METHODS: We randomly sampled 351 people with localised melanoma [American Joint Cancer Committee (AJCC) substages 0 - II] who had not had recurrent or new primary melanoma diagnosed from a total of 902 people diagnosed and treated for localised melanoma at a specialist centre in 2014. We interviewed participants by telephone about their experience of follow-up in the past year, and documented the proportion of patients who were undertaking shared care follow-up with a GP. We also recorded the frequency and type of investigations during follow-up. We calculated weighted estimates that are representative of the full inception cohort.
RESULTS: Of the 351 people who were invited to participate, 230 (66%) people consented to the telephone interview. The majority undertook shared care follow-up with a GP (61%). People who choose to have shared care follow-up with a GP are more likely to be male (p = 0.006), have lower AJCC stage (p for trend = 0.02), reside in more remote areas (p for trend
Subjects and Methods: In an analytical cross-sectional design, we used simple random sampling technique to select 242 multiracial Malaysian male fishermen aged between 18 and 75 years from five fishing villages located at Gurney Drive, Tanjong Tokong, Tanjong Bungah, Batu Ferringhi, and Teluk Bahang to participate in this study. During four consecutive weekends in January 2017, we conducted face-to-face interviews with participants using a pre-validated, interviewer-administered WHO oral health questionnaire. We categorized participants as having "good" or "poor" oral health based on a mean cutoff score of 14. Multivariate regression models were fitted to assess the oral health status and associated lifestyle factors among the study population, using SPSS version 22.
Results: We achieved a response rate of 97.6%. Overall, the prevalence of poor oral health in this study was 47.5%. "Income" (RM/month), "type of fishing," "additional occupation," "age" (years), "frequency of pies, buns consumed," and "frequency of sweets, soft drinks consumed" were significant predictors of oral health status among the fishermen.
Conclusion: Poor oral health is relatively highly prevalent among the fishermen in our study. The oral health status of fishermen in Teluk Bahang was consistent with the national average and significantly associated with their sociodemographic and lifestyle factors. Targeted interventions are required to arrest and reverse this trend.
METHODS: This was a qualitative study utilising the constructivist grounded theory approach. A total of 31 individuals aged 30 years and above from the community were sampled purposively. Eight interviews and six focus groups were involved, using a semi-structured topic guide.
RESULTS: A conceptual framework was developed to explain the public's decision-making process on health check participation for CVD prevention. The intention to participate in health checks was influenced by the interplay between perceived relevance and the individual's readiness to face the outcome of health checks. Health checks were deemed relevant if people perceived themselves to be at risk of CVD and there was an advantage in knowing their cardiovascular status. People were ready to face the outcome of health checks if they wanted to know the results and were prepared to deal with the subsequent management. The decision to participate in health checks was also influenced by external factors such as the views of significant others, and the accessibility and availability of resources including time and finances.
CONCLUSIONS: The intention to screen for CVD is motivated by two internal factors: the perceived relevance of the disease and readiness to face screening outcomes. Strategies targeting the internal decision-making process may prove to be key in improving the uptake of screening.
METHODS: A qualitative approach was employed using focus group discussions (FGD) and in-depth interviews (IDI) at an academic centre that trains family physicians. Twelve trainees, all of whom were in their hospital specialty's rotations and five faculty members were purposively selected. Three FGDs among the trainees, one FGD and two IDIs among the faculty members were conducted using a semi-structured topic guide. Data were collected through audio-recorded interviews, transcribed verbatim and checked for accuracy. A thematic approach was used to analyse the data.
RESULTS: There were four main themes that emerged from the analysis. Both educators and trainees bill the perspective that BL encouraged continuity in learning. They agreed that BL bridges the gap in student-teacher interactions. Although educators perceived that BL is in concordance with trainees learning style, trainees felt differently about this. Some educators and trainees perceived BL to be an extra burden in teaching and learning.
CONCLUSION: This study highlights a mix positive and negative perceptions of BL by educators and trainees. BL were perceived positively for continuity in learning and student-teacher interaction. However, educator and learner have mismatched perception of learning style. BL was also perceived to cause extra burden to both educators and learners. Integrating BL to a traditional learning curriculum is still a challenge. By knowing the strengths of BL in this setting, family medicine trainees in Malaysia can use it to enhance their current learning experience. Future study can investigate different pedagogical designs that suit family medicine trainees and educators in promoting independent learning in postgraduate training.
METHODS: We conducted 20 semi-structured in-depth interviews with experts, healthcare professionals, program managers or executives from UN agencies, public healthcare facilities, civil society organizations, and academic institutions in Malaysia. Interviews were transcribed and analyzed both deductively and inductively using thematic analysis.
RESULTS: Participant narratives highlight that the health needs of refugees and asylum-seekers in Malaysia are complex. As reported, access to healthcare is underpinned by numerous social, cultural and economic determinants compounded by a legal environment that lacks inclusivity of refugees and asylum-seekers. Apart from the health risks associated with the migration process, limited access to comprehensive healthcare post-arrival remain a problem for refugees and asylum-seekers in Malaysia. Key barriers to healthcare access are linked to poor health literacy and the lack of awareness on one's right to healthcare; language and cultural differences; protection issues resulting from a lack of legal status; and an inability to afford healthcare due to inadequate livelihoods. Overall, poor access to healthcare is perceived to have detrimental consequences on the health status of refugees, asylum-seekers and its host population, and may incur greater costs to the health system in the long run.
CONCLUSION: Comprehensive efforts in practice and research that tackle the social, cultural and economic determinants of health, and more inclusive health policies are crucial in strengthening healthcare access among refugees and asylum-seekers in Malaysia. Practical recommendations include improving the health literacy of refugees and asylum-seekers for better navigation of the health system; bridging language and cultural gaps through translation support and inter-cultural orientation; implementing policies grounded in the right to healthcare for all regardless of legal status and in the interest of public health; and establishing a larger evidence base to drive policy development and implementation for refugee health within the Malaysian context.
METHODS: Consenting parents participated in a semi-structured interview assessing their experience of having their child involved in BST. The qualitative data were analysed using thematic analysis. Parents were assured that their children's treatment would not be negatively affected in the case of withdrawal from the study.
RESULTS: A total of 54 parents responded and discussed their experience of their children's participation in clinical teaching. The majority of parents were keen to support medical students' learning, and felt that they could develop better insight into their child's health in association with the teaching session. Some parents found the sessions tiring; their interest increased when they were more actively involved in planning the BST sessions.
DISCUSSION: This study emphasises children's and adolescents' autonomy as a main principle in making decisions about involving them in BST. Clinical teachers often face problems attempting to properly plan and conduct BST sessions. Parents appreciate having an active role in planning the sessions and are supportive of medical student education. Clinical teachers must ensure that they protect the best interests of paediatric patients and their parents. At the same time, they should advocate for the obvious benefits of BST.
DESIGN: This was a qualitative study comprising semi-structured face-to-face interviews guided by 10 open-ended questions. Interviews were conducted until data saturation was achieved and no new ideas were formed. The interviews were audio-recorded, transcribed verbatim and analysed for themes. To derive themes, we employed directed content analysis of transcript data. Coding was completed using a combination of open, axial and selective coding.
SETTING: Four nursing homes in Singapore.
PARTICIPANTS: The study involved 17 participants (comprising 4 doctors, 4 pharmacists and 9 nurses).
RESULTS: Two key themes were identified, enablers and challenges. These were enablers and challenges faced by doctors, pharmacists and nurses towards deprescribing. The identified subthemes for enablers of deprescribing were: (1) awareness of medications that are unnecessary or could be targeted for deprescribing; (2) improving quality of life for patients with limited life expectancy; (3) improving communication between doctors, pharmacists and nurses; (4) systematic deprescribing practice and educational tools and (5) acknowledgement of possible benefits of deprescribing. The identified subthemes for challenges of deprescribing were: (1) symptoms not acknowledged as possibly drug-related; (2) lack of knowledge in patient's and family members' preferences; (3) lack of coordination between health professionals in hospitals and nursing homes and (4) limited tools for deprescribing. The development of a local guideline, mentoring nurses, case discussions, better shared decision-making and improving multidisciplinary communication, may help to support the process of deprescribing.
CONCLUSION: In conclusion, this study highlighted that deprescribing in the nursing homes is perceived by health professionals to be challenging and future research could assess how routine case studies, mentoring and better multidisciplinary communication could improve deprescribing knowledge and process in the nursing homes.
DESIGN/METHODOLOGY/APPROACH: The authors adopted a quantitative and qualitative approach, i.e., a self-administered questionnaire, unstructured and a semi-structured interview, which were used to collect the data. A questionnaire was distributed to Bahraini residents selected randomly. The framework was based on the technology acceptance model (TAM) and theory of reasoned action (TRA). Important variables from both the TAM model and TRA theory were extracted and jointly used to build the research model.
FINDINGS: The findings indicated that the most factors affecting e-health adoption are trust, health literacy and attitude. Additionally, people in the private and government sectors understand e-health benefits.
PRACTICAL IMPLICATIONS: If healthcare professionals understand the factors affecting e-health system adoption from an individual and organisational perspective, then nurses, pharmacists and others will be more conscious about e-health and its adoption status.
ORIGINALITY/VALUE: E-health system adoption has become increasingly important to governments, individuals, and researchers in recent years. A novel research framework, based on TAM and TRA, was used to produce a new integrated model.
METHODS: This was an exploratory qualitative study conducted via semi-structured interviews with twenty-two women who were married when they were younger than 18 years old in Kuching, Sarawak, Malaysia. Participants were recruited through purposive and convenient sampling with the use of data from a reproductive health clinic and recruitment in villages. Thematic analysis was used for data analysis.
RESULTS: Four overarching themes were identified: health risk behaviour, family poverty, early marriage as fate, and family disharmony.
CONCLUSIONS: In-depth understanding of the unique factors leading to child marriage locally will facilitate the introduction of new approaches to interventions to eradicate child marriage in Sarawak state, Malaysia.
OBJECTIVES: This paper aims to identify requirements in developing a breast examination awareness mobile app based on the component of the Health Belief Model (HBM) for integration in health promotion strategy.
METHODS: A qualitative approach using semi-structured in-depth interview was utilized in this study. A purposive sampling method was conducted among public women attending hospital services, software and content experts in a tertiary teaching hospital in the East coast of Peninsular Malaysia. These interviews were recorded, transcribed and organized using NVIVO 11. The main themes were identified through thematic analysis of the interview transcripts. Results: A total of 37 participants recruited in this study. The themes that emerged from the analysis are vulnerability, forecasting, reactive, influence, outcome and obstacles. The sub-themes findings supported the HBM's component in terms of the requirement for are an infographic risk factor, video (symptoms, self-examination), info (metastasis, survival, screening, triple assessment, treatment, myth and facts, benefit of early treatment, support groups), features (screening reminder, sharing button, prompt) and mobile app's design.
CONCLUSION: The research findings could provide a guide for future app development from public women, content and software experts. The information will be used to develop a breast examination awareness mobile app integrated with health theories.
METHOD: A cross-sectional qualitative study in which focus group interviews were conducted by 5 trained senior Cambodian dental students. A convenience sample of 56 older adults and caregivers was recruited across urban, semi-urban and rural locations. Focus group conversations were recorded, transcribed and analysed thematically.
RESULTS: The themes that emerged were around low expectations for both general health and oral health. A communal responsibility for health was expressed, and both money and transport were identified as key barriers to accessing care. Participants recognised that they had oral health problems, and acknowledged the impact of poor oral function on health and nutrition.
CONCLUSION: This study is an important first step in better understanding the oral health experiences and perceptions of older people in Cambodia. Participants described the impacts of poor oral health as being important, even when compared with other general health conditions.