Introduction: Workplace violence (WPV) among healthcare workers (HCW) remains a significant public health issue in Malaysia. This study aimed to determine the prevalence and associated factors of WPV among HCW in Emergency Departments of public hospitals in Melaka. Methods: A cross-sectional study was conducted among 231 HCW who were selected in Emergency Departments (ED) from three public hospitals in Melaka through proportionate stratified random sampling method. Data was collected using self-administered questionnaire which consists of three parts (personal and workplace data, workplace violence, and psychosocial workplace environment factors). The period of workplace violence studied was any occurrence of it within six months prior to this study. The data were anal-ysed using Statistical Package for Social Sciences (SPSS) software version 24. Results: The prevalence of WPV was found to be 38%, of which 88.9% were psychological violence, and were mostly perpetrated by combinations of type of perpetrators (51.9%). Multiple logistic regression shows that those aged 40 years and below have 5.4 times more likely to experience workplace violence compared to other age group, respondents with low job support has 2.9 times more likely to experience workplace violence compared to its counterpart, and respondents who work in secondary hospital have 2.7 times more likely to experience workplace violence compared to those who work in tertiary hospital. Conclusion: Preventive measures to prevent this issue should be in placed to tackle WPV especially among the at risk groups.
Objective: The aim of the study is to examine the prevalence and factors influencing PTSD among a sample of help-seeking women experiencing domestic violence. Methods: This was a cross-sectional survey study of 40 women in two shelters in Malaysia from 2007 to 2008. Measures include the Detailed Assessment of Posttraumatic Stress; the Measure of Wife Abuse; the Posttraumatic Cognitions Inventory; the Coping Scale for Adults; and the Provision of Social Relations. Results: Results showed that 60% of subjects
exhibited patterns of symptoms consistent with the diagnosis of PTSD. The most prominent posttraumatic symptoms reported were re-experience, avoidance, dissociative responses, and symptoms of increased arousal. Both negative appraisals about themselves and self blame for the abusive situations were positively associated with increased tendency to develop PTSD. The greater use of optimism coping style and the higher quality social
support appeared to lead to a significantly reduced tendency of developing PTSD. Negative appraisals about themselves were found to be the strongest positive predictor of PTSD [R² = 0.32, F(1,38)=17.67, p
Urban cities are synonym with a high incidence of penetrating chest injuries either from accidents or interpersonal violence. The outcome of penetrating chest wound can vary from immediate death to a prolonged morbidity. We here report a case of 39-year-gentleman who presented to Emergency Department Hospital Raja Permaisuri Bainun, Ipoh, Perak after being stabbed to the chest. His anterior penetrating chest wound was located at the 5th intercostal space medial to the midclavicular line. The stab wound penetrated the myocardium, causing minimal myocardial rupture. He also suffered from left haemothorax and hemopericardium. The haemothorax was drained with insertion of 32 French chest tube. The patient was admitted under the cardiothoracic team and discharged five days later without surgical intervention. He presented again to the Emergency Department with complains of shortness of breath and pleuritic pain. A left ventricular thrombus was detected via echocardiography. Unfortunately, he took his own discharge. Five days later he came again to Emergency Department with sporadic of loss of vision. The mural thrombus dislodged and embolized to the retinal artery causing amaurosis fugax. The patient was treated with aspirin 150mg and his symptoms subsequently resolved.
Smoking among rural adolescents in Malaysia is on the rise with a significant difference seen between urban and rural youths. Therefore, this study was carried out to determine a predictive model of smoking among the rural-school adolescents population in Malacca, Malaysia. An unmatched case-control study was conducted in 2010 involving 484 cases and 444 controls of Form Two students in Malacca, Malaysia, using cluster sampling. Smoking was the dependent factor of this study while the independent factors were individual, family, school and environment. Data were obtained through a self-administered questionnaire. The response rate of the study was 100% whereas the smoking prevalence was 20.9%. Binary logistic regression was used to determine the smoking predictive model. Strong predictors of smoking behaviour were: influenced by artistes who smoke (Adjusted OR=8.67, 95% CI 5.53-13.58); the male gender (Adjusted OR=6.7, 95% CI 4.14-10.83); Muslim (Adjusted OR=4.46, 95% CI 2.36-8.44); and the belief that smoking is not dangerous when the teacher is seen smoking as well (Adjusted OR=3.95, 95% CI 2.19-7.10). Other predictors were: being offered cigarettes by friends (Adjusted OR=2.81, 95% CI 1.79-4.42); the belief that smoking will relax the mind (Adjusted OR=2.45, 95% CI 1.33-4.51); having friends who smoke (Adjusted OR=2.32, 95% CI 1.29-4.81); forced by friends to smoke (Adjusted OR=2.17, 95% CI 1.15-4.12); have heard of the national No-Smoking Campaign (Adjusted OR=1.89, 95% CI 1.06-3.37); have problems with the school management (Adjusted OR=1.75, 95% CI 1.07-2.88); parental consent to watch sexual activities, drug use or violence on television or at the cinema (Adjusted OR=1.73, 95% CI 1.06-2.83); and have lunch in school (Adjusted OR=1.58, 95% CI 1.04-2.41). This paper ends with the recognition of the need for intervention in dismantling the predictors that can lead to the development of smoking among Malaysian adolescents in rural schools. of different pathological entities.
Workplace violence become a global concern and perceived as a very serious safety and health hazard especially in healthcare setting. The aim of this study was to determine the prevalence of workplace violence and its associated risk factors among healthcare workers in public hospital. Methods: This was a cross-sectional study which involved 136 randomly selected respondents among doctors and nurses in a public hospital in Kuala Lumpur. Data was gathered through a self-administered questionnaire consisted of two standardized questionnaire; Workplace Violence (WPV) and Job Content Questionnaire (JCQ-27). Results: The response rate was 91%. The prevalence of reported WPV was 71.3% where nurses (73.2%) had slightly higher prevalence than doctors (69.2%). The most common forms of WPV was verbal abuse (70.6%), followed by bullying/mobbing (29.4%), physical violence (11.0%), and sexual harassment (6.6%). The perpetrators were mostly among relatives of patients and visitors followed by the patients. Multiple logistic regression shows that respondents working in Accident and Emergency (A&E) Department was 17 times more likely to report workplace violence than those working in Pediatric Department. Also, for every 1 year younger, respondents were 5 times more likely to experience workplace violence controlling for other factors. Conclusion: The prevalence of workplace violent among respondents were high and most common among young workers, especially nurses and those working in A&E Department. Hence, further assessment should be carried out to reduce the identified risk factors and to find ways of solving this issue.
Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. The treatment of severe traumatic brain injury in pregnancy requires a multidisciplinary team approach. The management of a pregnant trauma patient warrants consideration of several issues specific to pregnancy, such as the alterations in the maternal physiology and anatomy. In the case of maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival is linked with the timing of caesarean section after maternal cardiac arrest. Moreover, the decision for perimortem caesarean section is clear after maternal cardiac arrest. The foetal survival rate is 67% if the operation is done before 15 min of cardiopulmonary compromise has occurred, and it drops to 40% at the duration range of 16-25 min. Whether minor or severe, traumatic brain injury during pregnancy is associated with unfavourable maternal outcomes. Injuries considered minor for the general population are not minor for pregnant women. Therefore, these patients should be intensively monitored, and multidisciplinary approaches should always be involved.
Culture-bound syndromes have been described worldwide in many individuals and, for certain syndromes, in epidemic proportion, yet these disorders have been classified as rare and exotic conditions warranting minimal attention. Development of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and the tenth edition of the International Classification of Diseases offers an opportunity for providing a more sophisticated classification of these phenomena. The authors examine amok, a syndrome first described in Malaysia that consists of homicidal frenzy preceded by a state of brooding and ending with somnolence and amnesia. They discuss the concept of and criteria for a culture-specific disorder and propose that amok be classified as a culture-specific explosive behavioral disorder in DSM-IV.
The number of people worldwide living with human immunodeficiency virus/ acquired immunodeficiency virus (HIV/AIDS) is more than 40 million, among them 17.7 millions are women (UNAIDS/WHO, 2006) The latest report from the Eastern Mediterranean Region shows that at least one million people are infected with HIV; among them 30% are women. The great majority of reported cases in the Region are men. However, the ratio of men to women cases varies in different countries. It ranges between “9:1 (as for example in Egypt), to 2:1” (as in Morocco and some parts of Yemen). Due to religious, social and cultural values regarding female purity, women and girls living with HIV and AIDS are subjected to greater discrimination than men. WHO reports show that a large percentage of the infected women in Arab countries have contacted the infection from their husbands especially migrants and drug abusers. In Arab countries, studies conducted show that 86% of women choose not to disclose their status of infection for the fear of abandonment, rejection, discrimination, violence, upsetting family members, and accusations of infidelity from their partners, families, and communities. As a result, many women only seek help at the last minute when they are already been terminally ill. Violence against women and girls in its different forms increases women's vulnerability to HIV infection and undermines AIDS control efforts. The fear of violence prevents many women from accessing HIV information, from getting testing and seeking treatment. Stigma and discrimination may also prevent them from carrying out their normal life activities. When women are blamed, this can lead to heightened levels of sexual and domestic violence, abandonment by families and communities, forced abortion or sterilization, dismissal from employment and loss of livelihood opportunities. A study of AIDS-related discrimination in Arab region found that over ten percent of women had lost financial support from family members since being diagnosed as HIV positive. There is a great deal of evidence to establish the significant link between gender-based violence and rising rates of HIV infection among women and girls throughout the world. HIV-positive women must be supported to make their own reproductive choices about whether and/or when to have children. Promote male involvement in sexual and reproductive health programmes. Finally the stigma, discrimination and violations must be stopped.
In an attempt to discover how the phenomenon of amok is viewed within its indigenous culture, the authors studied and interviewed 21 subjects in West Malaysia who were labeled as amok. This investigation showed that both the subjects and the Malay culture view amok as psychopathology, that amok cases are disposed of in line with this view, and that the behavior of the amok person conforms to social expectations of the phenomenon. Despite cultural proscriptions, however, the act is purposive and motivated and is subtly sanctioned by Malay society.
When public health researchers study the health effects of disasters (whether "naturally-occurring," disasters due to failure of technology, or disasters due to terrorism), some aspects of the post-disaster situation of victims are often overlooked. Social science research has shown that the vast majority of people tend to behave altruistically during and after a disaster. Nevertheless, cases of victimization of survivors do occur. They can include post-disaster victimization of survivors by other individuals (including fellow survivors, opportunistic outsiders, and even unethical aid workers and rogue members of the police, armed forces or international organizations such as the United Nations), groups (such as organized criminal gangs) and institutions (through neglect, incompetence, bureaucratic inefficiency or through institutionalized discriminatory practices). In this article, various kinds of post-disaster victimization that can occur are discussed.
Malaysia is a tropical country in the heart of south east Asia with a population of 24 million people of diverse ethnic, cultural and religious backgrounds living in harmony in 330,000 km(2) of land on the Asian mainland and Borneo. Malaysia, which lies on the crossroads of trade between east and west Asia, has an ancient history as a centre of trading attracting commerce between Europe, west Asia, India and China. It has had influences from major powers that dominated the region throughout its history. Today the country, after independence in 1957, has embarked on an ambitious development project to make it a developed country by 2020. In this effort the economy has changed from one producing raw material to one manufacturing consumer goods and services and the colonial health system has been overhauled and social systems strengthened to provide better services for its people. The per capita income, which was under 1,000 US dollars at independence, has now passed 4,000 US dollars and continues to grow, with the economy largely based on strong exports that amount to over 100 billion US dollars. The mental health system that was based on institutional care in four mental hospitals at independence from British colonial rule in 1957 with no Malaysian psychiatrists is today largely based on over 30 general hospital psychiatric units spread throughout the country. With three local postgraduate training programmes in psychiatry and 12 undergraduate departments of psychiatry in the country--all started after independence--there is now a healthy development of mental health services. This is being supplemented by a newly established primary care mental health service that covers community mental health by integrating mental health into primary health care. Mental health care at the level of psychiatrists rests with about 140 psychiatrists most of whom had undertaken a four-year masters course in postgraduate psychiatry in Malaysia since 1973. However, there continues to be severe shortages of other professionals such as clinical psychologists and social workers in mental health services. There are a few specialists, and specialized services in child, adolescent, forensic, rehabilitative, liaison or research fields of mental health. In the area of services for women and children, as well as the disabled in the community, there are strong efforts to improve the care and provide services that are in keeping with a caring society. New legislation on these are being passed every year and the setting up of a Ministry for Women's Affairs is one such move in recent years. Mental health in Malaysia has been slow in developing but has in the past decade seen important strides to bring it on par with other branches of medicine.