education

Nor NA, Yusof ZY, Shahidan MN

J Dent Educ, 2011 Dec;75(12):1611-9.
PMID: 22184601

The Ministry of Higher Education in Malaysia has called for the implementation of a soft skills module in all public universities in Malaysia. In response to this and as part of curriculum development efforts for a new integrated program for 2011, a study was undertaken to improve the University of Malaya (UM) Faculty of Dentistry's communication skills course. One of the study objectives was to investigate dental students' attitudes towards communication skills learning and the association between their attitudes and demographic and education-related characteristics. A cross-sectional survey--using a self-administered twenty-four-item adapted Communication Skills Attitude Scale (CSAS) that contained both positive (PAS) and negative (NAS) attitude subscales--was carried out targeting all final-year dental students at the UM and the Universiti Kebangsaan Malaysia (UKM). A total of 148 students completed the survey, yielding a response rate of 88.1 percent. Overall, UKM students had significantly more positive attitudes towards communication skills learning (PAS score: mean=48.69, SD=4.48, p<0.001) than UM students (mean=46.03, SD=4.22). There was no statistically significant difference in negative attitudes between the two groups. UKM students with more positive attitudes tended to be female (p<0.05). UM students with more negative attitudes perceived themselves as poor communicators (p<0.05), and UKM students with more negative attitudes tended to have poor English proficiency (p<0.05). This study found that both UM and UKM final-year dental students have positive and negative attitudes towards learning communication skills. These attitudes were significantly associated with certain background and education-related attributes. Outcomes of this study served as a valuable guide in strengthening the communication skills course for the UM's new, integrated dental curriculum.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext Caregivers' satisfaction of healthcare delivery at paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre in 2009

Aniza I, Rizal AM, Ng YS, Mardhiyyah M, Helmi I, Syamimi BK, et al.

Med J Malaysia, 2011 Jun;66(2):84-8.
PMID: 22106682

Patient's satisfaction has become increasingly important as patients evaluate healthcare services for both medical cost and quality. The purpose of this study was to measure the prevalence and the factors influencing caregivers' satisfaction. A cross sectional study of 262 respondents using universal sampling method was conducted at the paediatric clinics of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Overall, 90.5% were satisfied with the services provided. Satisfaction rates based on various healthcare delivery domains were: 95.0% for communication skills, 88.5% for interpersonal aspect, 83.6% for technical quality, 82.1% for financial aspect, 72.9% for time spent with doctors and 64.9% for ease of contact. This study shows that the caregivers (an unpaid person who helps a person cope with disease) were highly satisfied with the communicational aspect delivered by the clinic. However, there is still room for improvement on ease of contact domain and waiting time in order to produce high quality service.

Study site: Paediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Attitude of Health Personnel*
Differences in physician attitudes towards patient-centredness: across four medical specialties

Chan CM, Ahmad WA

Int J Clin Pract, 2012 Jan;66(1):16-20.
PMID: 22171901 DOI: 10.1111/j.1742-1241.2011.02831.x

Aims: There is limited study on patient-centred attitudes with regards to the patient–physician relationship in physicians. The objective of this study was to examine and compare physician attitudes toward patient-centredness in four different medical settings.
Methods: The present study utilised a cross-sectional survey design and purposive sampling to recruit physicians from a single academic medical centre via face-to-face interviews. Patient-centred attitudes of physicians specialising in surgery, oncology, obstetrics and gynaecology and primary care
(N = 78) were compared on the Patient–Practitioner Orientation Scale (PPOS) using an independent one-way analysis of variance (ANOVA). The four medical
specialties comprised the four levels, with role orientation (patient-centred orientation vs. doctor-centred orientation) as the dependent measure.
Results: A significant level of difference (p < 0.001) was found between the four specialisations:
oncologists were found to have the highest level of patient-centeredness, followed by obstetricians & gynaecologists and primary care physicians, with surgeons being the least patient-centred among specialisations sampled.
Conclusion: These data are the first from the South-East Asian region to demonstrate differences in
physician attitudes between medical specialties. Our findings prompt further investigation and confirmation as to whether physicians with particular attitudinal traits are attracted to any particular specialties of medicine, or if physician attitudes are acquired through professional experience and training. In addition, this study offers better insight into the attitudinal differences of physician between medical specialities.
Questionnaire: Patient–Practitioner Orientation Scale; PPOS

Matched MeSH terms: Attitude of Health Personnel*
Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

Yusof ZY, Jaafar N, Jallaludin RL, Abu-Hassan MI, Razak IA

J Dent Educ, 2010 Dec;74(12):1380-7.
PMID: 21123505

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.

Matched MeSH terms: Attitude of Health Personnel*
User satisfaction with services provided by a drug information center in Sudan

Fathelrahman AI, Awang R, Bashir AA, Taha IA, Ibrahim HM

Pharm World Sci, 2008 Dec;30(6):759-63.
PMID: 18704750 DOI: 10.1007/s11096-008-9245-0

OBJECTIVE: The services of the Ministry of Health Drug Information Center--Khartoum State were evaluated by assessing users' satisfaction.
METHOD: Four hundred and twenty-three subjects were recruited from center records using a systematic random sampling technique. Subjects who consented were interviewed by telephone using a specially designed semi-structured questionnaire. Descriptive as well as comparative analyses were carried out. Differences between groups were tested using the Chi-square test when applicable.
RESULTS: The majority of users surveyed (89.6%) had called the center from within Khartoum State and 10.4% of users had called from other states. Of the enquiries, 36.1% were from pharmacists, 29.5% from physicians, and 22.3% from laypersons. The vast majority (93.1%) of respondents were educated to degree level or higher. Approximately one fifth, one half, and one third of the users surveyed had consulted the center >5 times, 2-5 times, and once, respectively. More than 90% of users rated the services provided as good to excellent and 94.7% declared their probable intention to continue utilizing the center in the future.
CONCLUSION: The center succeeded in satisfying and retaining its users by providing an acceptable quality of service.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext Does clinical exposure to patients in medical school affect trainee doctors' attitudes towards mental disorders and patients?--A pilot study

Tan SMK, Azmi MT, Reddy JP, Shaharom MH, Rosdinom R, Maniam T, et al.

Med J Malaysia, 2005 Aug;60(3):328-37.
PMID: 16379188

Stigmatising attitudes towards mental illness may improve with clinical exposure during medical school training. Attitudes of 48 fourth year medical students in Universiti Kebangsaan Malaysia were assessed before and after their compulsory attachment in Psychiatry, using the Attitude Towards Psychiatry-30 (ATP) and the Attitude towards Mental Illness (AMI) questionnaires. ATP scores improved significantly with training (104.8 and 114.4, pre- and post-attachment respectively) as did AMI scores (63.4 and 68.1 respectively). Both improvements were statistically significant. (ATP: z = 4.55, p < 0.0005) (AMI: z = 3.75, p < 0.0005). Attitudes towards mental illness appeared to have become more favourable with clinical training in psychiatry.

Matched MeSH terms: Attitude of Health Personnel*
General dental practitioners' views on early childhood caries and timing of the first dental visit in Selangor, Malaysia

Hussein AS, Schroth RJ, Abu-Hassan MI

Asia Pac J Public Health, 2015 Mar;27(2):NP2326-38.
PMID: 23420056 DOI: 10.1177/1010539513475645

This survey evaluated the knowledge, attitudes, and practices of general dental practitioners (GDPs) in Selangor regarding early childhood caries (ECC) prevention and the recommended timing of a child's first dental visit. A questionnaire was mailed to 521 licensed GDPs. Descriptive statistics were used, and bivariate and logistic regression analyses were performed. The response rate was 52.6%. Although 89.8% mentioned counseling parents and caregivers, only 44.2% were familiar with anticipatory guidance. Whereas 98.2% agreed that early examinations are important to prevent ECC, only 51.8% were aware of the recommendation for a first visit by 12 months of age. GDPs who recommended early dental visits were significantly more likely to be recent graduates, more familiar with professional guidelines, and less likely to be deterred by a child's crying or behavior. In conclusion, GDPs in Selangor are aware about the importance of early dental visits in ECC prevention. However, a considerable number of them are still not aware of the recommendation that children must first visit the dentist by 12 months of age. Furthermore, some of their current practices in ECC management and prevention do not match professional recommendations.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext "I feel it is not enough…" Health providers' perspectives on services for victims of intimate partner violence in Malaysia

Colombini M, Mayhew S, Ali SH, Shuib R, Watts C

BMC Health Serv Res, 2013;13:65.
PMID: 23419141 DOI: 10.1186/1472-6963-13-65

This study explores the views and attitudes of health providers in Malaysia towards intimate partner violence (IPV) and abused women and considers whether and how their views affect the provision or quality of services. The impact of provider attitudes on the provision of services for women experiencing violence is particularly important to understand since there is a need to ensure that these women are not re-victimised by the health sector, but are treated sensitively.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext Medical students' attitudes toward abortion education: Malaysian perspective

Tey NP, Yew SY, Low WY, Su'ut L, Renjhen P, Huang MS, et al.

PLoS One, 2012;7(12):e52116.
PMID: 23300600 DOI: 10.1371/journal.pone.0052116

Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students' attitudes toward abortion education and presents a case for including abortion education in medical schools.

Matched MeSH terms: Attitude of Health Personnel*
The effect of a clinical posting in psychiatry on the attitudes of medical students towards psychiatry and mental illness in a Malaysian medical school

Reddy JP, Tan SM, Azmi MT, Shaharom MH, Rosdinom R, Maniam T, et al.

Ann Acad Med Singap, 2005 Sep;34(8):505-10.
PMID: 16205829

INTRODUCTION: The stigma attached to mental illness and the mentally ill is a universal phenomenon and a major barrier to the provision of mental health services. Stigmatising attitudes among doctors themselves can result in compromised patient care. The aim of this research project is to study the impact of a clinical posting in psychiatry on the attitudes of medical students to mental illness and to psychiatry. This paper reports the results of the first phase of a longitudinal study.
MATERIALS AND METHODS: A total of 122 year 4 medical students responded to this study. The Attitudes Towards Mental Illness (AMI) and Attitudes Towards Psychiatry (ATP) questionnaires were administered before and after an 8-week attachment in psychiatry.
RESULTS: We found that students had somewhat favourable attitudes towards psychiatry and mental illness at the start of their attachment, with a mean score of 108.34 on ATP (neutral score, 90) and 68.24 on AMI (neutral score, 60). There was a significant increase in the mean scores of both scales following the psychiatric attachment for female students (ATP: P = 0.003; AMI: P <0.0005), but not male students (ATP: P = 0.435; AMI: P = 0.283).
CONCLUSIONS: An 8-week clinical posting of fourth-year medical students in psychiatry was associated with an increase in positive attitudes to mental illness and to psychiatry among female students but not among male students.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext Primary care doctors' perceptions towards evidence-based medicine in Melaka State: a questionnaire study

Chan GC, Teng CL

Med J Malaysia, 2005 Jun;60(2):130-3.
PMID: 16114151

A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext A latent trait approach to measuring HIV/AIDS related stigma in healthcare professionals: application of mokken scaling technique

Ahmadi K, Reidpath DD, Allotey P, Hassali MAA

BMC Med Educ, 2016 May 30;16:155.
PMID: 27240562 DOI: 10.1186/s12909-016-0676-3

BACKGROUND: The attitudes of healthcare professionals towards HIV positive patients and high risk groups are central to the quality of care and therefore to the management of HIV/AIDS related stigma in health settings. Extant HIV/AIDS stigma scales that measure stigmatising attitudes towards people living with HIV/AIDS have been developed using scaling techniques such as principal component analysis. This approach has resulted in instruments that are often long. Mokken scale analysis is a nonparametric hierarchical scaling technique that can be used to develop unidimensional cumulative scales. This technique is advantageous over the other approaches; as the scales are usually shorter, while retaining acceptable psychometric properties. Moreover, Mokken scales also make no distributional assumptions about the underlying data, other than that the data are capable of being ordered by item and by person. In this study we aimed at developing a precise and concise measure of HIV/AIDS related stigma among health care professionals, using Mokken scale analysis.
METHODS: We carried out a cross sectional survey of healthcare students at the Monash University campuses in Malaysia and Australia. The survey consisted of demographic questions and an initial item pool of twenty five potential questions for inclusion in an HIV stigma scale.
RESULTS: We analysed the data using the mokken package in the R statistical environment providing a 9-item scale with high reliability, validity and acceptable psychometric properties, measuring and ranking the HIV/AIDS related stigmatising attitudes.
CONCLUSION: Mokken scaling procedure not only produced a comprehensive hierarchical scale that could accurately order a person along HIV/AIDS stigmatising attitude, but also demonstrated a unidimensional and reliable measurement tool which could be used in future studies. The principal component analysis confirmed the accuracy of the Mokken scale analysis in correctly detecting the unidimensionality of this scale. We recommend future works to study the generalisability of this scale in a new population.

Matched MeSH terms: Attitude of Health Personnel*
EMR continuance usage intention of healthcare professionals

Sayyah Gilani M, Iranmanesh M, Nikbin D, Zailani S

Inform Health Soc Care, 2017 Mar;42(2):153-165.
PMID: 27100821 DOI: 10.3109/17538157.2016.1160245

Electronic medical records (EMRs) have been proven to be effective tools for improving the safety and quality of healthcare despite their relatively low usage rate in hospitals. The long-term development by EMRs depends on the continued use of healthcare professionals. In this study, technology continuance theory (TCT) was used to evaluate the short-term and long-term continuance acceptance of EMRs among healthcare professionals. Data were gathered by surveying 195 medical professionals in Iran. The data were analyzed using the partial least squares (PLS) technique. The analysis showed that the TCT provided a deep understanding of user continuance intention toward EMRs. In addition, the findings illustrated that the determinants of continuance intention vary between short-term and long-term users. The theoretical and practical implications of the study are discussed.

Matched MeSH terms: Attitude of Health Personnel*
Fulltext A nationwide survey of public healthcare providers' impressions of family medicine specialists in Malaysia: a qualitative analysis of written comments

Chew BH, Cheong AT, Ismail M, Hamzah Z, A-Rashid MR, Md-Yasin M, et al.

BMJ Open, 2016 Jan 07;6(1):e009375.
PMID: 26743703 DOI: 10.1136/bmjopen-2015-009375

OBJECTIVE: To examine impressions of public healthcare providers/professionals (PHCPs) who are working closely with family medicine specialists (FMSs) at public health clinics.
DESIGN: Cross-sectional study.
SETTING: This study is part of a larger national study on the perception of Malaysian public healthcare professionals on FMSs (PERMFAMS).
PARTICIPANTS: PHCPs from three categories of health facility: hospitals, health clinics and health offices.
MAIN OUTCOME MEASURES: Qualitative analyses of written comments of respondents' general impression of FMSs.
RESULTS: The participants' response rate was 58.0% (780/1345), with almost equal proportions from each public healthcare facility. A total of 23 categories for each of the 648 impression comments were identified. The six emerging themes were: (1) importance of FMSs; (2) roles of FMSs; (3) clinical performance of FMSs; (4) attributes of FMSs; (5) FMS practice challenges; (6) misconception of FMS roles. Overall, FMS practice was perceived to be safe and able to provide effective treatments in a challenging medical discipline that was in line with the current standards of medical care and ethical and professional values. The areas of concern were in clinical performance expressed by PHCPs from some hospitals and the lack of personal attributes and professionalism among FMSs mentioned by PHCPs from health clinics and offices.
CONCLUSIONS: FMSs were perceived to be capable of providing effective treatment and were considered to be important primary care physicians. There were a few negative impressions in some areas of FMS practice, which demanded attention by the FMSs themselves and the relevant authorities in order to improve efficiency and safeguard the fraternity's reputation.
Study site: Klinik Kesihatan, Hospitals, Malaysia

Matched MeSH terms: Attitude of Health Personnel*

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