OBJECTIVE: The study aims to investigate the effect of the hospital nurse shift length and patient-centered care on the perceived quality and safety of nurses in the medical-surgical and multidisciplinary wards in Malaysia.
METHODS: A cross-sectional survey has been conducted on 12 hospitals in Malaysia. Data have been collected via a questionnaire. A stratified sampling has been used. The Hayes macro regression analyses have been used to examine the mediating effects of patient-centered care between the effect of working long shifts on the perceived quality and patient safety.
RESULTS: There is a significant mediation effect of patient-centered care between the effect of shift length on the perceived quality (F = 42.90, P ˂ 0.001) and patient safety (F = 25.12, P ˂ 0.001).
CONCLUSION: Patient-centered care mitigates the effect of the shift length on the care outcomes. The study provides an input for the policymakers that patient-centered care and restructuring duty hours are important to provide high-quality patient care.
DESIGN/METHODOLOGY/APPROACH: Using difference in differences model, BIMC Hospitals and Siloam Hospital Bali were compared before and after shift schedule realignment to test the association between shift schedule realignment and patient safety culture.
FINDINGS: Shift schedule realignment was associated with a significant improvement in staffing (coefficient 1.272; 95% CI 0.842 - 1.702; p<0.001), teamwork within units (coefficient 1.689; 95% CI 1.206 - 2.171; p<0.001), teamwork across units (coefficient 1.862; 95% CI 1.415 - 2.308; p<0.001), handoffs and transitions (coefficient 0.999; 95% CI 0.616 - 1.382; p<0.001), frequency of error reported (coefficient 1.037; 95% CI 0.581 - 1.493; p<0.001), feedback and communication about error (coefficient 1.412; 95% CI 0.982 - 1.841; p<0.001) and communication openness (coefficient 1.393; 95% CI 0.968 - 1.818; p<0.001).
PRACTICAL IMPLICATIONS: With positive impact on patient safety culture, shift schedule realignment should be considered as quality improvement initiative. It stretches the compressed workload suffered by staff while maintaining 40 h per week in accordance with applicable laws and regulations.
ORIGINALITY/VALUE: Shift schedule realignment, designed to improve patient safety culture, has never been implemented in any Indonesian private hospital. Other hospital managers might also appreciate knowing about the shift schedule realignment to improve the patient safety culture.
METHODOLOGY: A cross-sectional survey using selfadministered questionnaires was conducted among all specialists working in government specialist hospitals in the northern states of Malaysia.
RESULTS: Out of 733 questionnaires distributed, 467 were returned giving a response rate of 63.7%. Ninety-nine percent of the respondents believed that research benefits patients while 93.3% think research helps in their professional development. However, 34.8% think that under their present working conditions, it is unlikely they will participate in research. The major barriers identified were lack of funds for research (81%); lack access to expertise, software or statistical analysis (78.4%); interference with daily work schedule (75.1%) and inconsistent manpower in their department (74.2%). There are three barriers with statistically significant difference between hospitals with CRC compared to hospitals without CRC; lack of funds, mentors and access to expertise, software or statistical analysis. The demographic factors, attitudes and barriers contributing to involvement in research also investigated. The main facilitators for the conduct of research are potential to benefit patients and potential for professional development.
CONCLUSION: Taking note of the findings, the Ministry of Health can implement appropriate strategies to improve specialist participation in research.
Methods: A purposive design in combination with a convenience sampling approach was used to recruit 24 women ages 26 to 55 of Malay, Indian, and Chinese descent across 15 university departments in Kuala Lumpur, Malaysia. Audio recordings of the individual semi-structured interviews were transcribed and analyzed using grounded theory.
Results: Women identified two important life transitions, getting married and having children, as particularly influential in changing eating behavior. Women reported a desire to eat healthier that was in tension with pressures to cater to the taste preferences of their household members and to accommodate their work schedules. Persistent social norms of eating in group settings and difficulty in accessing foods perceived as nutritious were reported as barriers to changing individual eating behavior. Regardless of education level and marital status, women agreed that the act of eating was closely connected with cultural values and embodied important meanings that took precedence over eating as a health-promoting behavior. While all participants expressed a desire to eat healthier, many reported limited confidence in their ability to consistently give up familiar and tasty foods for healthier alternatives. Shifts in eating behavior such as trying new healthy recipes and adopting a more restrictive diet were reported as most feasible and personally applicable after learning about a family member's declining health.
Conclusions: In this urban, multiethnic population, increasing the accessibility of nutritious foods and changing cultural perceptions of the relationship between food and nutrition may be important for enabling healthy eating behaviors.
Funding Sources: Yale Sustainable Food Program, Yale School of Public Health.
Objectives: A cross-sectional study was carried out to explore the association of occupational, socio-demographic, and lifestyle factors with lung functions in traffic policemen in Kuala Lumpur (KL) and Johor Bahru (JB).
Methods: A spirometer was used to measure lung function of subjects, whereas a self-administered questionnaire was used to obtain their information on background data, lifestyle, and occupational factors. The statistical test used was Spearman rho's test and chi-square test; then, the factors were further tested using Logistic regressions.
Findings: 134 male subjects were selected as respondents in this study with 83% response rate. Among all the factors tested, age (FVC: χ = 8.42(3), p = 0.04), (FEV: χ = 8.26(3), p = 0.04), rank (FVC: χ = 8.52(3), p = 0.04), (FEV: χ = 8.05(3), p = 0.04), duration of services (FVC: χ = 11.0(1), p = 0.04), (FEV: χ = 6.53(1), p = 0.01), and average working hours (with the Measured FVC (litre), r = -3.97, p < 0.001; Measured FEV1 (litre), r = -3.70, p < 0.001; Predicted FVC, r = -0.49, p < 0.001; Predicted FEV1, r = -0.47, p < 0.001; and %Ratio FEV1/FV, r = -0.47, p < 0.001) were significantly related to lung function among traffic police.
Conclusions: Occupational factors play a crucial role, and hence, the authorities should take action in generating flexible working hours and the duration of services accordingly. The data from this study can help by serving as a reference to the top management of traffic police officers to develop occupational safety and health guideline for police officers to comply with the Occupational Safety and Health Act (OSHA, Act 514 1994).