Diabetes mellitus is a chronic disorder with many vascular complications, leading to significant morbidity and mortality. The prevalence of Type 2 diabetes mellitus in Malaysia has risen dramatically from 6.3% (NHMS 1 in 1986); to 8.3% (NHMS 2 in 1996); and to 14.9% (NHMS 3 in 2006). An audit was conducted on patient's medical records from selected MOH health facilities to assess the control of diabetes using HbA1c. The response rate was 69.6% and the control of diabetes was poor. Only 18.4% of patients with valid HbA1c had value less than 6.5%. This is notably worst amongst patients from younger age groups. Many recommended investigations such as fundoscopy and urine microalbumin had not been done regularly. Efforts to look for various vascular complications were under-reported. About 45% of patients had been treated with 2 oral antidiabetic agents; mainly the sulphonylureas and the biguanides. Only 13.3% of patients were on insulin despite having poorly controlled disease. There is an urgent need to improve the management of diabetes mellitus in these areas:- (i) improving the glycemic control status (particularly among younger diabetic patients) with early and optimal use of oral diabetic drugs and insulin; (ii) stringent monitoring of glycemic control with adequate funds for regular performance of HbA1c (at least every 6 monthly for all diabetic patients) (iii) organizing regular updates or interactive programme for diabetes healthcare providers from primary, secondary and tertiary care; (iv) ensuring regular and prompt review of diabetic complications so that the complications can be dealt with early; (v) producing more diabetes educators to strengthen and standardize the diabetes education programme; and promote patients adherence to non-pharmacological and pharmacological interventions.
Customer satisfaction is one of the main priority to any service provider. It indicates process and quality involved in delivering of services. However, satisfaction level varies from one service to another. In Indonesia, satisfaction study is seldom done on Posyandu activity. This study tries to understanding this issue. A cross sectional study was conducted on Posyandu services located in urban and rural areas of South Sumatera, Indonesia from November 2005 until January 2006 with 125 respondents in urban area and 123 respondents in rural area using multi stages random sampling. Data was collected via structured questionnaires using SERVQUAL score method based on five dimensions : tangible, reliability, responsiveness, assurance and empathy. The results showed that the proportion of satisfied customers was higher at 74% particularly in the rural area. Satisfied respondents were significantly associated with age, education, income and distance to Posyandu services. The most satisfying dimension were tangible and reliability especially in the urban area, but not for responsive and empathy dimension. Overall, the mean SERVQUAL score of all dimension was higher for the urban as compared to the rural area, implying that customer perceptions are much better from what was expected.
Responsive and empathy dimension were the main barrier affecting customer satisfaction. Staff development efforts such as training, refreshing and others form of organizational development strategies, therefore, need to be incorporated into its current managerial practice in order to improve the health services delivery and increase customers' satisfaction.
Purpose- Work ethics are practice and speed that should be practiced during working. This study was conducted to identify positive work ethics among health clinic staff who work at the counter and in the clinic
Design/methodology/approach- This study was carried out from January 2008 until December 2008. Health Clinic staff who work at the counter and in the clinic were chosen as respondents. Self- administered questionnaire was used to gain feedback on work ethic practice among staff. The questionnaire consists of evaluation questions on staff in the respondent's deoaftment
Findings- From the study, approximately B0% of staff have practiced positive work ethics, From 15 work ethics practices, there were only three that should be give attention; i.e. (i) gossiping, (ii) apathetic on reprimand and advice, and (iii) hot- tempered, Improvement strategies need to be formed especially strengthening the soft skills courses and increasing the communication skills to the counter staff, It is also wise to form a leader as a'role model' in improving effective supervisory skills in service counter. Keywords: Work Ethics, Counter Staff, Clinic Staff, Health Clinic
Purpose – Evidences have shown that participation in a cardiac rehabilitation programme improves outcomes and quality of life for cardiac patients. Hospital Serdang has conducted this programme since 2007 and it is the first to be run by the Rehabilitation Medicine Department. The purpose of this survey is to find out whether the programme is suitable, informative and useful from the patient’s perspective as well as to determine whether the 6 weeks duration is sufficient.
Design/ methodology/approach - A patient feedback survey using a self-administered questionnaire on the programme was conducted from January 2008 to December 2010 in Hospital Serdang.
Findings - A total of 323 patients were invited to join the programme but only 182 completed the programme and took part in this survey. 30% of the patients thought that the six weeks programme was not enough for them. 100% of the respondents agreed that the programme was beneficial, well suited to their problems and were willing to promote the programme to their friends. Therefore, it is recommended that this programme be extended to the community level.
Conclusion - In conclusion, this programme is beneficial, suitable, informative and adequate from the patient’s point of view. Extension of this programme into the community as a continuation of the hospital-based programme is likely to improve the outcome further.
Studies have shown that organisational excellence is influenced amongst others by top management leadership and management quality, human resource management and customer focus. This is clearly illustrated by international organisational excellence models, e.g the Malaysian Prime Minister Quality Award, the American Quality Award, EFQM Excellence and Deming Prize Criteria Models.
With the objective of finding out how well the Pathology Department, Hospital Tuanku Ja'afar Seremban fares, a study was conducted in early 2006 and a repeated study performed in 2007 after remedial actions and continuous improvement activities have been undertaken by the department leadership and top management. The study was performed on the staff (internal customer) to gauge the degree of satisfaction in the areas of leadership, resource management and customer focus.
The study showed an increased in the overall satisfaction i.e. 65.43% in 2007 compared to 18.29% in 2006. The staff of the department have appreciated that the current leadership has been strengthened and the management has shown improved caring, professionalism and team work as stipulated by the Ministry of Health's Corporate Culture. There has also been increased sense of belonging, feeling being cared for, appreciated and loved by the management. This has led staff being more proud of the organisation and 88.1% have maintained that they have worked very hard in 2007 study compared to 57.69% in 2006 study. This study has shown that top management and leadership commitment and being staff or internal customer focus, while instituting changes in the organisation would inevitably lead to increased staff satisfaction and this in turn leads to improved staff participation and contribution to the organisation.
Purpose - The acceleration of early retirement tendency leading to a fall in labour force is a topic of concern among professionals working with the Ministry of Health, in Malaysia. This paper attempts to highlight the contributing factors to early retirement among these professionals.
Design/ methodology/approach- A study involving employees of the Ministry of Health conducted in 2007 using self-administered questionnaire was carried out.
Findings- The sample s to of this sub study is 3600 with a response rate of 76.2 percent. Of the total responders, 39.1 percent admitted to having intention of early retirement. It also appears that the main factor contributing to this school of thought is perceived job dissatisfaction as described by 64.2 percent of the respondents. Lack of support from immediate superiors and denied opportunities for career advancement are also contributing factors. The Ministry of Health has to strategize and intervene accordingly in order to retain the current man power so as to curb the shortage of health professionals in the public sector.
Purpose - An outbreak of food poisoning had occurred in Health Institute A on 1st June 2010 which involved twenty four staffs. Six of them were hospitalized and eighteen received outpatient treatment. A case control study was done to describe the epidemiological characteristics of the outbreak and to determine the source of infection.
Design/methodology/approach - Food samples, rectal swab from cases, environmental and hand swab from the food handlers were also taken and sent for microbiological analysis.
Finding- The outbreak was explosive, and the prominent clinical features were abdominal pain (62.2%), fever (51.4%), and diarrhea (56.8%). The onset time was between 9-24 hours and the median incubation period was at 15 hours. The possible source of the outbreak was durian gravy (OR= 14.00,95%CI: 2.72-92.55, p<0.001, food attack rate: 100%) and rotijala (OR= 6.69, 95%CI: LB5-24.23, p<0.001, food attack rate: 95%), The microbiological investigation revealed that various microorganisms including Salmonella spp, The food was supplied by the same food supplier from Caterer B since 2006 and the assessment of the kitchen showed that the cleanliness rate was only 54,3% with positive results of Coliform in all utensils and areas investigated in the kitchen.
Conclusion- In conclusion, the most probable causative organism based on signs and symptoms, epidemiological analysis and microbiological results was Salmonella spp. from contaminated food seryed during the ceremony. Education on food safety and food hygiene especially personal hygiene and hand washing should be emphasized continuously for prevention of future outbreak,
Caring practice is one of the three core values of Corporate Culture of Ministry of Health Malaysia, initiated in 1991. A cross sectional study was conducted to determine the extent of hospital healthcare personnel practicing the element of caring. Self-administered questionnaires were mailed to all staff working in public hospitals followed by reminder letters and telephone calls. A total of 37,267 responded out of 69,385 personnel working in the hospitals with a response rate of 53.7%. Results showed that about half of the respondents perceived that they practice caring value of the corporate culture (49.5%) and only 33.3% perceived that their colleagues practiced it. The practice of caring value was highest among clinical specialists (65.4%) and lowest among the clerks (22.1%). Nurses perceived that 40.4% of their colleagues practiced caring values while the clerks perceived only 17.0% of their colleagues practice it. In conclusion, caring value is not being well practiced by healthcare staff especially among the support staff. There is a need for further research to study the reasons for poor caring practice by healthcare personnel and develop strategies to improve the situation.
This is a cross sectional study to assess the performance of Putrajaya Health Clinic in meeting the client's expectation among 403 clients who came to seek medical treatment through a systematic random sampling in the month of July 2006. Our aim is not only to reduce dissatisfaction among clients but also try to meet their expectations; we have adopted SERVQUAL method which defined satisfaction as the difference between perceptions and expectations. We would also like to refer this dissatisfaction as not able to meet clients' expectations. It was found that there were only 6.9% of clients dissatisfied in Putrajaya Health Clinic, but they had not been able to meet 81.5% of clients' expectation. As for demographic characteristics, there appeared to be a significant association between client's satisfaction and age, gender, ethnicity and educational level. For outpatient's, the greatest dissatisfaction is in the dimension of Reliability. Clients were not happy with the waiting time at the clinic. Apart from recruiting more staff, management should develop a comfortable waiting environment to reduce the agony of waiting.
Researchers all over the world have continuously contributed knowledge on common human cancers and its related risks. Despite these mountains of information, the trend of cancer problems has not significantly declined and perhaps in certain occasion, it gradually increased affecting those who are previously known to be less risky'. Cancer is still identified to be one of the top leading killer worldwide and is also the main source of psychosocial burden of the community particularly to the caregiver' Its problems are expected to be further increased as human beings are constantly modified and manipulated by unpredictable and dynamic human activities and globalization phenomena. Furthermore, the current advances in cancer therapy and others clinical interventions are not always guaranteed of a permanent cure, improve survival or prognosis, sustainable compliances, prolonging life and improving quality of life, thus the mortality and its associated biological and management complications are still prevalence. (Copied from article).
Tujuan menjalankan kajian ini adalah untuk mengetahui tahap kekerapan penyelidikan yang berkaitan dengan kesihatan mental yang dijalankan di fasiliti Kementerian Kesihatan Malaysia. Sebanyak 258 fasiliti Kementerian Kesihatan yang terlibat dalam kajian ini meliputi Hospital Mental, Hospital dengan perkhidmatan Pakar Psikiatri, Hospital tanpa perkhidmatan Pakar Psikiatri dan Pejabat Kesihatan Daerah. Borang kajiselidik telah dihantar melalui pos kepada Pengarah Hospital dan Pegawai Kesihatan Daerah dengan kadar maklumbalas 70.2%. Hasil kajian mendapati hanya 23(13.1%) fasiliti sahaja yang menjalankan kajian mengenai kesihatan mental. Sebanyak 37 kajian berkaitan kesihatan mental telah dijalankan bagi tahun 2003-2004. Penyebab utama penyelidikan kurang dijalankan disebabkan oieh peruntukan yang tidak mencukupi dan tiada kepakaran untuk menjalankan penyelidikan yang berkaitan dengan kesihatan mental. Antara penyebab lain adalah kekurangan anggota, NGO tidak berminat dan tiada latihan. Kesimpulannya menunjukkan tahap penyelidikan kesihatan mental di fasiliti Kementerian Kesihatan masih rendah.
The purpose of the present study is to provide a critical review on the revolution of the "compliance" concepts from compliance to adherence, and adherence to concordance for both pharmacological and non-pharmacological therapies. A comprehensive literature search was performed using online databases from Library of University Putra Malaysia, and Pub Med based on the keywords. The present study showed that both quantitative and qualitative studies cannot be neglected in assessing adherence and its related problems. One of major findings from the present review is that "compliance" was no longer suitable for current treatments and it is important to define concepts of the terms used (adherence or concordance) correctly and clearly. The findings reflected that researchers placed greater value on medication adherence than non-pharmacological adherence. There were three general factors related to treatments adherence, namely socio-economic factor, treatments-related factor and disease-related factor. The findings showed that both qualitative and quantitative studies found consistent results for most of the factors, except for the experience of diseases symptoms. Both study design contribute important values to the adherence studies and future studies should incorporate both quantitative and qualitative studies to understand adherence in both pharmacological and non-pharmacological treatments.
Acute Gastroenteritis (AGE) is common world wide and is a major health problem. The commonest cause is from contaminated water or food. Common infective agents are Rotavirus, Staph. aureus and Bacillus cereus. There was an AGE outbreak in Ipoh City from late August till early October 2006. Epidemiological and laboratory investigations were done. Fresh stool samples were taken from symptomatic patients. Water and food sampling were also done. Descriptive analysis of the outbreak was done. A total of 170 patients, mostly between 1 - 5 years of age, were affected. The highest incidents were seen in Bercham. Fever and diarrhea were the prominent features. Two stool samples (13.3%) were positive for E.coli and rotavirus respectively. Twelve of the twenty (60%) water samples taken were contaminated with coliform and fecal matter. Twenty-one of the eighty ((26.3%) food samples taken grew either E.coli, Staph. aureus or Bacillus cereus. It was concluded that a general source was responsible for this problem. The water supply to Ipoh City and the surrounding area is the most likely source. Novovirus was suspected as the organism involved because of the self-limiting and mild nature of the illness that occurred in this outbreak.
The AGE outbreak in Kinta District in September 2006 is due to contaminated
water supply from two water treatment