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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: Hospitals, Private/organization & administration
Fulltext The Relationship between Type of Music and Anxiety Level among Malaysian Women during Mammography

Mohd Zain, N., Ab Malek, N. N. F., Che Mut, N. A. I., Mohd Norsuddin, N., Abdullah Suhaimi, S. A., Ahmad Dahari, M., et al.

Physics and Technology in Medicine, 2020;1(2):7-12.
MyJurnal

Music is one of the suggested interventions that can reduce stress caused by pain from mammography procedures. The different types of music might affect the anxiety level during a mammogram screening. Thus, the study aimed to determine the anxiety level of women who underwent mammogram screening according to different types of music. A cross-sectional study was conducted on 60 women by using the purposive sampling technique in the radiology department at randomly selected private hospitals in Klang Valley from November 2018 to November 2019. Respondents were randomly divided based on the day of mammogram screening into two groups; namely slow and upbeat music. Descriptive analysis was used to determine the anxiety level for each group and T-test analysis was used to compare the significance of anxiety level between both groups. A total of 60 respondents had participated in this study with a total of 30 (50.0%) respondents allocated in slow music, while another 30 (50.0%) respondents were allocated in upbeat music. Patients who underwent mammography screening while listening to slow music had a high anxiety level (70.0%) as compared to upbeat music group (63.3%). There was no significant effect for music, t (60) = -0.54, p = 0.59, despite slow music (M = 1.70, SD = 0.47) attaining higher anxiety level than the upbeat music (M = 1.63, SD = 0.49). Upbeat music has the potential in reducing the anxiety level of women undergoing mammography screening.

Matched MeSH terms: Hospitals, Private
Fulltext The association of uvulo-palatoglossal junctional ulcers with exanthem subitum: a 10-year paediatric outpatient study

Chua KB

Med J Malaysia, 1999 Mar;54(1):58-64.
PMID: 10972006

A 10-year follow-up of children having exanthem subitum (ES) seen in an outpatient paediatric clinic, Kuala Lumpur, Malaysia shows that uvulo-palatoglossal junctional (UPJ) ulcer is a reliable early clinical sign of ES. During this period, 1,977 children (1,086 males, 891 females) had adequate follow-up from the age of 3 months to 24 months old. 897 children (478 males, 419 females) were noted to have UPJ ulcers. Of these 897 children, 855 (459 males, 396 females) presented with the classical clinical features of ES of maculopapular rash following 3 to 4 days of fever. The positive predictive value and the negative predictive value of UPJ ulcers in the clinical diagnosis of ES are 95.3% and 100% respectively. Among the 855 children with clinical features of ES, a provisional diagnosis of ES could be made in 781 children during the pre-eruptive phase by the presence of the UPJ ulcers. The other 74 children already had the rash at the time of consultation at the clinic. The peak age of occurrence of ES was 6 months old with 98.2% of the total cases of ES seen between the age of 4 and 12 months. There was no significant gender difference in the incidence of ES nor any seasonal variation. Mild to moderate diarrhoea was the other commonly associated clinical feature which usually presented from the third febrile day onwards.
Study site: Paediatric clinic, Assunta Hospital, Petaling Jaya, Selangor, Malaysia

Matched MeSH terms: Hospitals, Private
Fulltext The determinants of patient care manager role and the implementation of COVID-19 clinical pathway: a cross-sectional study

Aziz Alimul Hidayat A, Chen WL, Nor RM, Uliyah M, Badriyah FL, Ubudiyah M

PeerJ, 2022;10:e13764.
PMID: 35910779 DOI: 10.7717/peerj.13764

OBJECTIVE: This study aims to determine the factors associated with patient care manager role and the implementation of the clinical pathway among nurses in private hospitals.
METHODS: This study was conducted from January-July 2021 using the cross-sectional approach. The sample consisted of 168 nurses working in a private hospital in Surabaya City, East Java, Indonesia. Meanwhile, the data were collected using the Patient Care Manager Role Scale (PCMRS) and analyzed by multiple logistic regression to find the correlation between the variables.
RESULTS: A higher percentage of nurses namely 64.3% had compliance in COVID-19 clinical pathways with an average PCMRS score of 27.81 ± 2.43. Nurses with a high-level patient care manager role level had a significant compliance risk with odds ratio [OR] 440.137, 95% confidence interval [CI] [51.850-3736.184], and p-value = 0.000 compared to those with a low role.
CONCLUSION: The role of patient care manager and compliance with COVID-19 clinical pathways correlated significantly. Based on the results, several actions are needed for the early identification of patient service managers' roles to ensure compliance with COVID-19 clinical pathways and reduce the number of cases in Indonesia.

Matched MeSH terms: Hospitals, Private
The differences of patient satisfaction level in public and private hospitals in Makassar, Indonesia

Akbar FH, Rivai F, Awang AH

Enferm Clin, 2020 10;30 Suppl 6:165-169.
PMID: 33040892 DOI: 10.1016/j.enfcli.2020.06.038

OBJECTIVE: To know the difference in patient satisfaction level in the dental department of public hospitals and private hospital in Makassar.
METHODS: This study was conducted in December 2017-February 2018 in the dental department of Labuang Baji, which is a government hospital and Ibnu Sina Hospital, which is a private hospital. The samples were all patients who received dental treatment. Patient satisfaction was measured using a questionnaire (PSQ-18). Data were tested using Independent T-Test and ANOVA using SPSS version 24.
RESULTS: There were significant differences in accessibility, comfort, and communication between the public and private hospitals (p<0.05); the average value of patient satisfaction was higher in private hospitals.
CONCLUSION: Patients in private hospitals are more satisfied with the health services provided by health care providers, compared to patients in public hospitals.

Matched MeSH terms: Hospitals, Private*
Fulltext The incidence of deep venous thrombosis following arthroscopic knee surgery

Ng WM, Chan KY, Lim ABK, Gan EC

Med J Malaysia, 2005 Jul;60 Suppl C:14-6.
PMID: 16381276

A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.

Matched MeSH terms: Hospitals, Private
Fulltext The outcome of abdominal aortic aneurysm repair in northern Malaysia

Lakhwani MN, Yeoh KCB, Gooi BH, Lim SK

Med J Malaysia, 2003 Aug;58(3):420-8.
PMID: 14750383

A prospective study of all infrarenal abdominal aortic aneurysm (AAA) repairs both as electives and emergencies in Penang between January 1997 to December 2000 is presented. The objectives of the study were to determine the age, gender, racial distribution of the patients, the incidence, and risk factors and to summarize treatments undertaken and discuss the outcome. Among the races, the Malays were the most common presenting with infrarenal AAA. The mean age of patients operated was 68.5 years. Males were more commonly affected compared to females (12:1). Most infrarenal AAA repairs were performed as emergency operations, 33 cases (61.1%) compared to electives, 21 cases (38.9%). Total survival was 70.3% (elective 85.7%; emergency 57.6%). Mortality rate was 31.5% and the primary reason is the lack of operating time available for urgent operation and for treatment of concurrent disease states. Mycotic aneurysm with its triad of abdominal pain, fever and abdominal mass resulted in a significantly higher mortality (46.6%). Ninety six percent of the infrarenal AAA had transverse diameter greater than 6 cm. Morphologically 90.7% were fusiform AAA rather than saccular aneurysm (9.3%). Pulmonary complications (35.2%) were more common than cardiac complications (11.1%) possibly related to the urgent nature of the operation, smoking or history of pulmonary tuberculosis. Bleeding (14.8%) was the most common cause of mortality in ruptured mycotic infrarenal AAA.

Matched MeSH terms: Hospitals, Private
Fulltext Trends in post osteoporotic hip fracture care from 2010 to 2014 in a private hospital in Malaysia

Yeap SS, Nur Fazirah MFR, Nur Aisyah C, Zahari Sham SY, Samsudin IN, C Thambiah S, et al.

Osteoporos Sarcopenia, 2017 Jun;3(2):112-116.
PMID: 30775514 DOI: 10.1016/j.afos.2017.05.001

Objective: Following an osteoporotic fracture, pharmacological treatment is recommended to increase bone mineral density and prevent future fractures. However, the rate of starting treatment after an osteoporotic hip fracture remains low. The objective of this study was to survey the treatment rate following a low-trauma hip fracture at a tertiary private hospital in Malaysia over a period of 5 years.

Methods: The computerised hospital discharge records were searched using the terms "hip," "femur," "femoral," "trochanteric," "fracture," or "total hip replacement" for all patients over the age of 50, admitted between 2010 and 2014. The medical charts were obtained and manually searched for demographic data and treatment information. Hip operations done for non-low-trauma-related fracture and arthritis were excluded.

Results: Three hundred seventy patients over the age of 50 years were admitted with a hip fracture, of which 258 (69.7%) were low trauma, presumed osteoporotic, hip fractures. The median age was 79.0 years (interquartile range [IQR], 12.0). Following a hip fracture, 36.8% (95 of 258) of the patients received treatment, but out of these, 24.2% (23 of 95) were on calcium/vitamin D only. The median duration of treatment was 1 month (IQR, 2.5). In 2010, 56.7% of the patients received treatment, significantly more than subsequent years 2011-2014, where approximately only 30% received treatment.

Conclusions: Following a low-trauma hip fracture, approximately 72% of patients were not started on active antiosteoporosis therapy. Of those who were, the median duration of treatment was 1 month. This represents a missed opportunity for the prevention of future fractures.

Matched MeSH terms: Hospitals, Private
Fulltext Urologic Services in Public Hospitals Suffered a Greater Detriment Than Private Hospitals During the Battle of COVID-19

Ong WLK, Lechmiannandan S, Loeb S, Teoh JY

Urology, 2020 10;144:269-270.
PMID: 32687841 DOI: 10.1016/j.urology.2020.07.010
Matched MeSH terms: Hospitals, Private*
Fulltext Western impressions of the Hong Kong health care system

Bennett CL, Pei GK, Ultmann JE

West. J. Med., 1996 Jul-Aug;165(1-2):37-42.
PMID: 8855683

Hong Kong, Taiwan, Singapore, and Malaysia are initiating health care reform to meet the changing demands of populations with improved socioeconomic status and access to modern technologies and who are living longer than in previous generations. Hong Kong, in particular, is facing a unique set of circumstances as its people prepare for the transition in 1997 from a British colony to a Special Administrative Region of China. While spending only 4% of its gross domestic product on health care, it has a large and regulated public hospital system for most inpatient medical care and a separate, loosely regulated private health care system for most outpatient medical care. In 1993 the Secretary for Health and Welfare of Hong Kong initiated a year-long process to debate the pros and cons of 5 fundamental programs for health care reform. After a year of open consultation, options were chosen. We describe the Hong Kong health care system, the fundamental changes that have been adopted, and lessons for reformers in the United States.

Matched MeSH terms: Hospitals, Private
Fulltext X-ray examinations in private hospitals and clinics

Lam ES

Family Practitioner, 1978;3(4):31-34.

Matched MeSH terms: Hospitals, Private