Displaying publications 81 - 100 of 924 in total

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  1. Potential problems with interventions that restrict access to patients who present inappropriately to Emergency Departments
    Ting JY
    Med J Malaysia, 2005 Aug;60(3):392-3.
    PMID: 16379203
    Matched MeSH terms: Health Services Accessibility*; Health Services Misuse*
  2. Fulltext Coping styles of mothers with disabled children at rural community rehabilitation centres in Muar, Malaysia
    Nor Zaidah AH, Khairani O, Normah CD
    Med J Malaysia, 2004 Aug;59(3):384-90.
    PMID: 15727385 MyJurnal
    Chronic disability in children imposes great strains on a family. The responsibility of mothering disabled children may be detrimental to the well-being of mothers. This study aims to assess the different types of coping styles of mothers with disabled children and its influencing factors. It is a cross-sectional study using Coping Inventory Stressful Situation (CISS) scale to determine the mothers' coping styles. A sample of 81 mothers with disabled children attending two rural Community Rehabilitation Centres, were included in the study. Overall, the mothers were using a mixture of coping strategies. However, they scored more in the task-oriented (mean T score = 52.88) and emotion-oriented (mean T score = 50.52) coping styles, while the other subscales of coping styles, namely avoidance, distraction and social diversion were below average (mean T score < 50). Divorced mothers (p=0.04) and those with low educational level (p=0.00) were more inclined to use emotion-oriented coping strategies while mothers with younger children (< 5 years old) used more avoidance coping strategies (p=0.01). There were no significant difference of coping styles in association with the mothers' age, ethnicity, duration of marriage, number of siblings, child's birth order or gender. By understanding the mothers' coping styles, health care workers would be able to educate the mothers with effective coping strategies and consequently reduce their psychological distress.
    Matched MeSH terms: Community Health Services
  3. Fulltext Developing the Malaysian health system to meet the challenges of the future
    Merican MI, Rohaizat Y, Haniza S
    Med J Malaysia, 2004 Mar;59(1):84-93.
    PMID: 15535341 MyJurnal
    The Malaysian health care system is a success story among countries of equivalent socio-economic status. However there are numerous challenges faced by the nation, which create the need for changes and reform. There is rising consumer demands and expectations for high technology and high cost medical care due to improved standards of living, changing disease patterns and demographic changes, inadequate integration of health services, maldistribution of resources and the threats as well as opportunities of globalisation and liberalisation. The changes in health policy, priorities and planning for the country are guided by the country's development policies, objectives and the challenges of Vision 2020, Vision for Health and the goals of the health system in ensuring universal access, improving equity and efficiency and the quality of life of the population. The essential services in the health system of the future are information and education of individuals to empower support for the wellness paradigm. There is also a need to restructure the national health care financing and the health care delivery system. The present roles and responsibilities of MOH also need to be reviewed.
    Matched MeSH terms: Health Services Accessibility; Health Services Administration/trends*
  4. Fulltext Inappropriate utilization of emergency department services in Universiti Sains Malaysia hospital
    Selasawati HG, Naing L, Wan Aasim WA, Winn T, Rusli BN
    Med J Malaysia, 2004 Mar;59(1):26-33.
    PMID: 15535332
    Inappropriate utilization of Emergency Departments (ED) services may result in compromised management of patients requiring true emergency treatment. Significant attendance of non-emergency cases in ED was found in several countries. A cross-sectional study was conducted in Universiti Sains Malaysia Hospital (HUSM) to determine the proportion of the inappropriate cases and the utilization pattern by time (over 24 hours and within a week) and by diagnoses. A sample of 350 cases was randomly selected from ED-HUSM register of the year 2000. A decision flowchart, which was adopted from 4 guidelines, was applied to classify appropriate and inappropriate cases. There were 55% inappropriate cases in this study. The inappropriate cases increased considerably in early morning, late evening, during the weekend and early part of the week. Most common diagnoses of inappropriate cases were upper respiratory tract infections, mild acute gastroenteritis and urinary tract infections. Considerable attendance of inappropriate cases calls for interventions.
    Matched MeSH terms: Health Services Misuse*
  5. Fulltext Do adolescents attending Bandar Mas primary care clinic consult health professionals for their common health problems?
    Khairani O, Zaiton S, Faridah MN
    Med J Malaysia, 2005 Jun;60(2):134-9.
    PMID: 16114152
    The aims of the study were to determine the prevalence of the common health problems namely acne, overweight, smoking and depressive symptoms among adolescents attending a primary healthcare clinic, whether they seek treatment for these problems and the reasons for not consulting health professionals. It was a clinic-based, crosssectional study. All adolescents aged 13 to 20 years who attended the clinic during the study period were included in the study. The respondents were given self-administered questionnaires and their weights were measured to assess if they had the above disorders. A total of 215 adolescents were included in the study. The proportion of adolescents who had acne were 70.7%, overweight 8.9%, smoking 41.9% and depressive symptoms 9.8%. Only 25% of those who had acne, 47% of those who were overweight, 9.5% who had depressive symptoms and none of those who smoked had ever sought treatment for these problems. The common reasons given for not consulting the health professionals were 'did not consider it as a problem', 'shy' and 'thought there was no treatment available'. The majority of the adolescents who attended the clinic did not consult health professionals the above common health problems. It is important to educate them on these disorders and encourage health-seeking behaviour in adolescents.
    Matched MeSH terms: Health Services Needs and Demand/utilization*; Adolescent Health Services/organization & administration*
  6. The Community Follow-up Project (CFUP)
    Mohd Sidik S, Azhar MZ, Mohd Yunus A, Azlan Hamzah SA
    Med J Malaysia, 2005 Aug;60 Suppl D:54-7.
    PMID: 16315625
    The Community Follow-up Project (CFUP) is a project where medical students choose a hospital in-ward patient during their clinical ward-based attachments and follow-up this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups at the hospital, government clinics, general practitioners' clinics and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. By following their patients from the time their patients were in the hospital and back to their homes and community, the students are able to understand in depth the problems faced by patients, the importance of communication skills in educating patients on their illness and the importance of good communication between primary, secondary and tertiary care.
    Matched MeSH terms: Community Health Services*
  7. Management studies in medical education
    Noor Ghani S, Saimy I
    Med J Malaysia, 2005 Aug;60 Suppl D:66-8.
    PMID: 16315627
    In 1977, the World Health Assembly (WHA) set the social target--the "Health For All" goal and in 1995, urged member states to "re-orientate medical education and medical practice for "Health For All" (resolution WHA 48.8). This led to World Health Organisation to enunciate the "5-star doctor" needing skills in healthcare management, quality assurance and health economics. The Faculty of Medicine, University of Malaya introduced the New Integrated Curriculum (NIC) in 1995. The objective was aimed at producing a competent doctor with a holistic approach to the practice of medicine. This was to be achieved by having 3 strands of studies i.e. The Scientific Basis of Medicine (SBM), the Doctor, Patient, Health and Society (DPHS), and Personal and Professional Development (PPD) over the 5-year programme, split into 3 phases. Elements of the "5-star doctor" were introduced in strand 2--DPHS and strand 3--PPD. Management studies were introduced in the Personal and Professional Development (PPD) strand. This led to an instructional module--"Principles of Management in Health Care Services (PMGT)" comprising of the Management of Self, Resources and People and incorporating a three week field programme. Evaluation is undertaken at the end of the phase IIIA of the studies. This NIC approach will be able to produce a "5-star doctor", a team player, leader, communicator and an effective manager.
    Matched MeSH terms: Health Services Administration*
  8. Fulltext Oral health care in the elderly population in Malaysia--a review
    John J, Mani SA, Azizah Y
    Med J Malaysia, 2004 Aug;59(3):433-9.
    PMID: 15727396
    One of the undeniable facts about living is that everyday we are getting older. By 2050, it is projected that one out of every five Malaysians will be 60 or older. The economic challenge of this demographic change will affect development and the financial implications of sustaining well being of this group are formidable and complex. This population group has extensive oral disease, medical problems that complicate their oral care, and unique dental treatment challenges. The authors discuss the problem of oral healthcare among the aged, its impediments and propose some approaches for improvement to better serve the needs of this group of vulnerable members of our nation.
    Matched MeSH terms: Health Services for the Aged/standards*
  9. Factors influencing late stage of breast cancer at presentation in a district Hospital - Segamat Hospital, Johor
    Cheng ML, Ling DY, Nanu P KP, Nording H, Lim CH
    Med J Malaysia, 2015 Jun;70(3):148-52.
    PMID: 26248776 MyJurnal
    INTRODUCTION: In Malaysia, late stage presentation of breast cancer (stage III or IV) has been a healthcare problem that varies geographically throughout the country. This study aims to understand the factors influencing late stage of breast cancer at presentation among Malaysian women in Segamat Hospital, Johor, which is a district hospital.

    METHODS: A retrospective descriptive study was conducted on secondary data of all newly diagnosed breast cancer women from 1st August 2011 to 28th February 2014. Secondary data includes age, ethnicity, marital status, family history, education level, occupation, presenting symptom, duration of symptom, tumour size, tumour pathology, tumour grading, oestrogen, progesterone and HER-2 receptor status were collected and analysed using SPSS version 20.0.0.

    RESULT: In total, data from 52 women was analysed and two women were excluded for incompleteness as these women defaulted. Late stage at presentation was 59.6% of all new cases (17.3% stage III and 42.3% stage IV). The commonest age group of all women diagnosed with breast cancer was in the 5th decade. Majority of them were Malay, married and housewives with no family history of breast cancer. The statistically significant factors associated with late stage at presentation include Malay ethnicity (p=0.019), presenting symptoms other than breast lump (p=0.047), and duration of breast lump more than 3 months (p=0.009).

    DISCUSSION/CONCLUSION: The study demonstrated presentation at late stage of breast cancer is a major health concern among Malaysian women in district hospital. This may be attributed to different sociocultural beliefs, strong belief in complementary and alternative medicine, lack of awareness, and difficult accessibility to healthcare services.

    Matched MeSH terms: Health Services Accessibility
  10. Fulltext Maternal health care at the crossroads
    Sivalingam N
    Med J Malaysia, 2003 Mar;58(1):1-4.
    PMID: 14556320
    Matched MeSH terms: Maternal Health Services*
  11. Fulltext Paediatric admissions at a tertiary hospital in Kuala Lumpur--a case for a short-stay ward
    Chong LA, Lee WS, Goh AYT
    Med J Malaysia, 2003 Mar;58(1):89-93.
    PMID: 14556330
    The profile of admissions staying less than 24 hours admitted to the paediatric wards of University Malaya Medical Center, Kuala Lumpur, over a period of six weeks was reviewed to ascertain the need of a short-stay ward. Ninety-three (22%) of the 428 admissions admitted during the study period were discharged within 24 hours, 56 (60%) were discharged within 12 hours. Major categories of admissions were: elective investigative procedures (43%), and emergency admissions (44%). Reasons for emergency admissions: infections 42%, minor trauma/cerebral concussion 25% and febrile/afebrile seizures 11%. Only 20% required percutaneous oximetry monitoring and 2% required observations more frequently than 2 hourly. There may be a case for a short stay ward in a big paediatric unit in Malaysia.
    Matched MeSH terms: Health Services Needs and Demand/statistics & numerical data*
  12. Fulltext Utilisation of specialist medical manpower in Malaysia
    Wong SL, Mohan AJ, Suleiman AB
    Med J Malaysia, 1998 Sep;53(3):245-50.
    PMID: 10968161
    One hundred and twenty specialists from the Ministry of Health, the Universities and the private sector provided information on 4,802 patients seen over a total of two hundred and forty working days. This information was used to classify the patients into four categories based on a disease complexity classification. Each specialist's perception on the appropriateness of utilisation of his expertise was obtained. Complex cases requiring specialist expertise in management made up 69.8%, 73.5% and 19.1% of the cases of the Ministry of Health, University and private sector specialists respectively. Underutilisation was most marked with paediatricians and obstetricians in the private sector. The Specialist Register, the Programme for Accreditation of Hospitals and a National Health Financing Plan can be used to influence positively the case-mix of specialists.
    Matched MeSH terms: Health Services/utilization*; Health Services Misuse
  13. Fulltext Pre-admission management of acute gastroenteritis in children: too much or too little?
    Lee WS, Lee SP, Boey CCM
    Med J Malaysia, 1999 Mar;54(1):22-5.
    PMID: 10972000
    Two hundred and ninety five children admitted with acute gastroenteritis from January 1, 1996 to December 31, 1996 to the Paediatric unit, University of Malaya Medical Centre, Kuala Lumpur, were reviewed. Eighty-nine percent of children received treatment before admission. Information regarding the type of treatment received were available in 152 (52%) cases. Eighty percent of them were prescribed medications, 40% were prescribed glucose-electrolyte mixtures, and 13% were advised a change of formula. Only 18 children (12%) were advised to take glucose-electrolyte mixtures alone. The four most common prescribed drugs were: antibiotics (43%), antipyretics (39%), antidiarrhoeal agents (30%), and antiemetics (24%). The use of antibiotics, antiemetics and antidiarrhoeal drugs for children with acute gastroenteritis among primary care doctors appears to be common. The use of glucose-electrolyte mixtures was uncommon.
    Matched MeSH terms: Health Services Misuse*
  14. Fulltext Preferential utilization of healthcare systems by a Malaysian rural community for the treatment of musculoskeletal injuries
    Ariff KM
    Med J Malaysia, 2000 Dec;55(4):451-8.
    PMID: 11221156
    The preferential utilization of healthcare systems by a rural Malaysian community in Perlis for the treatment of musculoskeletal injuries was studied using focus group discussions. The objectives of the study were to explore the pattern of utilization of healthcare systems, the factors influencing the choice of a healthcare provider, rural residents' expectations of their healthcare provider and their views on integrating traditional and modern scientific healthcare systems. Most participants considered traditional and modern scientific healthcare systems as complementing each other. For musculoskeletal injuries, the traditional system was considered the primary choice of healthcare regardless of the participants' socioeconomic and educational levels. Key factors for preferring traditional care were the nature of treatment, the perceived shorter duration for recovery and inclusion of spiritual elements in the therapy. Barriers to seeking hospital treatment were the perceived longer duration for recovery, fear of surgery, use of metallic implants and casts that were culturally unacceptable and objections from elders. For perceived life-threatening situations, in children, pregnancy, and where injuries to internal organs were suspected, hospital treatment was preferred as the primary choice. Discussions on integrating traditional and modern scientific systems were inconclusive.
    Matched MeSH terms: Health Services/utilization*
  15. Fulltext Pattern of congenital heart disease and access to tertiary cardiac care in Malaysia
    Hung LC, Mohan AJ, Soo TL, Ng HP
    Med J Malaysia, 2000 Dec;55(4):424-32.
    PMID: 11221153
    This prospective, descriptive study was carried out to determine the pattern and the type of congenital heart disease seen in the Paediatric Departments in 4 government hospitals. The accessibility of surgical or transcatheter interventional treatment was also assessed. Consecutive new patients seen for suspected congenital heart disease from 1/1/95 till 31/12/95 (Group I) were registered. Records of patients seen from 1/1/95 to 31/8/95 (Group Ia) were reviewed 6 months after presentation to determine the nature of treatment received. Group II were cardiac patients who were first seen prior to the year 1995 and had undergone cardiac surgery or transcatheter interventional procedures in 1995. Of the 375 patients registered in the 4 hospitals, 250 were new patients and 125 were patients first seen prior to 1995 and had surgery or transcatheter interventional procedures in 1995. Of the 250 new patients, 83.2% had acyanotic cardiac lesions and 16.8% had cyanotic lesions. Ventricular septal defect was the commonest lesion, constituting 37.2%, followed by patent arterial duct (18.8%) and atrial septal defects (9.6%). At 6 month review, access to close-heart surgery or transcatheter interventional treatment were readily available. However, for patients with ventricular septal defects, 42.1% who required closure were still waiting for surgery 6 months after presentation. Of the 4 patients with Fallot's Tetralogy who required surgery, 2 had modified Blalock-Taussig shunt and 2 were awaiting surgery. In 1995, a total of 204 cardiac procedures were performed, there were 114 (55.9%) open heart procedures, 50 (24.5%) surgical ligation of the arterial duct, 28 (13.7%) modified Blalock-Taussig shunts, 11 (5.4%) transcatheter duct occlusion and 1 (0.5%) balloon valvuloplasty. The mean age of Fallot's Tetralogy repair was 6.4 years. No corrective surgery was performed for patients with complex cardiac lesions from the 4 hospitals in 1995. In conclusion, the pattern of congenital heart disease was similar to that seen world wide. Except for patent arterial duct, access to surgical treatment was inadequate.
    Matched MeSH terms: Health Services Accessibility*
  16. Fulltext Social problems and care of the elderly
    Arokiasamy JT
    Med J Malaysia, 1997 Sep;52(3):231-7.
    PMID: 10968091
    Several countries of Asia, including Malaysia, have in recent years experienced spectacular economic growth and social change. This, together with declining fertility
    rates and mortality rates, and accompanying increased
    expectation of life at birth have resulted in rapid population ageing of these countries. However, relative
    to the developed countries, where fertility and mortality declines, and improvements in social and economic conditions have evolved gradually over a period of a century, these phenomena in the developing countries of Southeast Asia are evolving in a much shorter time period aided by the availability of medical and technological advances and interventions that can prevent deaths and births and prolong the duration of disability free years of life. This poses a challenge to countries like Malaysia who have to cope with the ageing phenomenon with limited resources that are available. The elderly are a heterogeneous group who are affected by both health and non health factors. The latter are largely social factors related to health that contribute to social problems faced by the elderly. This paper addresses these before looking at the care of the elderly.
    Matched MeSH terms: Health Services for the Aged*
  17. Fulltext Differences in public and private health services in a rural district of Malaysia (letter)
    Hee HWJ
    Med J Malaysia, 1997 Sep;52(3):296-8.
    PMID: 10968103
    Comment on: Aljunid SM, Zwi AB. Differences in Public and Private Health Services in a Rural District of Malaysia. Med J Malaysia 1996;51(4):426-36
    Matched MeSH terms: Health Services*
  18. Fulltext Malaysia's ageing issues
    Arokiasamy JT
    Med J Malaysia, 1997 Sep;52(3):197-201.
    PMID: 10968084
    Matched MeSH terms: Health Services for the Aged*
  19. Fulltext Geriatric practice in Malaysia: issues and challenges
    Poi PJH
    Med J Malaysia, 1997 Sep;52(3):202-5.
    PMID: 10968085
    Matched MeSH terms: Health Services for the Aged*
  20. Fulltext Orthopaedic problems in the elderly
    Hamid AKA
    Med J Malaysia, 1997 Sep;52(3):226-30.
    PMID: 10968090
    Matched MeSH terms: Health Services for the Aged
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