Needle stick and sharps injuries and factors associated among health care workers in a Malaysian hospital.

Introduction: Needle stick and sharps injuries (NSSIs) have been recognized as one of the occupational hazards among health care workers (HCWs). They increase risk of spread of diseases like HIV, Hepatitis B and Hepatitis C. The objective of this study was to determine the prevalence and factors associated with needle stick and sharps injuries. Methods: This cross sectional study was conducted in Serdang Hospital Malaysia using a self-administered validated questionnaire. The respondents consisted of 345 HCWs namely medical assistant officer, staff nurses, medical laboratory technician and community nurse. Data was analysed using SPSS version 17. Results: Results showed that the overall mean age of the 345 respondents was 29.7years and it ranged from 22 years to 45 years with a median of 29 years. The mean age for the males (28.9 years) did not differ significantly from the females (29.9 years). The overall prevalence of needle stick or sharps injuries was 23.5%. Staff nurses had the highest prevalence (27.9%). The causes of NSSI in 58% of cases were hypodermic needle and 27.2% cases were recapping. Medical ward reported the highest NSSIs (51.9%). Knowledge on body fluid transmitted by HIV/AIDS and blood products was high (99.1%). Majority stated that they throw needles or sharps immediately after use in sharp bins (92.7%), do not separate needles from syringes prior to disposal (98.0%) and do not dissemble needles or sharps with hand (98.5%) and do not recap needles after use (94.3%). Majority also stated that they were aware about universal precaution guideline (96.5%) and needle stick and sharps injury needs to be reported (99.1%). However, out of those health care workers (23.5%) who had NSSI, only 30.9% had reported the incident of needlestick and sharps injuries indicating that there were gaps between knowledge and practice among the HCWs. There was a statistically significant association between NSSIs and age (p=0.01) of respondent, working experience (p=0.001) and job categories (p=0.03). Conclusions: The prevalence of NSSI was 23.5%. Although the knowledge on Universal Precautions is good, the prevalence of NSSIs is still high and there are gaps between knowledge and practice related to HIV prevention. NSSIs continue to pose a serious occupational problem

Prevalence and factors associated with medication non-compliance among patients with hypertension in a tertiary hospital: a cross-sectional study in Malaysia

Introduction: Hypertension contributes to major cardiovascular morbidities and mortalities worldwide and medication compliance is crucial in achieving target blood pressure control. This study aimed to determine the prevalence and factors associated with non-compliance towards anti-hypertensive medication in Malaysia. Methods: This is a cross-sectional study among hypertensive patients who were attending the medical outpatient department, Hospital Serdang from March until May 2018. Systematic random sampling was used to recruit patients and a structured self-administered questionnaire was used to collect information. Non-compliance is defined as attaining a score of 26 and below from the Medication Compliance Scale. Data analysis was done using SPSS v. 23. Multiple logistic regression was used to determine the predictors of medication non-compliance among hypertensive patients. Results: A total of 120 respondents were recruited into this study with a response rate of 60.9%. Mean age of the study respondents was 60.82 ± 11.25 years old. They were predominantly female (60.8%), Malay (58.3%) and attained at least secondary educational level (75.0%). The prevalence of non-compliance towards anti-hypertensive medication was 25%. Multiple logistic regression showed that side effects of medication (OR=5.59; 95% CI=1.29-24.21, p=0.021), traditional medications usage (OR=19.19; 95% CI=3.90-94.45, p=<0.001), health advice counsellors (OR=35.31; 95% CI=2.03-35.31, p=0.003) and duration of hypertension (OR=3.38; 95% CI=1.05-10.91, p=0.042) were predictors of non-compliance to anti-hypertensive medications among hypertensive patients Conclusion: Our study reported that those with longer duration of hypertension, suffered from side effect of medication and have experience in usage of traditional medicine are the predictors of medication non-compliance

Factors associated with falls among the elderly attending a government clinic in Kuala Lumpur

Introduction: Falls among the elderly can be associated with serious complications such as fractures, injuries and death. This study aims to ascertain the factors associated with falls among the elderly patients attending a government clinic located in Kuala Lumpur. Method: This was a cross-sectional study using a convenience sampling method. Data collection in 2017 from 322 elderly who attended the above clinic. A modified assisted self-administered questionnaire was used that contained the socio-demographic data, falls profile as well as extrinsic and intrinsic factors associated with falls. Analysis was done with SPSS v20.0. Results: 120 (37.27%) elderly reported falls in the past one year. The majority who had falls were females (n=76, 41.8%) and between the age of 80-89 years old (n=29, 44.6%). Malay ethnicity group, reported more falls compared to other ethnicities (n=93,44.5%). Significant associations were found between age, ethnicity and history of falls with falling (p<0.001). Intrinsic factors such as gait or imbalance problem, vision problem, using visual aids, having medical co-morbidities such as stroke, diabetes, Parkinson’s Dis-ease and osteoporosis, and being on antidiabetic drugs were also associated with increased risk of falling as well as extrinsic factors such as uneven floor, change in furniture position, poor lighting, lack of handrails, staircase, absence of railing at stairs and using walking aids (p<0.05). Conclusion: Factors founds to be associated with falls should be the primary intervention targets to help those who are at a heightened risk for falling such as visual problem and uneven floor, in order to reduce the negative impacts of falls

A framework for developing prediabetes self-care application

Preventing diabetes at the prediabetes stage is a crucial step to take as the damages done by diabetes is non-reversible. In the recent years, the number of diabetics has been increasing tremendously, which is predominantly due to unhealthy lifestyle and diet. To prevent diabetes, human behaviour needs to be altered: a new positive habit should replace an old habit. Self-care applications have great potential in fostering diabetes prevention. However, existing solutions mostly do not follow clinical guidelines, do not incorporate user expectations, are aimed to deliver a specific functionality (such as weight management), are not designed based on behavioural change theories, and therefore they are not designed for long term use. Integrating health behavioural change theories and the prediabetics' requirements into the development of self-care applications can empower consumers to better care of their own health. In this paper, we propose a prediabetes self-care application design framework, which incorporates behavioural change theories, and meets requirements of prediabetics. The framework was validated by a pool of health-related experts from various fields. Results indicate that the framework comprised necessary functions that would enable prediabetes to prevent diabetes. The framework would aid developers to design novel prediabetes applications that would enable users to take greater responsibility towards their health, which in return helps to save medical cost

User requirements for prediabetes self-care application: a healthcare professional perspective

The number of people with diabetes is increasing dreadfully in the world today. Efforts to prevent diabetes should be taken at the prediabetes stage itself, because with proper lifestyle changes, diabetes can be prevented or delayed. As such, a self-care application can help prediabetics to monitor their own health to prevent diabetes. The objective of this study is to explore the healthcare professionals’ perspectives that contribute to behavioural change in prediabetics and the user requirements for a self-care application. We conducted semi-structured interviews with eight healthcare professionals. Pre-determined set of open-ended questions were asked by the interviewer to prompt the discussion. Thematic Analysis approach was used to evaluate the responses. Overall, the health professionals were keen with the idea of empowering prediabetics to take control of their health conditions via a self-care application incorporating behaviour change techniques. Several functions were suggested to be included into the application such as forums to allow discussions among the prediabetics, coaching to communicate with healthcare professionals and peer/family support to motivate them to use the applications continuously

Factors associated with the level of physical activities among non-academic staffs in the Faculty of Medicine and Health Sciences of a public university in Selangor, Malaysia

Introduction: Many Malaysians does not engage in regular physical activity. The objective of this study was to deter-mine the factors associated with the level of physical activity among non-academics staff in the Faculty of Medicine and Health Sciences (FMHS), Universiti Putra Malaysia (UPM). Methods: This was a cross-sectional study using a self-administered questionnaire consisting socio-demographic, International Physical Activity Questionnaires (short form) and Depression, Anxiety and Stress Scale (DASS) scales to measure the level of physical activity and association with psychosocial and environmental factors. Ethical approval was obtained from the Ethics Committee for Research Involving Human Subjects (JKEUPM). Data was analysed using the SPSS 20.0. A p value of ≤ 0.05 was considered as statistically significant. Results: The response rate was 84% or 120 respondents. 68 (56.7%) respondents was found to have a good level of physical activity. Majority of them were women (70 [58.3%]), aged of < 33 years old (72 [60.0 %]), Malays (113 [94.2%]), and had tertiary education (81[67.5%]). There are significant associations between socio-demographic factors [gender (p=0.013), age (p=0.025) and level of education (p=0.020)] and environmental factor (performing physical activity at gymnasium (p=0.021)) with the level of physical activity on univariate analysis. On multivariate logistic regression, lower educational level (OR 2.96, p=0.016) and performing physical activity at gymnasium/sport centres (OR 4.66, p= 0.026) were associated with engaging with physical activity. Conclusion: Majority of the respondents have a good level of physical activity. Interventions should be planned for staffs otherwise identified as not having a good level of physical activity

The prevalence and factors associated with the delay in the initiation of breastfeeding

Advanced research using the latest technology confirms that breast milk is indeed far more superior compared to formula milk in either its ingredients or its psychological effect for both, mother and baby when practising breastfeeding. Aims: To determine the prevalence and factors associated with the delay in the initiation of breastfeeding. Method: This is a cross-sectional study; universal sampling method was used in this study. All postnatal mothers who delivered in Hospital Putrajaya, from 20 December 2010 until 31 January 2011 were approached and recruited in this study. The inclusion criterias were: all mothers who delivered in Hospital Putrajaya and babies who can be breastfed. The participants were asked to complete a set of self-administered questionnaire which was adapted from Radzniwan et al and Reassessment Tools for Breastfeeding Hospital Initiative with permission. Descriptive statistics (mean, range and standard deviation) was used to describe the sample. The Chi square test was used to determine the association between the dependent and independent variables. All the data collected were analyzed using the software Statistical Analysis Package for Social Sciences (SPSS for Window Version 17.0). A p value of less than 0.05 was considered as statistically significant. Result: From this study, the prevalence of the delay in initiation of breastfeeding is 55.7%. It is higher compared to the study by Dewey et al, It also shows that ethnicity, educational level and the age categories were associated with the delay in initiation of breastfeeding. Those of Malay ethnicity delayed initiation for about 52.8% from the Malay respondents Conclusion: The main factors that were directly associated with the delay in the initiation of breastfeeding were Malay ethnicity, age between 26 -30 years old, and those who have undergone caesarean section delivery. These target groups must be given priority in giving health education, physical and emotional support during antenatal, intranatal and post-delivery

Eliciting user requirements to design a prediabetes self-care application: a focus group study with prediabetics and diabetics

Objective: To explore the users’ insights that contributes to behaviour change in prediabetics and the user requirements for a self-care application from the prediabetics’ perspective. Methods/Statistical Analysis: We conducted Focus Group Discussions (FGD) on four distinct groups of diabetics and prediabetics at a Diabetes Resource Centre and among the public through advertisement. Open-ended questions were asked to stimulate the discussions. Transcripts of each discussion session were read several times, coded, categorised and analysed thoroughly by identifying the themes. The facial expressions during the discussion were also observed and taken into consideration. Findings: Results indicated that diabetes can be prevented through proper lifestyle changes, if and only if the person is willing to change his/her behaviour. The idea of a self-care application was well accepted by the participants and the components to be included were identified. The identified components are such as self-monitoring, diet, exercise, activity planning, goal setting, forum, social support and reminders. As for diabetics, taking medication has second highest priority where else it holds lesser priority among prediabetics. About 20% of the participants showed less interest in a self-care application either because they are not technology savvy or because of their advanced age status. Application/Improvements: A framework for designing prediabetes self-care application will be formulated, which integrates behavioural change theories

Execution and challenges of using focus group discussions as a research tool for secondary school students

Introduction: Focus group discussions (FGD) are a valuable method to obtain information and explore attitudes, feelings and views on a subject of research, especially when existing knowledge of the subject is inadequate. We used FGD as a tool to develop a cardiovascular disease (CVD) behavioural intervention programme for secondary school students. In this paper, we describe the planning and execution of the FGD and the various challenges faced. We believe that FGD will lead to development of a suitable and relevant intervention programme for our target group. Methods: Four out of nine districts in Selangor state were selected at random using the table of random numbers. In each of the selected districts, three schools were selected at random from the total list of schools. Participants to the FGD included students, teachers, parents and canteen operators who were then selected from the schools based on a voluntary basis of participation. Twenty-one facilitators and 20 scribes were trained to conduct the FGD. Questions for the FGD were semi-structured around six themes: CVD and its risk factors; diet; physical activity; self-image; smoking; and miscellaneous. Training for facilitators was provided using a Facilitator's Guide. Results: A total of 33 focus group discussions were conducted involving 297 participants from 11 schools. Discussions were scribed, audio taped and transcribed. Incentives for transport, certificates of participation and favourable venue were important motivating factors for participation. Conclusion: Detailed planning is important for the successful implementation of a FGD. An adequately planned and well-managed FGD can serve as an important tool to explore views of a research target population and develop a CVD behavioural intervention programme

Integrating health behavioural change theories in the design of prediabetes self-care applications: a systematic literature review

Type 2 diabetes is a lifelong metabolic disorder caused by high levels of glucose in the blood which can result in serious health conditions such as neuro-, nephro-, retino- and cardio-pathy. Enormous on-going research efforts and interventions are focussed on diabetes management but less on prediabetes which is associated with the prevention of or progression to Type 2 diabetes. Health behavioural change theories are important contributors to the effectiveness of interventions. However, they are rarely integrated systematically in the design of self-care applications for empowerment. In this paper, a Systematic Literature Review (SLR) is presented to evaluate the effectiveness of existing health behavioural change theories in managing prediabetes and to determine the effectiveness of self-care applications that incorporates these theories in their design. A total of four hundred and thirty-six papers were found in this regard. After careful study and the removal of duplicate papers and studies exclusion, 14 papers which met the inclusion criteria were selected for the review. On the whole, the review shows favorable impact of the integration of health behavioural change theories on prediabetics to better manage their prediabetes in changing behaviours, reducing blood glucose level, promoting healthier lifestyle habits, better body weight management and adoption of self-care behaviours. The commonly used theories were then identified to be incorporated into novel web and mobile self-care applications. This review will help application developers to integrate health behavioural change theories in designing impactful prediabetes self-care interventions. The results of this SLR show two clear gaps in this research field: 1) a lack of studies focussing on the integration of health behavioural change theories in prediabetes management and 2) a lack of studies contributing to the design of self-care applications for prediabetes. On a broader perspective, the review reveals that prediabetes self-care applications designed using health behavioural change theories have great potential in enabling prediabetics to take control of their health in preventing Type 2 diabetes