Displaying publications 1 - 20 of 67 in total

Abstract:
Sort:
  1. Yahya H
    Citation: Yahya H. Empowering Malaysians. Ministerial Meeting on Universal Health Coverage. Singapore, 2015

    Lecture focused on: Komuniti Sihat Perkasa Negara (KOSPEN)
    Matched MeSH terms: Patient Participation
  2. Ramly R
    The prevalence of Non Communicable Diseases (NCD) and its risk factors among Malaysian adults are still high. National Health Morbidity Survey (NHMS) 2015 shows that 17.5% of Malaysian adults have diabetes, out of which 53% are undiagnosed, 30.3% are hypertensive whereby 57% of them were undiagnosed. 1 in every 2 Malaysian adults is overweight or obese. Except for hypertension which prevalence is slightly lower compared to 2011 NHMS, all of these prevalences are increasing over the years in spite of vigorous efforts that have been conducted in educating and creating public awareness on the disease and its prevention and control. The increasing trend in NCD and its related risk factors have proved that the educational sensibility is not sufficient in prompting the adoption of healthy behaviors. Obstacles include lack of perceived priority for health, and lack of perceived priority for NCD within the health sector itself. NCD is very much associated with human behavior, environment, economic and social factors. Many studies and experiences have shown that carefully planned and fully implemented community-based intervention program play a big role in overcoming the problem of NCD. The intervention should consist of community and individual empowerment, environmental support and reorienting health services. In 2013, the ministry has taken a big step by embarking on a nationwide community based intervention program namely Komuniti Sihat Perkasa Negara (KOSPEN). This initiative brings the NCD prevention and control program to the community through trained health volunteers, who will function as health agent of change or health enablers that introduce and facilitate healthy living practices amongst their respective community members. This would serve as a mean to control NCD such as high blood pressure and diabetes and its associated risk factors such as obesity, unhealthy diet, smoking and sedentary life style within local communities Combining public education and efforts to prompt behavioral changes, KOSPEN is based on three main strategies which are advocacy and awareness, health policy adoption and establishment of healthy environments and routine NCD risk factors screenings. Trained volunteers are also capable of measuring blood pressure, blood glucose levels and body mass index (BMI) following which, at risk cases are referred to nearby health clinics for further confirmation and management. In addition to these, the volunteers who will be known as Gerak Sihat Malaysia (GSiM) are also trained to plan and organize related intervention programs at the community level for those who need it. As of May 2016, there is 5,000 KOSPEN localities nationwide with 30,000 volunteers trained. 300,000 adults have been screened for high Blood Pressure, at risk blood sugar level, overweight and smokers, out of which 70% have been referred to health clinics for Diabetic confirmation, 36% for high risk Blood Pressure and 6.5% for class II Obesity. In addition to this, weight management program is now being piloted in 134 KOSPEN localities. The Health Ministry is targeting as many as 10,000 KOSPEN localities and 50,000 GSiM by 2022. With this individual and community empowerment effort, almost six million citizens is estimated to get benefit from the program, while 1.6 million adults are expected to undergo NCD screening tests by KOSPEN volunteers.
    8th National Public Health Conference 2016, Managing Society in Combating Public Health Challenges, 2-4 August 2016
    Matched MeSH terms: Patient Participation
  3. Citation: Technical report. Evaluation of effectiveness of implementation of “Komuniti Sihat Perkasa Negara” (KOSPEN) programme in Malaysia- phase 1. Kuala Lumpur: Public Health Institute, Ministry of Health, Malaysia; 2015
    Matched MeSH terms: Patient Participation
  4. Citation: Garis panduan perlaksanaan komuniti Sihat Perkasa Negara (KOSPEN). Putrajaya: Ministry of Health, Malaysia; 2013
    Matched MeSH terms: Patient Participation
  5. Lee YK, Ng CJ, Lee PY, Tong WT, Sa'at H
    Z Evid Fortbild Qual Gesundhwes, 2022 Jun;171:89-92.
    PMID: 35610129 DOI: 10.1016/j.zefq.2022.04.020
    Shared decision making (SDM) activities in Malaysia began around 2010. The rise in the numbers of patients with chronic disease in Malaysia underscores a growing need for doctors to practice patient-centred care and SDM as more Malaysians come into regular contact with health decision-making scenarios. Recent guidelines for medical professionalism have emphasized that options and risks be discussed in consultations, especially for procedures with risk of adverse outcomes. Although SDM is not legally required, principles of SDM are applied in legal judgements on informed consent. Research on SDM has grown to include the adoption of patient and public involvement in research, an increased emphasis on incorporating local cultural values in SDM, and implementation of SDM in Malaysia's health system and organizational culture. While COVID-19 hindered the progress of SDM research, one positive development was that vaccination choices heightened public consciousness about personal decisional autonomy and the need to discuss pros and cons with doctors before making a medical decision.
    Matched MeSH terms: Patient Participation*
  6. Bahrom NH, Ramli AS, Isa MR, Abdul-Hamid H, Badlishah-Sham SF, Baharudin N, et al.
    J Prim Care Community Health, 2020 6 9;11:2150132720931301.
    PMID: 32507012 DOI: 10.1177/2150132720931301
    Background: High activation level has been associated with higher education background, better self-rated health status, and having adequate health literacy. However, there is a gap in the literature regarding the level of activation and the factors associated with it among patients with metabolic syndrome (MetS) in the Malaysian primary care setting. Objectives: This study aims to determine activation levels and the factors associated with high activation among individuals with MetS in primary care. Methods: A cross-sectional study was conducted at a university primary care clinic. Patient activation was measured using the Patient Activation Measure®-13 Malay version. Activation levels were dichotomized into "low activation" (levels 1 and 2) and "high activation" (levels 3 and 4). To determine the factors associated with high activation, simple logistic regressions (SLogR) followed by multiple logistic regressions (MLogR) were performed. Results: Of 333 participants, 280 (84.1%) were included in the final analysis. The mean activation score was 59.4 (SD ±10.20) and 61.8% had high activation level. Two variables were found to be significant on MLogR. Those who were employed have the odds of 3.135 (95% CI 1.442-6.816) of having high activation compared with those who were unemployed. Those with good self-reported health status have the odds of 6.482 (95% CI 1.243-33.792) of having high activation compared to those with poor self-reported health status. Conclusions: The majority of participants had high activation levels. Those who were employed and those who had good self-reported health status were more likely to have high activation levels. Findings of this study could be used to develop patient activation interventions to improve self-management skills among individuals with MetS in primary care. These may include problem solving support, individualized care plans, peer or family support, and skill building. Those in high activation group can be trained to become mentors to support their peers who have low activation level.
    Matched MeSH terms: Patient Participation*
  7. Lee YK, Ng CJ
    Z Evid Fortbild Qual Gesundhwes, 2017 Jun;123-124:66-68.
    PMID: 28527637 DOI: 10.1016/j.zefq.2017.05.019
    Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships. Current research on SDM comprises baseline surveys of decisional role preferences, development and implementation of locally developed patient decision aids, and conducting of SDM training workshops. Most of this research is carried out by public research universities. In summary, the current state of SDM in Malaysia is still at its infancy. However, there are increasing recognition and efforts from the academic institutions and Ministry of Health to conduct research in SDM, develop patient decision support tools and initiate national discussion on patient involvement in decision making.
    Matched MeSH terms: Patient Participation*
  8. Jackson T, Pinnock H, Liew SM, Horne E, Ehrlich E, Fulton O, et al.
    BMC Med, 2020 04 13;18(1):79.
    PMID: 32279658 DOI: 10.1186/s12916-020-01544-7
    BACKGROUND: Patient and public involvement (PPI) in research envisages a relationship built throughout the lifespan of a research project between academics, clinicians and PPI colleagues in order to inform, plan, execute and, in due course, disseminate and translate research. To be meaningful, all stakeholders need to actively engage in this exchange of expertise. However, despite some funders requiring PPI plans to be included in grant applications, there remains a gap between what is expected and what is delivered.

    MAIN BODY: As an exemplar, we reflect on how, in the Asthma UK Centre for Applied Research (AUKCAR), we set out to create a supportive, organised environment with the overarching value of 'keeping patients at the heart of everything we do'. The key has been in planning and creating a suitably funded organisational infrastructure with dedicated PPI researchers along with the development of and expectation to abide by an agreed set of norms and values. Specifically, expecting AUKCAR PhD students and early career researchers to engage with PPI has established a working mode that we hope will last. Regular interactions and proactive Patient Leads increase PPI network cohesion.

    CONCLUSION: With adaptation, the AUKCAR PPI model can be translated to international contexts.

    Matched MeSH terms: Patient Participation/methods*
  9. Kamaruzaman HF, Ku Abd Rahim KN, Mohamed Ghazali IM, Mohd Yusof MA
    PMID: 33745482 DOI: 10.1017/S0266462321000118
    Patient and public involvement (PPI) in health technology assessment (HTA) is widely promoted to ensure that all health-related decisions are made after taking into consideration the viewpoints of important stakeholders. In Malaysia, patients or their representatives have been involved in the development of HTA and Clinical Practice Guidelines (CPG) since 2009 and their influences have been growing steadily over the years. This paper aimed to describe the journey, achievements, challenges, and future direction of the PPI throughout all stages of the development and implementation of HTA and CPG in Malaysia. Currently, in Malaysia, patients or their representatives are mainly involved during the initial development of HTA and CPG drafts as well as during the internal and external reviews. Additionally, they are also encouraged to be involved during the implementation of HTA and CPG recommendations. Although their involvement in this aspect has slowly increased over time, challenges remain in the form of limited representativeness of selected patients or carers, uncertainty on the level of patient involvement allowed during the HTA/CPG development processes, and limited health literacy, which affect their ability to contribute meaningfully throughout the processes. Continuous improvement in these processes is important as patients or their representatives play a pivotal role in ensuring transparency, accountability, and credibility throughout the HTA/CPG development and decision-making processes.
    Matched MeSH terms: Patient Participation*
  10. Mohammad Arif Shahar, Mohd Faiz Tahir, Ahmad Marzuki Omar
    MyJurnal
    Despite advances in the management of diabetes, the rate of control of
    diabetes in the population remains modest. Perception of diabetes control is a key to
    patient empowerment. The aim of this study was to describe the perception of diabetes
    control among patient with poorly controlled diabetes. (Copied from article).
    Matched MeSH terms: Patient Participation
  11. Sabtu MY, Lim KK, Ismail H, Mohd Zaki NA, Lim KH
    Med J Malaysia, 2015;70 Suppl 1:70.
    Introduction: The Ministry of Health had initiated a national programme known as “KOSPEN” to study the prevalence of Non Communicable Diseases (NCDs) and its risk factors among the population. The aim of this study is to assess the awareness, knowledge and acceptance of KOSPEN programme among
    Community Development Department (KEMAS) personnel in Southern Zone, Malaysia.
    Methods: The cross-sectional study was conducted between October and mid December 2014. The study used validated self-administered questionnaires to collect data from the 2375 KEMAS staff from the state of Johor, Malacca and Negeri Sembilan. SPSS version 20 was used for data analysis.
    Results: The results revealed that only 25.5% of respondents were aware that they were on the KOSPEN committee and 65.7% said that they knew the functions of KEMAS in KOSPEN. 90.8% were aware that their responsibilities included identifying localities for KOSPEN, identifying volunteers (85.7%) and attending KOSPEN training (75.3%). In terms of knowledge, most of them knew the objectives of KOSPEN, such as “KEMAS will add on the value of the programmes and its activities” (84.3%) and “to establish trained health volunteers in the community” (85.9%). They also knew that healthy eating habits (94.7%), active lifestyle (93.4%), body weight management (87.0%), no smoking (86.8%) and health screening (92.2%) were the components of KOSPEN. Majority of the respondents perceived that the components for intervention in the community were good. The highest accepted component was health
    screening (83.5%), follow by healthy eating habits (82.0%), active lifestyle (80.4%), no smoking habit (76.9%) and body weight management (76.1%).
    Conclusion: the awareness, knowledge and acceptance of KOSPEN programme by KEMAS personnel are good. Several measures are currently being carried out to improve and strengthen the implementation of KOSPEN programme such as funding, screening equipment and health education materials.
    Matched MeSH terms: Patient Participation
  12. Sepucha KR, Matlock DD, Wills CE, Ropka M, Joseph-Williams N, Stacey D, et al.
    Med Decis Making, 2014 07;34(5):560-6.
    PMID: 24713692 DOI: 10.1177/0272989X14528381
    BACKGROUND: This review systematically appraises the quality of reporting of measures used in trials to evaluate the effectiveness of patient decision aids (PtDAs) and presents recommendations for minimum reporting standards.

    METHODS: We reviewed measures of decision quality and decision process in 86 randomized controlled trials (RCTs) from the 2011 Cochrane Collaboration systematic review of PtDAs. Data on development of the measures, reliability, validity, responsiveness, precision, interpretability, feasibility, and acceptability were independently abstracted by 2 reviewers.

    RESULTS: Information from 178 instances of use of measures was abstracted. Very few studies reported data on the performance of measures, with reliability (21%) and validity (16%) being the most common. Studies using new measures were less likely to include information about their psychometric performance. The review was limited to reporting of measures in studies included in the Cochrane review and did not consult prior publications.

    CONCLUSIONS: Very little is reported about the development or performance of measures used to evaluate the effectiveness of PtDAs in published trials. Minimum reporting standards are proposed to enable authors to prepare study reports, editors and reviewers to evaluate submitted papers, and readers to appraise published studies.

    Matched MeSH terms: Patient Participation/methods*
  13. Abidi SS, Goh A
    PMID: 11187636
    Easier and focused access to healthcare information can empower individuals to make 'informed' choices and judgements about personal health maintenance. To achieve 'optimum' patient empowerment, we need to re-evaluate and potentially re-design the processes of healthcare information delivery. Our suggestion is that healthcare information should be personalised according to each individual's healthcare needs and it should be pro-actively delivered, i.e. pushed towards the individual. We present an intelligent Personalised Healthcare Information Delivery Systems that aims to enhance patient empowerment by pro-actively pushing customised, based on one's Electronic Medical Record, health maintenance information via the WWW.
    Matched MeSH terms: Patient Participation*
  14. Townsend D
    Trop Doct, 2001 Jan;31(1):8-10.
    PMID: 11205619
    Rapid participatory research and project development is possible within a tightly controlled social context such as a prison. Having gained access, based on trust and mutual respect, external agents may then facilitate significant change. Given adequate support, incarcerated people with HIV/AIDS and limited medical access may be able to develop mutual care, social support and income-generating activities. In the Malaysian context, we estimated in 1998 that up to one-quarter of prisoners with HIV had indicators of significant disease. We estimated that significant indicators remained unrevealed among between one-half and two-thirds of these. Given prevailing conditions, these would probably only be amenable to peer-based care.
    Matched MeSH terms: Patient Participation*
  15. Lee SP, Haycock-Stuart E, Tisdall K
    Enferm Clin, 2019 09;29 Suppl 2:715-719.
    PMID: 31324547 DOI: 10.1016/j.enfcli.2019.04.109
    OBJECTIVE: The study was to examine the role of children in communication and decisions regarding their nursing care in a paediatric oncology ward in Malaysia.

    METHODS: The principles of focused ethnography underpinned the study design. Fieldwork took place over six months in one 32-bedded paediatric oncology ward. Twenty-one children, ranging in ages from 7 to 12 years diagnosed with leukaemia, their parents and 19 nurses participated. Data collection consisted of participant observation and semi-structured interview.

    RESULTS: Hospitalized children employed different roles of passive or active participants during the communication and decisions about their nursing care. Importantly, children are more likely to become active participants in the communication process when nurses interact directly with them, listening to them and giving them opportunities to ask questions in either the presence or absence of their parents. Equally, children are likely to be more passive participants when nurses do not communicate directly with them, choosing instead to directly interact with the child's parents. This study highlighted that the role of children as active and passive participants is not permanently engaged by individual children, rather their role fluctuates throughout the hospitalization journey. The fluctuations of a child's role are highly dependent on their preferences: how and when they want to be included in the communication and decisions process. Children's roles in communication and decisions are also varied and dependent on their particular contexts. A child's participation in one situation does not consistently reflect their participation with their role in other situations. The ways in which the children participate were oscillated throughout their hospitalization.

    CONCLUSIONS: This study provides empirical insight into children's experiences of triadic (child-nurse-parent) interaction during the decisions about their nursing care in paediatric oncological setting. A key recommendation calls for the development of assessment strategies to determine the 'ideal' position children would like to occupy, at any given point in time, throughout their hospitalization.

    Matched MeSH terms: Patient Participation*
  16. Bulgiba AM, Fisher MH
    Health Informatics J, 2006 Sep;12(3):213-25.
    PMID: 17023409 DOI: 10.1177/1460458206066665
    The study investigated the effect of different input selections on the performance of artificial neural networks in screening for acute myocardial infarction (AMI) in Malaysian patients complaining of chest pain. We used hospital data to create neural networks with four input selections and used these to diagnose AMI. A 10-fold cross-validation and committee approach was used. All the neural networks using various input selections outperformed a multiple logistic regression model, although the difference was not statistically significant. The neural networks achieved an area under the ROC curve of 0.792 using nine inputs, whereas multiple logistic regression achieved 0.739 using 64 inputs. Sensitivity levels of over 90 per cent were achieved using low output threshold levels. Specificity levels of over 90 per cent were achieved using threshold levels of 0.4-0.5. Thus neural networks can perform as well as multiple logistic regression models even when using far fewer inputs.
    Matched MeSH terms: Patient Participation*
  17. Price A, Albarqouni L, Kirkpatrick J, Clarke M, Liew SM, Roberts N, et al.
    J Eval Clin Pract, 2018 02;24(1):240-253.
    PMID: 29076631 DOI: 10.1111/jep.12805
    BACKGROUND: Funders encourage lay-volunteer inclusion in research. There are controversy and resistance, given concerns of role confusion, exploratory methods, and limited evidence about what value lay-volunteers bring to research. This overview explores these areas.

    METHODS: Eleven databases were searched without date or language restrictions for systematic reviews of public and patient involvement (PPI) in clinical trials design. This systematic overview of PPI included 27 reviews from which areas of good and bad practice were identified. Strengths, weaknesses, opportunities, and threats of PPI were explored through use of meta-narrative analysis.

    RESULTS: Inclusion criteria were met by 27 reviews ranging in quality from high (n = 7), medium (n = 14) to low (n = 6) reviews. Reviews were assessed using CERQUAL NICE, CASP for qualitative research and CASP for systematic reviews. Four reviews report risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow-up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning, and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation, and dissemination. Challenges identified include lack of clarity within common language, roles, and research boundaries, while logistical needs include extra time, training, and funding. Researchers report struggling to report involvement and avoid tokenism.

    CONCLUSIONS: Involving patients and the public in clinical trials design can be beneficial but requires resources, preparation, training, flexibility, and time. Issues to address include reporting deficits for risk of bias, study quality, and conflicts of interests. We need to address these tensions and improve dissemination strategies to increase PPI and health literacy.

    Matched MeSH terms: Patient Participation*
  18. Sondaram NK, Kadir@Shahar H, Abdul Manaf R
    MyJurnal
    Introduction: The increasing burden of Non-Communicable Diseases and their prevalence has led Ministry of Health (MOH) Malaysia to introduce a community empowerment program “Komuniti Sihat, Perkasa Negara” acronymed as KOSPEN in July 2013. Thirty thousand community health volunteers have been trained nationwide up to May 2015.
    Objective: To identify the factors associated with knowledge on KOSPEN and its implementation among community health volunteers in Kulim District.
    Methods: A cross-sectional study based on simple random sampling was conducted among community health volunteers Kulim District. Volunteers participated in this study were 194. Data collected using self-administered questionnaire. All data collected were analysed using IBM SPSS version 22 involving descriptive and inferential statistics with significance level set at 0.05.
    Results: The study found that level of knowledge on KOSPEN is associated with employment status (p=0.02) and awareness level (p<0.001) among the community health volunteers. The level of implementation is associated with age (p=0.025), education level (p=0.007) and employment status (p=0.017) of the community health volunteers. Employment status (aOR=2.133, 95% CI=1.056-4.306, p=0.035) and awareness level (aOR=6.119, 95% CI=2.701-13.867 p<0.001) were predictors of level of knowledge on KOSPEN. Level of implementation of KOSPEN by the community health volunteers could be predicted by education level (aOR=4.085, 95% CI=1.299-12.851 p=0.016).
    Conclusion: Generally the KOSPEN volunteers had good knowledge on KOSPEN and implementation of KOSPEN program. However, there are still misconceptions among the KOSPEN volunteers regarding their functions and role. Therefore it is important to empower the volunteers with awareness on their roles, functions and good knowledge.
    Matched MeSH terms: Patient Participation
  19. Lee PY, Cheong AT, Ghazali SS, Rashid AA, Ong SC, Ong SY, et al.
    Health Expect, 2022 Dec;25(6):2837-2850.
    PMID: 36098241 DOI: 10.1111/hex.13590
    BACKGROUND: Shared decision-making has been shown to improve the quality of life in metastatic breast cancer patients in high-literacy and high-resource settings. However, limited studies have examined the cultural preferences of metastatic breast cancer patients with shared decision-making implementation and the barriers encountered in an Asian setting where societal norms predominate and physician decision-making is at the forefront. This paper aims to identify (1) barriers to practising shared decision-making faced by healthcare professionals and patients and (2) strategies for implementing shared decision-making in the context of metastatic breast cancer management in Malaysia.

    METHODS: We conducted a qualitative study involving 12 patients diagnosed with metastatic breast cancer, 16 healthcare professionals and 5 policymakers from surgical and oncology departments at public healthcare centres in Malaysia. Semi-structured in-depth interviews and focus group discussions were conducted. The interviews were recorded, transcribed verbatim and analysed using the thematic approach. Nvivo software was used to manage and analyse the data.

    RESULTS: Five main themes emerged from the study: healthcare provider-patient communication, workforce availability, cultural and belief systems, goals of care and paternalism versus autonomy. Other strategies proposed to overcome barriers to implementing shared decision-making were training of healthcare professionals and empowering nurses to manage patients' psychosocial issues.

    CONCLUSION: This study found that practising shared decision-making in the public health sector remains challenging when managing patients with metastatic breast cancer. The utilization of decision-making tools, patient empowerment and healthcare provider training may help address the system and healthcare provider-patient barriers identified in this study.

    PATIENT OR PUBLIC CONTRIBUTION: Patients were involved in the study design, recruitment and analysis.

    Matched MeSH terms: Patient Participation
  20. Ngadimon IW, Islahudin F, Mohamed Shah N, Md Hatah E, Makmor-Bakry M
    Int J Clin Pharm, 2017 Feb;39(1):120-125.
    PMID: 27905077 DOI: 10.1007/s11096-016-0407-1
    Background Shared decision-making is vital in achieving desired drug therapy goals, especially with antibiotics, in view of the potential long-term reduction in drug resistance. However, shared decision-making is rarely practiced with adolescent patients. Objectives The aim of the study was to identify the effect antibiotic education has on willingness to engage in shared decision-making among adolescents in Malaysia. Setting Participants from secondary schools in Malaysia were enrolled with ethical approval. Method The adolescents answered a validated questionnaire, which included demographics, antibiotic knowledge, attitude towards antibiotic use, and the Control Preference Scale, which measures willingness to engage in shared decision-making. Afterwards, antibiotic education was delivered to participating students. Main outcome measure Knowledge about and attitude toward antibiotics were investigated. Results A total of 510 adolescents participated in the study. Knowledge of antibiotics significantly increased post education (pre 3.2 ± 1.8 vs. post 6.8 ± 2.1, p 
    Matched MeSH terms: Patient Participation/methods*; Patient Participation/trends
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links