Occupational health hazards as a result to exposure to mineral dust containing silica has been established long time ago in occupational health history. Its effects on lung function and symptom was evaluated in a cross sectional studied among 49 small enterprise pottery workers in the county of Sayong clustered in 3 villages. Respiratory symptoms and lung function was evaluated using MRC respiratory questionnaire 86 and standard spirometry performed. The prevalence of chronic cough, phlegm and chest tightness was 24.5%, 16% and16% respectively. There was no significant decrement in lung function parameters from the predicted normal value with the mean predicted FVC; FEV1 and FEV1/FVC ratio was 85.32%, 83.87% and 99.22 respectively. The relationship between lung symptoms and lung function parameters was evaluated and the result was not significant.
Low back pain (LBP) is a major medical and social problem associated with disability and work absenteeism. Since the effect on unawareness on back care among hospital staff may affect the smooth running of the services to the public and patients, it is the objective of this study to identified the awareness of back care among nurses so that preventive measures can be taken. About 80 nurses working in the outpatient clinic was survey using self addressed questionnaires which were adapted from Zutphen Physical Activity Questionnaire at Queen Elizabeth Hospital, Kota Kinabalu. Demographic analysis demonstrated that among the eighty nurses that responded, 37.5% (n=30) are Malays, 25% (n=25) Chinese and 37.5% (n=30) ( to include other Sabahan tribes). Their age group varies between 23 to 55 years of age. A total of 72 nurses, both agreed (45%,n=36) and strongly agreed (45%,n=36) that understanding good postures is important to prevent LBP. They felt strongly (55%, n=44) about the importance of correct lifting techniques, and having a well-designed workplace (50%,n=40). Regarding factors that cause LBP, 55% (n=44) of them strongly agreed that good lifting technique can prevent LBP while 56 (70%) agreed that prolong sitting doing computer work can cause LBP. About 60% (n=48) also agreed that LBP can cause stress and that 45% (n=36) of them strongly agreed that being overweight than average can worsen LBP. However, 40% (n=32) provide a neutral answer to whether height have any influence on LBP while 50% (n=40) agreed that weak back muscles can worsen the backache further. However, 45% (n=36) agreed that games that involved back movement have high risks and 55% (n=44) agreed that swimming helps to strengthen back muscle. The environmental factors addresses issues of footwear and soft mattress where 60%(n=48) agreed while 15%(n=12) strongly agreed that good footware and appropriate use of soft mattresses 60% (n=48) can prevent LBP. This study have demonstrated that the nurses that participated had a clear understanding and knowledge on back care even though a wider study need to be carried out to ensure validity of study finding.
Study site:outpatient clinic, Queen Elizabeth Hospital, Kota Kinabalu
Floods are natural disasters that occur without much warning. Natural disasters can result in negative impact due to highly stressful event. Floods can cause mental and emotional disorders to the victims and could also induce stress and trauma either in the short or long terms. This research was carried out to recognize the psychological sequelae of floods and how to overcome them. This study describes the cross sectional descriptive pattern of flood victims in Johor. The DASS Test Questionnaire which is a measurement tool endorsed by the Family Development Institute, Ministry of Health Malaysia was used. We carried out the research in 3 districts of Johor which were the worst hit areas by the flood disaster. Twenty-three percent of the participants were males while 77% were females. The DASS Test Questionnaire showed that 13% were mildly depressed, 7% moderately depressed and 3% were severely depressed. It also revealed that 22% were mildly anxious, 19% moderately anxious, 5% severely anxious and 4% had very severe anxiety. On the stress scores, 15% suffered mild stress, 11% were moderately stressed while 2% were severely stressed. A committee to conduct the motivation programme for the state of Johor was formed by Jabatan Kesihatan Negeri Johor with the cooperation of the PROKEM committee from Hospital Permai, Johor Bahru. This committee headed by the Deputy Director of Health (Medical Division) attempted to overcome the psychological sequelae suffered by flood victims. The activities conducted by the PROKEM staff and staff from the Ministry of Health were monitored by the committee based at Hospital Permai, Johor Bahru. The Bilik Gerakan was in operation for 24 hours a day with meetings conducted every morning and evening to brief and debrief members of staff who were going to carry out the motivation programme. Feedback was also obtained from staff on their return from the various relief centres.
CONTEXT: To investigate the antibiotic prescribing training received by dental students, clinical experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children.
METHODS: This was a cross-sectional study involving final year dental students from Malaysian and Asian dental schools. A self-administered questionnaire consisting of five clinical case scenarios was e-mailed to all final year students at selected dental schools. Students' responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic prescribing guidelines using Chi-square test. Data collected were analyzed using SPSS statistics version 20.
RESULTS: A total of 108 completed responses were received. About 74 (69%) students were from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05).
CONCLUSIONS: Final year dental students had low awareness and compliance with antibiotic prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced.
Completing a course in Immunology is expected to improve health care knowledge (HCK), which in turn is anticipated to influence a healthy lifestyle (HLS), controlled use of health care services (HCS) and an awareness of emerging health care concerns (HCC). This cross-sectional study was designed to determine whether these interrelationships are empirically supported. Participants involved in this study were government servants from two ministries in Malaysia (n = 356) and university students from a local university (n = 147). Participants were selected using the non-random purposive sampling method. Data were collected using a self-developed questionnaire, which had been validated in a pilot study involving similar subjects. The questionnaire items were analyzed using Rasch analysis, SPSS version 21 and AMOS version 22. Results have shown that participants who followed a course in Immunology (CoI) had a higher primary HCK (Mean = 0.69 logit, SD = 1.29 logits) compared with those who had not (Mean = -0.27logit, SD = 1.26 logits). Overall, there were significant correlations among the HLS, the awareness of emerging HCC, and the controlled use of HCS (p <0.001). However, no significant correlations were observed between primary HCK and the other variables. However, significant positive correlation was observed between primary HCK and controlled use of HCS for the group without CoI. Path analysis showed that the awareness of emerging HCC exerted a positive influence on controlled use of HCS (β = 0.156, p < .001) and on HLS (β = 0.224, p < .001). These findings suggest that having CoI helps increase primary HCK which influences controlled use of HCS but does not necessarily influence HLS. Hence, introducing Immunology at various levels of education and increasing the public awareness of emerging HCC might help to improve population health en masse. In addition, further investigations on the factors affecting HLS is required to provide a better understanding on the relationship between primary HCK and HLS.
Literature data on association between physical activity (PA) and health related quality of life (HRQoL) in non-clinical
adults population are still limited. Thereby, the objective of this study was to evaluate the association between PA and
HRQoL among the non-academic staff serving the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM),
Kuala Lumpur (KL). In this cross sectional study, 105 non-academic staffs aged between 18 to 60 years were recruited.
Self-administered questionnaires (Malay version of the International Physical Activity Questionnaire and World Health
Organisation Quality of Life-Brief Version) were administered among the participants. Mann Whitney test and Spearman’s
rho correlation were employed for the statistical analysis using SPSS version 22.0 Majority of participants (72.4%)
demonstrated high PA scores of ≥ 3000 MET-minutes/week. PA scores between genders was not statistically significant
(p = 0.137). However, total PA score of support staffs (median = 9039.0, IQR = 15811.00) was significantly higher compared
to staffs in management and professional group (median = 4329.0, IQR = 4189.00). The mean(SD) self-perceived HRQoL
score was 3.4 (0.76). There were no significant correlation between PA and all domains of HRQoL such as physical health,
psychological, social relationship and environmental domains (Correlation coefficient, ρ = -0.108, 0.003, -0.023, 0.026
respectively) with p = 0.273, 0.978, 0.818, 0.794 respectively. Majority of non-academic staffs of FSK, UKM engaged in
high physical activity. The PA levels of support staffs were significantly higher than management and professional staffs.
However, there was no statistically significant correlation observed between PA and domains of HRQoL.
The knowledge, attitude and practice of breastfeeding among young mothers during pre-Baby Friendly Hospital Initiative implementation was conducted at seven private hospitals in Malaysia. A structured interviewer administered questionnaire was given to all mothers (n=Z52) visiting the antenatal/postnatal clinic of the hospitals. The main respondents were Malays (57.5%) and Chinese (35%) . For most mothers, breastfeeding was combined with supplementary feeds of formula milk, with only 30% breastfed exclusively. The majority of mothers knew that breast-milk contained antibodies and can prevent illness, however many were unaware of breastfeeding's contraceptive effect if practised exclusively. Most mothers did not relate breastfeeding as being environmental friendly. Generally, there was no knowledge gained from the experience of having more children with reference to breastfeeding. Most mothers were influenced by their own beliefs regarding choice of feeding method. Therefore, a mother was empowered with the knowledge of all practical aspects of breastfeeding, it would encourage her to breastfeed her baby.
Study site: seven private hospitals in Malaysia
Despite awareness of the detrimental effects of smoking, many adolescents initiate or continue to smoke. One possible explanation for smoking 13 the belief that it can control body weight. The objective of this study was to determine the association between Body Mass Index and smoking among Malay adolescents in Kota Bharu, Kelantan. A cross·sectional study was conducted between January to June 2005 among 1364 students selected from ten co»educational government secondary schools in Kota Bharu using stratified multistage cluster sampling. Guided self-administered questionnaire and anthropometric measurement were taken. Data was entered using SPSS 12.0 and analysed using STATA 8.0. The overall prevalence of smoking was 6. 7%. The prevalence of smoking among boys was 13.8% and among girls was 1.1%. There was no association between Body Mass Index and smoking. However, the findings may not be generalized to out-of·school youth and other ethnic groups in this country. The study was not conducted anonymously and the use of questionnaire to report smoking status can lead to measurement bias. Strategies aimed at correcting the belief that smoking can reduce weight should be included as one of the components in the prevention of smoking.
Job satisfaction level of workers is among the important factors influencing the performance and productivity of an organization. A cross sectional study was conducted among Public Health Specialists in the Ministry of Health of Malaysia to identify their job satisfaction level and the factors influencing it. The respondents are from the Association of Public Health Specialists of Malaysia. A working in Ministry of Health. Focus group discussions were conducted in four states to develop a relevant and comprehensive questionnaire. Survey questionnaires were then mailed to the respondents. The response rate was 7 2.3%. In measuring the job satisfaction level seven aspects were studied. The study showed that ‘job and workload` is the main contributor to job dissatisfaction followed by ’management and policy aspect’, 'salary and remuneration: aspect’ and resources and facilities aspect. Most of the respondents (94.0%) were dissatisfied with their job. Gender and income were the predictors of general job satisfaction. As a conclusion, the management, policy and remuneration shouM be revised in order to overcome the problems identified and subsequently increase job satisfaction levels among Public Health Specialists in the Ministry of Health, Malaysia.
This is a cross-sectional study to determine the association between religious perception and smoking behavior of secondary male students in Kota Bharu, Kelantan. A self-administered questionnaire survey was conducted on 526 secondary four male students from eight randomly selected schools in Kota Bharu. There were 182 (34.6%) students who were current smokers, 12 (2.3%) were ex-smokers and 332 (63.1%) were non·smokers. More than half of the current smokers (53.4%) smoked regularly. Student’s perceptions on the religious opinion on smoking were signihcantly associated with smoking behavior. Other significant risk factors were having close friends who smoke, their perceptions on benefits and negative effects of smoking and the level of
y relationship with their fathers. These factors were also found to be good predictors of student's smoking status. Health education programs to control smoking should include the religious aspect of smoking to improve it’s effectiveness.
Recent years have witnessed unprecedented changes in the design and demands of work, and the emergence of job stress as a major concern. The aim of the study was to determine the psychosocial problems in relation to nature of work among female nurses at Hospital Selayang. The study was a cross-sectional study and the study population comprised of female nurses who are currently working at Hospital Selayang. A total of 393 study subjects were randomly selected and each respondent has been given a set of complete validated self-administrated Copenhagen Psychosocial Questionnaire. The result showed that the prevalence of having psychosocial problems was 24.9%. It is show that married nurses with more than three children has 3.54 (95%CI: 1.81-6.94) higher risks to have the problems compared to those with 3 or less children. Shiftwork nurses have 1.74 (95%CI: 1.01-2.99) more risk to have psychosocial problems compared to those who are not doing shiftwork. From the crude odds ratio, nurses who have served the service for more than seven years, there was 1.53 times more risk (95%CI: 0.89-2.63) to have psychosocial problems compared to those who only have service of seven years or less. From multivariate analysis, the risk of having psychosocial problems among nurses who are doing shiftwork found to be two times greater than those who are not doing shiftwork (OR=2.15; 95%CI: 1.12- 4.11) . Psychosocial problems in relation to nature of work among nurses at Hospital Selayang are higher among nurses who are doing shdtwork. The hospital management needs to overcome the problems and organizing the mental health programs among workers.
This study examines the level of quality initiatives commitment among public hospital managers and its determinants in view of limited study :0 date and a decline in self-initiated quality initiatives activities in Sarawak, Malaysia. This is a cross-sectional study with universal sampling method conducted in all the Z1 public iwspimls in Sarawak. The study population were the senior, middle and lower level managers. The research wal was self-administered structured questionnaire. A total of 382 managers responded, corresponding ta a response irate of 8 7. 2%. As a complement, four focus group discussions were conducted, consisting 31 participants. It was found that the level of quality initiatives commitment 0f managers was generally high (mecm= 4.23, SD=O.45). The regression analysis indicated that empowerment, communication and procedural justice (promotion) accounted for 38.9%, 346% and 1.2% respectively of the variation in commitment level. Dissatisfaction with resources, top management commitment and peer influence are among others being identified by participants of focus groups as important determinants of quality initiatives commitment. It is strongly recommended that there should be greater empowerment of hospital managers, more structured and effective communication, greater transparency in procedure for promotion and commitment of resources to quality efforts.
This descriptive cross sectional study was conducted to assess patient's satisfaction by evaluating the waiting time experienced by 27 (54%) inpatients and 23 (46%) outpatients who sought treatment at a private hospital in Selangor from 15th of May 2006 until 3rd of]une 2006. Majority of the patients (78%) were in the range between Z 1 - 40 years old and well»educated. Almost half (48%) were in the human resources employment category, 20% were in administration and marketing and 10% were professionals. Majority of them earned from RM1000-1999 (34%) and RMZ000-3999 (32%). Almost all of them (96%) agreed that the medical care that they had been receiving in the hospital was just about perfect. 98% agreed that the doctors treated them in a very friendly and courteous manner and 96% rated the care given by nurses as g0od/ excellent. 88% to 92% said that their communication with the doctors, nurses and other staff were good/ excellent. 80% waited less than 15 minutes at the registration counter, 52% waited less than 15 minutes to see the doctor and 44% waited less than 15 minutes at other places such as pharmacy and x-ray. Overall, 94% rated the level of services in the hospital as good/ excellent, Almost all (90%) would like to recommend the hospital to their friends and relatives. Our study demonstrated that the majority of the patients were satisfied with the doctors, nurses and environment of the private hospital. The average waiting time of patient before being attended to by a doctor was less than 30 minutes.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
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.
A cross-sectional study was conducted from December 2009 till May 2010 to determine the quality of life and factors influencing it among physically disabled teenagers. Data were collected from 59 physically disabled teenagers using guided questionnaire Short Form 36 (SF-36) and General Health Questionnaires 12 (GHQ 12). Quality of life among physically disabled teenagers is low for most domains of SF-36 as compared to the general Malaysian population. There was significant difference in quality of life among different races (mental health domain) and among different educational level and type of disability (physical functioning domain). There was no significant association between general health domain and other variables. Higher satisfaction in house, school and recreational environment showed a better quality of life. Higher stress level had a lower quality of life. Lack of disabled friendly environment at home, school and recreational places probably contribute to their quality of life. Schools and public places should have more disabled friendly facilities to improve independency and accessibility. Better education and training will increase their independence and enhance self-confidence. More attention and support at this age is important for them to develop interpersonal skills and character for their future.
The rapid development in the health sector has spurred many healthcare organizations to improve their productivity and quality, particularly in terms of service. Clinical Pathways was introduced with the objective of improving the quality of care and services in health; while at the same time eyeing the possibility of reducing the medical expenses. It can be defined as a document based tool that links the best available evidence and clinical practice and provides recommendations, the process and time frame for the clinical management of healthcare. A cross sectional study was carried out at University Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia with the aim to evaluate the level of knowledge about Clinical Pathways (CP) and to ascertain its level of practice in the implementation of CP among healthcare workers at UKMMC; and to establish correlated determinant factors. The study involved a total of 127 respondents; majority of whom were female (77.2%), aged between 32 and 45 years (51.2%), working as nurses (71.7%), and having working experience of six years or longer (52.0%) at UKMMC. The findings reveal that 52.8% of respondents agreed that there is a proper implementation of the Clinical Pathways (CP) programme at UKMMC; and that 52.0% of the respondents have a higher level of knowledge about CP and 70.1% of them practiced it well. The findings also unravel two factors (position and working experience) as the predictors of respondents’ level of knowledge about CP, and position as a predictor representing the practice of it at UKMMC. It can be safely surmised that most of the respondents have a higher level of knowledge about Clinical Pathways and that they practice it well in their daily task as healthcare workers.
This study aimed at measuring the quality of life (QOL) among young adults in rural area of Selangor, and determined the factors that affect the QOL scores. A cross-sectional study was conducted among young adults aged 18 to 39 years in rural area of Hulu Langat district, Selangor with a total sample of 308 selected through simple random sampling. Validated Malay version of WHOQOL-BREF questionnaire was used to measure the QOL, which generated overall QOL score and four domains’ scores of physical health, psychological health, social relationship and environmental QOL. The results showed that the highest mean score was social relationship domain 67.07 (18.87), followed by overall QOL 65.10 (17.92), environmental QOL domain 64.88 (12.83), psychological health domain 60.67 (11.88) and physical health domain 58.23 (11.00). Variables such as unemployment, having chronic diseases and mental distress were found to lower the QOL score.
Although the Ministry of Health Malaysia has been encouraging the practice of Traditional and Complementary Medicine (T&CM)1, 2 , 3, 4 but patients/clients has not been able to apply it for their need of medical treatments and sometimes it leads to negative outcomes due to lack of knowledge on T&CM and its safe applications5,6’ 7,8 Most of the western-trained physicians are ignorant of risk and benefits of T&CM9,10,11 . This study was aimed to determine the gap between knowledge regarding T&CM and perception on education in T&CM among the medical staffs in five selected hospitals in Malaysia. A cross-sectional survey was done at five public hospitals among medical staff in Malaysia by using quantitative methods. A total of 477 medical staffs were involved in this study. The study showed that the overall knowledge of T&CM among the medical staffs were poor (61.2%). Having good knowledge regarding T&CM were significantly higher in Hospital Duchess of Kent (52%, p=0.001), among the non-Malays (44%, p=0.047) and pharmacists (47.2%, p=0.030). Positive perception on health education in T&CM among medical staffs were high (85.3%) especially among females (88.1%, p=0.002) and pharmacists (93.7%, p< 0.001). The use of T&CM among the general population is relatively high in Malaysia and many patients increasingly seek the information on T&CM therapies from medical staffs. Knowledge regarding T&CM was poor in this study because most of the medical staffs have not been exposed to T&CM education. This interesting scenario between poor knowledge and high positive perception on health education in T&CM shows the demand of urgent intervention in educating the medical staffs. We recommend that medical staffs must have some basic education and knowledge about T&CM before they could offer advice to their patients. Doctors are of the utmost important in this regard because they play a very important role in patient care. Providing T&CM education to medical staff may help to integrate T&CM into the mainstream medicine.
Children less than 6 years old are the most vulnerable group to get harm from Environmental Tobacco Smoke (ETS) exposure, especially their respiratory system. To determine the prevalence of ETS exposure and its association with asthma like symptoms among children less than 6 years old. A cross sectional study was conducted in between January till April 2014 among parents with children less than 6 years old in Selangor, Malaysia. A total of 142 parents were selected by simple random sampling and data were collected using guided questionnaire on ETS exposure and asthma like symptoms (cough and wheeze) among their children. A total of 52.8% of children found to be exposed to ETS, and 43.7% were exposed from their father. ETS exposure significantly associated with cough without cold (adjusted OR=5.46, 95% CI 2.37, 12.61), dry cough at night (adjusted OR=3.74, 95%CI 1.41, 9.95) and cough upon physical activity (adjusted OR=3.08, 95% 1.07, 8.89) among these children. Children less than 6 years old are vulnerable to respiratory problem due to ETS exposure especially on cough symptoms. More strategies should be developing to reduce the exposure to ETS.
Leisure participation in old age is often a continuation of their participation at younger age. This study aims to explore the association between current and former leisure participation of the elderly. Methods: A cross-sectional survey was conducted among 268 persons aged 60 years and above, purposively selected from eight health clinics in Selangor. Current leisure participation was measured using a validated Leisure Participation Questionnaire (LPQ), specific for Malaysian elderly. The LPQ consists of 25 activities, categorized into recreational (physical), cognitive, social and productive activity. Frequency of participation in each activity was measured on a 6-point scale. Leisure participation at younger age only involved their general participation in leisure. The most common daily leisure activities were having conversations while relaxing (78.7%) and watching television (74.6%), while the least were from playing golf (0.01±0.12) and performing musical instruments (0.04±0.36). More than half (64.9%) reported being actively involved in any leisure
activity at younger age. Results: The study found there was a significant association between former and current leisure participation, especially for cognitive (t=-2.45, p=0.015), social (t=-2.68, p=0.008) and productive (t=-2.89, p=0.004) activities. However, only productive activity involvement was predicted by their leisure participation while younger (B=1.304, p=0.027). Conclusion: The findings suggest the importance of considering active intervention programmes at younger age to ensure better leisure participation of the elderly, especially in recreational physical activity.