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.
Stress in the work place is a global major risk factor to worker’s health, which triggers the workers to be poorly motivated and less productive. Objectives: The objective of the study was to determine the prevalence of job stress and its associated factors among Universiti Putra Malaysia staff. Methods: This is a cross sectional study involving 511 academic and non-academic staff of Universiti Putra Malaysia in Serdang. Probability proportionate to size was used for calculating the required sample size. Results: The overall prevalence of stress was 21.7% (21.0% among male and 23.0% among female). The variables found to be significantly associated with stress were: Job demand, coworker support, depression, anxiety, focus and venting of emotion and self-blame (p
Tobacco use among females is a rising public health issue. Further insight into the smoking epidemic can be gained from studying a specific subgroup of interest within the population. Determining predictors of each tobacco smoking type is necessary for planning tobacco specific intervention programmes. The aim of this study was to determine the prevalence of ever tobacco use and its associated socio-demographic factors among Saudi female adolescents aged 12 to 19 in Jeddah. A cross-sectional analytical study was conducted among female students from intermediate and high secondary schools in Jeddah during the academic year 2012-2013. Sampling with probability proportionate to size was used to select a sample of 5,150 students from 40 schools. The data were collected using validated self-administrated questionnaire that required information on tobacco use behaviours and selected socio-demographic characteristics. A total of 5,073 students participated in this study of whom 51.6% were from intermediate grades, and 83.1% from public schools. The prevalence of ever tobacco use was 44.2% (36.2% water pipe and 30.9% cigarettes). The significant predictors of ever tobacco use were student’s age, mother’s education, family structure, residence location and monthly student’s allowance. In conclusion, ever tobacco used is highly prevalent among female adolescents in Jeddah. Designing intervention programmes aimed at preventing Saudi female adolescents from smoking should include all forms of tobacco use.
The glycosylated haemoglobin (HbA1c) test is the most widely accepted laboratory test for evaluating long term glycaemic control. Patient’s understanding of HbA1c can lead to better glycaemic control. This study is aimed to determine the awareness and level of understanding of HbA1c among type 2 DM patients and its association with glycaemic control. A cross-sectional descriptive study among Type 2 DM patients undergoing routine follow up in an endocrine clinic of a tertiary centre in Malaysia. Patients were invited to answer a validated questionnaire which assessed their awareness and understanding of HbA1c. Their last HbA1c results were retrieved from the laboratory information system. A total of 92 participants were recruited. Fifty-six (60.9%) were aware of the term HbA1c. Fifty percent were categorised as having good HbA1c understanding, with age, monthly income and level of education being the factors associated with understanding. No significant association was noted between HbA1c understanding and glycaemic control, although more patients with good HbA1c understanding had achieved the target glycaemic control compared to those with poor understanding. The level of HbA1c awareness and understanding was acceptable. Factors associated with understanding were age, income and level of education. Continuing efforts however, must be made to improve patients understanding of their disease and clinical disease biomarkers.
Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.
The aim of the study was to determine coping strategies among breast cancer patients with depression and anxiety during chemotherapy. Methods: Breast cancer patients with confirmed diagnosis who were undergoing out-patient chemotherapy at the Oncology Unit, University Malaya Medical Centre were invited to participate in the study. They were assessed on their socio demographic profiles and clinical history. The Hospital Anxiety Depression Scale (HADS) was used by patients to report anxiety and depression. The Brief COPE Scale was used to assess coping strategies among the patients. Results: One hundred and forty one patients with mean age of fifty years participated in the study. Prevalence for depression was 19.1% and prevalence for anxiety was 24.1%. Patients who were having anxiety symptoms scored significantly higher on denial, behavioural disengagement and venting as their coping strategies compared to patients who were not anxious. Patients with depressive symptoms scored significantly higher in behavioural disengagement and self-blame as their coping strategies compared to those who were not depressed. Conclusion: Breast cancer patients undergoing chemotherapy experienced high level of depressive and anxiety symptoms. However different coping strategies were adopted to cope with their illness, chemotherapy treatment, practical and family problems, emotional and physical symptoms.
Study site: Oncology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
This study aims to determine the prevalence of obsessive compulsive disorder (OCD) among schizophrenic patients and the association of this condition with clinical and selected neurocognitive factors. This is a cross sectional study on one hundred schizophrenic patients who attended psychiatric clinic in National University Hospital and Kuala Lumpur Hospital over a four-months period. All patients diagnosed as schizophrenia according to DSM 1V were assessed using Mini International Neuropsychiatric Interview (MINI) Version 5 for the presence of Obsessive Compulsive Disorder, Brief Psychiatric rating Scale (BPRS) for severity of psychosis and Yale Brown Obsessive Compulsive Scale (YBOCS) for severity of obsessive compulsive (OC) symptoms. Socio-demographic data were obtained by direct interview. The neurocognitive assessment were done using Mini Mental State Examination , Rey Auditory Verbal Learning Test (RAVLT) and Digit Span. Fifteen percent of schizophrenic patients (15%) in this sample were found to have a diagnosis of Obsessive compulsive Disorder (OCD). The OCD and non-OCD schizophrenic patients did not differ significantly in term of age ,gender, race and family history of mental illness. However they differ significantly on employment, type of treatment medication and the presence or severity of current psychosis. Schizophrenic patients with OCD also showed no significant different in selected neurocognitive functions.
Introduction: Patients with mental disorders in Malaysia often seek help from traditional healers prior to consulting psychiatric service. The objective of the study is to determine the prevalence and experience of contact with traditional healers among patients with first-episode psychosis in Hospital Kuala Lumpur (HKL). Methods: This is a hospital-based cross-sectional descriptive study of 50 in-patients with first-episode psychosis in HKL. Structured Clinical Interview for DSM-IV Clinical Version for Axis I Disorders (SCID-CV) was used for establishing diagnosis. Socio-demographic data, information on help-seeking pathways, and experience of contact with traditional healers were determined through face-to-face interview and semi-structured questionnaires. Results: Twenty seven (54%) of the patients had at least one contact with traditional healers prior to consulting psychiatric service, and it was the most popular first point of non-psychiatric help-seeking contact (48%). About a quarter of them (24%) had 3 or more contacts with traditional healers prior to consulting psychiatric service. The most common type of traditional treatment received was prayer (25, 96.3%). Only 2 patients (7.41%) reported having some beneficial effects from traditional treatments. There were two patients who reported having adverse experience with traditional healers. Among those who had sought help from traditional healers, one third was recommended by at least one of their traditional healers to seek medical help. Conclusion: History of contact with traditional healers prior to consulting psychiatric service was common among inpatients with first-episode psychosis in HKL. There may be potential meaningful collaborations between psychiatrists and traditional healers for better management of patients.