Displaying publications 61 - 80 of 481 in total

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  1. Brown MK, Shahar S, You YX, Michael V, Majid HA, Manaf ZA, et al.
    BMJ Open, 2021 07 23;11(7):e044628.
    PMID: 34301647 DOI: 10.1136/bmjopen-2020-044628
    INTRODUCTION: Current salt intake in Malaysia is high. The existing national salt reduction policy has faced slow progress and does not yet include measures to address the out of home sector. Dishes consumed in the out of home sector are a known leading contributor to daily salt intake. This study aims to develop a salt reduction strategy, tailored to the out of home sector in Malaysia.

    METHODS AND ANALYSIS: This study is a qualitative analysis of stakeholder views towards salt reduction. Participants will be recruited from five zones of Malaysia (Western, Northern, Eastern and Southern regions and East Malaysia), including policy-makers, non-governmental organisations, food industries, school canteen operators, street food vendors and consumers, to participate in focus group discussions or in-depth interviews. Interviews will be transcribed and analysed using thematic analysis. Barriers will be identified and used to develop a tailored salt reduction strategy.

    ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Universiti Kebangsaan Malaysia Medical Research Ethics Committee (UKM PPI/1118/JEP-2020-524), the Malaysian National Medical Research Ethics Committee (NMRR-20-1387-55481 (IIR)) and Queen Mary University of London Research Ethics Committee (QMERC2020/37) . Results will be presented orally and in report form and made available to the relevant ministries for example, Ministry of Health, Ministry of Education and Ministry of Trade to encourage adoption of strategy as policy. The findings of this study will be disseminated through conference presentations, peer-reviewed publications and webinars.

    Matched MeSH terms: Qualitative Research
  2. Kadravello A, Tan SB, Ho GF, Kaur R, Yip CH
    Medicina (Kaunas), 2021 Jul 07;57(7).
    PMID: 34356974 DOI: 10.3390/medicina57070693
    Background and Objective: Despite the increasing treatment options for patients with metastatic breast cancer (MBC), unmet needs remain common, especially in low and middle-income countries where resources are limited and MBC patients face many challenges. They often join support groups to cope with their unmet needs. Currently, many MBC patients connect with each other via online support group in view of the constant availability of support and rapid information exchange. The objective of this study is to determine the unmet needs of women with MBC from an online support group. Material and Methods: Messages in an online support group of twenty-two MBC patients over a period of three years from August 2016 till August 2019 were thematically analyzed. Results: Three themes were generated, (1) unmet information needs (2) unmet financial needs (3) unmet support needs. Women needed information on side effects of treatment, new treatment options and availability of clinical trials. Although Malaysia has universal health care coverage, access to treatment remains a major challenge. When treatment was not available in the public hospitals, or waiting lists were too long, women were forced to seek treatment in private hospitals, incurring financial catastrophe. Insufficient private insurance and inadequate social security payments force many women to consider stopping treatment. Women felt that they were not getting support from their clinicians in the public sector, who were quick to stop active treatment and advise palliation. On the other hand, clinicians in the private sector advise expensive treatment beyond the financial capability of the patients. Women with families also face the challenge of managing their family and household in addition to coping with their illness. Conclusions: There is a need for healthcare professionals, policy makers, and civil society to better address the needs of MBC patients through patient-centered, multidisciplinary and multi-organizational collaboration.
    Matched MeSH terms: Qualitative Research
  3. Lee PY, Cheong AT, Ghazali SS, Salim H, Wong J, Hussein N, et al.
    NPJ Prim Care Respir Med, 2021 07 07;31(1):38.
    PMID: 34234145 DOI: 10.1038/s41533-021-00250-y
    Asthma self-management is a crucial component of asthma management. We sought to explore healthcare professionals' (HCPs') perceptions on barriers to asthma self-management implementation in primary care. We recruited 26 HCPs from six public primary care clinics in a semi-urban district of Malaysia in 2019. The analysis was done inductively. HCPs described barriers that resonated with the "COM-B" behaviour change framework. Capability-related issues stemmed from a need for specific self-management skills training. Opportunity-related barriers included the need to balance competing tasks and limited, poorly tailored resources. Motivation-related barriers included lack of awareness about self-management benefits, which was not prioritised in consultations with perceived lack of receptiveness from patients. These were compounded by contextual barriers of the healthcare organisation and multilingual society. The approach to implementation of asthma self-management needs to be comprehensive, addressing systemic, professional, and patient barriers and tailored to the local language, health literacy, and societal context.
    Matched MeSH terms: Qualitative Research
  4. Rajhans V, Mohammed CA, Ve RS, Prabhu A
    Educ Health (Abingdon), 2021 7 3;34(1):22-28.
    PMID: 34213440 DOI: 10.4103/efh.EfH_69_20
    Background: Current trends in health professions education are aligned to meet the needs of the millennial learner. The aim of this study was to identify learners' perceptions of an ongoing journal club (JC) activity in the optometry curriculum and evaluate the utility and efficiency of this method in promoting student learning.

    Methods: A qualitative approach with a phenomenological research design was adopted. The perceptions of undergraduate and postgraduate optometry students about JCs were captured using focus group discussions. A narrative thematic analysis was done using the verbatim transcripts and moderator's notes. Results are reported using "consolidated criteria for reporting qualitative research" guidelines.

    Results: A total of 33 optometry students participated in the study. Data analysis revealed three major themes related to (i) The ongoing practice of JC, (ii) student perceptions of JC and its relevance in facilitating student learning, and (iii) suggestions for modification of JC for achieving optimal educational outcomes.

    Discussion: Student feedback indicates that an instructional redesigning of JC is necessary, considering the characteristics and expectations of the current generation of learners and the rapid strides made in the field of educational technology. The recommendations provided are likely to resurrect an age-old approach that still has educational relevance if blended with collaborative learning formats and appropriate technology.

    Matched MeSH terms: Qualitative Research
  5. Cheong WL, Mohan D, Warren N, Reidpath DD
    Disabil Rehabil, 2021 07;43(15):2184-2190.
    PMID: 31769306 DOI: 10.1080/09638288.2019.1695000
    BACKGROUND: The needs of patients with multiple sclerosis have been well-studied in high-income, high-prevalence countries but few studies have been based in low- and middle-income countries where resources are relatively scarce. As such, little is known about the needs of patients living in these countries.

    OBJECTIVE: The study seeks to develop an understanding of the needs of patients with multiple sclerosis living in Malaysia in order to generate insights and contribute to a global database of patients' experience.

    METHOD: 12 patients with multiple sclerosis participated in this qualitative study and took part in a semi-structured interview. The interviews were transcribed and analysed using an iterative thematic analysis approach.

    RESULTS: The experiences, challenges and needs of the patients were reported. Five themes were developed (Daily living, Financial, Emotional and psychological, Healthcare, and Family). These predominantly revolved around the struggles of coping and adapting to the symptoms and disabilities imposed by multiple sclerosis, their heavy reliance on personal finances to cope with the increased costs of living for themselves and their families, as well as the limited healthcare services and treatments available to help them to manage the physical and emotional symptoms of multiple sclerosis.

    CONCLUSION: Patients with multiple sclerosis in Malaysia have complex needs that are neglected due perceived lack of importance of the disease and the poor understanding of multiple sclerosis in general. Patients rely heavily on their finances to improve their quality of life. This perpetuates health inequities and reform of the national health financing system is needed to provide patients with the healthcare and support they need.Implications for rehabilitationPatients with multiple sclerosis in Malaysia prioritize being able to cope and adapt to their disabilities in order to continue performing their activities of daily living.There is a need to increase the availability and accessibility of healthcare professionals that are experienced with the management of multiple sclerosis.Healthcare professionals need to improve their understanding of the patients' needs and what they consider to be important in order to provide therapy that is effective and relevant.Patients also require financial support to help them with the increased costs of living associated with MS as well as the costs of healthcare services such as physiotherapy and rehabilitation.

    Matched MeSH terms: Qualitative Research
  6. Dwekat IMM, Tengku Ismail TA, Ibrahim MI, Ghrayeb F
    Women Birth, 2021 Jul;34(4):344-351.
    PMID: 32684342 DOI: 10.1016/j.wombi.2020.07.004
    BACKGROUND: Respectful care during childbirth is a universal right for each woman in every health system, and mistreatment of women during childbirth is a major breach of this right.

    AIM: This study aimed to explore the views of Palestinian women and healthcare providers regarding factors contributing to the mistreatment of women during childbirth at childbirth facilities in the West Bank, Palestine.

    METHODS: A qualitative study was conducted in the West Bank, Palestine, from February 2019 to April 2019. In-depth interviews were conducted with six Palestinian women and five healthcare providers. Consent was obtained individually from each participant, and the interviews ranged from 40 to 50min. Data collection was continued until thematic saturation was reached. Open-ended questions were asked during interviews. Thematic analysis was used to interpret the data collected from the interviews.

    RESULTS: Four themes were identified with regards to the women and healthcare providers' views about factors contributing to the mistreatment of women during childbirth in the West Bank, Palestine: limitation in childbirth facilities, factors within the healthcare providers, the women themselves, and barriers within the community.

    DISCUSSION: Mistreatment of women during childbirth may occur due to the limitations of resources and staff in childbirth facilities. Some women also justified the mistreatment, and certain characteristics of the women were believed to be the factors for mistreatment.

    CONCLUSION: As the first known study of its kind in West Bank, the identified contributing factors especially the limitations of resources and staff are essential to provide good quality and respectful care at childbirth facilities.

    Matched MeSH terms: Qualitative Research
  7. Mohamad Hashim N, Yusof ANM, Engkasan JP, Hasnan N
    Spinal Cord, 2021 Jul;59(7):777-786.
    PMID: 33230272 DOI: 10.1038/s41393-020-00586-1
    STUDY DESIGN: Focus group qualitative study.

    OBJECTIVES: To explore factors affecting adherence to behaviours appropriate for the prevention of pressure injuries (PIs) in people with spinal cord injury (SCI) in Malaysia.

    SETTING: University Hospital, Malaysia METHODS: Four sets of focus group interviews were conducted, each with 5-10 participants, totalling 30 people with SCI. A trained interviewer used structured interviews designed to explore participants' experiences of complying with recommended behaviours for the prevention of PIs. All interviews were digitally recorded, transcribed, and analysed utilising thematic analysis.

    RESULTS: The factors that affected participants' adherence are classified into four main themes: (a) educational aspects, (b) internal drive, (c) social and environmental factors, and (d) post-SCI physiological changes.

    CONCLUSIONS: This qualitative study provides initial exploratory evidence regarding the thoughts, experience, and opinions pertaining to PI preventive behaviours within the Malaysian SCI population. The emerging themes contribute to an in-depth understanding of the competency of the Malaysian healthcare system in PI prevention, personal and societal factors influenced by the socio-demographic backgrounds, and disease-related factors that influence the adherence to such preventive interventions.

    Matched MeSH terms: Qualitative Research
  8. Russell V, Loo CE, Walsh A, Bharathy A, Vasudevan U, Looi I, et al.
    BMJ Open, 2021 06 30;11(6):e043923.
    PMID: 34193478 DOI: 10.1136/bmjopen-2020-043923
    OBJECTIVES: To explore primary care clinician perceptions of barriers and facilitators in delivering care for common mental disorders (CMD) before and after implementation of a consultation-liaison psychiatry service (Psychiatry in Primary Care (PIPC)) in government-operated primary care clinics and to explore the clinicians' experience of the PIPC service itself.

    DESIGN: This longitudinal qualitative study was informed by the Normalisation Process Model and involved audiotaped semi-structured individual interviews with front-line clinicians before (Time 1) and after (Time 2) the PIPC intervention. The Framework Method was used in the thematic analysis of pre/post interview transcripts.

    SETTING: Two government-operated primary care clinics in Penang, Malaysia.

    PARTICIPANTS: 17 primary care medical, nursing and allied health staff recruited purposely to achieve a range of disciplines and a balanced representation from both clinics.

    INTERVENTION: Psychiatrists, accompanied by medical students in small numbers, provided one half-day consultation visit per week, to front-line clinicians in each clinic over an 8-month period. The service involved psychiatric assessment of patients with suspected CMDs, with face-to-face discussion with the referring clinician before and after the patient assessment.

    RESULTS: At Time 1 interviewees tended to equate CMDs with stress and embraced a holistic model of care while also reporting considerable autonomy in mental healthcare and positively appraising their current practices. At Time 2, post-intervention, participants demonstrated a shift towards greater understanding of CMDs as treatable conditions. They reported time pressures and the demands of key performance indicators in other areas as barriers to participation in PIPC. Yet they showed increased awareness of current service deficits and of their potential in delivering improved mental healthcare.

    CONCLUSIONS: Despite resource-related and structural barriers to implementation of national mental health policy in Malaysian primary care settings, our findings suggest that front-line clinicians are receptive to future interventions designed to improve the mental healthcare capacity.

    Matched MeSH terms: Qualitative Research
  9. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    Int J Environ Res Public Health, 2021 Jun 26;18(13).
    PMID: 34206868 DOI: 10.3390/ijerph18136876
    Patient complaints and dissatisfaction should be taken seriously and used as an opportunity to provide acceptable services. Mounting evidence shows that the perception of the quality of healthcare services impacts health-seeking behaviors. This study explores the perceptions of good-quality antenatal and birthing services among postpartum women. A qualitative study using phenomenological inquiry was conducted in the Morang district, Nepal. The study participants were postpartum women with at least one high-risk factor who refused the referral hospital's birth advice. A total of 14 women were purposively selected and interviewed in-depth. NVivo 12 Plus software was used for systematic coding, and thematic analysis was performed manually. Three themes emerged: (i) women's opinions and satisfactory factors of health services, (ii) expectations of the health facility and staff, and (iii) a lack of suggestions to improve the quality of care. Women did not have many expectations from the healthcare facility or the healthcare providers and could not express what good quality of care meant for them. Women from low socioeconomic status and marginalized ethnicities lack knowledge of their basic reproductive rights. These women judge the quality of care in terms of staff interpersonal behavior and personal experiences. Women will not demand quality services if they lack an understanding of their basic health rights.
    Matched MeSH terms: Qualitative Research
  10. Webair HH, Ismail TAT, Ismail SB, Khaffaji AJ
    BMJ Open, 2021 06 18;11(6):e044300.
    PMID: 34145008 DOI: 10.1136/bmjopen-2020-044300
    OBJECTIVE: The current study aims to define patient-centred infertility care (PCIC) from the perspective of Arab women with infertility.

    DESIGN: Semistructured in-depth telephone interviews.

    SETTING: Hospitals providing infertility care, Jeddah, Saudi Arabia.

    PARTICIPANTS: Arab women who received infertility treatment during the 6 months preceding the interview at any hospital in Jeddah, Saudi Arabia. Interviews were conducted with Arab women experiencing infertility from January 2017 to December 2018. A purposive sample of 14 women were included in the final analysis with maximum variation.

    RESULTS: Participants highlighted nine important PCIC dimensions. Of these, four were agreed on by all participants: accessibility, minimising cost, information and education, and staff attitudes and communication. The remaining five dimensions were staff competence, physical comfort, privacy, psychological and emotional support, and continuity and coordination of care. The concept of PCIC was related to three major contributors: participants' demographics, patient experience with infertility care and health-seeking behaviour.

    CONCLUSIONS: The current study provided nine PCIC dimensions and items, which can guide efforts to improve the quality of infertility care in Arab countries in two ways: first, by raising infertility care providers' awareness of their patients' needs, and second, by developing a validated tool based on the dimensions for measuring PCIC from Arab patients' perspective. Clear differences between the Arab and the European PCIC model were found. Our findings concluded that women continued to exhibit basic unmet needs.

    Matched MeSH terms: Qualitative Research
  11. Foong CC, Bashir Ghouse NL, Lye AJ, Khairul Anhar Holder NA, Pallath V, Hong WH, et al.
    BMC Med Educ, 2021 Jun 05;21(1):320.
    PMID: 34090439 DOI: 10.1186/s12909-021-02712-w
    BACKGROUND: Self-regulated learning (SRL) is an important contributing element to the academic success of students. Literature suggests that the understanding of SRL among medical students is obscure as there is still some uncertainty about whether high performing medical students use SRL. This study explored the characteristics of high performing medical students from the SRL perspective to gain a better understanding of the application of SRL for effective learning.

    METHODS: Twenty-one students who scored at the 90th percentile in written knowledge-based assessment consented to participate in this study. Each student wrote a guided reflective journal and subsequently attended a semi-structured interview. Students were prompted to explain the rationales for their answers. The data were then analysed using thematic analysis to identify patterns among these students from the SRL perspective. Two coders analysed the data independently and discussed the codes to reach a consensus.

    RESULTS: High performing students set goals, made plans, and motivated themselves to achieve the goals. They put consistent efforts into their studies and applied effective learning strategies. They also employed coping mechanisms to deal with challenges. High performing students regularly evaluated their performance and adopted new strategies.

    CONCLUSIONS: This study reported that high performing students applied SRL and described the rationales of practice. Medical schools could design SRL-driven interventions to enhance the learning experiences of medical students. Recommendations are made for students on how to apply SRL.

    Matched MeSH terms: Qualitative Research
  12. Tuan Abdullah TN, Mat Min R
    AIDS Care, 2021 06;33(6):795-800.
    PMID: 32338043 DOI: 10.1080/09540121.2020.1757024
    People living with HIV (PLHIV) suffer from mental issues and need emotional support. Counselling is a part of HIV and AIDS care and management, and provides emotional support to PLHIV. Knowledge about HIV and AIDS care and management is not part of the counselling training curriculum in Malaysia. This study aims to explore the challenges experienced by registered counsellors who engage in counselling sessions with PLHIV. A total of five counsellors participated in this qualitative research. Data were gathered through a series of semi-structured interviews, and each of the interviews was conducted within one and half hours. Each of the participants was interviewed three times. The interviews were audio-recorded with the consent of the participants. The emergent themes were further explored in subsequent interviews until thematic saturation was reached, and data were analysed based on the grounded theory approach. The findings showed that lack of knowledge, limited training, and stigma among the registered counsellors contributed to resistance and poor trust among the PLHIV. Knowledge concerning the care and management of HIV and AIDS can be incorporated in a counselling training programme, and ongoing training related to HIV and AIDS are required.
    Matched MeSH terms: Qualitative Research
  13. Mohammadi S, Su TT, Papadaki A, Jalaludin MY, Dahlui M, Mohamed MNA, et al.
    Public Health Nutr, 2021 Jun;24(8):2273-2285.
    PMID: 32744217 DOI: 10.1017/S1368980020002293
    OBJECTIVE: To conduct formative research using qualitative methods among stakeholders of secondary schools to explore their perceptions, barriers and facilitators related to healthy eating and physical activity (PA) among Malaysian adolescents.

    DESIGN: A qualitative study involving eight focus groups and twelve in-depth interviews. Focus groups and interviews were recorded and transcribed verbatim. An inductive thematic analysis approach was used to analyse the data.

    SETTING: Four secondary schools in Perak and Selangor states (two urban and two rural schools) in Malaysia.

    PARTICIPANTS: Focus groups were conducted with seventy-six adolescents aged 13-14 years, and in-depth interviews were conducted with four headmasters, four PA education teachers and four food canteen operators.

    RESULTS: Stakeholders thought that adolescents' misperceptions, limited availability of healthy options, unhealthy food preferences and affordability were important challenges preventing healthy eating at school. Low-quality physical education (PE) classes, limited adolescent participation and teachers' commitment during lessons were perceived as barriers to adolescents being active at school. Affordability was the main challenge for adolescents from rural schools. Stakeholders perceived that a future school-based intervention should improve the availability and subsidies for healthy foods, provide health education/training for both adolescents and PE teachers, enhance active adolescent participation in PE and develop social support mechanisms to facilitate engagement with PA.

    CONCLUSIONS: These findings provide important insights into developing school-based lifestyle interventions to improve healthy eating and strengthening PA of Malaysian adolescents.

    Matched MeSH terms: Qualitative Research
  14. Rajbanshi S, Norhayati MN, Nik Hazlina NH
    PMID: 34071394 DOI: 10.3390/ijerph18115801
    Maternal and neonatal morbidity and mortality tend to decrease if referral advice during pregnancy is utilized appropriately. This study explores the reasons for nonadherence to referral advice among high-risk pregnant women. A qualitative study was conducted in Morang District, Nepal. A phenomenological inquiry was used. Fourteen participants were interviewed in-depth. High-risk women who did not comply with the referral to have a hospital birth were the study participants. Participants were chosen purposively until data saturation was achieved. The data were generated using thematic analysis. Preference of homebirth, women's diminished autonomy and financial dependence, conditional factors, and sociocultural factors were the four major themes that hindered hospital births. Women used antenatal check-ups to reaffirm normalcy in their current pregnancies to practice homebirth. For newly-wed young women, information barriers such as not knowing where to seek healthcare existed. The poorest segments and marginalized women did not adhere to referral hospital birth advice even when present with high-risk factors in pregnancy. Multiple factors, including socioeconomic and sociocultural factors, affect women's decision to give birth in the referral hospital. Targeted interventions for underprivileged communities and policies to increase facility-based birth rates are recommended.
    Matched MeSH terms: Qualitative Research
  15. Putra Y, Yusof MM
    Stud Health Technol Inform, 2021 May 27;281:814-815.
    PMID: 34042691 DOI: 10.3233/SHTI210288
    We evaluated medication reconciliation processes of a qualitative case study at a 1000-bed public hospital. Lean tools were applied to identify factors contributing to prescribing errors and propose process improvement. Errors were attributed to the prescriber's skills, high workload, staff shortage, poor user attitude and rigid system function. Continuous evaluation of medication reconciliation efficiency is imperative to identify and mitigate errors and increase patient safety.
    Matched MeSH terms: Qualitative Research
  16. Perialathan K, Johari MZ, Jaafar N, Yuke Lin K, Lee Lan L, Sodri NA, et al.
    J Prim Care Community Health, 2021 5 11;12:21501327211014096.
    PMID: 33966530 DOI: 10.1177/21501327211014096
    PURPOSE: This study aimed to assess and explore perceived sustainability and challenges of the intervention among Health Care Providers (HCPs) who were involved.

    METHODS: The study applied mixed-method embedded design to analyze both quantitative and qualitative data. Quantitative approach was used to evaluate sustainability perception from 20 intervention clinics via self-reported assessment form whereas qualitative data were obtained through in-depth interview (IDI) and focus group discussions (FGDs) 14 health care professionals participated in IDI session and were either care coordinators, liaison officers (LOs)/clinic managers, or medical officers-in-charge for the clinic's intervention. Nine FGDs conducted comprised 58 HCPs from various categories.

    RESULTS: HCPs from all the 20 clinics involved responded to each listed Enhanced Primary Healthcare (EnPHC) intervention components as being implemented but the perceived sustainability of these implementation varies between them. Quantitative feedback showed sustainable interventions included risk stratification, non-communicable disease (NCD) screening form, referral within clinics and hospitals, family health team (FHT), MTAC services and mechanisms and medical adherence status. Qualitative feedback highlighted implementation of each intervention components comes with its challenges, and most of it are related to inadequate resources and facilities in clinic. HCPs made initiatives to adapt based on clinical setting to implement the interventions at best level possible, whereby this seems to be one of the core values for sustainability.

    CONCLUSION: Overall perceptions among HCPs on sustainability of EnPHC interventions are highly influenced by current experiences with existing resources. Components perceived to have inadequate resources are seen as a challenge to sustain. It's crucial for stakeholders to understand implications affecting implementation process if concerns raised are not addressed and allocation of needed resources to ensure overall successfulness and long term sustainability.

    Matched MeSH terms: Qualitative Research
  17. Manaf RA, Mahmud A, Ntr A, Saad SR
    BMC Public Health, 2021 05 06;21(1):876.
    PMID: 33957870 DOI: 10.1186/s12889-021-10917-3
    BACKGROUND: The challenges faced by healthcare personnel in relation to dengue prevention and control are perennial but noticeably unexplored. It is often difficult to translate policies and decision making by the elite into astute management in consonance with the needs of rank-and-file personnel. In this study, we assess the impact of governance on dengue prevention and control activities in Malaysia as narrated by the elite.

    METHODS: A qualitative study using a case-study approach was conducted between January 2019 and November 2019 in the districts of Gombak and Klang, where the relevant key informants were located. Nineteen interviews were conducted among elite healthcare personnel from different divisions: management, vector, laboratory, inspectorate, health promotion and entomology. Semi-structured interviews were conducted. The sample size was determined through saturation point criteria. Purposive sampling techniques were used to recruit the participants. The interviews were audio recorded, and the transcribed text was analysed with deductive thematic analysis.

    RESULTS: Data analysis led to the development of 5 themes and 13 categories. The major principles of governance were embodied in a milieu of predicament, linked to constraints but also opportunities. The constraints resulted from inherent determinants of dengue outbreaks, the serviceability of governing policies and the macro-economics of budget allocation. The opportunities to sustain governance at the local operating level stem from a prevalent supportive internal management system, collaborative efforts among corresponding external government agencies and willingness to innovate and embrace novel technology.

    CONCLUSION: Elites are influential, often well-informed personnel tasked with making decisions that can reverberate across an organisation, impacting future plans and strategic policies. Political arrangements at higher levels will reflect in advance the tone of how governance in dengue prevention and control is operationalised by entities and individuals at lower levels of the health system. The prevailing centralised structure in the Malaysian health system will continue to entrench the position of the elite and intertwine it with governance and its predicaments.

    Matched MeSH terms: Qualitative Research
  18. Mohamed Rohani M, Mohd Nor NA
    J Dent Educ, 2021 May;85(5):690-698.
    PMID: 33476414 DOI: 10.1002/jdd.12528
    INTRODUCTION: The Special Care Dentistry (SCD) undergraduate program increasingly aims to address student attitudes toward people with disabilities (PWD). One of the efforts made by the Faculty of Dentistry, University of Malaya (FODUM), is to introduce Disability Equality Training (DET) as part of the learning activity in the SCD curriculum. This study aimed to explore students' perception about the DET program.

    METHODS: This was a qualitative research project exploring students' perception toward DET in 2 cohorts of third-year dental students from FODUM (n = 100). The reflection notes were analyzed using Luborsky's method of thematic analysis. Identification of themes was based on statements that were most frequently reported by students.

    RESULTS: The majority of the students gave positive feedback for the training, which includes enhanced knowledge, attitudes, and skills about treating PWD. They also reflected that the DET improved their understanding of social and professional responsibility. In terms of learning experience, many reported that the training was useful and enjoyable. Students' suggestions for improvement included learning "sign language", visiting special needs centers, and providing simulation exercises involving real PWD.

    CONCLUSION: Students' comments on the DET were positive and they enjoyed the learning experience. The findings support the continuation of DET as part of the undergraduate dental curriculum. Dental institutions seeking to implement or refine the SCD curriculum are encouraged to include DET based on its potential benefits for undergraduate students.

    Matched MeSH terms: Qualitative Research
  19. Ahmad Ramli FZ, Tilse C, Wilson J
    J Gerontol Soc Work, 2021 04 12;64(5):499-517.
    PMID: 33843484 DOI: 10.1080/01634372.2021.1912240
    Religion and culture affect the meaning and practicalities of caring for families with mental illness in Malaysia. Such care also differs according to social background, family values and support, commitment, availability, practicality and the needs of the care recipient. This qualitative study explores 14 Malay caregivers of the older adults with mental health problems in Kelantan, Malaysia. A semi-structured interview was translated and transcribed and subjected to thematic analysis using NVivo software. The findings show that cultural values and religion shaped the meaning of care as provided by the caregivers. The nature of the relationship is also important in determining the best person in the family to take over the caregiving role.
    Matched MeSH terms: Qualitative Research
  20. Che Abdullah CA, Saidi S, Lee SP
    Enferm Clin, 2021 04;31 Suppl 2:S152-S156.
    PMID: 33849151 DOI: 10.1016/j.enfcli.2020.12.012
    This review is conducted to understand the self-management experience among the patients throughout their cancer trajectory. Five databases were inputted systematic searches from February to April 2018. Several important themes emerged from the review, including their needs, facilitators, barriers, strategies, and provision of support towards self-management. The needs for sufficient and appropriate information was the most severe concern among nasopharyngeal cancer patients. Understanding self-management from the patients' perspectives may draw attention to specific concerns for self-management. However, the study of nasopharyngeal cancer patients is still under-researched. Therefore, exploratory research to understand their unique self-management experiences may help to design the care and support tailored to them to provide more holistic yet individualized care.
    Matched MeSH terms: Qualitative Research
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