Displaying publications 61 - 80 of 234 in total

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  1. Loh SY, Ong L, Ng LL, Chew SL, Lee SY, Boniface G
    Asian Pac J Cancer Prev, 2011;12(6):1489-95.
    PMID: 22126487
    BACKGROUND: Increasing survivorship warrants evidence-based intervention to help women manage living effectively with breast cancer. Breast cancer survivors may have many medical and psychosocial issues in the post- treatment period. Qualitative research was carried out to assess survivors' overall experience and if intervention helps in survivorship care. This paper reports exploration of benefit-findings from participation in an earlier 4-week self management intervention.

    METHODS: We used a grounded theory approach to analyze three focus groups conducted between May and August 2010 in Kuala Lumpur. We used random sampling to recruit the informants (n=21), all of whom had earlier participated in the 4 week self-management program held two years previously.

    FINDINGS: The women reported positive experience and growth with the self management program. Self-efficacy appears as an important underlying theme for successful experiences. The lack of proactive plans to provide bereavement support to surviving women was a key negative experience.

    CONCLUSION: The intervention successfully brought women together to work in close partnership with health professionals on ways to self manage the medical, emotional and role task as they live indefinitely with breast cancer, a new chronic illness. The beneficial effect from the 4 week intervention was expressed by women even at 2 years after the program. Having successfully developed a tightly knitted group, a major oversight was the lack of professional support on bereavement for grieving members when close friends passed away.

    Matched MeSH terms: Focus Groups/methods*
  2. Hossain M, Mani KK, Mohd Sidik S, Kadir Shahar H
    Acta Paediatr, 2016 Aug;105(8):e373-8.
    PMID: 27111395 DOI: 10.1111/apa.13447
    AIM: There are an estimated 372 000 worldwide deaths by drowning every year, and it has been described as a secret epidemic in Bangladesh. The aim of this study was to develop an intervention package to prevent children under the age of five from drowning in rural Bangladesh.

    METHODS: This was a qualitative study using focus group discussions in three villages in rural Bangladesh. The 45 participants were mothers and fathers with children under five, the parents of children who had drowned and community leaders.

    RESULTS: The majority of the participants (71%) were male. The focus groups revealed that most drowning's occurred between 11am and 2pm and that risk factors included the following: children not being able to swim, ditches that were not filled in, lack of medical facilities, parents who were not aware of childhood drowning and lack of information through the media about how to prevent of childhood drowning. Suggestions included using a mobile-based short messaging service or voice calls to parents, especially mothers, could increase awareness and reduce the risk of childhood drowning.

    CONCLUSION: A safety education programme could be effective in increasing knowledge and changing attitudes, which could prevent drowning among children in Bangladesh.

    Matched MeSH terms: Focus Groups*
  3. Hussan F, Er HM, Nadarajah VD
    BMC Med Educ, 2024 Nov 22;24(1):1347.
    PMID: 39574101 DOI: 10.1186/s12909-024-06284-3
    BACKGROUND: Learning analytics (LA) is a tool for gathering, analysing, and interpreting data related to student's learning behaviour, engagement, and performance. As the student data collected by the institutions are used to construct LA, it is essential to understand the acceptance and readiness of the students regarding the implementation of LA.

    METHODS: A sequential mixed method research design was used in this study. A validated questionnaire was distributed to undergraduate students of Medicine, Dentistry and Pharmacy programmes to collect their general views on LA. Focus group interviews with a total of 18 students were conducted to explore their perceptions in depth, followed by thematic analysis of the transcribed data.

    RESULTS: Generally, the students were aware of their demographic data, utilisation of learning management system and academic performance data being collected by the university. They were agreeable for collection of those data which had direct association with their learning to be used for LA. However, they expressed concerns about the privacy, confidentiality, and security of the collected data. Three themes emerged from the interviews, i.e., self-regulated learning, evidence-based decision making and data management. The students perceived that LA could help them to monitor achievement of learning outcomes and provide support for individualised learning paths through recommendations of learning resources and learning motivation. They also opined that LA could help educators and institutions by providing feedback on teaching and learning methods, resource allocation and interventions to create conducive learning environment.

    CONCLUSIONS: LA is a useful tool to support self-regulated learning, however, precautions should be exercised during implementation to ensure data privacy and security.

    Matched MeSH terms: Focus Groups*
  4. Chang CT, Chang KH, Cheah WL
    Asia Pac J Clin Nutr, 2009;18(2):257-64.
    PMID: 19713186
    The objective of this study was to explore the perception of, feelings and attitudes toward overweight or obesity, and the perceived barriers to weight loss among native adults from lower socio-economic background. A total of six gender- and ethnic-specific focus groups consisted of 38 overweight and obese purposefully and criterion selected adults (21 women and 17 men), participated in this study. An unstructured discussion guide based on the study objectives were used for the focus groups. The results showed that some participants perceived themselves as ugly, felt ashamed of their body size and were frustrated because they did not desire to be overweight. Due to their excess weight, most also expressed they were less effective in their work performances. Although some participants had negative attitudes toward themselves because of excess weight, this appeared to link to self-stigmatization rather than anti-obesity discrimination. The participants remained in the Pre-contemplation stage of losing weight probably because of perceived barriers such as difficulty to resist eating, lack of know how and previous failed attempts to lose weight. Importantly, this study provided some evidence that individuals in the Pre-contemplation stage are unable to take action to lose weight, even if effective strategies are suggested.
    Matched MeSH terms: Focus Groups; Focus Groups*
  5. Norlehan AS, Aisyah MZ, Rozimah O, Lee PY, Ng CJ
    Malays Fam Physician, 2014;9(2):34-40.
    PMID: 25883763
    INTRODUCTION: Continuous professional development (CPD) is an important aspect of a medical practitioner's career. AIMing to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors.
    AIM: The aim of the study was to explore the private general practitioners' (GPs) views, experiences and needs regarding CPD programme in the primary care service.
    METHODS: This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers' discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach.
    RESULTS: GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients' expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring.
    CONCLUSIONS: Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.
    KEYWORDS: Private general practitioner; continuous; medical education; primary care; professional development; qualitative study
    Matched MeSH terms: Focus Groups
  6. Birks M, Francis K, Chapman Y
    Int J Nurs Pract, 2009 Jun;15(3):164-71.
    PMID: 19531074 DOI: 10.1111/j.1440-172X.2009.01741.x
    Changes to the nursing profession over recent decades have provoked an increasing migration of nursing education into the tertiary sector. For nurses who live and work in developing nations, such as Malaysia, opportunities for further study might be limited, particularly for those located in more remote regions. This paper reports on a research study of registered nurses who undertook baccalaureate degree studies in off-campus mode in Malaysian Borneo. A grounded theory methodology was employed in this research, which is part of a larger study into the nature and outcomes of change experienced as a result of postregistration degree studies. This paper explores the reasons why nurses in this location enrolled in one such course and the extent to which completion of their studies addressed their motivational goals. The findings indicate that the experience of learning and acquisition of knowledge was well beyond what was expected, resulting in a sense of achievement that was similarly unanticipated.
    Matched MeSH terms: Focus Groups
  7. Loh SY, Packer T, Yip CH, Low WY
    Asia Pac J Public Health, 2007;19(3):52-7.
    PMID: 18333303 DOI: 10.1177/101053950701900309
    Naturalistic inquiry using focus group interviews was undertaken to explore experiences and perceived barriers to self management in women with breast cancer. The aim was to identify their perceived barriers to self management to aid the development of rehabilitation programmes. Successful programmes are strongly linked to patients' perceived needs. Four focus groups consisted of 39 women, were purposively recruited. Women's needs within the three areas of medical, emotional and role management of breast cancer were explored. The main barriers were unavailability of information, inability to access services-and-support, and socioeconomic-cultural issues (entrenched myths, low-socioeconomic status, and inadequate insurance-health legislative coverage). The findings provide the critically lacking 'expert-view' of survivors, who verified the importance of the medical, emotional and role management tasks, and highlighted barriers and structural solutions. With breast cancer becoming recognised as a form of chronic illness, this study is timely.
    Matched MeSH terms: Focus Groups
  8. Perera J, Lee N, Win K, Perera J, Wijesuriya L
    Med Teach, 2008;30(4):395-9.
    PMID: 18569661 DOI: 10.1080/01421590801949966
    Formative assessments and other learning tools are ineffective in the absence of formative feedback.
    Matched MeSH terms: Focus Groups
  9. Kiyu A, Steinkuehler AA, Hashim J, Hall J, Lee PF, Taylor R
    Health Promot Int, 2006 Mar;21(1):13-8.
    PMID: 16394026
    Sarawak, Malaysia has a large population of ethnic minorities who live in longhouses in remote rural areas where poverty, non-communicable diseases, accidents and injuries, environmental hazards and communicable diseases all contribute to a lower quality of life than is possible to achieve in these regions. To address these issues and improve the quality of life for longhouse people, the Kapit Divisional Health Office implemented the World Health Organization's Healthy Village programme in 2000. An evaluation was undertaken in 2003 to determine physical and behavioural changes resulting from the programme. The main changes evaluated were those involving smoking habits, exercise habits, health screening, fire safety, environmental improvements and food preparation and hygiene. A qualitative evaluation was conducted using participant observation and key-informant interviews, focus groups and observation. Results indicate that the programme is inspiring changes in various behavioural and physical characteristics of the study population. It is clear that the Healthy Village programme is a widely accepted way of improving health outcomes in longhouses, and that it is succeeding in making beneficial health changes.
    Matched MeSH terms: Focus Groups
  10. Wong LP
    PLoS One, 2012;7(12):e51745.
    PMID: 23272156 DOI: 10.1371/journal.pone.0051745
    BACKGROUND: This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory.
    METHODS: A total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur.
    RESULTS: The study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions.
    CONCLUSION: This study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.
    Matched MeSH terms: Focus Groups
  11. Lee YK, Lee PY, Cheong AT, Ng CJ, Abdullah KL, Ong TA, et al.
    PLoS One, 2015;10(11):e0142812.
    PMID: 26559947 DOI: 10.1371/journal.pone.0142812
    AIM: To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment.
    METHODS: Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.
    FINDINGS: The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture.
    CONCLUSIONS: A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.
    Matched MeSH terms: Focus Groups
  12. Abdullah A, Liew SM, Hanafi NS, Ng CJ, Lai PS, Chia YC, et al.
    Patient Prefer Adherence, 2016;10:99-106.
    PMID: 26869773 DOI: 10.2147/PPA.S94687
    BACKGROUND: Telemonitoring of home blood pressure (BP) is found to have a positive effect on BP control. Delivering a BP telemonitoring service in primary care offers primary care physicians an innovative approach toward management of their patients with hypertension. However, little is known about patients' acceptance of such service in routine clinical care.
    OBJECTIVE: This study aimed to explore patients' acceptance of a BP telemonitoring service delivered in primary care based on the technology acceptance model (TAM).
    METHODS: A qualitative study design was used. Primary care patients with uncontrolled office BP who fulfilled the inclusion criteria were enrolled into a BP telemonitoring service offered between the period August 2012 and September 2012. This service was delivered at an urban primary care clinic in Kuala Lumpur, Malaysia. Twenty patients used the BP telemonitoring service. Of these, 17 patients consented to share their views and experiences through five in-depth interviews and two focus group discussions. An interview guide was developed based on the TAM. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used for analysis.
    RESULTS: Patients found the BP telemonitoring service easy to use but struggled with the perceived usefulness of doing so. They expressed confusion in making sense of the monitored home BP readings. They often thought about the implications of these readings to their hypertension management and overall health. Patients wanted more feedback from their doctors and suggested improvement to the BP telemonitoring functionalities to improve interactions. Patients cited being involved in research as the main reason for their intention to use the service. They felt that patients with limited experience with the internet and information technology, who worked out of town, or who had an outdoor hobby would not be able to benefit from such a service.
    CONCLUSION: Patients found BP telemonitoring service in primary care easy to use but needed help to interpret the meanings of monitored BP readings. Implementations of BP telemonitoring service must tackle these issues to maximize the patients' acceptance of a BP telemonitoring service.
    Matched MeSH terms: Focus Groups
  13. Ohn MH, Ohn KM
    Ci Ji Yi Xue Za Zhi, 2019 06 06;32(2):211-215.
    PMID: 32269957 DOI: 10.4103/tcmj.tcmj_5_19
    Objective: The successful application of gamification in different educational settings shows that the use of gamification in medical education may be an effective solution. Even though many studies have been conducted to investigate the efficacy of the integration of gamification to different education curriculums, few studies have examined the reactions, behaviors, and attitudes of learners toward the use of gamification in medical education. Hence, this study aimed to evaluate the medical students' learning experience and acceptance of the use of gamification for the delivery of electrocardiogram lessons.

    Materials and Methods: A qualitative research method was used to generate findings in this study. The data collection methods included focus group discussions and interviews. Triangulation methods were used to ensure the validity and reliability of the qualitative data analyzed in this study. The thematic analysis of the data collected in this study helped to garner insights into the perception of participants and experts about the use of GaMed@™ for the delivery of ECG lessons.

    Results: A total number of 32 medical students and four experts in the fields of user experience, communication, social psychology, and game design participated in this study. The findings showed that in spite of the negative reports about the user experience and application of GaMed@™, the participants and experts affirmed its positive impact on the increased motivation and engagement of users.

    Conclusions: The impact of this concept can be maximized by tailoring the game design to foster-positive learning attributes, behaviors, and outcomes in students. However, further research studies must be conducted to investigate the impact of gamification designs on specific learning outcomes in students.

    Matched MeSH terms: Focus Groups
  14. Ismail MA, Ahmad A, Mohammad JA, Fakri NMRM, Nor MZM, Pa MNM
    BMC Med Educ, 2019 Jun 25;19(1):230.
    PMID: 31238926 DOI: 10.1186/s12909-019-1658-z
    BACKGROUND: Gamification is an increasingly common phenomenon in education. It is a technique to facilitate formative assessment and to promote student learning. It has been shown to be more effective than traditional methods. This phenomenological study was conducted to explore the advantages of gamification through the use of the Kahoot! platform for formative assessment in medical education.

    METHODS: This study employed a phenomenological design. Five focus groups were conducted with medical students who had participated in several Kahoot! sessions.

    RESULTS: Thirty-six categories and nine sub-themes emerged from the focus group discussions. They were grouped into three themes: attractive learning tool, learning guidance and source of motivation.

    CONCLUSIONS: The results suggest that Kahoot! sessions motivate students to study, to determine the subject matter that needs to be studied and to be aware of what they have learned. Thus, the platform is a promising tool for formative assessment in medical education.

    Matched MeSH terms: Focus Groups
  15. Ahmad A, Bahri Yusoff MS, Zahiruddin Wan Mohammad WM, Mat Nor MZ
    J Taibah Univ Med Sci, 2018 Apr;13(2):113-122.
    PMID: 31435313 DOI: 10.1016/j.jtumed.2017.12.001
    Objectives: Community-based education (CBE) has an impact on the types of medical students produced at the end of medical training. However, its impact on professional identity development (PID) has not been clearly understood. This study thus explores the effect of the CBE program on PID.

    Methods: A qualitative phenomenological study was conducted on a group of Universiti Sains Malaysia medical students who had finished the Community and Family Case Study (CFCS) program. Data were gathered through focused group discussions and student reflective journals. Participants were sampled using the maximal variation technique of purposive sampling. Three steps of thematic analysis using the Atlasti software were employed to identify categories, subthemes, and themes.

    Results: Personal, role, social, and research identities were generated that contribute to the PID of medical students through the CFCS program. The results indicate that the CFCS program nurtured personal identity through the development of professional skills, soft skills, and personal values. Pertaining to role identity, this is related to patient care in terms of primary care and interprofessional awareness. Pertaining to social identity, the obvious feature was community awareness related to culture, society, and politics. A positive outcome of the CFCS program was found to be its fostering of research skills, which is related to the use of epidemiology and research methods.

    Conclusion: The findings indicate that the CFCS program promotes PID among medical students. The current data highlight and provide insights into the importance of integrating CBE into medical curricula to prepare future doctors for their entry into the profession.

    Matched MeSH terms: Focus Groups
  16. Lu FJH, Gill DL, Yang CMC, Lee PF, Chiu YH, Hsu YW, et al.
    Front Psychol, 2018;9:2363.
    PMID: 30574106 DOI: 10.3389/fpsyg.2018.02363
    Although considerable research indicates that mental energy is an important factor in many domains, including athletic performance (Cook and Davis, 2006), athletic mental energy (AME) has never been conceptualized and measured. Therefore, the aim of this study was to conceptualize and develop a reliable and valid instrument to assess AME. In Study 1, a focus group interview established the initial framework of AME. Study 2 used a survey to collect athletes' experiences of AME and develop a scale draft titled "Athletic Mental Energy Scale (AMES)." In Study 3, we examined the psychometric properties and the underlying structure of AMES via item analysis, internal consistency, and exploratory factor analysis (EFA). In Study 4, we used confirmatory factor analysis (CFA) to examine AMES's factorial validity; and examined concurrent and discriminant validity by examining correlations with athletes' life stress, positive state of mind, and burnout. In study 5, we examined the measurement invariance of the 6-factor, 18-item AMES with Taiwanese and Malaysian samples. Study 6 examined the predictive validity by comparing AMES scores of successful and unsuccessful martial artists. Across these phases, results showed a 6-factor, 18-item AMES had adequate content validity, factorial structure, nomological validity, discriminant validity, predictive validity, measurement invariance, and reliability. We suggest future studies may use AMES to examine its relationships with athletes' cognition, affect, and performance. The application of AMES in sport psychology was also discussed.
    Matched MeSH terms: Focus Groups
  17. Soh KL, Davidson PM, Leslie G, DiGiacomo M, Soh KG
    Contemp Nurse, 2019 8 14;55(2-3):221-236.
    PMID: 31403398 DOI: 10.1080/10376178.2019.1643751
    Background: Quality improvement projects have been widely adopted to prevent complications in the ICU. Objective: This paper describes nurses' perceptions of implementation strategies and the potential sustainability of a practice change intervention to prevent complications in a Malaysian ICU. Design: A participatory action research using five focus group discussions were undertaken with 19 nurses in a single ICU in regional Malaysia. Focus group transcripts were analysed using thematic analysis. Results: The main themes derived from the interviews were: [1] Empowering staff to embrace evidence-based practices; [2] Staff knowledge, attitudes, and beliefs that impact on behaviour; and [3] management support and leadership are influential in staff behaviours (acceptance & perseverance of change process). Discussion: Resistance to change was recognized as a barrier to adopting evidence based recommendations. There is a need to improve nurses' knowledge, attitude and awareness of the importance of assessment for VAP, CRBSI and PIs in the ICU.
    Matched MeSH terms: Focus Groups
  18. Sinclair M, Phillips CJC
    Animals (Basel), 2019 Jun 05;9(6).
    PMID: 31195720 DOI: 10.3390/ani9060319
    The welfare of farm animals has been the focus of increasing international interest, however, the movement has had little engagement with livestock leaders who are, arguably, the stakeholders in the position most able to make decisions that impact on animal welfare at critical times. Previous studies have drawn attention to the need to engage in constructive collaborations with the livestock industry for the betterment of animal welfare, and to uncover mutual benefits for both stakeholders and proponents of animal welfare with which collaborations can be motivated. This study aimed to continue this need to understand leaders in livestock management, by consulting their opinions as to what constitutes the most critical animal welfare issues during farming and slaughter, and what they see as some of the solutions to begin addressing livestock welfare issues in their country. Seventeen focus group sessions were held with 139 leaders in livestock industries in six diverse countries in Asia, including China, India, Malaysia, Vietnam, Thailand, and Bangladesh. Leaders included government representatives, key academics in agriculture, and business managers and leaders within the domestic animal agriculture industries, as relevant to each country. After conducting thematic analysis and applying basic statistical measures, the findings suggest that solutions within the themes of education, training, and awareness are most valued. However, how each of these could be best addressed varied by country. The need for local research and local solutions also contributed to the most frequent opportunities, as did the requirement for prescriptive and consistent standards and expectations. A ranking of animal welfare issues is presented, as is a selection of suggested animal welfare initiatives resulting from the findings of this study.
    Matched MeSH terms: Focus Groups
  19. Ang CS, Teo KM, Ong YL, Siak SL
    Addict Health, 2019 Jan;11(1):1-10.
    PMID: 31308904 DOI: 10.22122/ahj.v11i1.539
    Background: The exponential growth of smartphones has afforded many users with ubiquitous access to socialization as seen in the various mobile apps used to communicate and connect with others. The present study employed mixed-method approaches to analyse the impact of phubbing on social connectedness among adolescents in Malaysia.

    Methods: A total of 568 adolescents were participated in quantitative surveys, and of these participating adolescents, 6 were further invited to join focus group interviews.

    Findings: Quantitative findings supported the mediating role of communication disturbance in the relationships between phone obsession and familial connectedness, school connectedness, and self-connectedness, but not for friendship connectedness. Qualitative findings further elucidated the detrimental effect of phone obsession on their sense of belonging from the perspectives of adolescents.

    Conclusion: This study reaffirms that phubbing behaviour is predictive of social disconnectedness. Therefore, preventive and treatment interventions should be developed to avoid and control a potential risk of social disconnectedness epidemics attribute to phubbing.

    Matched MeSH terms: Focus Groups
  20. Wharton-Smith A, Green J, Loh EC, Gorrie A, Omar SFS, Bacchus L, et al.
    BMC Infect Dis, 2019 Jan 11;19(1):45.
    PMID: 30634929 DOI: 10.1186/s12879-019-3680-5
    BACKGROUND: Malaysia has rising dengue incidence. World Health Organization clinical practice guidelines for managing dengue have been adapted by the Ministry of Health in Malaysia, with evidence of good awareness by clinicians. However, dengue mortality has not reduced. This study aimed to explore the challenges of dengue management for Medical Officers, with a particular focus on use of clinical practice guidelines.

    METHODS: Qualitative study using six focus groups and 14 semi-structured interviews with doctors responsible for dengue management at a large tertiary hospital in Malaysia.

    RESULTS: Dengue was recognised as difficult to diagnose and manage. Wide awareness and use of both WHO and Ministry of Health guidelines was reported, but several limitations noted in their coverage of particular patient groups. However, the phrase 'guidelines' also referred to local algorithms for fluid management, which were less clinically evidence-based. Where Medical Officers were well trained in the appropriate use of evidence-based guidelines, barriers to use included: the potential for 'following the algorithm' to undermine junior clinicians' claims to clinical expertise; inability to recognise the pattern of clinical progress; and lack of clinical experience. Other reported barriers to improved case management were resource constraints, poor referral practices, and insufficient awareness of the need for timely help seeking.

    CONCLUSIONS: Awareness of clinical practice guidelines is a necessary, but not sufficient, condition for optimal dengue management. In high prevalence settings, all clinical staff would benefit from regular dengue management training which should include diagnosis, practice in monitoring disease progression and the use of clinical practice guidelines in a range of clinical contexts.

    Matched MeSH terms: Focus Groups
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