Displaying publications 1 - 20 of 123 in total

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  1. Chow SK, Yap DFS, Sim JH, Tan PS, Hee NKY, Teow XM, et al.
    Med J Malaysia, 2023 Dec;78(7):907-913.
    PMID: 38159927
    INTRODUCTION: This study aimed to determine the prevalence and association between the severity of COVID-19 and short and long-term neuropsychiatric symptoms, as well as the risk factors for the development of these symptoms.

    MATERIALS AND METHODS: A prospective observational study was conducted between 1st October 2021 till September 2022 in the state of Johor, Malaysia. 300 patients with confirmed SARS-CoV-2 infection were randomly selected and followed up for six months. Data were analysed by using Chi-square test, Fisher's Exact test, Paired t test and Multiple logistic regression.

    RESULTS: The prevalence of short-term neuropsychiatric symptoms was 78%, with anosmia being the most prevalent symptom. Long-term symptoms were found in 22.75% of patients, with headache being the most prevalent (p= 0.001). COVID-19 Stage 2 and 3 infections were associated with a higher risk of short-term neuropsychiatric symptoms, OR for Stage 2 infection was 5.18 (95% CI: 1.48-16.97; p=0.009) and for Stage 3 infection was 4.52 (95% CI: 1.76-11.59; p=0.002). Complete vaccination was a significant predictor of longterm symptoms with adjusted OR 3.65 (95% CI 1.22-10.91; p=0.021).

    CONCLUSION: This study demonstrated that neuropsychiatric symptoms were common among COVID-19 patients in Johor, Malaysia and the risk of these symptoms was associated with the severity of the infection. Additionally, complete vaccination does not completely protect against long-term neuropsychiatric deficits. This is crucial for continuous monitoring and addressing neuropsychiatric symptoms in COVID-19 survivors.

    Matched MeSH terms: Inpatients*
  2. Hajialibeigloo R, Mazlum SR, Mohajer S, Morisky DE
    Nurs Open, 2021 Jul;8(4):1947-1957.
    PMID: 33811803 DOI: 10.1002/nop2.870
    AIM: To investigate the effect of self-administration of medication programme on medication adherence in cardiovascular inpatients and nurse's satisfaction.

    DESIGN: Randomized clinical trial with parallel-group design guided by the CONSORT checklist.

    METHODS: In this study, sixty cardiovascular inpatients were selected through convenience sampling and then randomly assigned to control and intervention groups, in 2018, Iran. The intervention group took responsibility for consuming their prescribed medication according to the self-administration of medication programme and the control group took medications routinely. Medication adherence was measured one and two weeks after the discharge via telephonic follow-up by Morisky Medication Adherence Scale MMAS-8-item and nurses' satisfaction by researcher-made questioner.

    RESULT: There was a higher medication adherence level in the intervention group rather than the usual care group at the follow-up. Most nurses in the study environment were very satisfied.

    CONCLUSION: The self-administration of medication programme can effectively increase patients' medication adherence and nurses' satisfaction.

    Matched MeSH terms: Inpatients*
  3. Looi JC, Allison S, Woon L
    Australas Psychiatry, 2023 Oct;31(5):659-661.
    PMID: 37424206 DOI: 10.1177/10398562231188264
    OBJECTIVE: Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors' clinical experience and the existing research literature.

    CONCLUSIONS: There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist's assessment of the temporary role, and consideration of the local service conditions.

    Matched MeSH terms: Inpatients
  4. Ng RJ, Choo WY, Ng CW, Hairi NN
    Health Policy Plan, 2024 Mar 12;39(3):268-280.
    PMID: 38300142 DOI: 10.1093/heapol/czae004
    The vital role of healthcare financing in achieving universal health coverage is indisputable. However, most countries, including Malaysia, face challenges in establishing an equitable and sustainable healthcare financing system due to escalating healthcare costs, an ageing population and a growing disease burden. With desirable pre-payment and risk pooling features, private health insurance (PHI) is considered an alternative financing option to reduce out-of-pocket (OOP) medical expenditure. However, ongoing theoretical and empirical debates persist regarding the adequacy of financial risk protection provided by PHI largely because it depends on its role, the benefit design and the regulations in place. Our study aimed to investigate the effect of supplementary PHI on OOP inpatient medical expenditure in Malaysia. Secondary data analysis was conducted using the Malaysian National Health and Morbidity Survey 2019 dataset. A total of 983 respondents with a history of inpatient hospitalization in the past 12 months were included in the study. Instrumental variable analysis using a two-stage residual inclusion was performed to address endogeneity bias, with wealth status and education level as the instrumental variables. Tobit regression model was used in the second stage considering the censored distribution of the outcome variable. Missing data were handled using multiple imputation. About one-fifth of the respondents had PHI. In this study, we found that having PHI significantly increased OOP inpatient medical expenditure in all three marginal effects. Additionally, age, residential location, ethnicity (citizenship), being covered by government guarantee letter, government funding and employer-sponsored health insurance were other significant factors associated with OOP inpatient medical expenditure. Our findings undermine a key justification to advocate PHI uptake among the population, with a need for the Malaysian government to reassess the role of PHI in healthcare financing and reconsider PHI subsidization policy. Regulations should also be strengthened to enhance the financial risk protection provided by PHI.
    Matched MeSH terms: Inpatients*
  5. Arshad AR, Ganesananthan S, Ajik S
    Med J Malaysia, 2000 Sep;55(3):331-40.
    PMID: 11200713
    A study was carried out in Kuala Lumpur Hospital to review the adequacy of documentation of bio-data and clinical data including clinical examination, progress review, discharge process and doctor's identification in ten of our clinical departments. Twenty criteria were assessed in a retrospective manner to scrutinize the contents of medical notes and subsequently two prospective evaluations were conducted to see improvement in case notes documentation. Deficiencies were revealed in all the criteria selected. However there was a statistically significant improvement in the eleven clinical data criteria in the subsequent two evaluations. Illegibility of case note entries and an excessive usage of abbreviations were noted during this audit. All clinical departments and hospitals should carry out detailed studies into the contents of their medical notes.
    Matched MeSH terms: Inpatients*
  6. Vepa A, Saleem A, Rakhshan K, Daneshkhah A, Sedighi T, Shohaimi S, et al.
    PMID: 34207560 DOI: 10.3390/ijerph18126228
    BACKGROUND: Within the UK, COVID-19 has contributed towards over 103,000 deaths. Although multiple risk factors for COVID-19 have been identified, using this data to improve clinical care has proven challenging. The main aim of this study is to develop a reliable, multivariable predictive model for COVID-19 in-patient outcomes, thus enabling risk-stratification and earlier clinical decision-making.

    METHODS: Anonymised data consisting of 44 independent predictor variables from 355 adults diagnosed with COVID-19, at a UK hospital, was manually extracted from electronic patient records for retrospective, case-control analysis. Primary outcomes included inpatient mortality, required ventilatory support, and duration of inpatient treatment. Pulmonary embolism sequala was the only secondary outcome. After balancing data, key variables were feature selected for each outcome using random forests. Predictive models were then learned and constructed using Bayesian networks.

    RESULTS: The proposed probabilistic models were able to predict, using feature selected risk factors, the probability of the mentioned outcomes. Overall, our findings demonstrate reliable, multivariable, quantitative predictive models for four outcomes, which utilise readily available clinical information for COVID-19 adult inpatients. Further research is required to externally validate our models and demonstrate their utility as risk stratification and clinical decision-making tools.

    Matched MeSH terms: Inpatients*
  7. Che Johan NAS, Rasani AAM, Keng SL
    Br J Nurs, 2023 Jan 26;32(2):74-80.
    PMID: 36715528 DOI: 10.12968/bjon.2023.32.2.74
    BACKGROUND: The use of mobile health (mHealth) applications, which provide opportunities to improve health and lessen health inequalities, is increasing. Studies assessing the readiness and ability of patients in Malaysia with chronic kidney disease (CKD) to use mobile phone apps to manage their health are limited.

    AIMS: This study aimed to assess the readiness and ability to use mHealth apps among patients with CKD in north-east Peninsular Malaysia.

    METHODS: A cross-sectional study was undertaken, using a convenience sample of 100 CKD medical inpatients in a tertiary teaching hospital. A structured, self-administered questionnaire on readiness and ability to use mHealth apps was adopted.

    FINDINGS: Nearly one in five patients (18%) actively used health applications. More than three-quarters (77%) were aged >40 years and a similar proportion were ready to use mHealth apps (78%), and nearly half (46%) were confident about connecting their device to wifi. There was a correlation between ability and readiness to use mHealth apps (r=0.4; P<0.05).

    CONCLUSIONS: Fewer than half of participants had a good command of mHealth applications. Therefore, support on the use of these apps is needed, and healthcare managers need to consider this.

    Matched MeSH terms: Inpatients
  8. Aishah AB, Foo YN
    Med J Malaysia, 1995 Sep;50(3):246-9.
    PMID: 8926903
    A retrospective six-month study of serum calcium and albumin in patients treated at the Kuala Lumpur Hospital was carried out. There were 19,291 subjects, of which the prevalences of hypocalcemia (corrected serum calcium of < or = 2.1 mmol/l) and hypercalcemia (corrected serum calcium of > 2.7 mmol/l) were 18.0% (3460 subjects) and 2.4% (468 subjects) respectively. Persistent hypocalcemia (a minimum of first two consecutive corrected serum calcium of < or = 2.1 mmol/l) was found in 408/19,291 subjects 2.1%). Serum calcium values of < 2.00 mmol/l were found in 98.5% of this group. Persistent hypercalcemia (a minimum of first two consecutive corrected serum calcium of > 2.7 mmol/l) was found in 108/19,291 subjects (0.5%) and 52/108 subjects (48.1%) had serum calcium values of > or = 3.0 mmol/l. 2902/3460 subjects (83.8%) and 313/468 subjects (66.9%) the hypocalcemia and hypercalcemia groups respectively failed to be retested (singletons). In the hypocalcemia group, 1115/2902 (38.4%) showed corrected serum calcium values of < 2.00 mmol/l), whilst 100/313 subjects (31.9%) of the hypercalcemia group had corrected serum calcium values of > or = 3.00 mmol/l. There were no significant differences between the mean corrected serum calcium between 3 age groups of the test population, namely in childhood ( < or = 65 years).
    Matched MeSH terms: Inpatients*
  9. Zain AM
    Med J Malaysia, 1991 Jun;46(2):171-6.
    PMID: 1839422
    A study of completed in-patient suicides at the University Hospital Kuala Lumpur (UHKL) and Hospital Bahagia Ulu Kinta (HBUK) between 1st January 1967 to 31st December 1987 were conducted. Records of completed in-patient suicides during the period were exhaustively studied. Only 18 cases were from UHKL and 23 cases were from HBUK. It was found that the suicide patients were mainly young Chinese males from the lower socio economic group. The main reasons for suicide were interpersonal conflicts and physical illness. Alcohol was not an important factor unlike patients in the West.. Suicidal intent was also important. Many of the suicides were committed during the early hours of the morning and they usually occurred at inaccessible places. The method was strongly influenced by availability. To the best knowledge of the author, this is the first study of in-patient suicides in Malaysia.
    Matched MeSH terms: Inpatients/psychology
  10. Mehmood A, Ahmed Z, Ghilan K, Damad A, Azeez FK
    Inquiry, 2021 11 20;58:469580211056060.
    PMID: 34796754 DOI: 10.1177/00469580211056060
    Health care systems aim to deliver high-quality medical care while considering efficient resource usage and cost-effective forms of interventions. Such purposes require scientific tools or mechanisms which aid in cost assessment before the efforts of cost reduction are considered. Diagnosis-related groups based costing methodology (Case-mix) is considered one of the preferred costing approaches in the health care sector. King Fahd Central hospital Jazan, the only tertiary hospital in the Jazan region, was selected for case-mix system-based patient-level costing of health services. The study's objective was to estimate the cost per Diagnosis-Related Group (DRG) per inpatient admission and compare it with the already established average cost of health care services for inpatients. We applied a cross-sectional retrospective approach to categorize the inpatients based on their diagnosis and procedures and then estimate the actual cost of health care services provided to inpatients during 2018 and compared it with the average cost of the health services. There was a considerable difference between DRG-based costing (SAR 269,663,897) and average costing (SAR 247,035,938). The Diagnosis Related Group costing was found to be more reliable and representative of the services provided to the patients and is recommended to be used for reimbursement purposes.
    Matched MeSH terms: Inpatients*
  11. Norshariza, J., Neoh, M.K., Betti, Sharina M.H.L., Aeininhayatey, A., Siti Farrah Zaidah, M.Y., Aini Zaharah, A.J., et al.
    Malays J Nutr, 2017;23(2):161-174.
    MyJurnal
    Introduction: Malnutrition in cancer patients affects the quality of life (QoL) of the patients and brings about adverse outcomes including morbidity and mortality. This study aims to determine the prevalence of malnutrition among cancer patients at the National Cancer Institute (NCI), Putrajaya.
    Methods: A cross-sectional study was conducted among 97 respondents who were admitted to the NCI between August 2014 and January 2015. Information on socio-demographic characteristics, clinical characteristics, anthropometric measurements, dietary intake and biochemical data were obtained. The Malnutrition Screening Tool (MST) was used to identify malnutrition risk, while the Subjective Global Assessment (SGA) determined patients’ nutritional status.
    Results: Approximately 61.9% and 43.5% of the patients were malnourished upon admission based on the MST and SGA scores, respectively. Four most common types of cancer among the malnourished patients were nasopharyngeal (NPC), lung, breast and colorectal cancer. About 56.9% and 21.6% of the malnourished patients, according to MST, were at Stage 4 and Stage 3 cancer, respectively. Meanwhile 69.7% of the malnourished respondents, based on SGA, were at Stage 4 cancer. Mean energy intake was 1463±577 kcal and protein intake was 54±22 g proteins.
    Conclusion: Prevalence of malnutrition in hospitalised cancer patients in the NCI was high, depending on age, body mass index (BMI), tumour location and cancer stage. Early identification of malnutrition status is required for proper nutritional intervention.
    Study site: National Cancer Institute (NCI) in Putrajaya, Malaysia
    Matched MeSH terms: Inpatients
  12. Subermaniam K, Welfred R, Subramanian P, Chinna K, Ibrahim F, Mohktar MS, et al.
    Front Public Health, 2016;4:292.
    PMID: 28119908 DOI: 10.3389/fpubh.2016.00292
    Falls and fall-related injuries are increasingly serious issues among elderly inpatients due to population aging. The bed-exit alarm has only previously been evaluated in a handful of studies with mixed results. Therefore, we evaluated the effectiveness of a modular bed absence sensor device (M-BAS) in detecting bed exits among older inpatients in a middle income nation in East Asia.
    Matched MeSH terms: Inpatients
  13. Black K
    Matched MeSH terms: Inpatients
  14. Lau SC, Azim E, Abdul Latiff Z, Syed Zakaria SZ, Wong SW, Wu LL, et al.
    Med J Malaysia, 2018 12;73(6):382-387.
    PMID: 30647208
    INTRODUCTION: A smooth transition of healthcare for young people with chronic illnesses from paediatric to adult healthcare services is important to ensure optimal outcome. At the moment, there are no standard guidelines to assess a patient's readiness to transfer care.

    METHODS: A cross-sectional study using a self-administered questionnaire, adapted from UNC (University of North Carolina) TRxANSITION self-assessment tool was conducted to evaluate patients' transition care readiness in paediatric haematology and paediatric diabetes clinic.

    RESULTS: A total of 80 patients (37 thalassaemia and 43 diabetes) with the mean age of 21.2 (SD±4.3) years, were recruited during the 3-month study period. Majority of the patients have basic knowledge regarding their medications, and were able to comply with their follow-up. The mean total score obtained by the respondents on this questionnaire was 15.3 (SD±3.59). Self-management skills and knowledge on disease were the two poorly scored section; with mean score of 3.78 (SD±1.38) and 4.28 (SD±1.20) respectively. Overall, only 21 (26.2%) respondents obtained high score (score above 75th percentile). Seventy-five percent of the respondents admitted that they were not ready for transfer to an adult healthcare service yet at the time of the study.

    CONCLUSION: We suggest that patients with high score should be prepared for transition to adult facility whereas those with a low score need to be identified to ensure provision of continuous education.
    Matched MeSH terms: Inpatients/psychology; Inpatients/statistics & numerical data
  15. Suryana K K, Widiana RIG, Suharsono H, Pujasakti MP, Putra WWS, Yaniswari NMD
    Med J Malaysia, 2021 07;76(4):461-465.
    PMID: 34305105
    INTRODUCTION: COVID-19 pandemic has a substantial impact on human life including the tourism sector (TS). Bali as a tourism destinations and the TS as major incomes of its population is greatly impacted, causing many to be jobless among those involved in TS. This situation may give psychological impact causing anxiety disorder (AD).

    OBJECTIVE: To investigate the association between severe anxiety disorder and other factors with COVID-19 disease severity.

    METHODS: This was cross-sectional study during March - November 2020. The diagnosis of SARS-CoV-2 was done by using RT-PCR from throat swabs, based on WHO's interim guidelines. AD was measured using self-reporting Generalized Anxiety Disorder-7 (GAD-7). All participants underwent, history taking, physical examinations, blood routine examination and chest radiography. Association between severe AD and other factors with COVID-19 disease severity were analyzed. Chi-square test (bivariate) and Logistic regression (multivariate) with the precision value of 95% was done and p-value less than 5% was considered significant.

    RESULTS: Positive rate of Covid-19 patients was 43% (292 / 678). Among those 292 with Covid-19, 74 (25.3%) participants had severe disease. Multivariate analysis showed severe anxiety (OR 696.11; 95%CI: 78.54 to 6169.98; p<0.001), hypertension (OR 37.02; 95%CI: 4.49 to 305.39; p=0.001) and neutrophyl lymphocyte ratio (NLR) less than 2.89 (OR 0.15; 95%CI: 0.04 to 0.62; p=0.009).

    CONCLUSION: Severe anxiety, hypertension and NLR less than 2.89 are potential independent risk factors for severe infection of SARS-CoV-2 (COVID-19).

    Matched MeSH terms: Inpatients/psychology; Inpatients/statistics & numerical data
  16. Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM
    Malays Orthop J, 2014 Nov;8(3):22-6.
    PMID: 26401231 MyJurnal DOI: 10.5704/MOJ.1411.005
    Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.
    Study site: Hospital Sultanah Nur Zahirah, Kuala Terengganu,Terengganu, Malaysia
    Matched MeSH terms: Inpatients
  17. Amer Siddiq AN, Ng CG, Aida SA, Nor Zuraida Z, Abdul Kadir R
    Objective: The aim of this study was to study the rate of readmission and look into factors that may contribute to this. Methods: This is a retrospective descriptive study of all psychiatric patients who were discharged from University Malaya Medical Center (UMMC). Case notes of those discharged during the study period was retrieved and analyzed. Those fulfilling the inclusion criteria were recruited and subjected to a questionnaire. Results: A total 107 patients were identified and only 95 participated. The readmission rate was 16.8%. Severity of illness was identified as the main risk factor for readmission in this study. Conclusion: Our readmission rate was similar to some developed nations and indicated good quality of care in UMMC. There appears to be other factors that may influence rate for readmission other than quality of in-patient care and outpatient community care. Keywords: readmission, mental illness, quality of care, Malaysia
    Matched MeSH terms: Inpatients
  18. Lee,Sze Chet, Ng,Chun Keat, Mohd Amiruddin Mohd Kassim, Pang,Nicholas Tze Ping
    Borneo Epidemiology Journal, 2020;1(1):79-87.
    MyJurnal
    COVID-19 has impacted the world in many ways due to fears of contracting the pandemic, social distancing, and large-scale movement control rules. These have especially grave consequences for inpatient psychiatry. This article reviews measures taken to adapt to the new norm in inpatient care, both for standalone psychiatry units and consultation-liaison units. For inpatient units, changes have been made for personal protective equipment usage, screening and triaging policies, and training and educational policies. Consultation liaison units together with inpatient units have been required to expand the scope of coverage and difficulties by providing certain teleconsultation services. As the new norm takes precedence, Sabah has to embrace and empower community-based psychiatry services for better outreach and coverage. This article discusses the issues underlying the new norm in the management of inpatient psychiatry patients in both units and presents some points and practical solutions on the ground to instil hope
    Matched MeSH terms: Inpatients
  19. Mohamad Isa, M.F., Tan, C.L., Gill, J.S.
    MyJurnal
    About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
    Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia
    Matched MeSH terms: Inpatients
  20. Ade Suzana Eka Putri, Syed Mohamed Aljunid, Amrizal Muhammad Nur
    MyJurnal
    Indonesian government secures the access of the poor towards health services through subsidised schemes. This study is aimed to describe the pattern of health expenditure by households and to describe the pattern of health service utilisation across household’s socioeconomic level in the city of Padang after seven years of the introduction of subsidised schemes. A household survey was conducted involving 918 households, with multistage random sampling method. The proportion of out-of-pocket (OOP) health spending as a share of household’s capacity to pay was regressive across consumption quintiles. The proportion of households with catastrophic health expenditure was 1.6% while 1.1% faced impoverished health expenses. Among those who need health care, the utilisation among the rich was higher than the poor. Health insurance schemes in Padang provides financial protection, however with regards to household’s capacity to pay, the poor has the higher burden of health payment. The gap on health service utilisation between the poor and the better-offs was still apparent for outpatient services and it has been narrowed for inpatient care. This study suggests that the subsidised schemes for the poor are highly needed and the possibility of the leakage of subsidies to the rich should be considered by the government.
    Matched MeSH terms: Inpatients
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