Objectives: A cross-sectional survey was carried out and sent to a total of 868 specialists working primarily in the ICU. The aim of this study was to explore knowledge, perception, and the antibiotic prescribing practice among specialists and advanced trainees in Malaysian ICU.
Materials and Methods: A cross-sectional survey was used, consisted of three sections: knowledge, perception, and antibiotic prescribing practice in ICU. Three case vignettes on hospital-acquired pneumonia (HAP), infected necrotizing pancreatitis (INP), and catheter-related bloodstream infection (CRBSI) were used to explore antibiotic prescribing practice.
Results: A total of 868 eligible subjects were approached with 104 responded to the survey. Three hundred eighty-nine antibiotics were chosen from seven different classes in the case vignettes. All respondents acknowledged the importance of pharmacokinetic/pharmacodynamic (PK/PD) in antibiotic optimization and majority (97.2%) perceived that current dosing is inadequate to achieve optimal PK/PD target in ICU patients. Majority (85.6%) believed that antibiotic dose should be streamlined to the organisms' minimum inhibitory concentration (MIC). In terms of knowledge, only 64.4% provided the correct correlations between antibiotics and their respective PK/PD targets. Compliance rates in terms of antibiotic choices were at 79.8%, 77.8%, and 27.9% for HAI, INP, and CRBSI, respectively.
Conclusion: Malaysian physicians are receptive to use PK/PD approach to optimize antibiotic dosing in ICU patients. Nonetheless, there are still gaps in the knowledge of antibiotic PK/PD as well as its application in the critically ill, especially for β-lactams.
Aims: To explore how impairments could affect the self-esteem of physically disabled people and how healthcare professionals and social support boost their self-esteem.
Materials and Methods: This study was conducted qualitatively whereby face-to-face interviews were conducted among 10 participants with physical disabilities. Participants were recruited from two rehabilitation centres in Kuantan, namely Community-based rehabilitation and rehabilitation, occupational therapy, and physiotherapy of public hospital in Kuantan. Interviews were conducted using the developed interview guide that explored on the disabled peoples' self-esteem and motivation, feelings toward attitude of the healthcare professionals, and satisfaction toward the physical, services, and social support from the healthcare professionals. Thematic analysis was done to identify the themes emerged from the interview transcripts.
Results: Five males and five females with age ranging from 31 to 58 years were interviewed. Five are still working or studying post impairments. Participants claimed being low self-esteem resulted from negative perception from the society, issue of rejection, being discriminated, and difficulty in getting support from the society. Most of the participants asserted that they gained their motivation and self-esteem due to the continuous support from various groups, such as their spouses, family members, colleagues, employers, and healthcare professionals.
Conclusions: Despite heavy workload and stressful working environment, positive attitude showed by the healthcare professionals is highly praised. Hence, this will indirectly improve the self-esteem, motivation, and rehabilitation progress of physically disabled people.
Aims: This study aimed to explore the general public's perception toward electronic cigarette use. Public support toward electronic cigarette regulation was also examined.
Settings and Design: This was a Malaysian population-based survey.
Materials and Methods: Data were obtained from the National E-Cigarette Survey (NECS) 2016, which used a multistage stratified cluster sampling household survey representing all Malaysian adults aged 18 years old. A cross-sectional survey was conducted among a total of 4288 adults.
Statistical Analysis Used: Descriptive and logistic regression analysis.
Results: Majority were aged 25-44 years old (44%), completed at least secondary education (69%), of Malay ethnicity (73%), and married (68%). Majority (88.1%) have never used electronic cigarette. A quarter (25.5%) perceived electronic cigarette helps people quit cigarette smoking, whereas 20.3% perceived electronic cigarette helps people to maintain cigarette abstinence. Approximately 85% believed that electronic cigarette use does not help in improving breathing and coughing. Majority (91.8%) disagreed that electronic cigarettes should be allowed in places where tobacco smoking is banned. Thus, 63.4% agreed that electronic cigarette should be banned completely rather than regulated.
Conclusion: Majority of general public had negative perception about electronic cigarette use.
METHODS: The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant.
RESULTS: Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale.
CONCLUSION: The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.
METHOD: This is a mixed-method study employing the Public Attitude Toward Epilepsy (PATE) scale as the quantitative measure, followed by a semi-structured interview. The qualitative data were then counted and analyzed concurrently with the quantitative data.
RESULT: A total of 410 respondents (104 people with epilepsy [PWE]; 104 family members [FM]; 100 medical students [MS]; 102 public [Pb]) aged 37 years (IQR 23-55) were recruited. They were mostly female (57.3%), Chinese (52.0%), and highly educated (63.7%). The attitudes toward epilepsy among medical students are the best, followed by the PWE and their family members, and the worst among the public. The qualitative results revealed 4 main themes, which were "general social values", "epilepsy severity and control", "PWE's abilities", and "harms and burdens to the respondents and others". A two-dimensional perception model was constructed based on these themes, which consisted of general-personal and universal-specific dimensions. Generally, the PWE/FM subgroup focused more on PWE's abilities, whereas the MS/Pb subgroup more on general social values, and harms and burden. In the education aspect, most attitudes were related to the epilepsy severity and PWE's abilities, whereas in employment, the main consideration was the PWE's abilities. Burden to life and concern about inheritance were major considerations in the marital relationship. Those with positive attitudes tend to highlight the importance of general social values, while negative attitudes associated more with epilepsy severity. In general domain, general social values were the main considering factor but in personal domain, most participants will consider epilepsy severity and control, harms and burden to themselves.
CONCLUSION: The perceptions underlying attitudes toward epilepsy were complex and varied between subpopulations, attitude levels, domains, and aspects of life. (304 words).
BACKGROUND: Work-life balance practices are associated with employee perceptions of the need for achievement and well-being which subsequently influence their intention to leave the organization. This study contributes new knowledge to nursing studies on work-life balance in an Asian and Islamic society where the expectations for women are to focus on family rather than career.
DESIGN: A cross-sectional, explanatory mixed methodology.
METHODS: This is a two-phase study conducted between 2015-2017 with 401 nurses in East Malaysia. In Phase 1, researchers surveyed 379 nurses to test eight hypotheses and in Phase 2 researchers interviewed 22 nurses to explore the results of Phase 1.
RESULTS: Phase 1 revealed job satisfaction mediates the relationship between work-life balance practices (e.g. flexibility and choice in working hours, supportive supervision), financial success, and intention to leave. However, life satisfaction and money as a motivator did not mediate such relationships. Phase 2 identified four important factors that cast light on survey results: working conditions of Malaysian nurses; inadequate compensation in the public healthcare sector; team-based practices; and pressure on senior nurses in both administrative and clinical roles.
CONCLUSION: This is one of the first studies to investigate work-life balance issues among nurses in Malaysia. Outcomes of this study extend the debates on work-life balance and employee well-being in an Asian Islamic social context.
IMPACT: The use of flexible working arrangements and collectivist teamwork approaches, improving compensation and employment benefits and eliminating the 'time-based job promotion' policy may help to mitigate work-life balance issues and intention to leave among nurses in Malaysia.
OBJECTIVES: To determine how women perceived their ANBE experience in the first 8 weeks postpartum including what was useful and what they would like to have been included, sources of ANBE and infant feeding practices at the time of survey.
METHODS: Women during their first 8 weeks postpartum who attended MOH clinics in Penang State, Malaysia were surveyed using a self-administered questionnaire in April and May 2015. Categorical responses were presented as numbers and proportions while free text responses were compiled verbatim and categorised into themes. The perceptions of primiparous and multiparous women were compared. Multivariate logistic regression adjusted to known confounders was used to determine if ANBE was associated with exclusive breastfeeding at the time of survey.
RESULTS: A total of 421 women completed the 15-item questionnaire (84% response rate) of which 282 were complete and available for analysis. Of these, 95% had received ANBE, majority (88%) from MOH clinics. Almost all women found it useful. However, there were areas both in the delivery (e.g. too short) and the content (e.g. nothing new) that were described as not useful; and areas they would like more coverage (e.g. milk expression, storage and overcoming low milk supply). The exclusive breastfeeding prevalence at the time of survey was 61%. ANBE was significantly associated with exclusive breastfeeding even after adjusting for confounders (adjusted odds ratio [aOR] 8.1, 95% confidence interval 1.7, 38.3).
CONCLUSIONS: ANBE is widely implemented and perceived as useful and may be associated with exclusive breastfeeding. Our findings give insight into content that women would like more of and how delivery of ANBE could be improved, including individualized sessions and communicating at a suitable level and language. Future studies could focus on the quality of ANBE delivery.