Displaying publications 61 - 80 of 313 in total

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  1. Khalid HM, Helander MG, Hood NA
    Appl Ergon, 2013 Sep;44(5):671-9.
    PMID: 22944486 DOI: 10.1016/j.apergo.2012.06.005
    The purpose of this study was to analyze people's attitudes to disasters by investigating how people feel, behave and think during disasters. We focused on disasters induced by humans, such as terrorist attacks. Two types of textual information were collected - from Internet blogs and from research papers. The analysis enabled forecasting of attitudes for the design of proactive disaster advisory scheme. Text was analyzed using a text mining tool, Leximancer. The outcome of this analysis revealed core themes and concepts in the text concerning people's attitudes. The themes and concepts were sorted into three broad categories: Affect, Behaviour, and Cognition (ABC), and the data was visualized in semantic maps. The maps reveal several knowledge pathways of ABC for developing attitudinal ontologies, which describe the relations between affect, behaviour and cognition, and the sequence in which they develop. Clearly, terrorist attacks induced trauma and people became highly vulnerable.
    Matched MeSH terms: Decision Making
  2. Ng CJ, Lee PY, Lee YK, Chew BH, Engkasan JP, Irmi ZI, et al.
    BMC Health Serv Res, 2013 Oct 11;13:408.
    PMID: 24119237 DOI: 10.1186/1472-6963-13-408
    BACKGROUND: Involving patients in decision-making is an important part of patient-centred care. Research has found a discrepancy between patients' desire to be involved and their actual involvement in healthcare decision-making. In Asia, there is a dearth of research in decision-making. Using Malaysia as an exemplar, this study aims to review the current research evidence, practices, policies, and laws with respect to patient engagement in shared decision-making (SDM) in Asia.

    METHODS: In this study, we conducted a comprehensive literature review to collect information on healthcare decision-making in Malaysia. We also consulted medical education researchers, key opinion leaders, governmental organisations, and patient support groups to assess the extent to which patient involvement was incorporated into the medical curriculum, healthcare policies, and legislation.

    RESULTS: There are very few studies on patient involvement in decision-making in Malaysia. Existing studies showed that doctors were aware of informed consent, but few practised SDM. There was limited teaching of SDM in undergraduate and postgraduate curricula and a lack of accurate and accessible health information for patients. In addition, peer support groups and 'expert patient' programmes were also lacking. Professional medical bodies endorsed patient involvement in decision-making, but there was no definitive implementation plan.

    CONCLUSION: In summary, there appears to be little training or research on SDM in Malaysia. More research needs to be done in this area, including baseline information on the preferred and actual decision-making roles. The authors have provided a set of recommendations on how SDM can be effectively implemented in Malaysia.

    Matched MeSH terms: Decision Making*
  3. Pau A, Jeevaratnam K, Chen YS, Fall AA, Khoo C, Nadarajah VD
    Med Teach, 2013 Dec;35(12):1027-41.
    PMID: 24050709 DOI: 10.3109/0142159X.2013.829912
    The Multiple Mini-Interview (MMI) has been used increasingly for selection of students to health professions programmes.
    Matched MeSH terms: Decision Making
  4. Abdullah A, Abdullah KL, Yip CH, Teo SH, Taib NA, Ng CJ
    Asian Pac J Cancer Prev, 2013;14(12):7143-7.
    PMID: 24460266
    BACKGROUND: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy.
    OBJECTIVE: This study aimed to explore the decision making experiences of women with early breast cancer.
    MATERIALS AND METHODS: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach.
    RESULTS: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves.
    CONCLUSIONS: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.
    Study site: Breast surgical units, Klang Valley, Malaysia
    Matched MeSH terms: Decision Making*
  5. Phua KL, Hue JW
    Am J Disaster Med, 2013;8(4):243-52.
    PMID: 24481888 DOI: 10.5055/ajdm.2013.0130
    Scientists and policy makers issuing predictions and warnings of impending natural disaster are faced with two major challenges, that is, failure to warn and issuing a false alarm. The consequences of failure to warn can be serious for society overall, for example, significant economic losses, heavy infrastructure and environmental damage, large number of human casualties, and social disruption. Failure to warn can also have serious for specific individuals, for example, legal proceedings against disaster research scientists, as in the L'Aquila earthquake affair. The consequences of false alarms may be less serious. Nevertheless, false alarms may violate the principle of nonmaleficence (do no harm), affect individual autonomy (eg, mandatory evacuations), and may result in the "cry wolf" effect. Other ethical issues associated with natural disasters include the promotion of global justice through international predisaster technical assistance and postdisaster aid. Social justice within a particular country is promoted through greater postdisaster aid allocation to the less privileged.
    Matched MeSH terms: Decision Making/ethics
  6. Yuvaraj R, Murugappan M, Norlinah MI, Sundaraj K, Khairiyah M
    Dement Geriatr Cogn Disord, 2013;36(3-4):179-96.
    PMID: 23899462 DOI: 10.1159/000353440
    OBJECTIVE: Patients suffering from stroke have a diminished ability to recognize emotions. This paper presents a review of neuropsychological studies that investigated the basic emotion processing deficits involved in individuals with interhemispheric brain (right, left) damage and normal controls, including processing mode (perception) and communication channels (facial, prosodic-intonational, lexical-verbal).
    METHODS: An electronic search was conducted using specific keywords for studies investigating emotion recognition in brain damage patients. The PubMed database was searched until March 2012 as well as citations and reference lists. 92 potential articles were identified.
    RESULTS: The findings showed that deficits in emotion perception were more frequently observed in individuals with right brain damage than those with left brain damage when processing facial, prosodic and lexical emotional stimuli.
    CONCLUSION: These findings suggest that the right hemisphere has a unique contribution in emotional processing and provide support for the right hemisphere emotion hypothesis.
    SIGNIFICANCE:
    This robust deficit in emotion recognition has clinical significance. The extent of emotion recognition deficit in brain damage patients appears to be correlated with a variety of interpersonal difficulties such as complaints of frustration in social relations, feelings of social discomfort, desire to connect with others, feelings of social disconnection and use of controlling behaviors.
    Matched MeSH terms: Decision Making
  7. Al-Areefi MA, Hassali MA, Mohamed Ibrahim MI
    Res Social Adm Pharm, 2013 Nov-Dec;9(6):981-8.
    PMID: 23218551 DOI: 10.1016/j.sapharm.2012.10.006
    Prescribing decisions are a complex phenomenon and influenced by many pharmacological and non-pharmacological factors. Little is known about the actual prescribing behaviors of physicians or the factors behind their prescribing decisions.
    Matched MeSH terms: Decision Making
  8. Ng CJ, Lee YK, Lee PY, Abdullah KL
    Australas Med J, 2013;6(2):95-9.
    PMID: 23483776 DOI: 10.4066/AMJ.2013.1655
    Patient decision aids (PDAs) help to support patients in making an informed and value-based decision. Despite advancement in decision support technologies over the past 30 years, most PDAs are still inaccessible and few address individual needs. Health innovation may provide a solution to bridge these gaps. Information and computer technology provide a platform to incorporate individual profiles and needs into PDAs, making the decision support more personalised. Health innovation may enhance accessibility by using mobile, tablet and Internet technologies; make risk communication more interactive; and identify patient values more effectively. In addition, using databases to capture patient data and the usage of PDAs can help: developers to improve PDAs' design; clinicians to facilitate the decisionmaking process more effectively; and policy makers to make shared decision making more feasible and cost-effective. Health innovation may hold the key to advancing PDAs by creating a more personalised and effective decision support tool for patients making healthcare decisions.
    Matched MeSH terms: Decision Making
  9. Lee YK, Ng CJ, Lee PY, Khoo EM, Abdullah KL, Low WY, et al.
    PMID: 23378747 DOI: 10.2147/PPA.S36791
    BACKGROUND: Patients with type 2 diabetes often require insulin as the disease progresses. However, health care professionals frequently encounter challenges when managing patients who require insulin therapy. Understanding how health care professionals perceive the barriers faced by patients on insulin will facilitate care and treatment strategies.
    OBJECTIVE: This study explores the views of Malaysian health care professionals on the barriers faced by patients using insulin.
    METHODS: Semi-structured qualitative interviews and focus group discussions were conducted with health care professionals involved in diabetes care using insulin. Forty-one health care professionals participated in the study, consisting of primary care doctors (n = 20), family medicine specialists (n = 10), government policymakers (n = 5), diabetes educators (n = 3), endocrinologists (n = 2), and one pharmacist. We used a topic guide to facilitate the interviews, which were audio-recorded, transcribed verbatim, and analyzed using a thematic approach.
    RESULTS: FIVE THEMES WERE IDENTIFIED AS BARRIERS: side effects, patient education, negative perceptions, blood glucose monitoring, and patient adherence to treatment and follow-up. Patients perceive that insulin therapy causes numerous negative side effects. There is a lack of patient education on proper glucose monitoring and how to optimize insulin therapy. Cost of treatment and patient ignorance are highlighted when discussing patient self-monitoring of blood glucose. Finally, health care professionals identified a lack of a follow-up system, especially for patients who do not keep to regular appointments.
    CONCLUSION: This study identifies five substantial barriers to optimizing insulin therapy. Health care professionals who successfully identify and address these issues will empower patients to achieve effective self-management. System barriers require government agency in establishing insulin follow-up programs, multidisciplinary diabetes care teams, and subsidies for glucometers and test strips.
    KEYWORDS: diabetes; focus groups; insulin; noncommunicable disease; primary care; qualitative study
    Matched MeSH terms: Decision Making*
  10. Mohamed NA, Muhamad M
    Asian Pac J Cancer Prev, 2013;14(3):2043-8.
    PMID: 23679316
    The purpose of this study ??s to profile older breast cancer survivors in Malaysia. In a survey study, ? custom made questionnaire was administered to 69 breast cancer patients and survivors between 60 and 84 years of age in Peninsular Malaysia. The main ethnic group recorded was Chinese, followed by Malay and Indian. The majority of women were married (87%) and had children (84.1%). Just over half (53.6%) had primary and secondary education, whereas 24.7% had higher education. Fifty five percent of the study participants made their own decision on treatment, 60.8% exercised at least 3 times in a week, and 56.6% sought information from specialists. Our study suggests that older breast cancer survivors are aware of the importance of exercise in their daily lives and make attempts to be cancer free (e.g. doing exercise, recreational activity and have good relationships with friends and family).
    Matched MeSH terms: Decision Making*
  11. Othman, M., Boo, H.C., Wan Rusni, W.I.
    MyJurnal
    The role of adolescents in family decision making related to food consumption in Malaysia has received comparatively little or no attention by researchers although there were evidences of differences in influences found in other countries. This study addressed the research gap by testing adolescents’ bilateral strategies in influencing their family decision using family power theory. A survey of 500 adolescents from urban area was conducted to investigate their influence based on their involvement in family consumer tasks. Key findings include strong relationship between perception of influence and rewards thus indicate the existence of strategies in adolescents influence attempt.
    Matched MeSH terms: Decision Making
  12. Ho, S.E., Koo, Y.L., Ismail, S., Hing, H.L., Widad, O., Chung, H.T., et al.
    Medicine & Health, 2013;8(2):73-80.
    MyJurnal
    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)
    Matched MeSH terms: Clinical Decision-Making; Decision Making
  13. Lee YK, Low WY, Ng CJ
    PLoS One, 2013;8(11):e80051.
    PMID: 24282518 DOI: 10.1371/journal.pone.0080051
    BACKGROUND: Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes.

    METHODS AND FINDINGS: We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28-67 years old. Our sample comprised 9 women and 12 men. Three main themes, 'treatment-specific values', 'life goals and philosophies', and 'personal and social background', emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients' decisions were influenced by sociocultural (e.g. religious background) and personal backgrounds (e.g. family situations).

    CONCLUSIONS: This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients' priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values.

    Matched MeSH terms: Decision Making*
  14. Abu Kasim NH, Abu Kassim NL, Razak AA, Abdullah H, Bindal P, Che' Abdul Aziz ZA, et al.
    Eur J Dent Educ, 2014 Feb;18(1):51-7.
    PMID: 24423176 DOI: 10.1111/eje.12058
    Training dentists today is challenging as they are expected to provide a wide range of dental care. In the provision of good dental care, soft skills are equally important as clinical skills. Therefore in dental education the development of soft skills are of prime concern. This study sought to identify the development of soft skills when dental students are paired in their clinical training. In this perception study, four open-ended items were used to elicit students' feedback on the appropriateness of using clinical pairing as an instructional strategy to promote soft skills. The most frequently cited soft skills were teamwork (70%) and communication (25%) skills. However, both negative and positive behaviours were reported. As for critical thinking and problem solving skills, more positive behaviours were reported for abilities such as to explain, analyze, find ideas and alternative solutions, and make decisions. Leadership among peers was not evident as leading without legitimate authority could be a hindrance to its development. If clinical pairing is to be used as an effective instructional strategy to promote soft skills amongst students, clear guidelines need to be developed to prepare students to work in a dental team and the use of appropriate assessment tools can facilitate the development of these soft skills.
    Matched MeSH terms: Decision Making
  15. Engkasan JP, Ng CJ, Low WY
    Spinal Cord, 2014 Feb;52(2):157-62.
    PMID: 24276416 DOI: 10.1038/sc.2013.145
    STUDY DESIGN: Qualitative study using individual in-depth interviews.
    OBJECTIVES: The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).
    SETTING: Public hospitals in Malaysia.
    METHODS: Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.
    RESULTS: The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.
    CONCLUSION: The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.
    Study design: Qualitative study using individual in-depth interviews.
    Matched MeSH terms: Decision Making
  16. Taib NA, Yip CH, Low WY
    World J Surg, 2014 Jul;38(7):1676-84.
    PMID: 24280975 DOI: 10.1007/s00268-013-2339-4
    Advanced breast cancer presentation remains a large obstacle in lowering mortality rates in low- and middle-resource countries. This study aims to explore the reasons why women present with breast cancer at an advanced stage.
    Matched MeSH terms: Decision Making*
  17. Yip CH, Bhoo Pathy N, Teo SH
    Med J Malaysia, 2014 Aug;69 Suppl A:8-22.
    PMID: 25417947 MyJurnal
    Four hundred and nineteen articles related to breast cancer were found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. One hundred and fifty four articles were selected and reviewed on the basis of clinical relevance and future research implications. Overall, Malaysian women have poor survival from breast cancer and it is estimated that half of the deaths due to breast cancer could be prevented. Five-year survival in Malaysia was low and varies among different institutions even within the same disease stage, suggesting an inequity of access to optimal treatment or a lack of compliance to optimal treatment. Malaysian women have poor knowledge of the risk factors, symptoms and methods for early detection of breast cancer, leading to late presentation. Moreover, Malaysian women experience cancer fatalism, belief in alternative medicine, and lack of autonomy in decision making resulting in delays in seeking or avoidance of evidence-based medicine. There are ethnic differences in estrogen receptor status, HER2 overexpression and incidence of triple negative breast cancer which warrant further investigation. Malay women present with larger tumours and at later stages, and even after adjustment for these and other prognostic factors (stage, pathology and treatment), Malay women have a poorer survival. Although the factors responsible for these ethnic differences have not been elucidated, it is thought that pharmacogenomics, lifestyle factors (such as weight-gain, diet and exercise), and psychosocial factors (such as acceptance of 2nd or 3rd line chemotherapy) may be responsible for the difference in survival. Notably, survivorship studies show self-management programmes and exercise improve quality of life, highlighting the need to evaluate the psychosocial impact of breast cancer on Malaysian women, and to design culturally-, religiously- and linguistically-appropriate psycho-education programmes to help women cope with the disease and improve their quality of life. Research done in the Caucasian populations may not necessarily apply to local settings and it is important to embark on local studies particularly prevention, screening, diagnostic, prognostic, therapeutic and psychosocial research.
    Matched MeSH terms: Decision Making
  18. Adeshina AM, Hashim R, Khalid NE
    Interdiscip Sci, 2014 Sep;6(3):222-34.
    PMID: 25205500 DOI: 10.1007/s12539-013-0204-7
    Hepatocellular Carcinoma is the most common type of liver cancer having a strong relation with cirrhosis. Undoubtedly, cirrhosis may be caused by the virus infection of hepatitis B (HBV) and hepatitis C (HBC) or through alchoholism. However, even when cirrhosis has not been developed, patients with hepatitis viral infections are still at the risk of liver cancer. Apparently, among the numerous medical imaging techniques, Computed Tomography (CT) is the best in defining liver tumor borders. Unfortunately, these imaging techniques, including the CT procedures, usually rely on an appended application to reconstruct the generated 2-D slices to 3-D model. This may involve high performance computation, may be time-consuming or costly. Moreover, even with the outstanding performances of CT in defining the liver tumor boundaries, contrast between tumor tissues and the surrounding liver parenchyma is too low in CT slices. With such a close proxity in the tumor and the surrounding liver tissues, accurate characterization of liver tumor is a challenge. Previously, algorithms were developed to reveal abnormalities in brain's MRI datasets and CT abdominal pelvic, however, introducing a framework that could accurately characterize liver tumor and its surrounding tissues in CT datasets would go a long way in contributing to medical diagnosis and therapy planning of Hepatocellular Carcinoma. This paper proposes an Hepatocellular Carcinoma framework by extending the functionalities of SurLens Visualization System with an automatic liver tumor localization technique using Compute Unified Device Architecture (CUDA). The study was evaluated with liver CT datasets from the Imaging Science and Information Systems (ISIS) Center, the Georgetown University Medical Center. Significantly, visualization of liver CT datasets and the localization of the entangled tumor was achieved without prior datasets segmentation. Interestingly, the framework achieved remarkably good processing speed at a reasonably cheaper cost with an immediate reconstruction of the datasets and mapping of the tumor tissues within the surrounding liver parenchyma.
    Matched MeSH terms: Decision Making, Computer-Assisted*
  19. Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R
    Asia Pac J Public Health, 2014 Sep;26(5):536-45.
    PMID: 24368749 DOI: 10.1177/1010539513514434
    This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.
    Matched MeSH terms: Decision Making*
  20. Krauss SE, Collura J, Zeldin S, Ortega A, Abdullah H, Sulaiman AH
    J Youth Adolesc, 2014 Sep;43(9):1550-62.
    PMID: 24122395
    Youth–adult partnership (Y–AP) has emerged as a key practice for enacting two features of effective developmental settings: supportive adult relationships and support for efficacy and mattering. Previous studies have shown that when youth, supported by adults, actively participate in organizational and community decision making they are likely to show greater confidence and agency, empowerment and critical consciousness, and community connections. Most of the extant research on Y–AP is limited to qualitative studies and the identification of organizational best practices. Almost all research focuses on Western sociocultural settings. To address these gaps, 299 youth, age 15 to 24, were sampled from established afterschool and community programs in Malaysia to explore the contribution of Y–AP (operationalized as having two components: youth voice in decision-making and supportive adult relationships) to empowerment, agency and community connections. As hypothesized, hierarchical regressions indicated that program quality (Y–AP, safe environment and program engagement) contributed to agency, empowerment and community connections beyond the contribution of family, school and religion. Additionally, the Y–AP measures contributed substantially more variance than the other measures of program quality on each outcome. Interaction effects indicated differences by age for empowerment and agency but not for community connections. The primary findings in this inquiry replicate those found in previous interview and observational-oriented studies. The data suggests fertile ground for future research while demonstrating that Y–AP may be an effective practice for positive youth development outside of Western settings.
    Matched MeSH terms: Decision Making*
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