Background: Social misconduct amongst adolescents is a worrying and ever growing problem in Malaysia, despite efforts taken to overcome it.
Methods : A cross sectional study was conducted among secondary school students in Melaka Tengah District to measure the prevalence and determine the factors associated with social misconduct amongst adolescents. A total of 414 form four students were recruited by systematic random sampling fulfilling the study criteria between Jun to September 2008, from eight randomly selected secondary schools in the district. Data were collected using a structured self-administered questionnaire and analyzed using SPSS software version 12.0. Socio-demographic, housing and family factors in relation with social misconduct were studied.
Results : The prevalence of the social misconduct in this study was 70.5%. The most prevalent misconduct includes loitering (37.4%), truancy (30.0%), watching pornographic films (28.7%), and involved in pre-sexual activities (23.7%). The factors that showed significant association with social misconduct were sex and race.
Conclusion : The prevalence of social misconduct is high among adolescent and males as well as Malays are at higher risk. Activities planned for adolescents should be stressed on the danger and effects of social misconduct and be more focused towards male and Malay adolescents.
Background : A cross-sectional survey was carried out in December 2007 to compare the healthrelated quality of life (HRQoL) of stroke survivors with that of general Malaysian population.
Methodology : Stroke patients were recruited from two community-based rehabilitation centres in Selangor. HRQoL was assessed using Medical Outcome 36-Item Short-Form Health Survey (SF-36).
Result : A total of 61 patients (34 males and 27 females) were interviewed. Majority were Chinese (85%) and a small percentage were Malays (15%). 82% (n=50) were elderly of 60 years and above, and the remaining 18% (n=11) were younger patients. 64% had stroke for one year and more, and 36% were less than a year post-stroke. All subjects were community-dwellers and lived with their families. The result showed that with the exception of bodily pain, the mean score of all SF-36 health domains of stroke patients were lower than that of the general population. The greatest difference was in role physical, followed by physical functioning. Female patients demonstrated higher score than the males in all SF-36 domains, in particular general health (57.2 vs 70.3, p=0.01) and social functioning (52.2 vs 73.1, p=0.00). There were no differences of HRQoL domains after comparison according to poststroke duration (all p>0.05).
Conclusion : HRQoL of stroke survivors is lower than that of Malaysian general population in all SF-36 health domains, with the exception of bodily pain.
Introduction : Stress is part of our life. It can happen anywhere including in medical school. Medical school is perceived as being stressful because their difficulties in education, longest period of study and dealing with the patients. Stress can be perceive as negative or positive. Coping strategies are the method that we can use to prevent stress when it comes to us. The aim of this study was to determine the prevalence of stress and coping strategies among of medical students in National University of Malaysia, Malaysia University of Sabah and Universiti Kuala Lumpur Royal College of Medicine Perak.
Methods : This study involved 450 medical students through stratified sampling in which 150 medical students from each of the three universities. This study was conducted through self administered questionnaires. The questionnaires included were socio demographic factor, Personal Stress Inventory (using Stress Symptoms Scale with 52 items), BRIEF COPE (Coping Orientation for Problems Experienced with 28 items). The determination of cut off point for stress symptoms score was using Receiver Operating Characteristic (ROC) curve.
Results : Response rate was 90.8%. The prevalence of stress among medical students were 44.1%. The contributory factors to the stress were financial problems, stress of up coming examination period, relationship problems with parents, peers, siblings and lecturers. Coping mechanisms which had significant association with stress includes self distraction, venting of emotion, denial, behavioral disengagement, humor and self blaming. Multiple linear regression analysis revealed a significant association (p
Introduction : The purpose of this study is to explore the differences of quality of life (QOL) of Malay and non-Malay breast cancer survivors using qualitative method.
Methods : Data was collected using in-depth face to face interview. List of the patients were obtained from Oncology & Surgery Departments and contact numbers were obtained from the medical record. The interviews were conducted either in their home or in the hospital after the appointment has been made.
Results : The majority of the Malays were unable to fulfill the needs of their families. However, the non-Malays were able to fulfill the needs of their families. The majority were satisfied with social interaction and the relationships with their families and friends. In terms of feelings, most survivors felt sad, angry and sometimes they feel like they were going to die early. However the majority coped well with their illness. Regarding sleep, all Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. All survivors were worried about the other female members of the family of getting the same illness. Most survivors did not have any problems with altered body image.
Conclusion : Malays did not have any sleeping problems, but most of the non-Malays reported serious problems. However, the majority of survivors coped well with their illnesses.
Introduction : Globalization has made health tourism possible and continues to flourish. For participating countries, this new industry rakes in billions of dollars a year, and is worth focusing on and being developed.
Objective : This write up aims to find out the history and success of health tourism in countries around the world, study the scenario in Malaysia and propose strategies which could make Malaysia prosper with this multibillion dollar industry.
Methodology: The methodology applied was compilation, data review and comparison from annual report, action plan report and articles.
Result : In the ASEAN region, Malaysia is making a mark in the health tourism industry, thanks to the availability of medical and technical expertise, political and economical stability, high quality infrastructure, and scenic beauty of the land. Nonetheless, despite all these, Malaysia has yet to be at par with her neighbours- Thailand, Singapore and India, in terms of the number of foreign patients and the revenue gained from this industry. Thus there is a serious and urgent need to conduct research to analyze the current situation and future prospects of health tourism in Malaysia. This industry is open to all countries around the world. It is those countries that can continually analyze and adapt that will prosper in the emerging medical tourism industry. Some of the key issues which need to be addressed are those of promotion, finding the niche market, branding, legislations, immigration and quality of healthcare. In addition to these, matters regarding human resource, particularly that of internal brain-drain, need to be looked into.
Conclusion : Malaysia has great potential of becoming the giant of the health tourism industry provided appropriate and timely actions are taken towards achieving it. The negative impact must not be ignored or overlooked; instead it must be thoroughly studied and rectified.
Introduction : Cervical cancer can be prevented through pap smear screening and its proper management of high risk cases. High level of knowledge regarding pap smear screening will encourage women to do pap smear as recommended.
Methadology : A cross sectional study was carried out in Jun 2007 to find out the level of knowledge regarding pap smear among married women in Kg. Sesapa Kelubi, Hulu Langat Selangor. Universal sampling was conducted using guided questionnaire and data was analysed using SPSS version 12.
Result : A total of 154 women participated in this study. Only 3.9% of respondents practiced pap smear as recommended and only 51.3% of them have high level of knowledge with 27.9% has no knowledge regarding pap smear. Women between the ages of 20-35 years old have higher level of knowledge (77.9%). The only factor that showed significant association with level of knowledge in this study is level of education. Age, income, gravida and occupation did not show any significant association.
Conclusion : The effectiveness of pap smear screening program should be regularly evaluated to determine the problem of its low coverage. Proper strategy should be planned to increase knowledge among women and their participation in pap smear program.
Introduction : Limited access to health services, variations in quality of health care and pressure to contain escalation of health care cost are problems in health care systems that are faced by all the societies in the world especially in developing countries. There is an urgent need to conduct a study to assess perception of individual towards health care services in the new planned National Healthcare Financing Scheme.
Objective : The study objective is to examine the perception towards health care services among the farming community and to assess the willingness to contribute to The New National Health Financing Scheme.
Methods : A cross sectional study involving farmers in the state of Selangor in Peninsular Malaysia was conducted. A total of 400 farmers as the household head were selected using multistage random sampling method.
Results : The respondents’ mean score of perception towards public healthcare services were higher than the respondents’ mean score of perceptions towards private healthcare services except for accessibility and convenience aspects. There was no association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards public healthcare services but there was association between willingness to contribute to The New National Healthcare Financing Scheme and perception towards private healthcare services.
Conclusion : Perception towards healthcare services is an important element in the implementation of The New National Healthcare Financing Scheme as it will determine the willingness of an individual to contribute to it.
Background : Safety and health is one of major concerns in public health issues. There are lots of injuries or accidents reported in the news which include school accidents and injuries.
Methodology : This survey was conducted among head of primary schools in Kota Bharu from May to June 2004. The objective of this study was to investigate the awareness about safety and health status among school’s head using a questionnaire.
Result : The study showed that knowledge on safety and health among the school’s heads were relatively low (7.7%). Forty-two percent of the schools did not implement any safety and health programme while more than 50 % did not have safety policies in their school.
Conclusions : It is necessary to have specific safety programmes in school in order to improve the safety and health awareness among teachers, staff, students and community.
Background : Risk management strategy at the workplace needs two way interactions between employee and employer. Therefore, study on risk perception among workers based on scientific analysis is needed to gain knowledge and understanding on how workers perceived risk at the workplace in order to design risk management strategies more effectively.
Methodology : A cross sectional study was carried out among 628 respondents from 36 medical laboratories in the public and private sector in Klang Valley. Using a self administered questionnaire, respondents were required to perceive risk on 30 hazards which have been identified in the medical laboratory. Each hazard was encoded by using Likert scale 1= not risky, 2= risky but low, 3= moderate risk, 4= high risk and 5= very high risk.
Result : Overall, the study showed that working in the medical laboratory was perceived to of moderate risk. When comparing among ethic groups, the Malays had the highest perception of risk (3.07±0.88) as compared with Indians (3.03±0.88) and the Chinese (2.78±0.90). Employee with higher education and position level perceived low level of risk compared to those with lower education and position level. For those working in different types of laboratories, there are significant difference on risk perception, (p=0.001). Employees who work in government sector perceived higher (3.12±0.93) risk compared to workers in private sector (2.85±0.88). In terms of OSH based knowledge, those with higher level of education and position have a high score knowledge on OSH compared to those have lower education and position level.
Conclusion : This study showed that risk perception among workers in medical laboratory is influenced by socio-demography factor such race, education level, job position and the laboratory where the respondents are working.
Low back pain (LBP) is a major medical and social problem associated with disability and work absenteeism. Since the effect on unawareness on back care among hospital staff may affect the smooth running of the services to the public and patients, it is the objective of this study to identified the awareness of back care among nurses so that preventive measures can be taken. About 80 nurses working in the outpatient clinic was survey using self addressed questionnaires which were adapted from Zutphen Physical Activity Questionnaire at Queen Elizabeth Hospital, Kota Kinabalu. Demographic analysis demonstrated that among the eighty nurses that responded, 37.5% (n=30) are Malays, 25% (n=25) Chinese and 37.5% (n=30) ( to include other Sabahan tribes). Their age group varies between 23 to 55 years of age. A total of 72 nurses, both agreed (45%,n=36) and strongly agreed (45%,n=36) that understanding good postures is important to prevent LBP. They felt strongly (55%, n=44) about the importance of correct lifting techniques, and having a well-designed workplace (50%,n=40). Regarding factors that cause LBP, 55% (n=44) of them strongly agreed that good lifting technique can prevent LBP while 56 (70%) agreed that prolong sitting doing computer work can cause LBP. About 60% (n=48) also agreed that LBP can cause stress and that 45% (n=36) of them strongly agreed that being overweight than average can worsen LBP. However, 40% (n=32) provide a neutral answer to whether height have any influence on LBP while 50% (n=40) agreed that weak back muscles can worsen the backache further. However, 45% (n=36) agreed that games that involved back movement have high risks and 55% (n=44) agreed that swimming helps to strengthen back muscle. The environmental factors addresses issues of footwear and soft mattress where 60%(n=48) agreed while 15%(n=12) strongly agreed that good footware and appropriate use of soft mattresses 60% (n=48) can prevent LBP. This study have demonstrated that the nurses that participated had a clear understanding and knowledge on back care even though a wider study need to be carried out to ensure validity of study finding.
Study site:outpatient clinic, Queen Elizabeth Hospital, Kota Kinabalu
Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.
Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.
Population ageing is inevitable in Malaysia as a result of declining fertility rates. Steps can be taken to face this challenge. These include ways to promote “healthy ageing” and “compression of morbidity” and ways to promote “productive ageing”, i.e., keeping the elderly economically and socially engaged. This article, based on a review of the literature, argues that it is illogical to force people into compulsory retirement at an arbitrary age when they can continue to contribute actively to society. Instead, ways can be devised to promote healthy ageing, prolonging independence and encouraging productive ageing through gradual economic and social disengagement of the individual depending on the individual’s physical health, mental health, contribution to society and personal inclination and preferences. Public policy in general and public health policy in particular can be designed or redesigned to help achieve this.
Objective : This scientific writing is meant for describing the problems faced by pharmacy staffs during heavy flood situations in Johore and the actions to be taken for solving these problems.
Methodology : This finding is in accordance to the observations, experiences and interview of staffs (through questionnaires), who are involved directly and indirectly in preparations of emergency during flood. Efficiency of pharmaceutical services provided during flood is evaluated.
Result : Several problems were identified when providing pharmaceutical services, such as purchasing and supplying of items, pre-packing, preparing drug charts, visit to relief centers, post-flood health campaign, and doctors from NGOs prescibing medicines out of MOH drug formulary. During the period of flood, usage of drug and non-drug items increases drastically resulting in the current stock in store were not sufficient to compensate for the high demand. Moreover, inaccessibility of certain roads in districts such as Segamat and Kota Tinggi, aggravated and worsen the problems of obtaining goods from suppliers. Workload of pharmacy staffs increased especially in activities such as pre-packing and preparing drug charts due to shortage of manpower.
Conclusion : Even though workload increased drastically during flood, pharmaceutical services provided by the state pharmacy are still able to maintain good quality services to cater for the need of healthcare professionals and patients. Throughout the flood period, all the difficulties and hurdles faced by us had been solved; due to the cooperation from other agencies. Besides, by writing this article, a disaster preparedness guideline is produced for the purpose of improving management of future disasters.
Gender bias are most obvious in the distribution of income and wealth. This reflects women’s unequal position in the labour market , their less favorable treatment in most social security systems and their lower status within the household. Discrimination against women is also evident in the political sphere. Their access to power is not commensurate with their numbers, their needs or their contributions as citizens. As well as affecting women’s physical and mental health, gender bias also affect the quality of the services they receive. In most developed countries, women are offered equal access to basic health care. However their use of those service may be hindered by a number of gender related factors which are likely to affect poor women in particular. In health organization, gender bias gives significant impact to the evaluation of staff performance, increase stress level and miscommunication. It is also influence the leadership style and also can create ‘glass ceiling’ phenomenon. Job dissatisfaction , absenteeism and high turn over are also the consequences of gender bias. Alongside the development of gender sensitive methods of routine data collection, gender bias in health research will also need to be addressed. Most biomedical research continues to be based on the unstated assumption that women and men are physiologically similar in all respects apart from their reproductive systems. Other biological differences are ignored, as are the social/gender differences that have such a major impact on health.
Introduction : The focus of this paper is to evaluate effectiveness of health education material produced and identify effective educational methods in disseminating health-related information. The study explores the knowledge, attitude and practice level among flood victims in Sub-District Sri Medan, Batu Pahat.
Methodology : Convenient sampling method was adopted as a technique to get 195 respondents aged 18 years and above who had stayed in flood relief centres in the district. A set of questionnaire designed to collect data on demography, effectiveness of health education material, accessibility to education materials, preferable educational methods during flood situation, and flood victims knowledge, attitude and practices.
Result : The study found no association between knowledge level and practice of seven steps hand washing. Result showed poster was regarded as most preferable method in disseminating health related information during flood. No association was found in demographic determinants and knowledge. The length of stay in relief centre has significant association with the level of knowledge obtained.
Conclusion : The use of qualitative and quantitative methods together able to determine accurately the effectiveness of the health education materials used during the disaster as well as the impact in behavioral change.
Skim Sistem Saraan Malaysia (SSM) telah diperkenalkan pada tahun 2002 menggantikan skim Sistem Saraan Baru (SSB) kepada kakitangan sektor awam. Satu kajian keratan rentas telah dijalankan ke atas Pakar Perubatan Kesihatan Awam (PPKA) pada 2004 yang bertujuan untuk mendapatkan persepsi mereka mengenai skim SSM. Semua PPKA yang berdaftar dengan Persatuan Pakar Perubatan Kesihatan Awam (PPPKA) yang berkhidmat dengan Kementerian Kesihatan Malaysia (KKM) dipilih sebagai responden. Kajian ini menggunakan borang soalselidik yang diisi sendiri oleh responden. Kadar respon kajian ini ialah 70.0% iaitu 217 responden. Kajian ini mendapati sebanyak 80.6% PPKA tidak bersetuju dengan pelaksanaan SSM, hanya 7.4% bersetuju dan sebanyak 12.0% berkecuali. Kelemahan-kelemahan utama SSM yang dikenalpasti oleh responden yang tidak bersetuju dengan SSM ialah prosedur atau skim perkhidmatan yang kabur(83.9%), peperiksaan Tahap Kecekapan yang tidak releven (54.1%) dan kenaikan pangkat terjejas (40.5%). Hasil kajian ini dapat membantu pihak-pihak yang terlibat memperbaiki kelemahan-kelemahan SSM supaya pelaksanaannya menjadi lebih mantap dan dapat menangani kelemahan yang wujud di dalam skim tersebut.
Satu kajian keratan rentas telah dijalankan ke atas 285 orang penduduk yang berumur 18 tahun dan ke atas di Kg. Bangi Daerah Hulu langat, Selangor D.E. dari 6-12 Mac 2006. Objektif kajian ini adalah untuk melihat prevalens senaman dan faktor yang mempunyai hubungan dengannya. Kaedah persampelan universal telah digunakan dan pengumpulan data melalui borang soalselidik berpandu. Alatan yang digunakan termasuk penimbang berat Seca dan sfigmomanometer yang telah di kalibrasi, stateskop dan pita pengukur ketinggian. Hasil kajian menunjukkan hanya 13.7% daripada responden yang di kaji di dalam kategori cukup bersenam mengikut definisi kajian. Antara faktor-faktor yang mempunyai hubungan yang signifikan dengan prevalens cukup bersenam adalah jantina (p=0.004), tahap pendidikan (p=0.02) dan status perkahwinan (p
Introduction: Diabetes Mellitus is a chronic disease and major cause of chronic renal disease. Chronic renal disease can be prevented if known risk factors were been early detected. Albuminuria is the earliest clinical evidence of chronic renal disease. Objectives of this study is to identify the incidence of albuminuria and relationship between albuminuria with socio demographic and clinical factors such as blood sugar control, blood pressure control, excessive body mass index and hypercholesterolemia.
Methodology: Data been collected from patient’s record that been regularly follow up at Primary Healthcare Clinics in Negeri Sembilan. Duration of study follow up was from the date of they been diagnosed of Diabetes Mellitus Type 2 until detection of albuminuria or 1st July 2007,end date of data collection then survival analysis been done.
Result: Majority of study population was female 60.9% and Malay 69.7%. Mean age was 59.9 ± 10.7 and duration having Diabetes Mellitus was 7.0 ± 6.3 years. Only 22% achieved optimum glucose (HbA1c < 6.5%), controlled blood preassure 130/80 mmHg 42.3%, level of cholesterol <4.5 mmol/L only 22.7 %, 11.4% of patients having ideal body weight < 23 kg/m2. The incidence of Diabetes Mellitus Type 2 was 24.4 cases per 1000 population. The median of follow up duration was 22 years; with minimum follow up was 7 months and maximum 42 years. Survival analysis showed that the median of free albuminuria among cases was 22 years (CI 95%:16.5 – 27.4). The log rank test showed no significant relationship between high blood pressure, excessive body mass index and hypercholesterolemia with albuminuria. This study noted that the occurrence of albuminuria seems to be higher among those were hypertensive (26.6%), and excessive body mass index (24.7%).
Conclusion: Percentage of Diabetes Mellitus Type 2 patient that achieved optimum clinical target still very low. Early detection of albuminuria is very important as preventive measure of diabetes nephropathy. Good blood pressure control and ideal body weight also prevent of occurring diabetes nephropathy complication.
Keywords: Diabetes Mellitus Type 2, albuminuria, survival analysis.
Introduction: Physiological changes in the oral cavity and dental-related complications may occur during pregnancy. These intraoral changes that occur during pregnancy combined with lack of routine dental check-ups and delays in treatment for oral disease, place pregnant women at higher risk for dental infections. The objectives of this study was to assess the knowledge and awareness of pregnant women on periodontal disease and its effect on pregnancy, to investigate the relationship of their knowledge and awareness with level of education and the barriers of oral healthcare utilization among pregnant women.
Methodology: A self-administered questionnaire with an introductory letter and consent form were given to pregnant women who came for their routine maternity check-up at the Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital. Data entry and analysis was done using Statistical package for Social Sciences (SPSS) version 12.
Result: Ninety-two pregnant women responded to the questionnaire. Only 23.9% answered correctly to the question on what is plaque. However, 45.7% knew that plaque can cause gum disease and a majority of the respondents 72.8% also knew that bleeding gum is an indication to inflamed gums. The result shows that, although 59.8% of the respondents were aware that it is necessary to brush their teeth frequently during pregnancy, only less than half of the respondents (44.6%) were aware that dental plaque and poor plaque control may cause periodontal disease among pregnant women. The majority (33.7%) feels that the long waiting time in the clinic would be their main barrier in seeking dental treatment.
Conclusion: A majority of pregnant women have limited knowledge and poor awareness on periodontal disease and its effect on pregnancy.
Study site: Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital