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  1. Ishak S, Nfe F, Zakaria Sz S, Adli A, Jaafar R
    Pediatr Int, 2019 Jan;61(1):67-72.
    PMID: 30484931 DOI: 10.1111/ped.13724
    BACKGROUND: Inadequate pain management is linked to potential neurodevelopmental and behavioral problems. Sufficient knowledge in neonatal pain is required to facilitate optimal pain management. The aim of this study was therefore to assess the knowledge and perception of pain experienced by neonates requiring intensive care among pediatric doctors working in a level III neonatal intensive care unit in Malaysian hospitals.

    METHODS: This was a cross-sectional study conducted over a period of 18 months. A self-administered questionnaire assessing knowledge and perception regarding neonatal pain was used.

    RESULTS: Twenty-four hospitals participated in the study, with 423 respondents. The response rate was 85%. One hundred and ninety-seven respondents (47%) were aware of tools for neonatal pain assessment, but only 6% used them in daily practice. Doctors with >4 years of experience in neonatal care had better awareness of available pain assessment tools (59.4% vs 40.9%, P = 0.001). Sixteen statements regarding knowledge were assessed. Mean score obtained was 10.5 ± 2.5. Consultants/specialists obtained a higher mean score than medical officers (11.9 vs 10.4, P < 0.001). More than 80% of respondents were able to discriminate painful from non-painful procedures.

    CONCLUSION: Clinicians involved in neonatal care, especially those with longer experience were knowledgeable about neonatal pain. Gaps between knowledge and its application, however, remain. Implementation of clinical guidelines to improve the quality of assessment and adequate pain management in neonates is recommended.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  2. Chia ZJ, Jehosua SY, Lim KS, Khosama H, Hamid DH, Fong SL, et al.
    Epilepsy Behav, 2020 02;103(Pt A):106833.
    PMID: 31839499 DOI: 10.1016/j.yebeh.2019.106833
    INTRODUCTION: Epilepsy stigma has been associated with poor quality of life among people with epilepsy (PWE). It is important to understand the variation and degree of epilepsy stigma in one of the most populous and culturally diverse nations in the world, Indonesia. Hence, this study aimed to test the validity and reliability of the Indonesian version of the Public Attitudes Toward Epilepsy (PATE) scale.

    METHOD: The translation was performed according to standard principles and tested in 200 native Indonesian speakers who were aged above 18-year-old for psychometric validation.

    RESULTS: The items in each domain had similar means and standard deviations (equal item variance), means ranging from 2.17 to 2.86 in general domain and 2.75 to 3.56 in personal domain and, standard deviations ranging from 0.87 to 1.05 and 0.88 to 1.01 in general and personal domain, respectively. Item-domain correlations were more than 0.5 for all items, and they correlate higher within their own domain compare with the other domain (convergent and divergent validity). Multitrait analysis showed similar variance, floor, and ceiling patterns to a great extent compared with the initial study. The Indonesian PATE scale also showed mostly similar correlation with demographic characteristics except monthly income. Principle axis analysis revealed strong factor loading (>0.3) in their hypothesized domain, except item 14. The Cronbach's α values for general and personal domains were 0.836 and 0.765, which were within the accepted range of 0.7 to 0.9.

    CONCLUSION: The Indonesian PATE scale is a validated and reliable translation for measuring public attitudes toward epilepsy.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  3. Hagger MS, Hamilton K, Hardcastle SJ, Hu M, Kwok S, Lin J, et al.
    Soc Sci Med, 2019 12;242:112591.
    PMID: 31630009 DOI: 10.1016/j.socscimed.2019.112591
    RATIONALE: Familial Hypercholesterolemia (FH) is a genetic condition that predisposes patients to substantially increased risk of early-onset atherosclerotic cardiovascular disease. FH risks can be minimized through regular participation in three self-management. BEHAVIORS: physical activity, healthy eating, and taking cholesterol lowering medication.

    OBJECTIVE: The present study tested the effectiveness of an integrated social cognition model in predicting intention to participate in the self-management behaviors in FH patients from seven countries.

    METHOD: Consecutive patients in FH clinics from Australia, Hong Kong, Brazil, Malaysia, Taiwan, China, and UK (total N = 726) completed measures of social cognitive beliefs about illness from the common sense model of self-regulation, beliefs about behaviors from the theory of planned behavior, and past behavior for the three self-management behaviors.

    RESULTS: Structural equation models indicated that beliefs about behaviors from the theory of planned behavior, namely, attitudes, subjective norms, and perceived behavioral control, were consistent predictors of intention across samples and behaviors. By comparison, effects of beliefs about illness from the common sense model were smaller and trivial in size. Beliefs partially mediated past behavior effects on intention, although indirect effects of past behavior on intention were larger for physical activity relative to taking medication and healthy eating. Model constructs did not fully account for past behavior effects on intentions. Variability in the strength of the beliefs about behaviors was observed across samples and behaviors.

    CONCLUSION: Current findings outline the importance of beliefs about behaviors as predictors of FH self-management behaviors. Variability in the relative contribution of the beliefs across samples and behaviors highlights the imperative of identifying sample- and behavior-specific correlates of FH self-management behaviors.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  4. Lim SC, Mustapha FI, Aagaard-Hansen J, Calopietro M, Aris T, Bjerre-Christensen U
    Med Educ Online, 2020 Dec;25(1):1710330.
    PMID: 31891330 DOI: 10.1080/10872981.2019.1710330
    Background: Continuing Medical Education (CME) is a cornerstone of improving competencies and ensuring high-quality patient care by nurses and physicians. The Ministry of Health (MOH) Malaysia collaborated with Steno Diabetes Centre to improve diabetes-related competencies of general physicians and nurses working in primary care through a six-month training programme called the Steno REACH Certificate Course in Clinical Diabetes Care (SRCC).Objective: This impact evaluation aimed to assess the effect of participation of general physicians and nurses in the SRCC in selected public primary healthcare clinics in Kuala Lumpur and Selangor, Malaysia.Design: The quasi-experimental, embedded, mixed-methods study used concurrent data collection and the Solomon four-group design. Participants in an intervention group (Arm 1) and control group (Arm 3) were assessed by pre-and post-test, and participants in separate intervention (Arm 2) and control (Arm 4) groups were assessed by post-test only. Quantitative and qualitative methods were used to assess the effect of the programme.Results: Thirty-four of the 39 participants in the intervention groups (Arms 1 and 2) completed the SRCC and were included in the analysis. All 35 participants in the control groups (Arms 3 and 4) remained at the end of the study period. Significant improvements in diabetes-related knowledge, skills and clinical practise were found among general physicians and nurses in the intervention group after the six-month SRCC, after controlling the pretest effects. No clear changes could be traced regarding attitudes.Conclusion: SRCC participants had significant improvements in knowledge, skills and clinical practice that meet the current needs of general physicians and nurses working in primary care in Malaysia. Thus, SRCC is an effective CME approach to improving clinical diabetes care that can be scaled up to the rest of the country and, with some modification, beyond Malaysia.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  5. Al-Alimi KR, Razak AAA, Saub R
    Afr Health Sci, 2018 Dec;18(4):1036-1045.
    PMID: 30766570 DOI: 10.4314/ahs.v18i4.25
    Backgrounds: People in Yemen and in East African countries chew khat more than five hours daily.

    Objectives: The aim of this study was to assess the relationship between khat and occlusal caries progression.

    Methods: A cohort study was carried out among 98 Yemeni khat chewers and 101 non-chewers aged 18-35 years old with early occlusal caries lesions. All participants answered questions on socio-demographic, khat , oral hygiene , sugar intake, and oral health knowledge at baseline. All posterior teeth with an early enamel lesion on occlusal surfaces detected by visual inspection at baseline were also subjected to DIAGNOdent assessment to confirm early lesion (DIAGNOdent reading 13-24). Participants were re-examined after 12 weeks. Caries progression was considered to occur when the DIAGNOdent reading was >25. Data were analyzed using Relative risk, Mann-Whitney U test, a Wilcoxon Signed-Rank test and logistic regression analysis.

    Results: Occlusal caries progression incidence between khat chewers and non-chewers, with the relative risk was 1.68. There was no significant difference in occlusal caries progression on chewing side and non-chewing side among khat chewers. Khat chewing was a statistical predictor for those with low income.

    Conclusion: Khat is a risk factor for occlusion caries progression among low income group.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  6. Mustari S, Hossain B, Diah NM, Kar S
    Asian Pac J Cancer Prev, 2019 06 01;20(6):1613-1620.
    PMID: 31244279 DOI: 10.31557/APJCP.2019.20.6.1613
    Each year, many countries from developed world publishes reports on early cancer detection; which is absolutely
    absent in most developing countries like Bangladesh.Very limited evidence is found on the role and acceptance of Pap
    test among the women of Bangladesh in determining cervical cancer. More research and updates are needed relating Pap
    test in early detection of cervical cancer. Thus the purpose of this study is set to assess the opinions of Bangladeshiurban
    womentowardsthe Pap test. A questionnaire-based survey of 400 Bangladeshi urban women was evaluated by on their
    socio-demographic characteristics, knowledgeand attitudes towards Pap testing. In general, the findings reveal that
    respondents havea good understanding of thepurpose of Pap test screening with 3.92 (Mean score). With 3.54 Mean
    score,the respondents believed that Pap tests are recommended to women who are married and with 3.45 mean score
    women believed that Pap tests arerecommended only to those who have children. Generally, respondents possess good
    knowledge of Pap test and its purpose. These findings can be used in identifying prospect cervical cancer screening
    significance populations and trend for future intrusion.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  7. Ramli HA, Moey SF, Abdul Mutalib AM
    Asian Pac J Cancer Prev, 2019 06 01;20(6):1913-1920.
    PMID: 31244318 DOI: 10.31557/APJCP.2019.20.6.1913
    Background: Breast cancer (BC) awareness is relatively poor among Malaysian women indicated by the presence of BC at a late stage and the low rate of mammography screening. Only a few theoretically based studies have been conducted on Malaysian women’s participation in mammography. Therefore, the objective of this study is to use health belief model (HBM) and stage of change model (SCM) to determine the relationship between health beliefs on the behavioral adoption of mammography amongst women in Kuantan, Pahang. Methods: Five hundred and twenty women were randomly selected to complete the survey. Data were analyzed using multinomial logistic regression (MLR) to ascertain the multivariate relationships between health beliefs and stage of mammography behavioral adoption. Results:
    The MLR test indicates that there is no significant difference in perceived severity, benefits, motivator factors and cues to action between participants in the action stage and the maintenance stage. However, significant differences existed in perceived severity, susceptibility, motivator factors and self-efficacy between the pre-contemplation, relapse and contemplation stage to that of the referenced (maintenance) stage of mammography adoption. Conclusion: Women in the action stage are more likely to progress towards maintenance stage as they perceived breast cancer as a disease that leads to death and that mammogram screening is beneficial in detecting the disease at an early stage. However, women in the pre-contemplation, relapse and contemplation stage are found unlikely to move towards the maintenance stage as they perceived their risk of getting breast cancer is low.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  8. Loh KW, Majid HA, Dahlui M, Roslani AC, Su TT
    Asian Pac J Cancer Prev, 2013;14(6):3799-804.
    PMID: 23886185
    BACKGROUND: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon.

    MATERIALS AND METHODS: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness.

    RESULTS: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay.

    CONCLUSIONS: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  9. Al-Qazaz HKh, Sulaiman SA, Hassali MA, Shafie AA, Sundram S, Al-Nuri R, et al.
    Int J Clin Pharm, 2011 Dec;33(6):1028-35.
    PMID: 22083724 DOI: 10.1007/s11096-011-9582-2
    BACKGROUND: Most of interventions that have attempted to improve medication adherence in type 2 diabetes have been educational; on the assumption that knowledge regarding diabetes might affect patients' adherence to their treatment regimen.
    OBJECTIVES: The purpose of the study was to investigate any association of knowledge and medication adherence with glycemic control in patients with type 2 diabetes mellitus. Setting The study was conducted at the Diabetes Outpatients Clinic, Hospital Pulau Pinang.
    METHODS: A cross-sectional study was conducted with a convenience sample of 540 adult patients with type 2 diabetes attending the clinic. A questionnaire including previously validated Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used and the patients' medical records were reviewed for haemoglobin A1C (HbA1C) levels and other disease-related information. A total of 35 (6.48%) patients were excluded after data collection due to lack of HbA1C results.
    RESULTS: Five hundred and five patients were included in the final analysis, with a mean age of 58.15 years (SD = 9.16), 50.7% males and median HbA1C of 7.6 (IQR was 6.7-8.9). The median total knowledge score was 7.0 (IQR was 5.0-10.0) while the median adherence score was 6.5 (IQR was 4.75-7.75). Significant correlations were found between the three variables (HbA1C, knowledge and adherence). A significantly higher score for knowledge and adherence (P < 0.05) was found in those patients with lower HbA1C. Higher diabetes knowledge, higher medication adherence and using mono-therapy were significant predictors of good glycemic control in the multivariate analysis.
    CONCLUSION: Patients' knowledge about diabetes is associated with better medication adherence and better glycemic control. In addition to other factors affecting medication adherence and glycemic control, healthcare providers should pay attention to knowledge about diabetes that the patients carry towards medication adherence.

    Study site: Diabetes Outpatients Clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  10. Hasan SS, Ahmed SI, Bukhari NI, Loon WC
    Complement Ther Clin Pract, 2009 Aug;15(3):152-7.
    PMID: 19595416 DOI: 10.1016/j.ctcp.2009.02.003
    OBJECTIVE: The primary objective of this study was to evaluate the use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics. Another aim was to identify demographic and socio-economic factors that are associated with CAM use.
    RESEARCH DESIGN AND METHODS: Face-to-face interviews of conveniently selected patients with chronic diseases were conducted in outpatient clinics of a general hospital. A validated data collection form was used to gather the information regarding pattern, perception, reasons, and perceived effect of CAM on the disease state. The other relevant information including demographics, diagnosis, indication, and treatment were collected from the patients' medical records.
    RESULTS: Out of 321 patients interviewed in this study, 205 patients were using some form of CAM, and thus the utilisation rate was 63.9%. A significant number of patients (35.5%) were using CAM for diabetes mellitus. Thirteen types of CAM were identified in the study with the most common being vitamins supplements (48.2%), herbal medicines (26.4%), ginseng (4.7%) and traditional Chinese medicine (4.0%). The patients with higher education level, higher income, and aged more than 50 years were independently associated with CAM use. Majority of the patients (77.6%) reported that their condition had improved by using CAM.
    CONCLUSION: The present study confirms the high frequency of CAM use among patients with chronic diseases in a Malaysian public hospital. The popularity of CAM indicated the patients' preference towards holistic approach to health care.
    Study site: Outpatient clinics, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  11. Koo JH, Leong RW, Ching J, Yeoh KG, Wu DC, Murdani A, et al.
    Gastrointest Endosc, 2012 Jul;76(1):126-35.
    PMID: 22726471 DOI: 10.1016/j.gie.2012.03.168
    BACKGROUND: The rapid increase in the incidence of colorectal cancer (CRC) in the Asia-Pacific region in the past decade has resulted in recommendations to implement mass CRC screening programs. However, the knowledge of screening and population screening behaviors between countries is largely lacking.
    OBJECTIVE: This multicenter, international study investigated the association of screening test participation with knowledge of, attitudes toward, and barriers to CRC and screening tests in different cultural and sociopolitical contexts.
    METHODS: Person-to-person interviews by using a standardized survey instrument were conducted with subjects from 14 Asia-Pacific countries/regions to assess the prevailing screening participation rates, knowledge of and attitudes toward and barriers to CRC and screening tests, intent to participate, and cues to action. Independent predictors of the primary endpoint, screening participation was determined from subanalyses performed for high-, medium-, and low-participation countries.
    RESULTS: A total of 7915 subjects (49% male, 37.8% aged 50 years and older) were recruited. Of the respondents aged 50 years and older, 809 (27%) had undergone previous CRC testing; the Philippines (69%), Australia (48%), and Japan (38%) had the highest participation rates, whereas India (1.5%), Malaysia (3%), Indonesia (3%), Pakistan (7.5%), and Brunei (13.7%) had the lowest rates. Physician recommendation and knowledge of screening tests were significant predictors of CRC test uptake. In countries with low-test participation, lower perceived access barriers and higher perceived severity were independent predictors of participation. Respondents from low-participation countries had the least knowledge of symptoms, risk factors, and tests and reported the lowest physician recommendation rates. "Intent to undergo screening" and "perceived need for screening" was positively correlated in most countries; however, this was offset by financial and access barriers.
    LIMITATIONS: Ethnic heterogeneity may exist in each country that was not addressed. In addition, the participation tests and physician recommendation recalls were self-reported.
    CONCLUSIONS: In the Asia-Pacific region, considerable differences were evident in the participation of CRC tests, physician recommendations, and knowledge of, attitudes toward, and barriers to CRC screening. Physician recommendation was the uniform predictor of screening behavior in all countries. Before implementing mass screening programs, improving awareness of CRC and promoting the physicians' role are necessary to increase the screening participation rates.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice/ethnology*
  12. Baba Y
    Malays J Reprod Health, 1990 Dec;8(2):72-6.
    PMID: 12343151
    A study of knowledge, attitude and practice was carried out among sixty nine married Orang Asli women in the district of Kuaia Langat. The study showed that oniy a smail proportion of the women were using family planning methods. About half of the study women were stiil uncertain with regards to their attitude towards family planning. The findings aiso showed that there was no diversity of the methods with oral contraceptive being the major choice. Majority of the husbands had indeed positive feeling towards family planning. The women also considered breastfeeding as a major method of contraception.
    PIP: A knowledge-attitude-practice (KAP) study of 69 married Orang Asli women from Kuala Langat district, Malaysia is reported. The Orang Asli comprise 2744 people in 412 households served by rural health services and a few private practitioners. The median age of the sample was 16.3 years, of whom 18.8% were married before age 15. 47.8% knew of family planning methods. 53.6% of the women said that they and their husbands approved of family planning, 2.9% disapproved, and the rest were undecided. Only 30.4% had discussed family planning with their husbands. 21.7% stated that they would use contraception, either the pill or sterilization, after their family was completed.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  13. Noor Laily Abu Bakar, Tan BA, Tey NP, Yusuf Y
    Malays J Reprod Health, 1983 Dec;1(2):109-19.
    PMID: 12313333
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  14. Neblett RS, Chia YC, Abdullah N, Ablah E
    Med J Malaysia, 2019 12;74(6):483-491.
    PMID: 31929473
    INTRODUCTION: Ethnic differences may influence diabetes selfcare practices and glycaemic control among people with type 2 diabetes mellitus. This qualitative study explored goals, beliefs about treatment effectiveness, knowledge, and barriers to and facilitators for diabetes self-care among the three main ethnic groups in Malaysia.

    METHODS: Patient focus group discussions were conducted in three different ethnic groups: Malays, Chinese, and Indians. Participants were recruited from the primary-care clinic of a university medical centre located in an urban area. Focus group discussions were audio-recorded, transcribed, and analysed using a thematic approach.

    RESULTS: A total of 31 patients participated in the study: Malays (n=12), Indians (n=10), and Chinese (n=9). There were three sessions for each ethnic group. Reported goals primarily related to quality of life and glycaemic control. Participants expressed the belief that the combination of diet, exercise, and medications is effective for controlling diabetes. Groups described their obtaining information external to a healthcare system and reported a need for more specific, practical counselling from health professionals on diet, exercise, and medications. Barriers to and facilitators for diabetes self-care practices were categorised into three major themes: having discipline, social habits, and "other" themes.

    CONCLUSION: Emerging themes were similar across the ethnic groups and included quality-of-life goals, confidence in combination treatment, common use of complementary and alternative medicine, need for further counselling, and the challenge regarding self-discipline.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  15. Khan TM, Buksh MA, Rehman IU, Saleem A
    Papillomavirus Res, 2016 12;2:122-127.
    PMID: 29074171 DOI: 10.1016/j.pvr.2016.06.001
    This cross-sectional study comprises a questionnaire-based survey regarding knowledge about human papillomavirus and its vaccine among students in different educational fields at public and private universities in the city of Lahore in Pakistan. A 26-item questionnaire was used to attain the objective of this study. The reliability of this tool was assessed using Cronbach's alpha (0.79) and the Kaiser-Meyer-Olkin value was 0.827. The response rate to the survey was 78.0%, of whom the majority (74.9%) were females and 308 (79%) were single (median age=23 years). While assessing the respondents' knowledge about HPV, 223(57%) students reported that they had already heard of HPV (human papillomavirus) and nearly 215 (55%) reported that HPV causes cervical cancer and can infect both men and women. Gender and field of study were two main factors found influencing the respondents' knowledge about HPV. Moreover, students' understanding about the mode of transmission of HPV was cursory: 40.51% said they did not know how HPV is transmitted, 133 (34.10%) stated that HPV spreads through the exchange of bodily fluids, and 22 (5.64%) selected cough/sneezing. In terms of prevention, 175 (44.87%) students stated that HPV can be prevented by vaccination, 30.0% reported sexual abstinence, 21.54% using condoms, and nearly 5.38% disclosed use of antibiotics. Addressing the knowledge of students regarding HPV vaccine, nearly 53% stated there is no vaccine against HPV and almost 64% rejected the statement that HPV vaccine prevents cervical cancer. In addition, students reported that they will be more than willing to get vaccinated for HPV if their physician recommend them (RII=0.74) followed by parents (RII=0.69). The results of this study revealed a poor understanding among respondents about the health problems associated with HPV, its prevention, modes of transmission and arability of HPV vaccine in Pakistan.
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  16. Yeong SW, Choong YC
    Complement Ther Med, 2017 Dec;35:92-108.
    PMID: 29154074 DOI: 10.1016/j.ctim.2017.09.005
    OBJECTIVES: We investigated the knowledge and characteristics of herbal supplement usage of the customers of community pharmacies in a Malaysian population.

    DESIGN AND SETTING: Self-administered questionnaires (in English, Malay, or Chinese) were provided to customers at three community pharmacies in Malaysia (Ipoh, Perak). Questionnaire validation and translation validation were performed. A pilot study was conducted before actual questionnaire distribution. Informed consent was obtained from all participants.

    RESULTS: Total number of participants was 270 (99 males and 171 females) with majority from the 31-50 age group (41.5%). Among the participants, 45.6% were herbal users. The most commonly used herbal supplements were evening primrose oil (17.9%), ginkgo biloba (13.0%), and milk thistle (8.5%). The participants seemed to have sufficient knowledge regarding herbal supplements including safety, quality, and indication of use from medical literature. Participants obtained information about herbal supplements from pharmacists (26.9%), package inserts (25.2%), friends (20.5%), and the Internet (13.3%) more often than from their doctors (9.8%). Most herbal users did not inform their doctors about their usage of herbal supplements (68.3%) or the side effects (61.5%). Herbal supplement users also tended to be women, >50-year-old, and those with higher monthly household incomes.

    CONCLUSIONS: Community pharmacists have a vital role in educating their customers about the safe use of herbal supplements. The participants had sufficient knowledge about herbal supplement usage; therefore, customers of these community pharmacies may have benefitted from the advice of the pharmacists. Further studies could be carried out in future on the knowledge, skills and roles of community pharmacists in the safe use of herbal supplements.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  17. Lee SF, Teh XR, Malar LS, Ong SL, James RP
    Int J Pharm Pract, 2018 Oct;26(5):442-449.
    PMID: 29193388 DOI: 10.1111/ijpp.12413
    OBJECTIVES: Despite the availability of a wide selection of anti-diabetic treatments, many type 2 DM (T2DM) patients still do not have controlled glucose levels. In addition to pharmacological intervention, patients' own implicit beliefs about their illness should be targeted for health intervention. Thus, we conducted a quantitative study to evaluate the associations between illness perception (IP) domains and metabolic control (HbA1c) of T2DM patients in Selama Hospital and to identify patients' perceptions of the causal T2DM factors.
    METHOD: A cross-sectional study was conducted in the outpatient department of Selama Hospital from October to December 2015. A total of 200 T2DM patients were recruited using systematic random sampling. A self-administered validated questionnaire consisting of three sections was used, and the data were analysed using SPSS version 18. The associations between eight IP domains and HbA1c were evaluated via multiple linear regression. P values <0.05 were considered significant.
    KEY FINDINGS: The analysis included data from 200 respondents with a mean age of 57.7 years (SE = 9.8). The majority were women (64.5%) and Malays (86%) with a primary school education (43.5%) and a family history of diabetes (53.5%). The median duration of illness was 5 years (IQR = 7), and the median HbA1c level was 8.15% (IQR = 3.1). The mean score for the eight IP domains was 33.7 (SE = 8.43) out of a total score of 80. Using multiple linear regression, HbA1c was found to be significantly associated with IP domains of identity symptoms at 0.221 (95% CI 0.083-0.358). Moreover, 79.4% of patients ranked diet and eating behaviour as the main factor for T2DM.
    CONCLUSION: The IP domain of identity symptoms was significantly correlated with T2DM metabolic control. By understanding patients' IP, healthcare providers can focus on behavioural approaches to managing T2DM patients. Steps must be taken to educate patients about the importance of diet control in managing T2DM.
    Study site: Outpatient clinic, Selama Hospital, Perak, Malaysia
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  18. Chan GC, Tang SF
    Singapore Med J, 2006 Apr;47(4):266-70.
    PMID: 16572235
    INTRODUCTION: A study was carried out in a primary healthcare clinic in the Hulu Langat district of Malaysia to assess the parental knowledge, attitudes and antibiotic use for common childhood acute upper respiratory tract infection (URTI).
    METHODS: A cross-sectional study involving 421 parents, who were surveyed by using an interviewer-administered questionnaire, from April to June 2001.
    RESULTS: Approximately 59 percent of parents from this study believed that weather was the main cause of acute URTI of their children, 13 percent thought it was due to food, and only about 27 percent said it was caused by germs. Nearly 68 percent, 69 percent and 76 percent of them believed that antibiotics was helpful in treating the common cold, cough and fever, respectively. 29 percent of parents who thought that their child with acute URTI needed antibiotics were not prescribed with any. On the other hand, 17 percent believed that antibiotics were unnecessary when prescribed. 28 percent of parents had requested for antibiotics, and 93 percent received what they requested for their child with acute URTI. About 31 percent of parents who did not request any antibiotics claimed that private general practitioners habitually prescribed antibiotics. The antibiotic compliance was poor with only 74 percent completing the entire course, with 85 percent of them stopping once they improved symptomatically. 15 percent of parents gave "leftover" antibiotics, 24 percent gave "shared" antibiotics, and 5.5 percent bought antibiotics for their child with acute URTI without consulting a doctor.
    CONCLUSION: This study shows that parents often have inadequate knowledge and misconceptions on antibiotic use for acute URTI in children. Improved parental education may reduce unnecessary antibiotic prescription and antimicrobial resistance in the community.
    Study site: Klinik Kesihatan Batu 9, Hulu Langat, Selangor, Malaysia
    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  19. Ooi CY, Hanafi NS, Liew SM
    Singapore Med J, 2019 Nov;60(11):596-604.
    PMID: 30644527 DOI: 10.11622/smedj.2019011
    INTRODUCTION: Colorectal cancer (CRC) was the third most commonly diagnosed cancer worldwide in 2008 (1.23 million cases, 9.7%). CRC screening was shown to be effective in reducing 70% of CRC mortality. However, the screening rate for CRC remains poor.

    METHODS: A cross-sectional survey was conducted among primary care physicians (PCPs) in public primary care clinics in Kuala Lumpur, Malaysia. A 30-item self-administered questionnaire was used to assess the knowledge and practice of CRC screening.

    RESULTS: The response rate was 86.4% (n = 197/228). Less than half (39.1%) of the respondents answered correctly for all risk stratification scenarios. Mean knowledge score on CRC screening modalities was 48.7% ± 17.7%. The knowledge score was positively associated with having postgraduate educational qualification and usage of screening guidelines. Overall, 69.9% of PCPs reported that they practised screening. However, of these, only 25.9% of PCPs screened over 50% of all eligible patients. PCPs who agreed that screening was cost-effective (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.69‒6.59) and those who agreed that they had adequate resources in their locality (OR 1.92, 95% CI 1.01‒3.68) were more likely to practise screening. Knowledge score was not associated with the practice of screening (p = 0.185).

    CONCLUSION: Knowledge and practice of CRC screening was inadequate among PCPs. Knowledge of screening did not translate into its practice. PCPs' perceptions about cost-effectiveness of screening and adequate resources were important determinants of the practice of screening.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
  20. Nur Asyura Adznam S, Shahar S, Rahman SA, Yusof NA, Arshad F, Yassin Z, et al.
    J Nutr Health Aging, 2009 Dec;13(10):925-30.
    PMID: 19924355
    OBJECTIVE: Prior to the development of a healthy ageing and risk reduction of chronic diseases intervention package for older people in Malaysia, a need assessment study was conducted to identify nutritional knowledge status and information needs, as part of an action research process.

    DESIGN: A cross sectional study was conducted among 267 elderly people, 54 care givers and 66 health professionals in two rural areas of Peninsular of Malaysia (i.e Sabak Bernam, Selangor and Kuala Pilah, Negeri Sembilan). Information on nutritional knowledge was obtained from an interview based questionnaire for older subjects and caregiver and through self administered questionnaire from the health professionals. Anthropometric and functional measurements were also conducted among elderly subjects.

    RESULTS: It was found that the elderly subjects had poor nutritional knowledge with 43.8% of them classified as having unsatisfactory nutritional knowledge, followed by moderately satisfactory (33.7%), very unsatisfactory (15.7%) and good (6.7%). Talks, counselling sessions with health professionals and electronic media such as television and radio were the most preferred nutrition education sources among elderly subjects and their care givers. The majority of health professionals studied (98.5%) had good nutritional knowledge. Although most of them (93.6%) were involved in management of the elderly, only 45.5% incorporated nutritional information component in this activity. Most of the health professionals used the guidelines for management of elderly patients (63.6%). However, nutritional knowledge was very minimal in these guidelines. Multiple regression analysis indicated that 'level education', involvement in 'social activities', presence of 'hearing problems', the Instrumental Activities of Daily Living (IADL) score, having previous 'nutritional information' and 'participation in healthy eating programme' were the major predictors of nutritional knowledge score among elderly subjects.

    CONCLUSION: Based on the above findings it is thus, imperative that an appropriate nutritional intervention package and programme be developed so as to help improve nutritional knowledge and subsequently the nutritional status of the rural elderly Malays.

    Matched MeSH terms: Health Knowledge, Attitudes, Practice*
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