Employees support during the implementation of planned organizational changes is important to ensure
successful change. Therefore, this study attempts to explain the phenomenon of behavioral support for
change by integrating Lewin's Three Steps Model and Theory of Planned Behaviour. The literature
review of planned organizational change models developed by previous researchers based on the Three
Steps of Lewin Change Model was undertaken before the change model for this study was developed which involved three phases of change namely motivation to change, commitment to change, and
behavioural support for change. Based on that model, the Theory of Planned Behaviour was used to
explain the relationship between the variables where perceived benefits of change (attitude), supervisor
support (subjective norms) and change self-efficacy (perceived behavioural control) was predicted to
influence commitment to change (behavioral intention), which in turn affects individual behaviour to
support change (behavior). Subsequently, this study proposes a conceptual model based on the latest
literature to be implemented in depth empirical studies to test the proposed model.
A qualitative study was conducted to assess the nursing students’ experiences of their clinical practice at one public university in Sarawak, Malaysia. Purposive sampling was used to recruit nine undergraduate nursing degree students at a medical faculty. An in-depth interview based on an open-ended questionnaire was used to collect data. The open-ended questionnaire was used to assess the students’ expectation, feelings, challenging experiences related to work culture, knowledge and skills in patient care, teaching learning supports, people interpersonal relationship, students’ role and their coping mechanism in clinical practice. Data were analysed using content analysis approach facilitated by Nvivo software (Version 8.) The themes emerged from the data analysis included (a) Gaining insight into the reality of clinical working environment and (b) challenges. The subthemes illustrated the students’ challenges were interpersonal relationship with people at the work place, different ward environment, theorypractice gap and insufficient clinical practice, and anxiety. The participants also reported experiencing anxiety due to challenges; however, after a period of time, they learnt to cope with them. The students were able to use different coping mechanism such as internal and external motivation, and this increased their confidence as they progressed in their learning. The learning difficulties faced by nursing students during clinical placement show that a supportive learning environment is important. This study proposed practical strategies to empower students in clinical learning and increase their self-esteem and confidence. In order to improve quality of students’ clinical education, adequate and effective work collaboration between nursing education and health care services are recommended. Future research should focus on how to create a supportive clinical learning environment in local setting
Simulated Patient (SP) is defined as a layperson that simulates to portray the role of a patient with health-related conditions based on varying levels of training. International Medical University (IMU) has been utilising SP for more than 10 years for simulation activities including learning sessions and examination. Due to a series of complex interaction within the SP programme, the aim of the study was to explore the experience of lecturer, student and SPs towards the interaction within the SP programme. The findings of the research were aimed to improve the teaching sessions and examination through the improvement of the SP programme. A total of 17 participants were recruited for 6 interviews, including both focus group and one-to-one interview session. The researcher used a list of guide questions to explore both positive and negative experiences. Manual transcribing and coding technique were used for data analysis, while Qualitative Data Analysis (QDA) was used for data management and additional analysis. The themes for the lecturer group were: SP resemble a real patient, The making of scenario, and SP feedback; while the themes for the students group were: Simulated patient as an effective learning tool, Fairness, and Feedback from simulated patient; whereas Effective learning session, Motivation and Preparation prior class were the themes for the SP group. SPs’ contribution was valuable if the SP is able to resemble a real patient and able to demonstrate effective feedback skills. Standardisation of the character portrayal and SP feedback influenced the fairness along the students’ journey. Lecturers, SPs and students influenced the success of an SP-based simulation session.
Student athletes represent a unique segment of society, having to manage a set of expectations and challenges that are distinct and psychologically demanding. They are expected to achieve the highest level of sporting excellence while also performing well academically. A basic qualitative study was used to gain an understanding of the nature and type of psychological challenges faced, and ways the student athletes successfully managed or was currently managing those challenges. The results entailed two overlapping groups of challenges; internal and external, where internal consisted of emotional strain, expectations from one’s self, balance between sports and studies, and present feelings of regret, while external consisted of issues with their coach, perception of others, and transition to tertiary education. Additionally, there were three ways of managing those challenges namely through problem-focused coping, emotion-focused coping, and experiential learning. Those three domains are further explored and discussed, with consideration to the local context and the role of individual differences.
Breast Self-Examination (BSE) is a process whereby women examine their breasts regularly to detect any abnormal swelling or lumps in order to seek prompt medical attention. The purpose of this study was to investigate the knowledge and practice of BSE among female non-medical students in UKM, Bangi. A cross-sectional study was conducted using self-administered and validated questionnaire among 364 students. The results showed that only 37.1% performs BSE and 45% of the students have good knowledge. Age, marital status, using internet and pamphlets as source of information, personal, and family history of BC, were significantly associated with knowledge level of students. Practice of BSE was significantly associated with knowledge level. From multivariate analysis, BSE was more likely to be done among students with family history, students who using internet and pamphlet as sources of information, also among students with good knowledge. As conclusions, the practice of BSE is inadequate among the respondents in spite of most of them had heard about BSE. The results suggest the need of providing continuing educational programs to increase the knowledge level on BSE which in turn will have a positive effect on students to practice and motivate to perform BSE.
Employee motivation affects productivity and need to be channeled towards the accomplishment of organizational goals. A cross sectional study was conducted among Public Health Specialists (PHS) in the Ministry of Health Malaysia to study their motivation level and the factors influencing this. The respondents were from the Association of Public Health Specialists of Malaysia working in the Ministry of Health. Quantitative Technique self-administered questionnaires were used in this study and the questionnaires were mailed to the respondents. The response rate for this study was 72.3%. In measuring the motivation level, five (5) aspects were studied. The social aspect, self -achievement aspect and autonomy aspect were found to be the main aspects that motivated the respondents. With regard to motivation level, 55.8 % respondents had low motivation level. In order to improve the motivation level among PHS, the aspect of self actualization and autonomy required serious attention. In the future, PHS are expected to play a major role in controlling, promoting, preventing, maintaining, restoring and solving problems in order to enhance the health of the Malaysian population.
Women and elderly are often linked to several disadvantages and constraints in many aspects of life. The scenario could be even worse for an elderly woman. Participating in leisure has proven to be beneficial for elderly in general. Yet little is known about the pattern of leisure and constraints faced by elderly women in order for them to pursue leisure activities. This study aims to explore the various leisure constraints faced by the elderly women. A total of 20 elderly women were involved in this study, which were selected purposively and also by snowballing technique. An in-depth interview was conducted with each respondent lasted approximately 15 to 30 minutes. The identified constraints were categorized into three main themes, which were structural, intrapersonal and interpersonal constraints. Among factors that had been identified were preoccupation with domestic affairs, the unavailability of appropriate space or area to perform desired leisure activities, lack or unavailability of transportation, safety issue, misperceptions that being old should focus on religious activity and becoming effortless, domestic activities are comparable to exercise and lacking of elderly people to perform certain activities together. In view of the modifiable nature of most of constraints faced by the elderly women to pursue leisure activities, necessary actions should be taken by the relevant authorities in tackling the constraints and at the same time developing a more active and healthy elderly women society. The right of the elderly women and women in general should be acknowledged, including their desire to actively involve in certain leisure activities. They should also appropriately educate on the importance of leisure and involvement in other type of leisure activities other than religious activities.
Employee satnfaction surveys can provide the information needed to improved levek of productivity, job and loyalty. Management can identify the factors of job issues and provide solutions to improve the working environment. A cross sectional descriptive study on employee satisfaction among a health care district office’s staff was conducted in Perak in March - April 2006. A total of 19 staff were randomly picked and interviewed in the data collection process. Almost all understand the objectives of the administration unit (94%) and were satisfied with the management leadership’s style (78%- l 00%) . Majority agreed that their relationship with immediate superior and within the group was harmonious and professional (89%) and they preferred an open problem solving method in handling conflict (72 %). The most common type of incentive rewarded by the administration to express gratitude to their staff was certificate (56%); bonus and medal (33%); and informal gesture (28%). Majority (83%) were also satisfied by the method used to disseminate the information in their units. Majority agreed that the working environment in the administration unit were conducive (72%), their ideas were equally considered during decision making sessions (89%) and training opportunities were similarly given to them by the management (72%). This study revealed that employee satisfaction was determined by several factors such as management leadership's style, opportunity to contribute skills and idea; reward and incentive; and conducive king environment.
Cancer screening is an important part of any cancer control program and the success of any screening program is partly dependent on having large numbers of the high risk population availing themselves of the service. The purpose of this study was to assess the cancer screening behavior of fulbtime employed women staff of an institute of higher learning using the Health Belief Model (HBM) construct. The results showed that the rate of reported regular cancer screening behavior (Pap smear screening, breast self examination (BSE), clinical breast examination (CBE) and mammography screening) were low. The rates for regular screening were 42.5% (Pap smear), 20.9% (BSE), 15.5% (CBE) and 9.4% (mammography). There were differences in the dimensions of the HBM between the women who reported regular screening and those that did not. The perceived barriers", "perceived benefits” and “motivation” dimensions were different in Pap smear screening, whereas the "confidence” dimension was different in BSE. Recommendations were made for a health education program targeting both women and men to increase uptake of cancer screening services by women.
Study on motivational readiness for change is crucial to promote understanding of behavioural change among Methadone Maintenance Tretment (MMT) patients. A widely used method recently is via Stages of Change and Treatment Eagerness Scale for drug abusers (SOCRATES-8D). The aims of this study were to; 1) determine the general level of readiness for change, 2) assess differences in terms of readiness to change (RtC) based on socio-demography and clinical characteristics and 3) compare RtC with different health-related quality of life (HRQOL) levels. Methods: A convenient sample of MMT volunteers from Terengganu, Malaysia was enrolled. The SOCRATES-8D was administered (3 subscales; Likert-type responses 1-5; higher score, better RtC). Data was analysed using SPSS 15, employing descriptive statistics and non-parametric tests for score comparisons. Results: The mean age of 55 Malay respondents was 37.0 years, male (98.2%), = lower secondary qualification (65.5%) and addiction period > 15 years (52.7%). Generally the Recognition level was "low", Ambivalence and Taking Steps were moderately-rated. Most of them within unsatisfactory levels of RtC. Abusers with < 20 months treatment were significantly "more ready" for behavioural changes (p0.05). Conclusion: Findings demonstrated that patients were rather ready to adopt positive behavioural changes regardless of their sociodemographic backgrounds. Thus continuous efforts and psychosocial support from various authorities should be geared towards enhanced readiness as part of ensuring the success of MMT programme in the future.
Urolithiasis considered as a disease condition that is neglected in terms of research because of its perceived low prevalence and possibly the seemingly good prognosis associated with it. However, in recent years, the prevalence of urolithiasis is increasing in both developed and developing countries and the disease is associated with significant burden and healthcare cost from patients’ caregivers, and society’s perspective. All healthcare providers (including pharmacists) have an important role to play in the management of this disease and it deserves more attention in terms of clinical practice and research. This review aims to provide a comprehensive understanding of patient satisfaction, from the aspect of defining satisfaction of patients, perceptions toward disease management, and a review of literature of satisfaction of patients with kidney stones and its magnitude in healthcare provided. The medical literature has many articles about urolithiasis management options. However, there have been no sufficient published studies discussing patient-reported outcomes of kidney stone management to evaluate their satisfaction, preferences, treatment expectations, and quality of life. Future studies are needed to spot the light on kidney stones patients’ preferences and reported outcomes.
Comfort and acceptance by healthcare professionals are crucial for effective operation of clinical pharmacy services. To date, there is no published report on the perceptions towards clinical pharmacy services from Tawau, Sabah or anywhere else in Malaysia. The objective of this study is to evaluate the comfort, perceptions and expectations of healthcare professionals towards the clinical pharmacy services in Tawau Hospital. This crosssectional, questionnaire-based study was carried out in 10 wards of Tawau Hospital with clinical pharmacy services, from June to July 2014. Validated questionnaires with consent were anonymously distributed to doctors and nurses. The self-administered questionnaires consisted of four sections: demographic, comfort level, expectations, and experiences dealing with clinical pharmacists. A 4-point Likert scale, where 1 = strongly disagree, while 4 = strongly agree, was used to indicate the level of agreement. Of 292 questionnaires administered, 269 were completed, giving a response rate of 92.1%. Compared to nurses, higher percentage of doctors were less comfortable with clinical pharmacists providing drugrelated education, suggesting the use of drugs to prescribers, designing pharmacotherapy regimes, and monitoring safety and outcomes of the designed regimens. The participants have great expectations, perceptions and experiences with clinical pharmacists of Tawau Hospital. Majority of the healthcare professionals who have direct contact with clinical pharmacists in their work were generally receptive and have high expectations towards patient-oriented clinical pharmacy services.
Introduction:The incidence of pertussis has been said to increase over the years, and the affected patient-age group has also changed with the increasing number of cases amongst adolescents and adults. Therefore, adults require booster vaccination for protection against pertussis infection. Vaccination among healthcare workers (HCW) should be prioritized when a country implements an adult vaccine. However, the coverage of pertussis vaccination is still deficient among HCW due to low-risk perception. This study focused on finding the risk perception of pertussis in-fection amongst the HCWs based on the Protection Motivation Theory (PMT) and their acceptance to take pertussis vaccination. Methods: This was a cross-sectional study using online survey. The website link is given to the Health-care workers consisting of doctors, Assistant Medical Officers, nurses, and Environmental Health Officers. Results: A total of 853 responders responded to the questionnaire. Most of the respondents (81.5%) are willing to receive the pertussis vaccine. Independent t-test showed that the PMT score was significantly different between those willing and those not willing to take the vaccine (p-value < 0.001, t statistics (df)= 7.729 (325). Robust path analysis showed that sociodemographic factors (age, the institution of working and prior pertussis vaccination) (p=0.004), threat (p
Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.
Introduction: Tobacco induced illness remains a major contribution to premature death and global burden of dis- eases. The introduction of MPOWER policies by World Health Organization held the value to monitor the imple- mentation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respon- dents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.
Introduction: This study examines the psychometric characteristics of a translated version of the Beck Depression Inventory II (BDI – II) among Malaysian school students. Methods: The sample consisted of 257 boys and 302 girls. This study employed WINSTEPS 3.74 to provide statistics and other information from Rasch Model analysis, namely, the fit statistics, dimensionality analysis, rating scale analysis, reliability and separation indices, differential item func- tioning analysis, and distribution of items difficulty and students’ ability. Results: Rating scale analysis showed that category 2 and category 3 of the ratings were not different. Meanwhile, Item 19 did not fit the model’s expectations; and thus, it was omitted from further analyses. The scale demonstrated a high person reliability and a high person separation index. There were no items demonstrating gender DIF. The school students endorsed feeling guilty as the least severe symptom of depression, while committing suicide as the most serious symptom. Conclusion: In general, the BDI-II demonstrated acceptable properties in measuring depression symptoms among school students.
Introduction: Urbanisation is a key determinant of population health. Malaysia’s exemplary economic growth in the early 1990s and the consequent development and urbanisation led to significant changes in health, lifestyle and quality of life. Rising expectations, changing demographics and nutrition and disease transitions were challenges synonymous to an increasingly urban Malaysia. As the Government targets optimal population health, this paper aims to explore one of the many challenges of urbanisation, namely the prevalence of non-communicable diseases or NCDs. For the purpose of this paper, NCD is proxied by Diabetes Mellitus. Methods: This study is based the 2015 National Health and Morbidity Survey, which is a cross-sectional population-based survey, involving 30,000 re- spondents. Given the binomial nature of the survey variables, the multinomial Probit model was employed using the STATA statistical software. Results: Generally, age, gender and race are significant in determining health outcomes. Socioeconomically, all three variables of income, education and employment are significant. For lifestyle factors, findings show that only the weight and physically active status have a role in determining health outcomes. Finally, the urban variable is also positive and significant. Conclusion: Findings show that the prevalence of Diabetes Melli- tus, is rising along with urbanisation and that there is a health penalty for the urban population and also for those who do not embrace healthy lifestyles. Additionally, other factors are equally important as urban health determinants, encompassing both the demographic and socioeconomic factors.
Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.
Introduction: One of the biggest global health threats of the 21st century is climate change It is so catastrophic that the climate action has been given a platform as it is the 13th goal of the 17 United Nations Sustainable developmen-tal goals (SDG). This review seeks to understand the factors causing climate change, followed by understanding the impact it has on individual and population health. We also identify the strategies to control and prevent further cli-mate change. Methods: Reviews of local and international articles from the past ten years was conducted. The focus of the review was the causes, health effects as well as strategies. Data base used was Pro Quest. Results: This re-view identified that the main contributor to climate change are man-made activities such as fossil fuels combustion, livestock farming, and deforestation. This change in climate has many repercussions from mass migrations, increase communicable diseases as well as an increase in extreme weather events and natural disasters. All this eventually leads to the deterioration of individual and population health. Strengthening adaptivity to climate-related hazard, climate change integration into national policies, education, awareness-raising, impact reduction and early warning are actions that are present in Malaysia to manage this crisis. Conclusion: Climate change is occurring globally, and its presence can no longer be denied. Actions have been put forth, but only when its importance and impact is taken seriously will the positive changes be sustainable.
Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
Introduction: Laboratory screening tests are common elements of health care. Comprehensive care of patients is dependent on the results of laboratory investigations. Dissemination of knowledge and improving attitude of com-munity for utilization of laboratory services are utmost important in community health care. This study aimed to assess the knowledge and utilization of the laboratory services among the employees of University Malaysia Sabah, determine their expectations of employees on the medical laboratory services.
Methods: A total of 200 UMS staff participated. The data were collected using a cross-sectional self-administered questionnaires and descriptive data analysis was done.
Results: 5% of the participants in this study agreed to have the health check and blood screening tests every year. Less than 10% of respondents agreed to do more frequent blood tests check if they are at high risk such as family history of cancer, hypertension and diabetes 181 out of 200 respondents do not agree that doing laboratory tests can help for early diagnosis of some diseases. The most used laboratory tests were plasma sugar (70.8%), blood grouping (60.4%), urine examination (50%) and serum lipid (46%).
Conclusion: Based on the results, recommendations were made to improve the knowledge, attitude and utilization of the laboratory services and set up laboratory services easily accessible by the university community. This will lead to positive health benefits in people and improve associated health outcomes.