Search

Background. The study investigates critical care nurses' perceptions of medication administration errors (MAEs) in a tertiary hospital in Kelantan, Malaysia, within the unique sociocultural context of East-Coast Malaysia. The research aims to understand the causes and underreporting of MAEs and assess the proportion of reported incidents according to MAE types. Methods. A cross-sectional study involving 424 critical care nurses from Hospital Raja Perempuan Zainab II (HRPZII), Hospital Sultan Ismail Petra (HSIP), and Hospital Tanah Merah (HTM) was conducted. Nurses in administrative roles or unavailable during the survey period were excluded. The study utilized a validated Medication Administration Errors Survey questionnaire to gauge nurses' perceptions on the causes of MAEs, reasons for underreporting, and the percentage of reported incidents based on MAE types. Results. Results indicate that illegible medication orders from doctors were identified as the primary cause of MAEs, while a lack of 24-hour pharmacist availability received the lowest score. The most common reason for not reporting MAEs was identified as the nursing administration's focus on individuals rather than systemic issues when errors occur. The majority of MAEs were non-intravenous, with incorrect timing of administration being the leading cause. Conclusion. The study sheds light on critical care nurses' perspectives on MAEs in a Malaysian hospital setting, highlighting key factors contributing to these errors and barriers to their reporting. Understanding these perceptions is crucial for developing strategies to mitigate MAEs and enhance patient safety in critical care environments. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated women's health beliefs, the use of breast cancer (BC) screening services, and the factors that potentially influence uptake of screening. Methods: Face‐to‐face interviews were conducted with a randomly selected community sample of 992 women (>40 years old) in Selangor State, Malaysia. Results: Approximately 35% of women received a clinical breast examination (CBE) and 27% had a mammogram within the last 1 to 2 years. The regression analyses indicated that Chinese ethnicity has higher perceived susceptibility to BC compared to Malay ethnicity (mean 7.74, SD: 2.75; 95% CI 0.09, 1.03) whilst a lower perceived susceptibility was observed in women aged ≥70 years (mean 6.67, SD: 3.01; 95% CI −1.66, −0.24) compared to women aged 40–49 years. Indian Malaysian women (mean 16.87, SD: 2.59; 95% CI 0.12, 1.01) and women who had received a CBE (mean 16.10, SD:2.35; 95% CI 0.18, 0.89) were more likely to have higher perceived benefits scoring. Indian ethnicity, secondary education and tertiary education, top 20% income group, past history of CBE and mammogram uptake were significantly associated with lower barriers scoring. Conclusions: There is a need to target BC screening uptake improvement programmes towards communities in which women experience disadvantages related to income, education, employment, and, in particular, to tailor programmes to take into consideration differences between ethnic groups regarding their beliefs about cancer screening. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has accelerated implementation of telemedicine in healthcare facilities for delivery of care. Healthcare providers' acceptance of the telemedicine services is important for successful implementation of this new system. A questionnaire based on the Technology Acceptance Model (TAM) has been used to measure user acceptance of telemedicine service. The aim of this study was to translate and validate the English version of the questionnaire into Malay, to extend the availability and utilization of this questionnaire in Malaysia. A forward and backward translation of the questionnaire was conducted to produce the TAM in the Malay version (Malay-TAM). Panel experts assessed content validity. Internal consistency reliability was determined using Cronbach's alpha. Confirmatory factor analysis based on structural equation modelling was performed to validate the factor structure. The questionnaire was then tested on and completed by 149 healthcare workers from several public health clinics across Malaysia. The Malay-TAM demonstrated good reliability with Cronbach's alphas ranging from 0.823 to 0.912. Factor analysis showed good convergent validity but relatively poor discriminant validity. All five constructs were retained to preserve content validity. The findings suggest that the Malay-TAM can serve as a reliable and valid instrument to measure acceptance to telemedicine. [ABSTRACT FROM AUTHOR]

Background. The CYP2C19*2 allele may be associated with a reduced antiplatelet effect for clopidogrel. Here, we assessed whether CYP2C19*2 alleles correlate with clopidogrel responsiveness following the administration of clopidogrel in healthy Malaysian volunteers. Methods. Ninety volunteers were genotyped for CYP2C19*2 and CYP2C19*3 alleles. Forty-five of 90 volunteers were included in the clopidogrel response studies and triaged into three genotypes, namely, CYP2C19*1/*1 (n = 17) CYP2C19*1/*2 (n = 21) and CYP2C19*2/*2 (n = 17). All subjects received 300 mg of clopidogrel, and platelet reactivity was assessed after a four-hour loading utilizing the VerifyNow-P2Y12 assay. Platelet activity was reported using P2Y12 reaction units (PRUs), and nonresponder status was prespecified at PRU = 230. Results. Following clopidogrel intake, CYP2C19*2/*2 carriers had a significantly higher mean PRU compared to the CYP2C19*1/*2 and CYP2C19*1/*1 (291.0 ± 62.1 versus 232.5 ± 81.4 versus 147.4 ± 87.2 PRU, P < 0.0001) carriers. Almost half of the participants (46.7%) were found to be nonresponders (3 were CYP2C19*1/*1, 11 were CYP2C19*1/*2, and 7 were CYP2C19*2/*2). Conclusion. In healthy Malaysian volunteers, CYP2C19*2 allele was associated with a decrease in platelet responsiveness to clopidogrel. However, clopidogrel nonresponders can be found not only in the carriers of CYP2C19*2/*2, but also in the carriers of CYP2C19*1/*2 and CYP2C19*1/*1. The present paper demonstrated that genotype information does not correlate with clopidogrel response, and genotyping may represent a less robust approach compared to platelet activity testing in guiding clopidogrel therapy. [ABSTRACT FROM AUTHOR]

Aim: To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses. Background: Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors. Methods: A cross‐sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses. Results: The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00–5.00), which differed across 24 nursing care elements. Basic nursing care and communication‐related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p <.001). No significant association was found between missed nursing care and nurses' intention to leave (p >.05). Conclusion: The occurrence of missed nursing care was noted to be low. Implications for Nursing Management: Practical strategies such as an acuity‐based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care. [ABSTRACT FROM AUTHOR]

Introduction. Disability has adverse effects on health, wellbeing, and life quality. Vision disorder is one of the top-ranked causes of disability in the elderly population. This study aims to determine the prevalence and factors associated with vision disability among the elderly in Malaysia. Methodology. Data collection from National Health and Morbidity Survey (NHMS) 2018 was obtained. This survey focused on elderly health by using two-stage stratified cluster sampling design. The Washington Group Extended Question Set on Functioning (WG ES-F) was used to determine the vision disability. The data were analyzed using SPSS version 21.0 utilizing a complex sample design with multivariable logistic regression analysis to determine the prevalence and associated factors to vision disability. Results. A total of 3,977 elderly completed the vision disability questionnaire. The overall prevalence of vision disability among those who were 60 years old and above was 4.5%. Multiple logistic regression revealed that no formal education (AOR: 6.69, 95% CI: 1.52, 29.49), only primary education (AOR: 4.26, 95% CI: 1.01, 18.03), unemployed/retiree or homemaker (AOR: 3.25, 95% CI: 1.79, 5.89), hypertension (AOR: 1.45, 95% CI: 1.00, 2.09), and malnourished elderly (AOR: 2.84, 95% CI: 1.76, 461) had higher odds for having vision disability. Conclusion. The findings suggest that a low education level, unemployment, hypertension, and malnourishment are significant risk factors for VD among Malaysia's elderly. Strengthening awareness campaigns to increase VD awareness and provide high-quality rehabilitation services must target specific groups, such as the elderly with a low level of education and the unemployed. Empower primary healthcare providers with the knowledge and skills necessary to improve the quality of eye care delivery and expand eye screening in settling VD issues nationally. [ABSTRACT FROM AUTHOR]

The Community‐Based Rehabilitation (CBR) services under the Malaysian Ministry of Women, Family and Community Development have provided two types of services for disabled children: centre‐based and home‐based care since 1984. A cross‐sectional study was conducted among parents and caregivers with children receiving treatment at CBRs on the east coast of Peninsular Malaysia, to determine the level of satisfaction with the services provided. Respondents were recruited via multi‐staged sampling, and simple randomisation at CBR level. Respondents self‐administered the Physical Therapy Satisfaction Questionnaire (PTSQ) and provided sociodemographic data. A total of 297 respondents were recruited and all the questionnaires were returned complete, making the response rate 100%. Total satisfaction scores and factors influencing respondents' satisfaction for both groups were analysed. The mean total satisfaction score for centre‐based and home‐based were 84.69 (SD = 10.01) and 75.30 (SD = 12.23; t = 7.160, p ≤.001) respectively. Ninety‐eight per cent of centre‐based and 89% of home‐based respondents were satisfied with the current services. There were significantly mean differences in the satisfaction level of respondents of different states respectively (Kelantan mean 84.92 10.83, Terengganu mean 77.49 11.16 and Pahang mean 77.47 12.93, p ≤.001). Factors associated with satisfaction were education (p =.002), occupation (p = <0.001), monthly income (p =.001) and source of income (p =.001). In conclusion, majority of parents and caregivers were satisfied with current services provided at CBR and satisfaction with services was dependent on CBR centre location and education and financial earning capacity. [ABSTRACT FROM AUTHOR]

Despite the importance of carers supporting the lives of people with mental illness, there are limited studies investigating the well‐being and needs of Malay carers in multicultural Singapore. The Malays consist of 13.4% of Singapore's population. A mixed methods qualitative dominant research approach was used to explore the well‐being and needs of Malay carers in a voluntary welfare organisation. The Kessler‐10, Friendship Scale and Carers' and Users' Expectations of Services—Carer version were used to assess the needs and well‐being of 17 Malay carers. Findings show that Malay carers experienced poor well‐being and had numerous unmet needs. Four main themes were found: (a) Concerns related to relatives with mental illness, (b) Mental health practices related to carers, (c) Holistic support for carers and (d) Preference for greater spiritual support in mental health. Recovery‐oriented mental health practice implications are discussed. Spirituality of Malay carers needs to be given greater consideration in recovery‐oriented mental health services. [ABSTRACT FROM AUTHOR]

Preparing healthcare students for community care has been emphasised due to the global ageing population. An instrument to measure students' community care competency is lacking. This study aimed to develop and evaluate the psychometric properties of a new scale known as Community Care Competency Scale (CCCS) for measuring nursing students' community care competency. CCCS consists of 21 items derived from literature review and community care standards. Content validity was established through a panel of seven experts in the areas of knowledge with a content validity index of 0.96. A cross‐sectional study was undertaken in a university in Singapore by using an anonymous self‐administered questionnaire to nursing students, and obtained a response rate of 87% (n = 283). Psychometric properties were explored using convergent and known‐group validity testing, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and Cronbach's alpha test. The results showed good convergent and known‐group validity. EFA and CFA showed a coherent construct of the 21 items of CCCS in a one‐factor model. The Cronbach's alpha of 0.94 indicated excellent internal consistency. The CCCS is a valid, reliable and easy‐to‐administer instrument that measures community care competency. This instrument will contribute to the empirical body of knowledge on evaluating the effectiveness of community care educational programmes for nursing students to prepare future healthcare professionals. [ABSTRACT FROM AUTHOR]

A cross‐sectional study design was created, using the Index of Perceived Community Resilience (IPCR) and Buckner's Index of Cohesion (BIC) to survey 386 flood evacuees from six communities in Kelantan, Malaysia, in 2015. The respondents were mostly female (54.7%); lived in basic housing (95.6%); average income (55.9%); secondary level schooling (81.1%); not involved with community organisations (95.1%), volunteering activities (91.2%), or emergency teams (96.9%); inexperience with injury during flooding (94%); experienced the emergency disaster (61.6%); and their mean age was 49 years old. Overall, respondents scored a high level of community disaster resilience (CDR) (mean 3.9) and social cohesion (mean 3.79). Also, respondents' housing type, event of injury during disaster, volunteering in post‐disaster activities, and emergency team participation were significantly associated with CDR (p = 0.001–0.002), organisational involvement (p = 0.016), and emergency disaster experience (p = 0.028) were significantly associated with social cohesion. The Pearson correlation coefficient results mostly showing a moderate, weak, and one with a strong relationship. There is a strong relationship between community participation (CDR) in events and BIC variables (r = 0.529, p = 0.001). Other analysis shows a moderate but significant relationship with BIC; is open to ideas (r = 0.332, p = 0.001); community has similar values/ideas (r = 0.421, p = 0.001); sense of pride (r = 0.389, p = 0.001); strong leadership (r = 0.339, p = 0.001); positive change (r = 0.484, p = 0.001); and able to handle problems (r = 0.454, p = 0.001). Overall, the results show that respondents had high levels of CDR and social cohesion, while the demographic characteristics show the impact of CDR and social cohesion. In conclusion, the data gives original insight into the level of association between social cohesion and disaster resilience, which could be used as a building block in sustainable disaster recovery. There is a need to explore this further on programmes designed to improve social cohesion across communities. [ABSTRACT FROM AUTHOR]

What is known and objective The introduction and success of imatinib mesylate ( IM) has brought about a paradigm shift in chronic myeloid leukaemia ( CML) treatment. However, despite the high efficacy of IM, clinical resistance develops due to a heterogeneous array of mechanisms. Pharmacogenetic variability as a result of genetic polymorphisms could be one of the most important factors influencing resistance to IM. The aim of this study was to investigate the association between genetic variations in drug efflux transporter ABCC1 ( MRP1) and ABCC2 ( MRP2) genes and response to IM in patients with CML. Methods We genotyped 215 Malaysian patients with CML (comprising of two groups with 108 IM resistant and 107 IM responsive) for polymorphisms of ABCC1 (2012G>T and 2168G>A) and ABCC2 (-24C>T, 1249G>A and 3972C>T) genes. Genotype, allele and haplotype frequencies were compared between two groups of patients. Patients with CML were further stratified according to their clinical response to IM into those having cytogenetics and molecular responses, and the associations with genotypes were evaluated. Results and discussion We observed no significant differences in the distribution of any of the tested genotypes between the investigated groups. However, on evaluating the risk association, ABCC2 T-24G1249T3972 haplotype was found to be associated with IM resistance ( P = 0·046). These results suggest that haplotype variants -24T and 3972T might be associated with lower expression of ABCC2 protein and reduced transport activity and hence might be contributing to development of IM resistance. What is new and conclusion Our results suggest the ABCC2 T-24G1249T3972 haplotype was associated with imatinib resistance. However, the evidence is as yet insufficient to establish this haplotype as a predictive biomarker for response to the drug. [ABSTRACT FROM AUTHOR]

This article presents the findings of a self-report study of the consequences of being an informal caregiver in Malaysia. The aim of this exploratory study was to examine Malaysian efforts in assisting informal caregivers, based on an analysis of the issues and concerns raised by the caregivers themselves. Data were obtained from a cross-sectional survey of informal caregivers in 2009. This sample comprised parents, spouses and/or adult siblings, and adult children, caring for their children, spouses or siblings and parents who were chronically ill and/or had a disability. Of 300 prospective participants, only 175 could be located (58%), but all those contacted agreed to participate. Respondents were randomly selected and interviewed using a structured questionnaire to identify the emotional, financial, social and physical issues consequent upon being a caregiver. Most respondents reported that their care-giving responsibilities had impacted their emotional, financial, social and/or physical well-being. Inadequate and/or uncertain income was by far the greatest concern followed in descending order by social, physical and emotional consequences. The one-way analysis of variance showed significant differences among the three categories of caregivers with respect to physical and emotional consequences. The findings show that care-giving has detrimental effects on the lives of informal caregivers, and that they are in significant need of social support to help them deal with care-giving tasks and responsibilities. Based on the findings, an integrated social support programme is proposed, tailored to the needs of informal caregivers. [ABSTRACT FROM AUTHOR]

Summary What is known and Objectives: Testing for cytochrome P450-2C9 ( CYP2C9) and vitamin K epoxide reductase complex subunit 1 ( VKORC1) variant alleles is recommended by the FDA for dosing of warfarin. However, dose prediction models derived from data obtained in one population may not be applicable to another. We therefore studied the impact of genetic polymorphisms of CYP2C9 and VKORC1 on warfarin dose requirement in Malaysia. Methods: Patients who were attending clinics at our hospital and prescribed warfarin with stabilized INR levels of 2-4 were selected. DNA was extracted from blood samples and subsequently genotyped for CYP2C9*1, *2, *3, VKORC1 (G-1639A) and VKORC1 C1173T. Linear regression modelling using age, CYP2C9 and VKORC1 genotypes, sex, weight and height was undertaken to define a warfarin dosing algorithm. An initial model was developed using data from one cohort of patients and validated using data from a second cohort. Results and Discussion: A model which included age and variants of CYP2C9 and VKORC1 account for about 37% of the variability in warfarin dose required to achieve INR of 2-4. Among the parameters evaluated, only VKORC1 (G-1639A) and (C1173T) alleles, and age correlated with warfarin dose at 6 month. The mean dose predicted using the algorithm derived from cohort 1 was lower than the actual dose for cohort 2 (3·30 mg, SD 0·84 vs. 3·45 mg, SD 1·42). There was no relationship between INR values and the dose taken by the patients. Race, sex, weight and height did not correlate with dose. What is new and Conclusion: This study identifies factors which affect warfarin dosing in the Malaysia population. However, our best model does not account sufficiently for the variability in dose requirements for it to be used in dose prediction for the individual patient. Other important influential factors affecting warfarin dose requirement remain to be identified. [ABSTRACT FROM AUTHOR]