METHODS: This study employed mixed method in a sequential exploratory design. The semi-structured interviews were conducted with three graduates from different cohorts. The qualitative analysis of the interviews found six emerging themes for professional behavior and clinical competencies development. These themes were then developed into a 55-item questionnaire. The questionnaire was then distributed to 84 medical graduates for exploratory factor analysis (EFA) from February to April 2019. The quantitative data were analyzed using IBM SPSS ver. 21.0 (IBM Corp., Armonk, USA) for principal axis factoring. After conducting EFA, we proceeded with confirmatory factor analysis (CFA) with another 120 graduates to validate the tool.
RESULTS: Eighty-four graduates completed the questionnaire for EFA. Upon completion of EFA, 35 out of 55 items of the questionnaire were found to be valid and reliable. The most appropriate fit was seven factors, which explained 58.18% of variance between them after 15 iterations with Cronbach's α of 0.916. The personal satisfaction factor was noted to be weak. It was therefore added to patient management factor due to its similar intention. The final EFA factor after the modification was six. The CFA found that 34 out of 35 items was valid and reliable that representation of the latent variables.
CONCLUSION: The questionnaire has achieved the desired construct validity score and can be used as an evaluation tool to assess professional behavior and clinical competencies from the graduates' perspective.
METHODS: An integrative literature review was conducted to investigate barriers impacting the quality of end-of-life care. This review process involved searching database like MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EBSCO, and ScienceDirect up to November 2023. Search strategies focused on keywords related to barriers in end-of-life care and critical care nurses from October 30th to November 10th, 2023. The inclusion criteria specified full-text English articles published between 2010 and 2023 that addressed barriers perceived by critical care nurses. This integrative review employs an integrated thematic analysis approach, which combines elements of deductive and inductive analysis, to explore the identified barriers, with coding and theme development overseen by the primary and secondary authors.
RESULTS: Out of 103 articles published, 11 articles were included in the review. There were eight cross-sectional descriptive studies and three qualitative studies, which demonstrated barriers affecting end-of-life care quality. Quality appraisal using the Mixed Method Appraisal Tool was completed by two authors confirmed the high credibility of the selected studies, indicating the presence of high-quality evidence across the reviewed articles. Thematic analysis led to the three main themes (1) barriers related to patients and their families, (2) barriers related to nurses and their demographic characteristics, and (3) barriers related to health care environment and institutions.
CONCLUSION: This review highlights barriers influencing the quality of end of life care perceived by critical care nurses and the gaps that need attention to improve the quality of care provided for patients in their final stages and their fsmilies within the context of critical care. This review also notes the need for additional research to investigate the uncover patterns and insights that have not been fully explored in the existing literature to enhance understanding of these barriers. This can help to inform future research, care provision, and policy-making. Specifically, this review examines how these barriers interact, their cumulative impact on care quality, and potential strategies to overcome.
METHODS: This was a cross-sectional study of 859 Malaysian medical students from 21 medical schools who voluntarily completed a self-administered online questionnaire that was disseminated by representatives from medical schools nationwide and social media platforms of a national medical student society.
RESULTS: 37.8% of the respondents were optimistic about a career with the Ministry of Health (MOH), Malaysia in the future. Most of the respondents (91.2%) plan to join and complete the MOH Housemanship programme as soon as possible after graduation, with the majority of them (66.2%) planning to complete it in their state of origin. After 2 years of Housemanship programme, only more than half of the respondents (63.1%) plan to continue their careers in MOH. Slightly more than a quarter (27.1%) of the total respondents plan to emigrate to practise medicine, with 80.7% of them planning to return to Malaysia to practise medicine after some years or after completing specialisation training. Combining the career intentions of Malaysian medical students immediately after graduation and upon completion of the 2 years housemanship programme, only a slight majority (57.5%) of the respondents plan to continue their career in MOH eventually. Most of the respondents (85.0%) intend to specialise.
CONCLUSION: A concerning number of Malaysian medical students plan to leave the Ministry of Health workforce, the main healthcare provider in Malaysia, in the future. Urgent government interventions are needed to address the underlying factors contributing to the potential exodus of future doctors to prevent further straining of the already overburdened healthcare system, posing a significant threat to public well-being. An annual national study to track medical students' career intentions is recommended to gather crucial data for the human resources for health planning in Malaysia.
MATERIALS AND METHODS: Dundee Polyprofessionalism Inventory I: Academic Integrity questionnaire was administered to BDS students of a private dental institution in Malaysia. Differences in the level of recommended sanctions were assessed by Mann-Whitney U and Kruskal-Wallis test.
RESULTS: There was unanimous agreement that all 34 statements of lapses of academic integrity as unacceptable. The highest agreement (95.6%) was related to threatening or abusing university employees or students and involvement in paedophilic activities, whereas the lowest agreement was observed for getting or giving help for coursework against rules (47.3%). The most frequent behaviours observed among peers were lack of class punctuality (55.1%) and providing and receiving proxy attendance services (49.3%). About 36% admitted to not being punctual themselves, 26.8% for accepting or providing help for course work and 22.9% for receiving and providing proxy attendance. Female students displayed stricter recommended sanctions, with the most significant difference relating to joking disrespectfully about body parts (p
OBJECTIVES: This study aimed to assess PCPs' knowledge and attitudes toward childhood hearing loss, investigate the association between knowledge and attitudes, and examine the influence of demographic factors on PCPs' knowledge and attitudes towards childhood hearing loss.
METHODS: This cross-sectional study was conducted from 30 November 2017 to 30 July 2018 at three public health clinics in Malaysia, specifically in the Federal Territory of Kuala Lumpur, Selangor, and Terengganu. A self-administered questionnaire assessed PCPs' knowledge of general facts, diagnosis and intervention, and risk factors for childhood hearing loss. Additionally, the questionnaire evaluated PCPS' attitudes across cognitive, affective, and behavioural domains regarding childhood hearing loss.
RESULTS: Most participants lacked sufficient knowledge about childhood hearing loss, with 61.4% not seeing it as a major health issue. Almost half (45.9%) didn't know that children with hearing loss can succeed in regular schools, and 78% were unaware that hearing aids don't fully restore normal hearing. Participants' awareness of risk factors varied widely, ranging from 24.6% to 90.3%. Despite these knowledge gaps, participants generally had positive attitudes towards childhood hearing loss, especially in cognitive and behavioural aspects. The study found a strong positive link between knowledge and attitudes, but demographic factors didn't significantly affect them.
CONCLUSIONS: This study highlights the urgent need to address knowledge gaps among Malaysian PCPs regarding childhood hearing loss. While these knowledge gaps exist, PCPs' positive attitudes form a foundation for developing targeted educational interventions to improve PCPs' knowledge and skills in managing childhood hearing loss. Collaborative efforts are essential to translate these findings into meaningful improvements in paediatric audiological care.
DESIGN: A systematic review was conducted that adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
DATA SOURCES: MEDLINE, Embase, CINAHL, Web of Science, PsycINFO and Google Scholar were searched up to 23 February 2024.
STUDY ELIGIBILITY CRITERIA AND SETTING: Qualitative, quantitative and mixed-method primary research studies. There was no limitation on the publication date, geographical locations or the study settings.
PARTICIPANTS: Pharmacists, doctors, nurses and students from these respective professional groups in any country.
PRIMARY OUTCOME MEASURES: The levels of healthcare staff and students' KAPs about disposal of unwanted medications.
DATE EXTRACTION AND SYNTHESIS: Data extraction was conducted by four of the researchers independently. The study details were categorised into three main domains, that is, KAP using the KAP model. Other relevant information was also extracted, and synthesised in overall themes, such as challenges and recommendations.
RESULTS: Thirty-seven studies from 18 countries (Asia n=21, the USA n=7, Africa n=5, EU n=2, South America n=2) were included. 86.5% (n=32) investigated participants' knowledge of medication disposal. Although there was a good level of awareness about the environmental impacts, there were significant gaps in knowledge regarding correct disposal methods, available services, guidelines and training. Thirty studies explored participants' attitudes towards medication disposal. There was a generally positive attitude towards the need for environmentally safe disposal practices. Thirty-five studies evaluated participants' practices in relation to medication disposal. Although there was generally a positive attitude and some understanding of appropriate disposal methods, the majority of the participants did not follow the practice guidelines, especially outside healthcare settings.
DISCUSSIONS AND CONCLUSIONS: Although healthcare staff and students have fair knowledge and positive attitudes towards medicine disposal, their actual practices are lacking. One significant challenge identified is the limited awareness about proper disposal methods coupled with a lack of established services or guidelines. Even in cases where take-back programmes are available, they often face issues with accessibility. To tackle these challenges, it is suggested that governmental bodies should establish and enforce clear policies on medication disposal while also expanding educational initiatives to increase understanding among professionals and students. Furthermore, improving access to take-back programmes is crucial for ensuring safe medication disposal and minimising potential environmental and health hazards.
PROSPERO REGISTRATION NUMBER: CRD42024503162.
DESIGNS: A sequential explanatory mixed-methods study was conducted, starting with a cross-sectional quantitative phase using a self-administered online questionnaire that adapted previous instruments to the current setting based on Human, Organisation, Technology-Fit and Technology Acceptance Model frameworks, followed by a qualitative phase using in-depth interviews. However, this article explicitly emphasises the quantitative phase.
SETTING: The study was conducted in five MOH hospitals with THIS technology from five zones.
PARTICIPANTS: Prior to the quantitative field study, rigorous procedures including content, criterion and face validation, translation, pilot testing and exploratory factor analysis (EFA) were undertaken, resulting in a refined questionnaire consisting of 41 items. Confirmatory factor analysis (CFA) was then performed on data collected from 343 respondents selected via stratified random sampling to validate the measurement model.
RESULTS: The study found satisfactory Kaiser-Meyer-Olkin model levels, significant Bartlett's test of sphericity, satisfactory factor loadings (>0.6) and high internal reliability for each item. One item was eliminated during EFA, and organisational characteristics construct was refined into two components. The study confirms unidimensionality, construct validity, convergent validity, discriminant validity and composite reliability through CFA. After the instrument's validity, reliability and normality have been established, the questionnaire is validated and deemed operational.
CONCLUSION: By elucidating critical success factor and acceptance of Casemix, this research informs strategies for enhancing its implementation within the THIS environment. Moving forward, the validated instrument will serve as a valuable tool in future research endeavours aimed at evaluating the adoption of the Casemix system within THIS, addressing a notable gap in current literature.
RESEARCH METHOD: The study has adopted a mixed-method research design. Data was collected from 15 frontline healthcare workers through semi-structured interviews to achieve study objectives. Descriptives and content analysis were conducted to explore voice barriers and alternative practices to solve their concerns. After that, a quantitative study was conducted to determine the statistical significance of the identified voice barriers and the magnitude of their effect. For this purpose, data was collected from 480 frontline healthcare workers in the primary, secondary, and territory healthcare units. A questionnaire survey was used for data collection. Then, multistage hierarchical regression analysis was employed for data analysis.
RESULTS: Study findings highlight the determinants of two key factors: withholding patient safety concerns and withholding worker safety concerns. First, the study identifies several factors that increase the likelihood of healthcare workers withholding concerns about patient safety. These factors include professional designation, work experience, blackmailing, overconfidence, longer work tenure, feelings of insult, early career stage, fear of patient reactions, bad past experiences, job insecurity, and uncooperative management. Fear of increased workload also plays a significant role. Second, when it comes to work-related safety concerns, factors such as gender, shyness, lack of confidence, fear of duty changes, management issues, interpersonal conflicts, and resource shortages contribute to the withholding of concerns. To navigate these challenges, healthcare workers often resort to strategies such as seeking political connections, personal settlements, transfers, union protests, quitting, using social media, engaging in private practice, or referring patients to other hospitals.
CONCLUSION: Findings demonstrates that healthcare workers in Pakistan often withhold safety concerns due to hierarchical pressures, personal insecurities, and fear of repercussions. Their reliance on external mechanisms, such as political influence or social media, underscores the need for significant reforms to improve safety culture and management support. Addressing these issues is crucial for ensuring both patient and worker safety.
METHODOLOGY: An online survey in dual languages (Malay and English) was conducted between April 2022 and May 2022 among 1001 adult PwO and 200 HCPs (general practitioners, endocrinologists, obstetricians/gynaecologists, cardiologists, and other appropriate specialities).
RESULTS: The findings highlighted significant gaps in obesity awareness, with 57% of PwO misclassifying their weight status as normal or overweight. While 68% of PwO valued discussing weight management with HCPs, success rates remained low. On average, patients made three weight loss attempts in adulthood, with 63% regaining weight even after maintaining weight loss for six months or more. Key barriers included insufficient exercise, motivation deficits, and poor hunger control. Although 88% of HCPs recognised obesity as a chronic disease affecting overall health, patient disinterest, limited awareness of treatment options, and time constraints hindered effective intervention. Despite 70% of PwO trusting HCPs' medication recommendations, only 10% received weight loss prescriptions.
CONCLUSIONS: This study emphasises the need for enhanced communication between HCPs and PwO, along with comprehensive support that includes mental health services. Addressing the perception gap regarding weight management responsibility is crucial. The results suggest that culturally contextualised approaches to obesity management in Malaysia are essential. Our findings highlight the urgent need for developing treatment strategies and policies targeting identified barriers and establishing collaborative frameworks to enhance obesity management within Malaysia's healthcare system.
MATERIALS AND METHODS: This is questionnaire-based observational comparative study. Once the questionnaire is filled, the application of CP is tested on an airway model and competency level is documented. An education hand out is passed to all participants after the procedure. The improvement and knowledge retention were assess after 2 month.
RESULTS: A total of 81 completed surveys were returned comprises of of 34 medical officers, 23 staff nurses and 24 assistant medical officers. 75.3% subjects have work experience more than a year but only 59.3% of them were trained in CP application. A total of 69.1% participants passed the pre educational handout test and 100% passed the post educational handout test. However, for pre educational handout phase, 81.5% participants passed the theory part while only 42% passed the practical component. In post educational handout phase, the number of respondents who passed both components was 97.5% and 63% respectively. There are positive correlation between designation and working experience with overall passes in this study.
CONCLUSIONS: The theoretical knowledge of CP is satisfactory but clinical application is poor especially in the pre educational handout phase. The educational handout is proved to improve the knowledge transfer and retention with regards to CP.