The objective of the study is to investigate the extent of preventive and promotive health care in the ambulatory management of paediatric gastroenteritis in an incompletely immunised child using the simulated patient methodology. Only 44% of doctors explained to the fathers the nature of their child's ailment. 75% of clinicians prescribed oral rehydration solution but only 4% met the Gold Standard. The questionnaire survey showed that doctors rated immunisation as a very important health message to disseminate to all parents. But only 3% of doctors in the study advised parents to complete each child's immunisation once he is well. The extent of preventive and promotive health care in ambulatory paediatric practice in the Klang Valley is very low. (Copied from article).
Patient satisfaction plays a crucial role in ensuring utilization of healthcare services, continuity of care, and compliance towards treatment. Thus, this study aimed at determining the level of patient satisfaction with the services provided by the UKMMC primary care clinic. A descriptive cross-sectional study involving 317 patients attending the clinic from February to March 2011 was carried out. They were selected through systematic random sampling. Using a validated self-administered Patient Satisfaction Questionnaire-46 (PSQ-46) in English and Malay versions, general satisfaction and satisfactions with five different subscales (doctors, nurses, accessibility, facilities and appointment) were assessed. A majority of the patients (93.1%) were generally satisfied with the overall services. Among the five subscales, patients were most satisfied with the doctors (96.5%), but only 35.6% of the patients were satisfied with the facilities. The proportions of patients who were satisfied with other subscales were: 86.1% (appointment), 82.0% (nurses) and 68.1% (accessibility). There was a significant association between each of the subscales and the general satisfaction (p
Dental caries is the main oral health problem in hearing-impaired (HI) children and remains the most neglected need. The present study aimed to determine caries prevalence and treatment needs in HI children and the association with salivary parameters. A cross-sectional study was conducted on 63 HI children aged between 7-14 years who attended a special school for the deaf. Clinical oral examination was done and salivary parameters (resting flow rate and resting pH) were measured. Caries experience was charted using the index of decay-filled teeth (dft) and Decay-Missing-Filled Teeth (DMFT) for primary and permanent dentition respectively. Data were analysed using SPSS version 12.0. The mean age was 11.5 (SD 2.39) years and 53.8% were female. Dental caries prevalence was 88.0% (95% Cl: 73.0, 100.0) in primary dentition and 85.0% (95% Cl: 73.0, 96.0) in permanent dentition. The mean dft was 6.1 (SD 4.14) and the mean DMFT was 4.9 (SD 3.28). The mean resting flow rate was 0.14 (SD 0.08) ml/min while mean pH was 6.8 (SD 0.79). Both pit and fissure sealants and restorations were the highest (83.1%) treatment needs. Only 3.1% of the children did not require any treatment. There were no significant association between both salivary flow rate and salivary pH with caries experience in the primary (p=0.342, p=0.610 respectively) and permanent (p= 0.99, p=0.70 respectively) teeth. In conclusion, children with HI have high caries prevalence and unmet need for dental treatments. Salivary pH and resting flow rate of the children were not associated with their caries experience.
Clinical psychology is a specialised field of professional psychology that is much needed with regards to the treatment of mental disorders, behaviour problems and learning difficulties. The field of clinical psychology has been integrated into the health system, especially the mental health and education system, in many western countries. In Malaysia, clinical psychology is still a new concept and has yet to be accepted into the medical and health systems in Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 59-6660 general. This preliminary study looks at the awareness of 199 medical and health sciences professional with regards to clinical psychology. Results of this survey found that only 13.6% of the respondents demonstrated basic knowledge of what clinical psychology is. The awareness of clinical psychology as a clinical profession, and its benefits within the health system is still very much lacking among medical and health sciences professionals. The need to improve awareness of clinical psychology as a clinical profession as well as a health science discipline is very important as clinical psychology services are able to contribute to more holistic treatment of health problems in Malaysia.Implications of this study includes the need for the awareness of clinical psychology to be improved.
Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.
Comparison of rates of smoking across countries revealed that students are more likely to begin smoking in medical school than to give it up and increase their cigarette consumption rather than decrease it. A cross-sectional survey of all consenting medical students in a private medical university in north Malaysia was conducted in 2008 to determine the prevalence and smoking habits among them. A self administered questionnaire which was returned to the investigators in a sealed envelope was used. Results were tabulated and analysed with SPSS version 13.0 software. The response rate was 83.3% (508/610). The prevalence rate for current smokers was 5.3% (27/508) and for ever smokers 9.3% (47/508). Factors significantly associated with smoking were gender (p<0.001), age group (p<0.001) and family income (p=0.003). The odds of being a smoker was 14 folds high when a family member smoked and the odds of being an ever smoker was almost 6 folds more when a family member smoked. Friends were the most common influence to start smoking and the most common reason to stop smoking among ever smokers. The reasons for not smoking among the never smokers were health concerns and the distasteful smell of cigarettes. A module on how to help medical students to stop smoking should be included in the curriculum of every medical school. This will not only help them become good educators but will prevent them from picking up the habit. Educational intervention should also include family members who smoke.
Key words: smoking, medical students, university, Malaysia
Cognitive Impairment is common in late life and may be due to the normal process of ageing, or associated with physical or mental disorder which contributes to a decrease in quality of life, neuropsychiatric symptoms, increased disability and increased healthcare cost. The aim of this study is to determine the prevalence of cognitive impairment among the elderly members in NACSCOM in Day Care Centres within the Klang Valley and its associated socio-demographic factors such as age, gender and educational level. This cross-sectional study was conducted on 101 members of NACSCOM in Day Care Centres of Damansara,Subang Jaya and Setapak using assisted questionnaires as the research tool. The questionnaire comprising of a total of 10 questions based on Elderly Cognitive Assessment Questionnaires (ECAQ), consisted of three parts, memory, orientation and recall. One correctly answered question earned the respondent one mark. The total score for ECAQ is 10 where respondents with scores of 5 and below were identified as having cognitive impairment. Data collected was analyzed using Chi-square test (SPSS version 18). The prevalence of cognitive impairment among the elderly members of NACSCOM in Day Care Centres within the Klang Valley was 4.0%. This study also showed that there was no statistically significant association between cognitive impairment and sociodemographic factors such as age, gender and education. Prevalence of cognitive impairment among the members of NACSCOM in Day Care Centres within the Klang Valley was found to be low. This could be attributed to the fact that members actively participated in activities organized by NACSCOM. The study also did not find any statistically significant association between cognitive impairment and age, gender and education.
Caregivers may experience the need for information, social support, a range of services and financial support in caring for children with disabilities. However, some of these needs are unmet. This study aims to determine the perceived unmet needs among caregivers of children with disabilities at the Community-based Rehabilitation centre (CBR). A cross-sectional study was carried out among a total of 337 caregivers, who were recruited from 12 CBR centres in Selangor. The unmet needs were assessed using Family Needs Survey (FNS) questionnaire, which included six subscales of needs such as need for information, social support, community services, explaining to others, financial support and family functioning. Caregivers identified the need for information that the child might receive in the future as their greatest need (94.4%) and the least was the need for getting more counseling or help in getting a job (16.3%). The mean score for the overall unmet needs was 18.67 (SD=7.623). Out of six subscales of FNS, the need for information had the highest rating which was 98.3%, followed by need for social support (93.4%), need for community services (84.0%), need for financial support (79.9%), need for family functioning (61.8%) and need for explaining to others (46.2%). The unmet needs varied within the subscales. Therefore, more effective intervention programs are needed in community-based rehabilitation centres to match or reduce those varied unmet needs in order to allow caregivers to provide better care for their children with disabilities.
Occupational stress exists in all professions, but the nursing profession appears to experience more stress at work compared to other health care workers. Stressful conditions at the workplace may cause the high turnover and burnout among nurses. This study objective was to determine the level of stress and its associated factors among in-patient ward nurses. A cross sectional study using the stratified random sampling method was carried out among 114 staff nurses from 5 different departments in a public hospital in Kuala Lumpur. Respondents were requested to complete a single set of validated and self-administered questionnaire, the Depression, Anxiety, Stress Scale (DASS) . Data was analysed using SPSS 17. In general, the prevalence of stress at the department of Medicine was found to be higher compared to other departments studied. There was also a statistical significant relationship between the prevalence of stress and types of department (p 0.05). In conclusion, stress had no significant association with sociodemographic factors (age, marital status and financial status) and working environment except for type of department nurses work in. There might be some other possible confounders that have a bigger potential in becoming stressors compared to those independent variables in this study.
Improvement in the service quality system of health clinics in Malaysia had increase with the increase of national development. However, customer dissatisfaction towards regular service still has become an issue in the provision of health service in clinics throughout this country. This study aims to identify factors that influence customer satisfaction such as sociodemographic factors of patients, the location of clinic (rural or urban) and the most important SERVQUAL dimensions in determining customer satisfaction. This study conducted in October and November 2008 in Hulu Langat District. SERVQUAL questionnaires were used. Probabilistic sampling was used for the selection of respondents and the number of samples for each clinic was based on the workload of the clinic. Overall, the results showed that there are differences in levels of customer satisfaction between urban clinic (25.8%) and rural (30.7%). The most critical service quality dimensions for urban clinics are the responsiveness and reliability dimensions with a mean value of -0.7018 and -0.7434. Responsiveness, existence and reliability are the weakest quality service dimensions (mean -0.6317, -0.6718 and -0.6028) in rural clinics. It was found that customers’ ethnicity and education affect customer satisfaction in both the urban and rural clinics. Gender and type of work are factors that affect customer satisfaction only in urban clinics. Overall customer satisfaction at health clinics in Hulu Langat District is low. The difference between urban and rural clinics show the customers' needs in the area is different.
Key words: Customer satisfaction, SERVQUAL, health clinics, services.
Pregnant women are at higher risk of transmitting the infections to their foetus. This prompted the “Prevention of Mother to Child Transmission (PMTCT) Program” in Malaysia since 1998. The objective of this cross sectional study was to determine the knowledge, attitude and practice (KAP) of pregnant mothers in the west of Sabah towards HIV/AIDS and its influencing factors. Data were obtained through self administered questionnaires. Results showed that only 32.2% of the
respondents have good knowledge compared to 67.8% who had poor knowledge (p
Aim of study: To describe the residents of nursing home for the elderly in relation to their socio-demographic, physical and mental profiles. Method: A cross-sectional study design was carried out. The elderly in two selected nursing homes in Kuantan, Pahang were interviewed. The respondents were interviewed using a structured questionnaire which included the biodata, social background, and medical illness, presence of cognition, depression and ability to perform basic activities of daily living (ADL). Results: Results are available for 36 respondents out of 41 residents, giving a response rate of 87.8%. Chinese (77.8%), male (63.9%), single or divorced (50%), and low income (69.4%) was consisted the majority. Most respondents (86.1%) suffered from chronic illness, 61.1% were functional dependent (according to Barthel index), 33.3% have cognitive impairment (according ECAQ) and 22.2% have depression (according to GDS-14). The most common functional dependence was mobility on level surface (47.2%), followed by climbing stairs (38.9%).Conclusion: This study had identified chronic illness, cognitive impairment, depression, and functional decline as major health problems of the elderly in nursing homes that require greater attention and intervention.
The objective of this study was to determine the prevalence of sleep disturbance with work characteristics among nurses in the Melaka Hospital, Malacca, Malaysia. This was a cross sectional study conducted in Melaka Hospital. Universal sampling was conducted and a Malay version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire was used in data collection. Socio-demographic characteristics such as age, marital status, number of children and work characteristics such as type of work schedule and duration were also enquired. Factors associated with poor sleep quality were compared between those nurses with good sleep quality by using logistic regression. There were 607 nurses who completed the questionnaire with a response rate of 73.1%. There was a moderate prevalence (57.8%) of poor sleep quality (PSQI > 5) in all study subjects. The prevalence of sleep disturbance was more widespread among nurses who worked shifts (62.0%) compared to non-shift working nurses (41.5%) p
The aim of this study was to determine whether the home environment was a risk factor for falls occurring at home among the elderly in the Masjid Tanah community, Malaysia. An analytical cross-sectional study conducted from early June 2006 until May 2007 in six randomly selected villages in Masjid Tanah Province. A total of 516 participants were included in this study. Overall prevalence of falls among the study participants was 27.3%. Home falls accounted for 66.7% of the total falls. In conclusion, there was no association between home environment and home fall in this study. Logistic regression analysis showed that having a depressive mood was the main determinant for home falls among the elderly in this study.
Automotive industry in Malaysia is one of the booming industries which encompass the design, development and manufacturing of motor vehicles. However, it has its own setback as the interaction between complex tools, machines, and instruments, coupled with humans as workers pose several health hazards. A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorders (MSD) and the association with awkward posture among automotive assembly line workers. A simple random sampling method was adopted and data were collected based on Standardized Nordic Questionnaire (SNQ) and Rapid Upper Limb Assessment (RULA) method for analysing awkward posture. With a response rate of 83%, a total of 232 assembly line workers with at least one year job tenure participated in this study. The findings revealed that 78.4% of workers reported MSD while the highest percentage of complaints concerned the lower back (50.9%). Three factors were found to be significantly associated with MSD: age (χ2=5.61, p=0.018), job tenure (χ2= 8.26, p=0.004) and awkward posture (χ2= 65.37, p < 0.001). Logistic regression analysis indicated that significant risk factors for MSD symptoms were workers aged ≥ 25 years old (OR= 2.25, 95%CI 1.14-4.46) and those workers with equal and more than three years job tenure (OR= 2.44, 95%CI 1.04-5.63). In addition, workers in the very high and high RULA action level who were 69 times (OR = 69.38, 95%CI 14.51- 331.73) and 12 times (OR = 12.42, 95%CI 5.21-29.58), respectively, also had higher odds of complaints of MSD. The high prevalence of MSD shows that MSD symptoms is a significant problem among automotive assembly line workers while age, job tenure and awkward posture based on RULA action level are the significant factors for MSD. In particular, this study proves that the prevalence of MSD increases as the RULA action level and job tenure increases. Thus, this problem could be reduced by decreasing RULA action level through appropriate ergonomic workstation design and ergonomic training for workers.
Mental health is a growing concern in the field of occupational health globally due to its social, health, and economic implications on the individual and the community at large. As universities in Malaysia are advancing towards becoming world-class research universities, academicians are now faced with more pressures, making them more vulnerable to burnout. A cross sectional study was conducted among 194 randomly sampled academicians from a faculty of a public university. Data was collected using a self-administered questionnaire to assess the sociodemographic characteristics, occupational characteristics and burnout. Analysis was done using SPSS version 21. The response rate was 87.1%. The overall prevalence of burnout was 10.7% with significant associations between gender (χ2 = 4.61; p = 0.03), teaching experience (χ2 = 0.83; p = 0.02), job satisfaction (χ2 = 11.33; p = 0.001). Female academicians have a higher prevalence of burnout (14.3%). Academicians who have fewer years of teaching experience (
Background: Personality disorders is one of the most assessed mental health problems among prison population. To date, no local psychometric instrument to assess personality disorder is available in Malaysia. Objective: The aim of this study is to validate the Malay-translated version of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) among prisoner. Methods: A cross-sectional study was designed, involving female prisoners (n=90). Face validity, factor analysis, and reliability testing were conducted with a one-week interval test-retest. Results: The translated instrument produced four factors structure. The internal consistency is moderate (α=.64), with high test-retest reliability (ICC=.82). Conclusion: The Malay-translated version of the MSI-BPD was found valid and reliable to identify borderline personality disorder among female prisoner in future studies.
Objective: The objective of this study was to establish the relationship between symptoms of PTSD and various scores of emotional intelligence scales. This study employed a cross-sectional research design. Participants were recruited from the local community health centre in Dearborn, Michigan, USA. The Child Posttraumatic Stress Reaction Index (CPTS-RI) measured the presence of PTSD symptoms and the Adolescents Multifactor Emotional Intelligence Scale (AMEIS) measured emotional intelligence. Results: The findings suggest an inverse relationship between PTSD severity and emotional intelligence. The PTSD score was negatively correlated with all AMEIS subscales. Two significant negative correlations were found in the tasks of using emotion and understanding emotion. Conclusion: Findings suggest that individuals with severe PTSD symptoms appear to lack the abilities to understand and use emotions. These findings might be useful in identifying factors that may contribute to decreasing the severity of PTSD symptoms of these children. Implications of the findings were discussed, and recommendations for future research are presented. ASEAN Journal of Psychiatry, Vol. 15 (2), July - December 2014: 220-224.
Objective: Literatures on factors influencing performance of the Stroop interference have been elusive on coping styles. Past investigations of coping influence on Stroop test have been indirect and inconclusive due to variability of multidimensional coping models and application of different Stroop test. The concept of constricted versus flexible or broad cognitive style have linked personality and coping styles to Stroop performance. The objective of this study was to determine the associations of coping styles with Stroop resistance towards interference (Stroop RI) and subsequently determine the predictors of Stroop performance. Methods: This was a cross-sectional community research design study with purposive sampling. In this study, the self-administered Brief COPE inventory questionnaires and Stroop Test were performed among 205 undergraduate medical students. Results: Findings revealed that behavioural disengagement (r=-0.361), dysfunctional coping (r=-0.355), self-blame (r = 0.222), and substance abuse (r = -0.173) showed negative correlation and proven strong association with Stroop RI. Further multiple regression analyses identified behavioural disengagement (R2 = 0.13), and dysfunctional coping (R2 = 0.024) as significant predictors for interference. Conclusion: Coping styles have implication on Stroop test exhibited in varied cognitive styles. Integrating coping styles factor on Stroop test has glimpsed the future direction of other neuropsychological assessment batteries on the importance of profiling individualistic baseline norms. ASEAN Journal of Psychiatry, Vol. 16 (1): January – June 2015: XX XX.
Objective: The involvement of families in assisting health professionals in providing care for their family members who suffer a stroke during hospitalization is common in Malaysia. Family caregivers are accountable in providing for the first-ever stroke survivor’s needs, including maintaining functional improvements gained in rehabilitation and the long-term well-being of the stroke survivors. The objective of this study was to determine the predictors of life satisfaction among family caregivers of hospitalized first-ever stroke patients. Methods: This was a cross-sectional community research design study with purposive sampling. It involved 102 family caregivers of hospitalized first-ever stroke patients of two tertiary hospitals in Kelantan. The Bakas Caregiving Outcomes Score (BCOS) was used to measure life satisfaction. Multiple linear regression was used to determine the predictors of life satisfaction. Results: Out of 102 respondents, 21 were males and 81 were females with age range of 16 to 76 years. Significant predictors of life satisfaction of caregivers while caring for their hospitalized first-ever stroke family members were caregivers’ health (β: -2.875, 95%CI: -5.725, -0.025, p = 0.048), patients’ age (β: - 4.251, 95% CI: - 6.379, -2.123, p