Displaying publications 61 - 80 of 126 in total

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  1. Lim RB
    Ther Adv Respir Dis, 2016 10;10(5):455-67.
    PMID: 27585597 DOI: 10.1177/1753465816660925
    Despite advances in the detection, pathological diagnosis and therapeutics of lung cancer, many patients still develop advanced, incurable and progressively fatal disease. As physicians, the duties to cure sometimes, relieve often and comfort always should be a constant reminder to us of the needs that must be met when caring for a patient with lung cancer. Four key areas of end-of-life care in advanced lung cancer begin with first recognizing 'when a patient is approaching the end of life'. The clinician should be able to recognize when the focus of care needs to shift from an aggressive life-sustaining approach to an approach that helps prepare and support a patient and family members through a period of progressive, inevitable decline. Once the needs are recognized, the second key area is appropriate communication, where the clinician should assist patients and family members in understanding where they are in the disease trajectory and what to expect. This involves developing rapport, breaking bad news, managing expectations and navigating care plans. Subsequently, the third key area is symptom management that focuses on the goals to first and foremost provide comfort and dignity. Symptoms that are common towards the end of life in lung cancer include pain, dyspnoea, delirium and respiratory secretions. Such symptoms need to be anticipated and addressed promptly with appropriate medications and explanations to the patient and family. Lastly, in order for physicians to provide quality end-of-life care, it is necessary to understand the ethical principles applied to end-of-life-care interventions. Misconceptions about euthanasia versus withholding or withdrawing life-sustaining treatments may lead to physician distress and inappropriate decision making.
    Matched MeSH terms: Quality of Health Care
  2. Lim MT, Lim YMF, Teh XR, Lee YL, Ismail SA, Sivasampu S
    Int J Qual Health Care, 2019 Aug 01;31(7):37-43.
    PMID: 30608582 DOI: 10.1093/intqhc/mzy252
    OBJECTIVE: To determine the extent of self-management support (SMS) provided to primary care patients with type 2 diabetes (T2D) and hypertension and its associated factors.

    DESIGN: Cross-sectional survey conducted between April and May 2017.

    SETTING: Forty public clinics in Malaysia.

    PARTICIPANTS: A total of 956 adult patients with T2D and/or hypertension were interviewed.

    MAIN OUTCOME MEASURES: Patient experience on SMS was evaluated using a structured questionnaire of the short version Patient Assessment of Chronic Illness Care instrument, PACIC-M11. Linear regression analysis adjusting for complex survey design was used to determine the association of patient and clinic factors with PACIC-M11 scores.

    RESULTS: The overall PACIC-M11 mean was 2.3(SD,0.8) out of maximum of 5. The subscales' mean scores were lowest for patient activation (2.1(SD,1.1)) and highest for delivery system design/decision support (2.9(SD,0.9)). Overall PACIC-M11 score was associated with age, educational level and ethnicity. Higher overall PACIC-M11 ratings was observed with increasing difference between actual and expected consultation duration [β = 0.01; 95% CI (0.001, 0.03)]. Better scores were also observed among patients who would recommend the clinic to friends and family [β = 0.19; 95% CI (0.03, 0.36)], when health providers were able to explain things in ways that were easy to understand [β = 0.34; 95% CI (0.10, 0.59)] and knew about patients' living conditions [β = 0.31; 95% CI (0.15, 0.47)].

    CONCLUSIONS: Our findings indicated patients received low levels of SMS. PACIC-M11 ratings were associated with age, ethnicity, educational level, difference between actual and expected consultation length, willingness to recommend the clinic and provider communication skills.

    Matched MeSH terms: Quality of Health Care/statistics & numerical data
  3. Lim LL, Lau ESH, Kong APS, Davies MJ, Levitt NS, Eliasson B, et al.
    Diabetes Care, 2018 06;41(6):1312-1320.
    PMID: 29784698 DOI: 10.2337/dc17-2010
    OBJECTIVE: The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes.

    RESEARCH DESIGN AND METHODS: We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes. Two reviewers extracted data and appraised the reporting quality.

    RESULTS: In a meta-analysis of 181 trials (N = 135,112), random-effects modeling revealed pooled mean differences in HbA1c of -0.28% (95% CI -0.35 to -0.21) (-3.1 mmol/mol [-3.9 to -2.3]), in systolic blood pressure (SBP) of -2.3 mmHg (-3.1 to -1.4), in diastolic blood pressure (DBP) of -1.1 mmHg (-1.5 to -0.6), and in LDL cholesterol (LDL-C) of -0.14 mmol/L (-0.21 to -0.07), with greater effects in patients with LDL-C ≥3.4 mmol/L (-0.31 vs. -0.10 mmol/L for <3.4 mmol/L; Pdifference = 0.013), studies from Asia (HbA1c -0.51% vs. -0.23% for North America [-5.5 vs. -2.5 mmol/mol]; Pdifference = 0.046), and studies lasting >12 months (SBP -3.4 vs. -1.4 mmHg, Pdifference = 0.034; DBP -1.7 vs. -0.7 mmHg, Pdifference = 0.047; LDL-C -0.21 vs. -0.07 mmol/L for 12-month studies, Pdifference = 0.049). Patients with median age <60 years had greater HbA1c reduction (-0.35% vs. -0.18% for ≥60 years [-3.8 vs. -2.0 mmol/mol]; Pdifference = 0.029). Team change, patient education/self-management, and improved patient-provider communication had the largest effect sizes (0.28-0.36% [3.0-3.9 mmol/mol]).

    CONCLUSIONS: Despite the small effect size of multicomponent integrated care (in part attenuated by good background care), team-based care with better information flow may improve patient-provider communication and self-management in patients who are young, with suboptimal control, and in low-resource settings.
    Matched MeSH terms: Quality of Health Care/standards*
  4. Liao XH, McIlwaine G
    Scott Med J, 1995 Jun;40(3):77-80.
    PMID: 7569869
    This cross sectional study explored the health problems and health needs in the local Chinese community in Glasgow. Several data collection methods have been used in this study, including face-to-face and telephone structured interviews, postal and hand delivered questionnaires. A total of 800 questionnaires were processed, and 493 were completed, giving an overall response rate 61.6%. The results from the present survey indicated that the health status of Chinese residents in Glasgow is poorer than that of the local population. The most important findings of the study is that the Chinese community in Glasgow underuse health services, and unmet health needs exist in the community. The main barrier to effective use of present health services and benefit from the health promotion and health education programmes is language difficulties. Following discussion with the local community, options for improving the health services for the Chinese community in Glasgow were obtained. The findings of the study have implications for health service purchaser/providers of health care to the Chinese population generally in Scotland.
    Matched MeSH terms: Quality of Health Care
  5. Lennox SS
    RN, 1991 Jun;54(6):104.
    PMID: 2034975
    Matched MeSH terms: Quality of Health Care*
  6. Lee YH, Quek ST, Khong PL, Lee CS, Wu JS, Zhang L, et al.
    Br J Radiol, 2020 Sep;93(1113):20200082.
    PMID: 32584595 DOI: 10.1259/bjr.20200082
    OBJECTIVE: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions.

    METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice.

    RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic.

    CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care.

    ADVANCES IN KNOWLEDGE: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.

    Matched MeSH terms: Quality of Health Care/standards*
  7. Lee YF
    Med J Malaysia, 2017 04;72(2):89-90.
    PMID: 28473669
    No abstract available.
    Matched MeSH terms: Quality of Health Care
  8. Lee SY, Tang SJ, Rockey DC, Weinstein D, Lara L, Sreenarasimhaiah J, et al.
    Gastrointest Endosc, 2008 Jun;67(7):1076-81.
    PMID: 18384789 DOI: 10.1016/j.gie.2007.11.037
    Anticoagulation and antiplatelet medications may potentiate GI bleeding, and their use may lead to an increased need for a GI endoscopy. We hypothesized that there might be different practice patterns among international endoscopists.
    Matched MeSH terms: Quality of Health Care
  9. Kieny MP, Bekedam H, Dovlo D, Fitzgerald J, Habicht J, Harrison G, et al.
    Bull World Health Organ, 2017 07 01;95(7):537-539.
    PMID: 28670019 DOI: 10.2471/BLT.16.187476
    Matched MeSH terms: Quality of Health Care
  10. Khan MU, Hassali MA, Ahmad A, Elkalmi RM, Zaidi ST, Dhingra S
    PLoS One, 2016;11(2):e0149623.
    PMID: 26901404 DOI: 10.1371/journal.pone.0149623
    BACKGROUND: Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship.

    METHODS: A cross-sectional study was conducted among community pharmacists between March-April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data.

    RESULTS: A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p<0.05). Similarly, more experienced pharmacists (> 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05).

    CONCLUSION: The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and improve their perception and practices towards antimicrobial stewardship.

    Matched MeSH terms: Quality of Health Care*
  11. Khalid bin Sahan A
    Med J Malaysia, 1977 Sep;32(1):1-5.
    PMID: 609336
    Matched MeSH terms: Quality of Health Care
  12. Khalid Y
    Med J Malaysia, 1998 Dec;53(4):325-6.
    PMID: 10971973
    Matched MeSH terms: Quality of Health Care/standards*
  13. Kelly AM, Keijzers G, Klim S, Graham CA, Craig S, Kuan WS, et al.
    Emerg Med Australas, 2015 Jun;27(3):187-91.
    PMID: 25940885 DOI: 10.1111/1742-6723.12397
    Shortness of breath is a common reason for ED attendance. This international study aims to describe the epidemiology of dyspnoea presenting to EDs in the South East Asia-Pacific region, to compare disease patterns across regions, to understand how conditions are investigated and treated, and to assess quality of care.
    Matched MeSH terms: Quality of Health Care/standards
  14. Kamaludin KM, Muhammad M, Wahat NW, Ibrahim R
    Asian Pac J Cancer Prev, 2013;14(8):4795-800.
    PMID: 24083746
    The involvement of non-government organizations (NGOs) and support groups has helped strengthen public health services in addressing cancer care burden. Owing to the contribution of volunteers in cancer care, this article documents a qualitative study that examined challenges in attracting and retaining cancer care volunteers as part of the effort to develop a volunteer recruitment model. Data were collected through three focus group discussions involving 19 cancer support group members in Malaysia. Findings of the study revealed that mobility and locality appeared to be significant in Malaysian context, while the need for financial support and time flexibility are challenges faced by cancer support groups to attract and retain volunteers. The findings imply that cancer care initiatives can benefit from more local volunteers but at the same time these volunteers require flexibility and financial support to sustain their engagement.
    Matched MeSH terms: Quality of Health Care*
  15. John J, Yatim FM, Mani SA
    Asia Pac J Public Health, 2011 Sep;23(5):742-53.
    PMID: 20460281 DOI: 10.1177/1010539509357341
    This study investigates patients' expectations and perceptions of service quality in public dental health care and measures their "satisfaction gap." This descriptive study involved 481 dental outpatients in Kelantan, Malaysia. A modified SERVQUAL 20-item instrument was used to assess patients' expectations before and perceptions after receiving dental treatment. The "satisfaction gap" was then measured.
    RESULTS: showed that patients visiting for management of dental pain were more satisfied (P = .007) than those visiting with appointment. The most significant service quality dimensions were related to responsiveness, assurance, and empathy of the dental health care providers. There was a significant difference between the patients' expectations and their perceptions of service provided (P < .01) with regard to all dimensions. In conclusion, dental service providers should give emphasis to the compassionate and emotional aspects of care and to remember that they are integral components of quality service.
    Matched MeSH terms: Quality of Health Care*
  16. Jiwa M, Othman S, Hanafi NS, Ng CJ, Khoo EM, Chia YC
    Qual Prim Care, 2012;20(5):317-20.
    PMID: 23113999
    Malaysia has achieved reasonable health outcomes even though the country spends a modest amount of Gross Domestic Product on healthcare. However, the country is now experiencing a rising incidence of both infectious diseases and chronic lifestyle conditions that reflect growing wealth in a vibrant and successful economy. With an eye on an ageing population, reform of the health sector is a government priority. As in other many parts of the world, general practitioners are the first healthcare professional consulted by patients. The Malaysian health system is served by public and private care providers. The integration of the two sectors is a key target for reform. However, the future health of the nation will depend on leadership in the primary care sector. This leadership will need to be informed by research to integrate care providers, empower patients, bridge cultural gaps and ensure equitable access to scarce health resources.
    Matched MeSH terms: Quality of Health Care/economics; Quality of Health Care/standards; Quality of Health Care/trends*
  17. Jarrar M, Minai MS, Al-Bsheish M, Meri A, Jaber M
    Int J Health Plann Manage, 2019 Jan;34(1):e387-e396.
    PMID: 30221794 DOI: 10.1002/hpm.2656
    BACKGROUND: There is no clear evidence that can guide decision makers regarding the appropriate shift length in the hospitals in Malaysia. Further, there is no study that explored the value of patient-centered care of nurses working longer shifts and its impact on the care outcomes.

    OBJECTIVE: The study aims to investigate the effect of the hospital nurse shift length and patient-centered care on the perceived quality and safety of nurses in the medical-surgical and multidisciplinary wards in Malaysia.

    METHODS: A cross-sectional survey has been conducted on 12 hospitals in Malaysia. Data have been collected via a questionnaire. A stratified sampling has been used. The Hayes macro regression analyses have been used to examine the mediating effects of patient-centered care between the effect of working long shifts on the perceived quality and patient safety.

    RESULTS: There is a significant mediation effect of patient-centered care between the effect of shift length on the perceived quality (F = 42.90, P ˂ 0.001) and patient safety (F = 25.12, P ˂ 0.001).

    CONCLUSION: Patient-centered care mitigates the effect of the shift length on the care outcomes. The study provides an input for the policymakers that patient-centered care and restructuring duty hours are important to provide high-quality patient care.

    Matched MeSH terms: Quality of Health Care*
  18. Jackson AA
    Family Physician, 1994;6:4-6.
    Audit has improved certain aspects of management of typhoid fever detected through Klinik Perubatan Masyarakat at Hospital Universiti Sains Malaysia. We audited records of clinic patients who were blood culture positive for Salmonella typhi. For August to October 1992, we found 10 out of 31 cases (32%) were not admitted. Some of these were patients who defaulted, while some were managed as outpatients but not notified. We took action to educate the medical officers. For November 1992 - March 1993 we found 8 out of 24 cases (33%) were not admitted. Although the admission rate was no better, there was a non significant improvement in rate of notification by doctors. Defaulters were now the main problem, and so we took action to improve their follow-up, by using the clinic staff nurse. For April - August 1993, only 1 out of 16 cases (6%) was not admitted. This was a significant improvement (p=0.03)

    Study site: Klinik Perubatan Masyarakat at Hospital Universiti Sains Malaysia
    Matched MeSH terms: Quality of Health Care
  19. Ibrahim AA, Ahmad Zamzuri M'I, Ismail R, Ariffin AH, Ismail A, Muhamad Hasani MH, et al.
    Medicine (Baltimore), 2022 Jul 29;101(30):e29627.
    PMID: 35905245 DOI: 10.1097/MD.0000000000029627
    The Teleprimary Care-Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics. The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21. A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR. With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.
    Matched MeSH terms: Quality of Health Care*
  20. Hweissa NA, Lim JN, Su TT
    Eur J Cancer Care (Engl), 2016 Sep;25(5):864-70.
    PMID: 27350095 DOI: 10.1111/ecc.12537
    In Libya, cervical cancer is ranked third as the most frequent cancer among women with early diagnosis being shown to reduce morbidity and mortality. Health-care providers can influence women's screening behaviours, and their lack of recommendations for screening can be one of the barriers that affect women's participation in screening programmes. This study aims to assess the health-care provider's perception around cervical cancer screening. In-depth, face-to-face interviews were conducted with 16 health-care providers, from both public and private sectors in Az-Zawiya city, Libya, between February and July of 2014. The interviews were recorded and transcribed, then analysed using thematic analysis. Our findings suggest that health-care providers did not provide sufficient information regarding cervical cancer screening for women who attend health-care facilities. The results highlight the role played by health-care professionals in motivating women to attend cervical cancer screening programs, and the need for health education of health-care providers to offer a precious advice regarding the screening. On the other hand, health-care providers highlighted that implementation of reminding system of cervical cancer screening will support them to improve screening attendance. In addition, health-care providers stressed the necessity for educational and awareness campaigns of cervical cancer screening among Libyan women.
    Matched MeSH terms: Quality of Health Care
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