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  1. Azmi J, Nurumal MS, Mohamed MHN, Rahman NSA
    Int J Prev Med, 2020;11:6.
    PMID: 32089806 DOI: 10.4103/ijpvm.IJPVM_83_19
    Background: The study evaluates the changes of pre and post stages of behavioral change, motivation level, and smoking status among cardiovascular disease patients, participating in the new smoking cessation program in Hospital Tengku Ampuan Afzan, Kuantan.

    Methods: A total of 65 adult cardiac patients were randomly distributed into two groups, i.e., intervention and control group, who were baseline smokers and assessed in three phases. Initially, the first, second, and third phase collected the information about their demographic details, their smoking status, and smoking status using cotinine amylase strip, respectively.

    Results: It showed that behavioral change was significant for the control group (P value = 0.031), while motivation level improved for both groups (i.e., control, P value = 0.000 and intervention group, P value = 0.001). The smoke quitting status percentage was higher for intervention group 41.9% and lower for control group 20.6%; however, the P value was insignificant for both control group (1.000) and intervention group (0.250).

    Conclusions: This study suggests a need for more personal testimonial videos to focus on other smoking-related diseases.

  2. Jamaludin TSS, Mohammad NM, Hassan M, Nurumal MS
    Enferm Clin, 2021 04;31 Suppl 2:S372-S376.
    PMID: 33849203 DOI: 10.1016/j.enfcli.2020.09.028
    This study aimed to survey the level of knowledge and practice on medication adherence among Type II diabetes mellitus (DM) patients. A cross-sectional study was conducted with a total of 220 DM patients by using a convenience sampling method. It was found that 64.5% of studied participants have a high level of knowledge with good practice toward medication adherence. There was a significant association between sociodemographic characteristics with the level of knowledge and practice toward medication adherence. This study finding provides information to health care providers to improve their patient's care by playing their important role in promoting the importance of knowledge on medication adherence for a better quality of life to the DM patients. Not only a physician but also the nurse could enhance health education for their patient on medication adherence during the follow-up appointment.
  3. Nurumal MS, Diyono NQH, Che Hasan MK
    Sultan Qaboos Univ Med J, 2020 Nov;20(4):e374-e379.
    PMID: 33414944 DOI: 10.18295/squmj.2020.20.04.015
    Objectives: Self-efficacy is an important factor in determining the ability of students to execute tasks or skills needed in the implementation of interprofessional learning (IPL). This study aimed to identify levels of self-efficacy with regards to IPL skills among undergraduate healthcare students and to investigate differences according to gender, programme of study and year of study.

    Methods: This descriptive cross-sectional study was conducted between January and March 2018 at the International Islamic University Malaysia, Kuantan, Malaysia. The Self-Efficacy for Interprofessional Experiential Learning scale was used to evaluate the self-efficacy of 336 students from five faculties including nursing, medicine, dentistry, pharmacy and allied health sciences.

    Results: Significant differences in self-efficacy scores for the interprofessional interaction subscale were identified according to programme of study, with pharmacy students scoring significantly lower than allied health students (mean score: 54.1 ± 10.4 versus 57.4 ± 10.1; P = 0.014). In addition, there was a significant difference in self-efficacy scores for the interprofessional interaction subscale according to year of study, with first-year students scoring significantly lower compared to fifth-year students (mean score: 52.8 ± 10.4 versus 59.9 ± 11.9; P = 0.018). No statistically significant differences in self-efficacy scores were identified with regards to gender or for the interprofessional team evaluation and feedback subscale.

    Conclusion: These findings may contribute to the effective implementation of IPL education in healthcare faculties. Acknowledging the influence of self-efficacy on the execution of IPL skills is crucial to ensure healthcare students are able to adequately prepare for future interprofessional collaboration in real clinical settings.

  4. Nurumal MS, Zain SHM, Mohamed MHN, Shorey S
    J Sch Nurs, 2021 Oct;37(5):333-342.
    PMID: 31455149 DOI: 10.1177/1059840519871641
    Preventing smoking among adolescents is critical. This study evaluated the effectiveness of the Smoking Prevention Education Program among nonsmoking adolescents. A quasi-experimental study design was used. Data were collected from Year 5 students (n = 140) from four government primary schools in the Kuantan and Pahang districts of Malaysia. The participating schools were randomly assigned into the intervention and control groups. Questionnaires and exhaled carbon monoxide (CO) levels were used to collect data at the baseline and at 3 months postintervention. At 3 months postintervention, the percentage of nonsmokers remained 100% in the intervention group, while 2.9% of the participants in the control group reported to have smoked in past 7 days. Comparatively, the mean scores of attitudes, subjective norms, and nonsmoking intentions of the intervention group improved significantly. The intervention was effective in preventing smoking initiations among Malaysian adolescents; however, further evaluation of this intervention is needed among varied populations.
  5. Kowitlawkul Y, Yap SF, Makabe S, Chan S, Takagai J, Tam WWS, et al.
    Int Nurs Rev, 2018 Apr 06.
    PMID: 29633267 DOI: 10.1111/inr.12457
    AIMS: To investigate the key determinants of nurses' quality of life and work-life balance statuses in a tertiary hospital in Singapore.
    BACKGROUND: Nurses' quality of life can directly and indirectly impact patients' safety and quality of care. Therefore, identifying key factors that influence nurses' quality of life is essential in the healthcare delivery system.
    METHODS: A descriptive quantitative study design was adopted, and validated questionnaires were used. Data were collected in a period of 3 months (March to May 2014) at a 600-bed tertiary hospital in Singapore. One thousand and forty nurses participated in the study.
    RESULTS: Social support and sense of coherence were found to be significant predictors for high quality of life in all domains. Most nurses in this study spent more time on work than their private lives. However, there was no significant difference in job satisfaction among the four groups of nurses' proportions of percentages of actual time spent on work and private life.
    CONCLUSIONS: Cultivating social support from family, friends/colleagues and supervisors can help an individual cope with stress and enhance a nurse's quality of life.
    IMPLICATIONS FOR NURSING POLICY AND PRACTICE: Even though nurses who spent more time at work were still satisfied with their job, they might need to be aware of their physical health and work environment. Nursing policy related to nurses' physical health and environment should be established. Health promotion programmes such as physical exercise and mindfulness interventions should be conducted to promote nurses' well-being and healthy workplace environments to enhance nurses' quality of life.
  6. Mohamad Ismail MF, Abdullahi Hashi A, Bin Nurumal MS, Bin Md Isa ML
    Enferm Clin, 2018 Feb;28 Suppl 1:212-216.
    PMID: 29650189 DOI: 10.1016/S1130-8621(18)30070-6
    Health workers, like nurses are tasked to save the lives of their patients, however, there are instances in which health workers have to deal with difficult cases in taking a life, such as abortion. Scholars in the field of healthcare assert that abortion is morally justified if it is sought for health reasons. Nevertheless, there are a number of cases in which abortion is sought on other grounds other than health, such as the individual choice to do so. Can a nurse refuse to provide their professional service towards these people? This paper uses analytical and comparative methods to address ethical issues in abortion from the Islamic and conventional perspectives. Nursing implication: Since the nurses instruct and assist people in forming a decision as they engage in nursing care, utilising a comprehensive view of abortion based on Islamic sources would provide a foundation in Muslim perspectives as they interact with Muslim patients. The subject area to investigate the degree of knowledge among nurses regarding the Islamic moral judgement on this event is extremely recommended for future management.
  7. Nurumal MS, Salahuddin MA, Daud A, Shahadan SZ, Abdul-Mumin K, Shorey S
    Enferm Clin, 2019 09;29 Suppl 2:471-475.
    PMID: 31350157 DOI: 10.1016/j.enfcli.2019.04.070
    OBJECTIVE: The learning styles of millennial students, also known as Generation 'Y', have been examined in the past to match the teaching style of an educator with the aim of improving behaviors, attitudes, and academic achievements. However, focus on Generation 'Y' healthcare undergraduates from a multi-cultural Asian society, is scarce and fragmented. Therefore, this research aims to identify the learning style preferences of Generation 'Y' undergraduates enrolled in varied healthcare programs at a Malaysian University.

    METHOD: A quantitative cross-sectional study design was adopted. Honey and Mumford's Learning Style Questionnaire was used to explore the learning styles.

    RESULTS: The reflector learning style was most preferred by the Malaysian healthcare undergraduates, and no significant difference was found between the learning styles of the clinical group and the semi-clinical group.

    CONCLUSIONS: Educators should engage Malaysian healthcare undergraduates in a non-threatening environment - Association between learning style and sociodemographic warrants further investigation.

  8. Lee WL, DeWitt D, Chui PL, Sahibudeen AKS, Nurumal MS, Chinna K, et al.
    J Gerontol Nurs, 2021 Mar 01;47(3):23-28.
    PMID: 33626161 DOI: 10.3928/00989134-20210209-04
    The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23-28.].
  9. Abdul Rahman N', Nurumal MS, Awang MS, Mohd Shah ANS
    Australas Emerg Care, 2020 Dec;23(4):240-246.
    PMID: 32713770 DOI: 10.1016/j.auec.2020.06.005
    INTRODUCTION: Emergency departments (EDs) routinely provide discharge instructions due to a large number of patients with mild traumatic brain injury (mTBI) being discharged home directly from ED. This study aims to evaluate the quality of available mTBI discharge instructions provided by EDs of Malaysia government hospitals.

    METHODS: All 132 EDs were requested for a copy of written discharge instruction given to the patients. The mTBI discharge instructions were evaluated using the Patient Education Materials Assessment-Printable Tool (PEMAT-P) for understandability and actionability. Readability was measured using an online readability tool of Malay text. The content was compared against the discharge instructions recommended by established guidelines.

    RESULTS: 49 articles were eligible for the study. 26 of the articles met the criteria of understandability, and 3 met the criteria for actionability. The average readability level met the ability of average adult. Most of the discharge instructions focused on emergency symptoms, and none contained post-concussion features.

    CONCLUSION: Majority of the discharge instructions provided were appropriate for average people to read but difficult to understand and act upon. Important information was neglected in most discharge instructions. Thus, revision and future development of mTBI discharge instruction should consider health literacy demand and cognitive ability to process such information.

  10. Isa RM, Saidi S, Salam A, Nurumal MS, Jamaludin TSS
    Enferm Clin, 2021 04;31 Suppl 2:S321-S325.
    PMID: 33849190 DOI: 10.1016/j.enfcli.2020.12.037
    This study aimed to survey the factors influencing attendance to eye screening among Diabetes mellitus (DM) patients. This cross-sectional survey was carried out among 170 DM patients using self-administered questionnaires. Majority of participants, 45.9% (n=78) highlighted that lack of information regarding diabetes and not understanding the significance of eye screening are the barriers to eye screening. Whereas, 10.6% (n=18) reported lack of access to healthcare facilities, 6.5% (n=11) experienced time limitation and 2.9% (n=5) suffered financial issues. However, more than half of the participants (58.2%) have good knowledge related to diabetic eye complications. There was a significant difference between educational level with patients' attendance in yearly eye screening. Lack of information received by the patients on the importance of eye screening and communication issues seems to be prominent and becomes the reason for patients not attending eye screening.
  11. Jamaludin TSS, Nurumal MS, Ahmad N, Muhammad SAN, Chan CM
    Enferm Clin, 2021 04;31 Suppl 2:S58-S62.
    PMID: 33849230 DOI: 10.1016/j.enfcli.2020.10.019
    This systematic review aimed to appraise and synthesize the available evidence that examines the soft skill elements in clinical nursing assessment for undergraduate nursing students. This systematic review also is in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies were identified based on the inclusion criteria with language filters but were limited to articles published from January 2000 to March 2019. Two reviewers independently conducted the quality assessment, data extraction, and analysis on all included studies. A total of 17 articles were included in this review. Studies showed that without developing adequate soft skill elements in the clinical skill assessment, students are graduating unprepared to be successful in the workplace. There is a need to consider and adopt soft skill elements in clinical skill assessment to improve the quality of nursing graduates and ultimately to create a positive impact on patient outcomes.
  12. Lee WL, Rambiar PNIMS, Rosli NQB, Nurumal MS, Abdullah SSS, Danaee M
    Nurse Educ Today, 2022 Dec;119:105563.
    PMID: 36150294 DOI: 10.1016/j.nedt.2022.105563
    BACKGROUND: The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait.

    OBJECTIVE: Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide.

    DESIGN: Cross-sectional online survey was conducted from October to December 2020.

    SETTINGS: Two established public institutions located in Malaysia.

    PARTICIPANTS: A total of 345 nursing students pursuing diploma and bachelor nursing programs.

    METHODS: Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3).

    RESULTS: Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (β = -0.111, -0.192; p values < 0.05) and higher callousness (β = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (β = 0.265, p 

  13. Mohd Hatta NNKN, Nurumal MS, Isa MLM, Daud A, Ibrahim M, Sharifudin MA, et al.
    Cent Asian J Glob Health, 2019;8(1):348.
    PMID: 32002313 DOI: 10.5195/cajgh.2019.348
    Introduction: Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period.

    Methods: A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women's socio-demographic characteristics and their knowledge and attitude towards maintaining bone health.

    Results: Participants' age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants' attitude towards bone health.

    Conclusion: This study showed that the age and education levels have significantly different knowledge of bone health.

  14. Makabe S, Kowitlawakul Y, Nurumal MS, Takagai J, Wichaikhum OA, Wangmo N, et al.
    Ind Health, 2018 Jun 01;56(3):212-219.
    PMID: 29491251 DOI: 10.2486/indhealth.2017-0066
    The study aimed to compare nurses' quality of life and investigate key determinants among Asian countries with different economic status. A cross-sectional survey was conducted across five Asian countries (Japan, Singapore, Malaysia, Thailand, and Bhutan). Quality of life (WHOQOL-BREF), job stress (National Institute of Occupational Safety and Health questionnaire), and demographic data were assessed. Stepwise multivariate linear regression analysis was performed to identify the key determinants of quality of life. Participants were 3,829 nurses (response rate: 82%) with a mean age of 33 ± 10 yr and majority were women (92%). Regarding quality of life, Bhutan yielded the highest scores, followed by Malaysia, Thailand, Singapore, and Japan, and these results were statistically significant. The key determinants that were significantly related to quality of life were "stress coping ability," "life satisfaction," "Japan," "social support," "job stress," and "Singapore" (adjusted R2=0.46). In conclusion, nurses' quality of life differs across Asian countries and is not linked to the country's economic development. To maintain a good quality of life for nurses, an international exchange program like international nursing conferences for work environment and staff coping strategies is recommended to broaden institution' minds and share experiences and exchange views to be able to realize their own problems and discover global solutions to them.
  15. Shorey S, Ang E, Baridwan NS, Bonito SR, Dones LBP, Flores JLA, et al.
    Nurse Educ Today, 2022 Jan 24;110:105277.
    PMID: 35101809 DOI: 10.1016/j.nedt.2022.105277
    BACKGROUND: The COVID-19 pandemic has disrupted the lives of many. Particularly, nursing students experience greater stress as their normal curriculum is interrupted and some of them face the risk of being infected as frontline workers. Nursing faculty members may face similar struggles, in addition to developing teaching materials for online learning. Thus, it is important to examine the faculty members' and students' views on their ability to adapt during the pandemic to obtain a holistic view of how learning and training has been affected.

    DESIGN: The descriptive cross-sectional quantitative design was used.

    SETTINGS: Data were collected from Southeast and East Asian Nursing Education and Research Network (SEANERN) affiliated nursing institutions from January 2021 to August 2021.

    PARTICIPANTS: A total of 1897 nursing students and 395 faculty members from SEANERN-affiliated nursing institutions in Cambodia, Hong Kong, Indonesia, Japan, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam were recruited for this study.

    METHODS: Quantitative surveys were used to explore the satisfaction levels in education modalities, confidence levels, psychosocial well-being, sense of coherence and stress levels of nursing students and faculty members during the COVID-19 pandemic.

    RESULTS: Participants were mostly satisfied with the new education modalities, although most students felt that their education was compromised. Both groups showed positive levels of psychosocial well-being, despite scoring low to medium on the sense of coherence scale and experiencing great stress. The participants' sense of coherence was positively correlated with their psychosocial well-being and negatively correlated with stress levels.

    CONCLUSIONS: While the COVID-19 pandemic had negatively impacted the lives of nursing students and faculty members, most of them had a healthy level of psychosocial well-being. Having a strong sense of coherence was associated with better psychosocial health and lower stress levels. As such, it may be helpful to develop interventions aimed at improving the sense of coherence of nursing students and staff to help them manage stressors better.

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