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Fulltext Profile of in-patient suicides in two hospitals in Malaysia

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
Psychological processes of suffering of palliative care patients in Malaysia: a thematic analysis

Tan SB, Loh EC, Lam CL, Ng CG, Lim EJ, Boey CCM

BMJ Support Palliat Care, 2019 Mar;9(1):e19.
PMID: 27098972 DOI: 10.1136/bmjspcare-2015-001064

Although suffering in palliative care has received increasing attention over the past decade, the psychological processes that underpin suffering remain relatively unexplored.
OBJECTIVE: To understand the psychological processes involved in the experiencing of suffering at the end phase of life.
METHODS: Semistructured interviews were conducted with 20 palliative care inpatients from an academic medical centre in Kuala Lumpur, Malaysia. The transcripts were thematically analysed with NVIVO9.
RESULTS: 5 themes of psychological processes of suffering were generated: (1) perceptions, (2) cognitive appraisals, (3) hope and the struggles with acceptance, (4) emotions and (5) clinging. A model of suffering formation was constructed.
CONCLUSION: The findings may inform the development of mechanism-based interventions in the palliation of suffering.

Matched MeSH terms: Inpatients/psychology*
Fulltext Transition care readiness among patients in a tertiary paediatric department

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
Severity of anxiety disorder and other factors associated with disease severity among COVID-19 patients in a hospital, Bali, Indonesia

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
Development and Validation of a Cross-Country Hospital Patient Quality of Care Assessment Tool in Europe

Villiers-Tuthill A, Doulougeri K, McGee H, Montgomery A, Panagopoulou E, Morgan K

Patient, 2017 Dec;10(6):753-761.
PMID: 28523465 DOI: 10.1007/s40271-017-0246-8

BACKGROUND: Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework.
DESIGN: We conducted a multi-country cross-sectional study.
METHODS: Following a literature review and patient focus groups, an expert panel generated questionnaire items. Following a pilot study, item numbers were reduced. The final questionnaire consisted of three sections: demographics, perceived QoC and one open-ended question. Data was collected from patients (n = 531) discharged from hospitals across seven countries in South East Europe (languages: Turkish, Greek, Portuguese, Romanian, Croatian, Macedonian and Bulgarian). Reliability and validity of the measure were assessed.
RESULTS: Confirmatory factor analysis was used to compare various factor models of patient-perceived QoC. Good model fit was demonstrated for a two-factor model: communication and interpersonal care, and hospital facilities.
CONCLUSIONS: The ORCAB (Improving quality and safety in the hospital: The link between organisational culture, burnout and quality of care) Patient QoC questionnaire has been collaboratively and exhaustively developed between healthcare professionals and patients. It enables patient QoC data to be assessed in the context of the IOM pillars of quality, considering both technical and interpersonal dimensions of care. It represents an important first step in including the patient perspective.

Matched MeSH terms: Inpatients/psychology*
Factors influencing bladder management in male patients with spinal cord injury: a qualitative study

Engkasan JP, Ng CJ, Low WY

Spinal Cord, 2014 Feb;52(2):157-62.
PMID: 24276416 DOI: 10.1038/sc.2013.145

STUDY DESIGN: Qualitative study using individual in-depth interviews.
OBJECTIVES: The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).
SETTING: Public hospitals in Malaysia.
METHODS: Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.
RESULTS: The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.
CONCLUSION: The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.
Study design: Qualitative study using individual in-depth interviews.

Matched MeSH terms: Inpatients/psychology
Suicide attempts among depressed inpatients with depressive disorder in a Malaysian sample. Psychosocial and clinical risk factors

Chan LF, Maniam T, Shamsul AS

Crisis, 2011;32(5):283-7.
PMID: 21940256 DOI: 10.1027/0227-5910/a000088

Depressed inpatients constitute a high-risk population for suicide attempts.

Matched MeSH terms: Inpatients/psychology
Exploring terminally ill patients' and their families' perceptions of holistic care in Malaysia

Loh KY

Int J Palliat Nurs, 2006 Jan;12(1):38-41.
PMID: 16493304 DOI: 10.12968/ijpn.2006.12.1.20396

AIM: To document the perception of terminally ill patients and their family members on the care provided to them, and to look at the components of holistic care that are viewed as inadequate.
METHODS: Thirty cancer patients from a 10-bed palliative ward and their family members who were the chief carers were interviewed. They were asked to give their perceptions on four major areas of care: physical, social, psychological and spiritual. The participants were asked to report which area(s) of the service were inadequate.
RESULTS: Most patients and family members perceived that they received adequate physical care. However, the psychosocial and spiritual aspect of care were perceived as inadequate by the majority of patients and their families. None of the patients interviewed had ever been asked about spiritual distress.
CONCLUSION: The holistic model of care in caring for terminally ill patients is not practised fully. Further development in the psychosocial and spiritual aspects of care is necessary. There is a need to conduct further research to address these domains.

Matched MeSH terms: Inpatients/psychology*