CROSS-SECTIONAL STUDY ASSESSING FACTORS ASSOCIATED WITH PERCEIVED DENIAL AMONG POST-MYOCARDIAL INFARCTION SURVIVORS IN A MALAYSIAN CARDIAC HEALTH FACILITY

Objectives: The aim of this study was to determine the factors associated with perceived denial among post-myocardial infarction (post-MI) survivors in Malaysia. Methods: This descriptive-analytical single-hospital cross-sectional study was conducted between July and September 2016 among 201 post-MI survivors aged between 24 and 96 years old at the outpatient cardiac clinic in a Malaysian public hospital. A self-administered questionnaire that consisted of the validated 8-items Verbal Denial of Myocardial Infarction Questionnaire, and items on socio-demographic, health attributes and social support characteristics based on the OSLO-3 Social Support Scale (OSS-3) was utilized. Descriptive, bivariate and multivariate analyses were conducted. Results: The average total score of perceived denial in post-MI survivors was 22.1 (SD ± 6.1) and ranged between 8 and 37. At multivariate level, greater denial score was more prevalent in singles, those with time-to-event of ≤ 1 year, those sustained arrhythmias, those who perceived good health, and those received a lot of other people’s concern. These associations were statistically significant (p<0.05). Conclusion: Perceived denial was significantly associated with socio-demographics, health attributes and social support in post-MI survivors. Early screening is crucial to prompt primary caregivers to initiate potential coping mechanisms for better prognosis and improved quality of life. Â

Patient Satisfaction in Malaysia’s Busiest Outpatient Medical Care

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country’s busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly “technical quality” and “accessibility and convenience,” but satisfaction was low in terms of service orientation of doctors, particularly the “time spent with doctor,” “interpersonal manners,” and “communication” during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country’s health service satisfaction

Emotional Burnout, Perceived Sources of Job Stress, Professional Fulfillment, and Engagement among Medical Residents in Malaysia

This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI). Mean (±SD) age of the respondents was 26.5 (±1.6). The most common source of job stress was “fear of making mistakes.” Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies

Factors Associated with Perceived Life Chaos among Post-Myocardial Infarction Survivors in a Malaysian Cardiac Care Facility

Background and objectives: Survivors of chronic life-threatening conditions like myocardial infarction (MI) are often confronted with multiple physical and psychological stressors as a consequence of elevated demands of lifestyle adjustments and modifications. Such stressors, collectively known as &#8220;life chaos&#8222;, cause disruption to one&#8217;s lifestyle equilibrium of having organized, calm, and regular routines. The objective of the current study was to determine the level of life chaos and its associated correlates among post-myocardial infarction (post-MI) survivors in Malaysia. Materials and Methods: An analytical cross-sectional study was conducted among 242 post-MI survivors in a Malaysian cardiac health facility from July to September 2016. A self-administered questionnaire in Malay that consisted of items on socio-demographics, health attributes, validated OSLO-3 Social Support Scale (OSS-3), and the Modified Confusion, Hubbub, and Order Scale (CHAOS-6) was utilized in this study. Descriptive, bivariate, and multivariate analyses were conducted. Results: The sample constituted of 208 (86%) men and 34 (14%) women. The average age was 55 years (SD = 11), and the age ranged between 24 and 96 years. Overall, 128 (52.9%) of the total post-MI survivors had highly chaotic lives. In multivariate analysis, younger age, lower household income, perceived financial insecurity, poor health status, and multiple comorbidities were related to the high chaos score, and these associations were statistically significant (p &lt; 0.05). Conclusions: Highly chaotic lifestyles were prevalent in post-MI survivors. Demographic, health attributes, and socio-economic factors were important correlates of life chaos

What Is the Estimated COVID-19 Reproduction Number and the Proportion of the Population That Needs to Be Immunized to Achieve Herd Immunity in Malaysia? A Mathematical Epidemiology Synthesis

We aimed to determine Malaysia’s COVID-19 reproduction number and herd immunity threshold through a mathematical epidemiology synthesis. Using time-series incidence data, the time-dependent reproduction number (Rt) was yielded over time during the COVID-19 containment measures in Malaysia. The value of Rt at the beginning of the epidemic and prior to any interventions in place was used to determine the proportion of the population that needs to be immunized to achieve herd immunity. Rt was strongly influenced by interventions being put in place. We established that at least 74% of the Malaysian population needs to be vaccinated to achieve herd immunity against COVID-19. This threshold estimate is somewhat influenced by the availability of an efficacious vaccine. A vaccine with 95% efficacy would approximately synthesize a herd immunity threshold of 78%. We conclude that Rt is a valid estimator to determine the effectiveness of control measures and a parameter of use to synthesize herd immunity thresholds in the current COVID-19 pandemic

Psycho-socioeconomic factors affecting complementary and alternative medicine use among selected rural communities in Malaysia: a cross-sectional study.

INTRODUCTION:The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. OBJECTIVE:This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. METHODS:A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. RESULTS:The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. CONCLUSION:Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia

Perceived Stress among Malaysian Railway Workers

Results: Mean (SD) age of workers was 41.4 (10.7), with the majority aged 30 years or older (79.3%). Mean (SD) perceived stress was 18.8 (4.3). In multiple linear regression analysis, the significant predictors of high stress were high school versus tertiary education (β = 0.10, 95% CI 0.11, 1.73, P = 0.027) and being a white collar worker versus blue collar (β = 0.113, 95% CI 0.10, 1.74, P = 0.010). Conclusions: Education level and type of work were significantly associated with perceived stress among railway workers in this study

Influence of Population Density for COVID-19 Spread in Malaysia: An Ecological Study

The rapid transmission of highly contagious infectious diseases within communities can yield potential hotspots or clusters across geographies. For COVID-19, the impact of population density on transmission models demonstrates mixed findings. This study aims to determine the correlations between population density, clusters, and COVID-19 incidence across districts and regions in Malaysia. This countrywide ecological study was conducted between 22 January 2021 and 4 February 2021 involving 51,476 active COVID-19 cases during Malaysia’s third wave of the pandemic, prior to the reimplementation of lockdowns. Population data from multiple sources was aggregated and spatial analytics were performed to visualize distributional choropleths of COVID-19 cases in relation to population density. Hierarchical cluster analysis was used to synthesize dendrograms to demarcate potential clusters against population density. Region-wise correlations and simple linear regression models were deduced to observe the strength of the correlations and the propagation effects of COVID-19 infections relative to population density. Distributional heats in choropleths and cluster analysis showed that districts with a high number of inhabitants and a high population density had a greater number of cases in proportion to the population in that area. The Central region had the strongest correlation between COVID-19 cases and population density (r = 0.912; 95% CI 0.911, 0.913; p &lt; 0.001). The propagation effect and the spread of disease was greater in urbanized districts or cities. Population density is an important factor for the spread of COVID-19 in Malaysia