Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors.
Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used.
Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was -4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05,P= 0.004) and insulin use (adjusted B = -0.84,P= 0.011) were QoL predictors.
Conclusion: T2DM negatively impacts the patient's QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.
Study site: Klinik Kesihatan, Malaysia
BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005.
OBJECTIVE: To evaluate the effectiveness of MMT.
METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20.
RESULTS: There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains.
Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.
INTRODUCTION: Both gestational diabetes mellitus (GDM) and hyperglycaemia less severe than GDM are associated with risk of adverse pregnancy outcomes. We describe the study design of a prospective cohort of pregnant women recruited in early pregnancy with follow-ups of mothers and infants up to 2 years after birth. The primary aim of the study was to identify the determinants and outcomes of maternal glycaemia.
METHODS AND ANALYSIS: Seremban Cohort Study (SECOST) is an ongoing prospective cohort study in which eligible pregnant women in first trimester (<10 weeks of gestation) are recruited from Maternal and Child Health clinics in Seremban District, Negeri Sembilan with seven follow-ups during pregnancy through 2 years postnatally. Infants are followed up every 6 months after birth until 2 years old. A standard 75 g oral glucose tolerance test is performed between 24 and 32 of weeks of gestation and as close to 28 weeks of gestation. Pregnancy and birth information are obtained from medical records. Sociodemographic, anthropometric, biochemical, dietary, physical activity, smoking, depression, child feeding and other data of mothers and infants are obtained at follow-ups.
ETHICS AND DISSEMINATION: This study is approved by the Medical Research Ethics Committee (MREC), Universiti Putra Malaysia (UPM/FPSK/100-9/2-MJKEtika) and MREC, Ministry of Health Malaysia (KKM/NIHSEC/08/0804/P12- 613). Permission to conduct this study is also obtained from the Head of Seremban District Health Office. All participants are required to provide written informed consent prior to data collection. The research findings will be disseminated at journals and conference presentations.
Study name: Seremban Cohort Study (SECOST)
This study aimed to evaluate the usability (ease of use) and utility (impact on user's decision-making process) of a web-based patient decision aid (PDA) among older-age users. A pragmatic, qualitative research design was used. We recruited patients with type 2 diabetes who were at the point of making a decision about starting insulin from a tertiary teaching hospital in Malaysia in 2014. Computer screen recording software was used to record the website browsing session and in-depth interviews were conducted while playing back the website recording. The interviews were analyzed using the framework approach to identify usability and utility issues. Three cycles of iteration were conducted until no more major issues emerged. Thirteen patients participated: median age 65 years old, 10 men, and nine had secondary education/diploma, four were graduates/had postgraduate degree. Four usability issues were identified (navigation between pages and sections, a layout with open display, simple language, and equipment preferences). For utility, participants commented that the website influenced their decision about insulin in three ways: it had provided information about insulin, it helped them deliberate choices using the option-attribute matrix, and it allowed them to involve others in their decision making by sharing the PDA summary printout.
Study site: urban tertiary teaching hospital outpatient clinic in Malaysia (primary care clinic, University Malaya Medical Centre, UMMC, Kuala Lumpur, Malaysia)
This study determined the accuracy of Modified Checklist for Autism in Toddlers (M-CHAT) in detecting toddlers with autism spectrum disorder (ASD) and other developmental disorders (DD) in community mother and child health clinics. We analysed 19,297 eligible toddlers (15-36 months) who had M-CHAT performed in 2006-2011. Overall sensitivities for detecting ASD and all DD were poor but better in the 21 to <27 months and 27-36-month age cohorts (54.5-64.3%). Although positive predictive value (PPV) was poor for ASD, especially the younger cohort, positive M-CHAT helped in detecting all DD (PPV = 81.6%). This suggested M-CHAT for screening ASD was accurate for older cohorts (>21 months) and a useful screening tool for all DD.
Objectives: Periodontitis is a chronic disease which remain undiagnosed and untreated without proper examination and referral to specialist clinic for further management Therefore, this study was conducted to evaluate the pattern of referrals to Universiti Teknologi MARA (UiTM) Periodontal Specialist Clinic. Materials and methods: A total of 176 periodontal cases referred to UiTM Periodontal Specialist Clinic in year 2011 and 2016 were identified and patient’s referral forms were collected. The data obtained were the referred cases from undergraduate student clinics, other specialist clinics, UiTM primary dental care clinic and private dental clinics. Descriptive data analysis was conducted using frequency distribution by SPSS. Chi square analysis was used to evaluate the association of source of referral, diagnosis and reason for referrals to Periodontal Specialist Clinic. Results: There was increased referral cases to Periodontal Specialist Clinic in 2016 (86.9%) compared to 2011 (13.1%). Most referral to Periodontal Specialist Clinic were received from faculty’s undergraduate student clinic in both 2011 and 2016 (46%), followed by other specialists (27.3%), primary care clinic (25.6%) and private practice (1.1%). 96% of cases were referred for intervention by periodontist as more than half of the cases were referred for the non-surgical periodontal treatment. Chi square analysis showed the association between source of referral and reason for referral was statistically significant (p value=0.000). Conclusion: Proper periodontal screening in all patients and necessary referral to specialist clinic is crucial to prevent undiagnosed periodontal disease.
INTRODUCTION: With increasing evidence of disease transmission through doctors' white coats, many countries have discouraged doctors from wearing their white coats during consultations. However, there have been limited studies about patients' preferences concerning doctors' attire in Malaysia. This study, therefore, aimed to investigate patients' perceptions of doctors' attire before and after the disclosure of information about the infection risk associated with white coats.
METHOD: This cross-sectional study was conducted from 1st June 2015 to 31st July 2015 at three different primary care settings (government, private, and university primary care clinics) using a self-administered questionnaire. A 1:5 systematic random sampling method was employed to select the participants. The respondents were shown photographs of male and female doctors in four different types of attire and asked to rate their level of confidence and trust in and ease with doctors in each type of attire. Subsequently, the respondents were informed of the risk of white coat-carried infections, and their responses were reevaluated. Data analysis was completed using SPSS Version 24.0. Associations of categorical data were assessed using the Chi-Square test, while the overall change in perceptions after the disclosure of additional information was examined using the McNemar test. Results with p-values < 0.05 were considered statistically significant.
RESULTS: A total of 299 respondents completed the questionnaire. Most of the respondents had more confidence and trust in the male (62.5%) and female (59.2%) doctors wearing white coats. A high proportion of the respondents from the government clinic (70.5%) felt more confidence in male doctors dressed in white coats (p-value = 0.018). In terms of ethnicity, male doctors in white coats were highly favored by Malays (61.0%), followed by the Chinese (41.2%) and Indians (38%) (p = 0.005). A similar preference was observed for the female doctors, whereby the highest number of Malays (60.3%), followed by the Chinese (41.2%) and Indians (40.0%) (p = 0.006), had a preference for female doctors wearing white coats. Only 21.9% of the initial 71.9% of patients who preferred white coats maintained their preference (p < 0.001) after learning of the risk of microbial contamination associated with white coats.
CONCLUSION: Most patients preferred that primary care doctors wear white coats. Nevertheless, that perception changed after they were informed about the infection risk associated with white coats.
Introduction: Diabetic retinopathy (DR) is one of the commonest complications of diabetes mellitus. This study was to determine the prevalence of DR and its association with chronic kidney disease (CKD), high HbA1c and dyslipidemia among diabetic patients in government primary care clinics.
Materials and Methods: A cross sectional study was carried out. The respondents were selected from diabetic registry at two government primary care clinics in Kuantan, Pahang via stratified random sampling method during the study period from May 2010 to April 2011. The respondents were interviewed and assessed clinically using a structured questionnaire. Retinal examination was performed by accredited staff using non-mydratic retinal imaging and DR was classified according to the International Clinical Diabetic Retinopathy Disease Severity Scale.
Results: Out of 400 respondents, 58.8% were diagnosed with diabetes less than 5 years and 51.0% had uncontrolled blood pressure (>130/80 mmHg). The prevalence of DR and maculopathy were 33.5% and of 17.8% respectively. Most of these patients (22.3%) had mild non-proliferative DR. DR patients had higher percentages CKD (17.9% vs. 6.8%; p<0.001) and a higher mean of HbA1C (8.69 vs. 8.11; p=0.015) compared to non-DR patients. The study revealed that DR was independently associated with CKD {OR: 3.46, 95% CI (1.76, 6.80)} and high HbA1c {OR: 1.12, 95% CI (1.02, 1.23)}. Those with dyslipidemia however, has 39% less risk of DR {OR: 0.61, 95% CI (0.39, 0.94)}.
Conclusion: This study showed that diabetic patients with CKD and high HbA1c have greater risks to develop DR but has protective risk with dyslipidemia.
KEYWORDS: diabetic retinopathy (DR), non-mydratic retinal camera, primary care clinic
The population of Malaysia is estimated in 2018 to be around 32.04 million and 23.5% of the population resides in rural areas. The Ministry of Health has provided healthcare services to the rural areas with the access of modern healthcare facilities based on the two-tier healthcare system. In remote areas, mobile health clinic is the extension of healthcare service by the nearest static health clinic. However, most of the remote areas only covered by a community clinic or Klinik Desa which is limited for mother and child healthcare. There is demand from the people in remote areas for static health clinic or Klinik Kesihatan. Objectives: This study is to evaluate and compare the effectiveness between two health services in remote areas applied in Sabah. This study also determines which type of health services that able to worth the service to people in remote areas. Methods: This is a descriptive study. Data was taken from HMIS report (Per PL 206) under Sabah State Health Department. The data analysed by using Microsoft Excel. Results: This study was conducted based from the data obtained in 2015 till 2017 for the number of patients attended to static health clinics and mobile health clinics on selected remote areas. For example, Jambongan Health Clinic only have an average of 10 – 15 patients per day while the Mobile Health Clinic team under Beluran Health District which covers the adjacent remote areas of Jambongan Island have more than 20 patients per day on a single visit. Another example is from Terian Health Clinic in Penampang, which only have an average of 5 – 10 patients per day. However, on the mobile health team on a single visit to the village next to Terian which is Kg. Buayan, the average patients attended for the service is mo re than 20 patients. Conclusion: From the study, it was noted that people in remote areas prefer the mobile health service to visit their villages. This can be due to financial issue and limitation of transportation service to the nearest static clinic. The density of population and the development of the rural areas play important roles for the healthcare service to be effective in remote areas.
Introduction: Self-efficacy for eating predicts successful weight loss and maintenance in Type 2 Diabetes Mellitus (T2DM) individuals. The Weight Efficacy
Lifestyle (WEL) questionnaire determines self-efficacy for controlling eating. This study aims to validate the Malay-translated version of the WEL questionnaire and
to establish the cut-off scores to define the level of eating self-efficacy in Malaysian T2DM individuals.
Methods: A total of 334 T2DM individuals, aged 55.0±9.0 years, were recruited from a primary healthcare clinic based on sampling ratio. Medical records were reviewed for eligibility. Inclusion criteria included BMI ≥23kg/m2, and no severe diabetes complications. The WEL questionnaire assessed eating resistance during negative emotions, food availability, social pressure, physical discomfort and positive activities, and was back translated into Malay language. Self-efficacy was rated on a 0-9 scale with higher WEL scores indicating greater self-efficacy to resist eating. Factor analysis established the factor structure of the WEL questionnaire. Inter-item and item-total correlations determined construct validity while internal consistency described the reliability of the structure.
Results: A two-factor structure accounting for 49% of variance was obtained, and it had adequate reliability, as indicated by Cronbach’s α of 0.893 and 0.781 respectively. Item-total correlations of r>0.700, p<0.01 and inter-item correlations of r<0.500, p<0.01 demonstrated construct validity. Cut-off scores of ≥44 and ≥32, respectively for factor one and two defined high eating self-efficacies in T2DM individuals.
Conclusion: The Malaytranslated version of the WEL questionnaire appears to be a valid and reliable tool to assess self-efficacy for controlling eating behaviour in Malaysian T2DM population.
Keywords: Diabetes, eating self-efficacy, Malay, reliability, validity
Introduction: Cervical cancer ranks as the second most frequent cancer among women in Malaysia. Although a cervical screening program has been introduced since 1960s and is provided free of charge in all government health facilities, the coverage and adherence rate to recommendation among Malaysian women remains low.
Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines and its associated factors among women attending a health clinic in Malaysia.
Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergone a Pap smear. Universal sampling method was applied to select participants among women who attended the selected health clinic from January 2013 to May 2013. A self-administered questionnaire was used to obtain the socio-demographic characteristics, socio-health data and perceptions about cervical cancer and Pap smear screening. The data was analysed using descriptive statistics and multiple logistic regression.
Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status, duration of marriage, education level, employment, household income and number of children were not significantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit, perceived barrier and cues to action did not show significant association with non-adherence to Pap smear screening.
Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measures should be taken to increase Pap smear screening coverage in our country. Other factors beyond Health Belief Model that influence Pap smear screening practice among Malaysian women should be explored.
Background: Diabetes quality of life (DQoL) instrument has been widely used to measure quality of life among diabetes patients. This study aimed to develop a revised version of DQoL instrument that incorporated issues of redundancies in the items and strengthen the basis of validity of the instrument.
Methods: This was a cross-sectional study where diabetes patients were recruited from December 1, 2014, until end of March 2015 at a public health clinic in Peninsular Malaysia. A questionnaire that included patients' information and DQoL instrument was distributed to patients. Item selection of DQoL instrument was conducted to screen and finalize the items based on issues of missing values and redundancy. Validity testing was conducted for the revised DQoL instrument based on exploratory factor analysis, confirmatory factor analysis, and Rasch analysis.
Results: The pattern structure matrix yielded three domains similar to the original version with 18 items. The minimum factor loading from the structure matrix was 0.358. The item's and person's reliability was excellent with 0.92 and 0.84 for "satisfaction" domain, 0.98 and 0.60 for "impact" domain, and 0.99 and 0.57 for "worry" domain, respectively. Confirmatory factor analysis has dropped 5 items and the revised version of DQoL contained 13 items. Composite reliability of the revised version was computed for "satisfaction" domain (0.922; 95% CI: 0.909-0.936), "impact" domain (0.781; 95% CI: 0.745-0.818), and "worry" domain (0.794; 95% CI: 0.755-0.832).
Conclusion: A revised version of DQoL that maintains the conceptualization of "satisfaction," "impact," and "worry" with 13 items was successfully developed.
Situated learning characterises the learning that takes place in the clinical environment. Learning in the workplace is characterised by transferring classroom knowledge into performing tasks and this may take various forms. In the medical education field, the cognitive apprenticeship instructional model developed by Collins (2016) supported this learning in the workplace setting due to its common characteristics of apprenticeship. This paper analysed two concrete learning situations in a Malaysian undergraduate and an Omani postgraduate learning environment. Both learning situations occurred in the primary healthcare outpatient setting. The cognitive apprenticeship model was used to identify characteristics of the individual learning environments and discusses factors that stimulate learning. Attention was paid to the role of reflection in stimulating learning in the described settings. The paper provided the context in both institutes, described the learning situation and provided an analysis based on the theoretical framework. Based on the analysis of the situations, solutions to problems in the two settings were suggested.
Introduction: Nicotine cravings and withdrawal symptoms are associated with higher rates of relapse. It has been shown that combining behavioral therapy and pharmacotherapy leads to a higher long-term abstinence rate in those who quit smoking. Al-Quran recitation has been proven to reduce anxiety among athletes before tournaments and pulse and heart rates among patients awaiting cardiac operations. As most of the patients who wish to stop smoking experience high-anxiety states, we postulate that Al-Quran recitation will also able to reduce craving among smokers attempting to quit smoking.
Methods: Fifty smokers from an outpatient clinic were randomly assigned to control and intervention groups. They were taught different ways of coping with smoking urges, i.e., counseling using the 12'M' method (control group) versus Al-Quran recitation (intervention group). They met for four consecutive weeks of counselling and to fill out a withdrawal scale. Carbon monoxide (CO) levels were tested at baseline and at week 4. At week 12, the number of cigarettes smoked was measured again. The decrease in the number of cigarettes considered to be clinically significant for the calculation of sample size was based on expert opinion.
Results: The reduction in the number of cigarettes smoked was 7 cigarettes in the counselling group and 9 cigarettes in Al-Quran recitation group over 12 weeks duration. There was a statistically significant difference in the number of cigarettes smoked between the groups. There was also a statistically significant difference in the change in cravings between the groups at week 4 (p-value = 0.005). However, the difference in the changes in CO levels between the two groups was not statistically significant.
Conclusion: Al-Quran recitation produced a statistically significant reduction in the number of cigarettes smoked at week 12 and a significant change in cravings at week 4 among smokers attempting to quit. Difference in smoking abstinence rates was not measured in this study.
CONTEXT: Family planning is crucial for everyone within the reproductive age to promote the health and welfare of every member of the family. For the medical students, it is essential to have core knowledge, understanding of family planning concept, and competency in communication skills with the patients. The final-year medical students are posted in Maternal and Child Health Clinics for 3 weeks to gain the knowledge and practical experiences on the primary healthcare in the community.
AIMS: The aim of this study was to explore the experiences of final-year medical students on family planning services offered at community clinics in Malaysia.
SETTINGS AND DESIGN: This was qualitative study.
SUBJECTS AND METHODS: This qualitative study used the data of the students' reflection written in the case reports on family planning. Coding, identification of subthemes, and themes were done by two researchers independently using RQDA software.
STATISTICAL ANALYSIS USED: Thematic analysis.
RESULTS: Final-year medical students who had exposure to the clinical services at primary care clinic, regarding Malay word (Klinik Kesihatan) gained the learning opportunities during family planning session such as learning by observation, clerking, and counseling the patients, understanding the barriers to utilizing services and learning for their self-improvement. These learning opportunities lead to developing the positive attitudes on their learning experiences and the positive attitudes toward the concept and services of family planning.
CONCLUSIONS: To have the better understanding of family planning services and provide the better care to the community in the future, the clinical exposure at the primary care clinics should be promoted for medical students in Malaysia.
Evidence-based data confirm the relationship between an increased availability of effective contraception and reduction in induced abortion rate. In Malaysia, the contraception prevalence rate in 1966 was 8.8 per cent to 52 per cent in 1984, but has levelled off since then. In recent years there has been increasing report of babies ‘abandonment’ in Malaysia. The aim of this study is to determine the knowledge, attitudes and practices related to contraception among women and doctors in Kota Kinabalu the capital of Sabah, Malaysia. Descriptive and analytical community-based cross-sectional study was used. A total of 240 women and 60 doctors were selected from either private or public clinics. The instrument used was face-to-face interview for the women and self-administered questionnaires for doctors. Analysis was done using SPSS version 21. The doctors (80%) felt that contraception is extremely important, and routinely discuss (63%) with their patients. Oral contraceptive pill (97%) is the most common type of contraceptive available in their clinics. About 68% of doctors surprisingly cited that abstinence plays a major part in their contraceptive advice. The average correct answer by doctors on knowledge is 62%. The women surveyed (98.8%) have heard of contraception. The main reason for using is for spacing of pregnancy and many stopped or did not use because of fear of side effects. Women attending the public clinic appear to know more about female and male sterilization and intrauterine contraceptive device compared to those attending private clinic. Further research is needed to reinforce this study.
Study site: Klinik Kesihatan (maternal and child health clinics), private general practitioner clinics. Kota Kinabalu, Sabah, Malaysia
The main objective of this study was to obtain information regarding the effects of educational and socio-economic status of the patients on the prescribing pattern of non-steroidal antiinflammatory drugs (NSAIDs) by the qualified medical personnel in the outpatient departments (OPDs) of two selected polyclinics in Kota Kinabalu, Sabah, Malaysia. A total of 200 selected patients (100 from each polyclinic) attending the OPDs were interviewed using a questionnaire. Again data were collected, photocopied and later analyzed. Educated and higher income group of patients mostly attended in a Private Polyclinic (PPC) whereas less educated and lower income group of patients generally attended UMS Polyclinic (UPC). This was reported as a probable reason for the wide variations in the prescribing pattern with respect to pharmacological subclasses of NSAIDs in the OPDs of two polyclinics. The present results strongly support that probable reason. The number of patients taking NSAIDs before coming to hospital was more in PPC compared to UPC. They were influenced by pharmacists, friends and doctor’s advice given previously. In conclusion, it may be mentioned that overall prescribing pattern of NSAIDs among two polyclinics is rational.
Introduction: The prevalence of diabetes mellitus among Malaysian aged ≥ 18 years increased from 11.6% (2006) to 17.5% (2015). Positive self–care behaviour leads to good glycaemic control. The objective of this study is to determine the self-care behaviour, its associated factors and predictors among type 2 diabetes mellitus (T2DM) patients in government health clinics at a district of Northern Peninsular Malaysia.
Methodology: A cross-sectional study was conducted on 546 T2DM patients aged ≥ 18 years, recruited by simple random sampling method. A validated self-administered questionnaire including socio-demographic characteristics, diabetes profile, knowledge, Health Belief Model (HBM) and Summary of Diabetes Self-care Activity Scale (SDSCA) was used. Data were analysed using SPSS version 22.0. Self-care behaviour is the dependent variable.
Results: The respondents practised 3.4 (SD = 1.11) days self-care behaviour past 1 week. The predictors of self-care behaviour were self-efficacy (standardized β = 0.257, p < 0.001), knowledge (standardized β = 0.112, p = 0.007), female (standardized β = 0.107, p = 0.010), combination oral hypoglycaemic agents (OHA) and insulin (standardized β = -0.182, p = 0.002), and monthly income < RM1,000 (standardized β = -0.129, p = 0.002). The entire group of variables significantly predicted self-care behaviour [F (6, 539) = 15.79, p < 0.001, adjusted R2 = 0.140] with total variance of 14.9%. Self-efficacy was the strongest predictor in self-care behaviour.
Conclusion: The findings enable us to identify the specific groups with predicted lower self-care behaviour which are useful in future planning and implementation of intervention.
Study site: Klinik Kesihatan, Malaysia
Introduction: In first six months of life, breastfeeding is the recommended form of feeding by the World Health Organisation for the growing child. To enable the working mother to continue this noble practice, adequate workplace breastfeeding support and self- efficacy is needed. This study aims to determine the prevalence of breastfeeding among working mothers of children aged three months to two years and factors associated with breastfeeding practice including workplace support and mother’s self-efficacy. Method: This is a cross sectional questionnaire study carried out in a rural Health Clinic in Selangor using socio-demographic data, Workplace Breastfeeding Support Scale (WBSS), and the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF). This study was conducted for a period of three months from April to June 2015. The respondents were employed Malaysian mothers of healthy infants aged three months to two years. A total of 84 participants were involved in the study. Data analysis was done with SPSS 22.Results: The prevalence of breastfeeding among working mothers were high at 97.6%. We found significant association of breastfeeding practice with workplace breastfeeding support (p=0.005) and self-efficacy (p= 0.017). We also noted a significant correlation between breastfeeding workplace support and breast feeding self-efficacy (r= 0.40, p