Design: Qualitative study using focus group discussions. Participants' responses were audio recorded, transcribed, grouped under various domains and listed out and analysed.
Setting: A private medical college in Perak state, Malaysia.
Participants: Forty-six medical students from years 2 to 5 were included. Eight focus groups were formed with two focus groups from each academic year (six students each in seven groups and four students in one group). Students were informed through their respective student leader of each year and received a participant information sheet and an informed consent form which were completed and returned if they decided to participate in the focus group discussions.
Results: The participants had different levels of understanding of primary care depending on their level of exposure to primary care. Senior students with more exposure had a better understanding about primary care and its services. Attractive factors towards choosing primary care as a career included short working hours with a more balanced family and social life, being able to treat patients as a whole with continuity of care and closer relationship with patients. Unattractive factors included routine, unchallenging and boring practice, poor salary, work overload and administrative work in government clinics, being less recognised by other specialties; and the poor perception by other doctors that those pursuing primary care were not 'brilliant enough' for more 'sophisticated disciplines like surgery or paediatrics'.
Conclusion: This study showed that the medical students' level of exposure to primary care played a crucial role in determining their understanding of primary care practice and their choice of career in primary care. Issues to be addressed include remuneration, workload and the prejudice against primary care as a career pathway. Suggestions included introducing early exposure to fun and challenging primary care postings in the medical curriculum and producing well trained, skilled and enthusiastic role models.
DESIGN: Systematic review and meta-ethnography.
DATA SOURCES: Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015).
ELIGIBILITY CRITERIA: Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services.
DATA SYNTHESIS: A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria.
RESULTS: 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke.
LIMITATIONS: Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems.
CONCLUSIONS: Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not have the knowledge or skills to re-engage. This can be addressed by: (1) increasing stroke specific health literacy by targeted and timely information provision, and (2) improving continuity of care between specialist and generalist services.
SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO 2015:CRD42015026602.
METHODS: A survey was conducted among OT users in August 2022. Respondents completed a 44-question anonymised online survey covering sustainability in (1) knowledge, (2) attitude, (3) practice, and (4) proposed changes to current practices. Points were assigned to knowledge (15 points) and attitude (40 points) sections. Practice was evaluated based on proportion of measures practiced. Appropriate statistical tests were used, with significance p
METHODS: A total of 208 dentists from DSC nationwide completed an online questionnaire in June 2022. Demographic data and information on dentists' expanded roles were retrieved. Responses on dentists' satisfaction and perceived barriers were collected using a 5-point ordinal scale. Mann-Whitney U and Kruskal-Wallis tests were used to compare the mean rank differences for CS. Factors influencing CS were analysed using multiple logistic regression (MLR) (P < .05).
RESULTS: The mean age of the respondents was 32.68 ± 2.48 years. Almost half (49.0%) of the respondents were attached to a non-hospital-based clinic. The majority (72.0%) of them were permanently attached to the DSC. About half of the dentists (51.0%) strongly agreed that they received no financial incentives for their expanded role at the MOH DSC. Dentists attached at a non-hospital-based clinic (P = .046), working with more than 15 years of experience (P = .013), and having 12 to 18 months' duration of attachment (P = .014) were more satisfied. MLR analysis revealed that non-Malay respondents (odds ratio [OR], 1.54; P = .035) and those who applied for scholarships more than 3 times (OR, 1.85; P = .050) were more satisfied. In contrast, more than 19 months at the DSC decreased CS (OR, 0.44; P = .029).
CONCLUSIONS: Despite having a similar organisational structure, DSC dentists had different satisfaction levels. Dentists' ethnicity, duration of attachment, and frequency of applying for scholarships influenced their CS. Future career advancement plans in the MOH should consider these important influencing factors to ensure the delivery of quality health care from their personnel.
METHOD: An exploratory phenomenology qualitative study was conducted whereby subjects were purposively selected based on previous experience in observing Ramadan fasting. Face-to-face in-depth interviews were conducted, and study data were analyzed thematically and iteratively coded using a constant comparison method.
RESULTS: Four major themes emerged from the data, namely: (i) "fasting experiences", (ii) "perceived side effects of fasting", (iii) "health-seeking behavior" and, (iv) "education and awareness needs". Patients expressed the significance of Ramadan fasting as well as the perceived impact of fasting on their health. Additionally, there is lack of health-seeking behaviour observed among patients thus, raising needs for awareness and education related to Ramadan fasting.
CONCLUSIONS: Findings of this study shed light on patients' experiences and perceptions regarding Ramadan fasting which warrants the needs for an effective communication between patients and health care practitioners through a structured-Ramadan specific education program.
METHODS: A quasi-experimental multiple time series was conducted starting in September 2017 and ending in June 2018. 140 nurses were sampled using the proportionate stratified random sampling technique; 132 were completed the study 67 the intervention group, while 65 in the control group.
RESULTS: There were no significant differences in nurses' job performance or commitment between the 2 groups (control and intervention). A repeated measure MANOVA test for both groups revealed that the interaction between group and time was statistically significant (F (4, 127) = 144.841; P = .001; Wilk's Λ = 0.180; η2 = .820), indicating that groups had a significantly different pattern of job performance and commitment over time. A repeated test The MANCOVA test for both groups across time revealed significant differences in nurses' job performance and nurses' commitment at a less than 0.05 significance level (F (2127) = 320.724; P = .001; Wilk's Λ = 0.165; η2 = 0.835), and the overall effect of time was significant for all dependent variables (F (4125) = 36.879; P = .001; Wilk's Λ = 0.459; η2 = 0.541).
CONCLUSION: The educational intervention was effective in improving nursing job performance among the study sample. The improved commitment of respondents in the intervention group was attributed to the improvement in job performance.
DESIGN: Cross-sectional study.
SETTING: This study is part of a larger national study on the perception of the Malaysian public healthcare professionals on FMSs.
PARTICIPANTS: PHCPs from three categories of health facilities, namely hospitals, health clinics and health offices.
MAIN OUTCOME MEASURES: Qualitative analysis of written comments of respondents' expectation of FMSs.
RESULTS: The participants' response rate was 58% (780/1345) with an almost equal proportion from each public healthcare facility. We identified 21 subthemes for the 623 expectation comments. The six emerging themes are (1) need for more FMSs, (2) clinical roles and functions of FMSs, (3) administrative roles of FMSs, (4) contribution to community and public health, (5) attributes improvement and (6) research and audits. FMSs were expected to give attention to clinical duty. Delivering this responsibility with competence included having the latest medical knowledge in their own and others' medical disciplines, practising evidence-based medicine in prehospital and posthospital care, better supervision of staff and doctors under their care, fostering effective teamwork, communicating more often with hospital specialists and making appropriate referral. Expectations ranged from definite and strong for more FMSs at the health clinics to low expectation for FMSs' involvement in research; to mal-expectation on FMSs' involvement in community and public health programmes.
CONCLUSIONS: There were some remarkable differences in expectations on FMSs from the three different PHCPs. These ranged from being clinically competent and administratively available for patients and staff at the health clinics, to mal-expectations on FMSs to engage in public health affairs. Relevant parties, including FMSs themselves, could take appropriate self-improvement initiatives to enhance public practice of family medicine and patient care.
TRIAL REGISTRATION NUMBER NMRR ID: 08-12-1167.
MATERIALS AND METHODS: A cross-sectional study was conducted using a self-administered questionnaire entitled the Family Presence Risk-Benefit Scale and Family Presence Self-Confidence Scale. Purposive sampling method was used to include 130 nurses working in eight Intensive Care Units at Hospital Universiti Sains Malaysia. Descriptive statistics and Pearson's Correlation test were used to analyse the variables of FPDR.
RESULTS: Findings revealed that nurses in the critical care setting perceived low risk-benefit and low self-confident with regards to family presence during resuscitation. Pearson correlation analysis showed no correlation between perceptions of risk-benefits and self-confidence among critical care nurses (r = -0.016).
CONCLUSION: Relatively, nurses perceived that family presence during resuscitation would place high risk and low benefit to the family members. Thus there is a need for education, training, and guideline to enrich the concept of FPDR and its implementation.