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  1. Kim Sooi L, Lean Keng S
    PMID: 24093047 DOI: 10.1155/2013/438139
    This is a cross-sectional, descriptive study among Malay women admitted in the antenatal and postnatal ward to determine the prevalence and use of herbal medicines during pregnancy and elemental analysis in the most popular herbs. A total of 460 women were surveyed. Herbal medicine use during pregnancy was 34.3%, while 73% utilized herbal medicines during labor, because of a belief that it may shorten and ease labor. The most commonly used herbal medicines in pregnancy were Anastatica hierochuntica L. (60.1%) followed by coconut oil (35.4%). The majority of women (89.2%) used only one type of herbal medicines and took one capsule/glass (38%) per day. Herbal medicines use by pregnant women is largely unsupervised (81%), with most women getting information from their parents (60.7%) and buying the products directly from traditional midwives (32.2%) and 77% agreed upon its efficacy and safety. From the 460 respondents, 89.8% women were in the low end of the herbs knowledge. There was a significant difference found between knowledge score and income (P < 0.05). Microdiffraction analysis revealed significant presence of carbon, oxygen, silica, calcium, magnesium, aluminium, potassium, zinc, and iron that were found in Anastatica hierochuntica L. and proved to have good benefits for pregnancy.
  2. Lean Keng S, AlQudah HN
    J Adv Nurs, 2017 Feb;73(2):465-481.
    PMID: 27601180 DOI: 10.1111/jan.13142
    AIMS: To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery.

    BACKGROUND: The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan.

    DESIGN: Two-phase mixed methods sequential explanatory design and grounded theory.

    SETTING: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20).

    METHODS: Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis.

    RESULTS: Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance.

    CONCLUSION: There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making.

  3. Liu KT, Wan Rosli WR, Yusuf A, Lean Keng S
    Belitung Nurs J, 2021;7(6):493-499.
    PMID: 37497287 DOI: 10.33546/bnj.1802
    BACKGROUND: Breast cancer genetic (BRCA) testing for cancer susceptibility is an emerging technology in medicine.

    OBJECTIVE: This study assessed the knowledge and attitude of nurses regarding BRCA genetic testing in a tertiary teaching hospital in Malaysia.

    METHODS: A descriptive cross-sectional study was conducted among 150 nurses using a simple random sampling technique in a tertiary teaching hospital in northeast peninsular Malaysia. Data were collected using a self-administered questionnaire consisting of socio-demographic data, assessing nurses' knowledge and attitude regarding BRCA genetic testing. Fisher exact test analysis was used to determine the association between socio-demographic characteristics with knowledge and attitude level. In addition, the overall knowledge and attitude were analysed using the sum score of each outcome based on Bloom's cut-off point.

    RESULTS: Of the 150 nurses, 66.7% had high knowledge level about BRCA genetic testing, and 58% were positive towards genetic testing. The participants' mean age was 28.9 years (SD = 6.70). Years of working experience (p = 0.014) significantly influenced knowledge level on BRCA genetic testing, whereas speciality working experience (p <0.001) significantly influenced BRCA genetic testing attitudes.

    CONCLUSIONS: The results show that most nurses have adequate knowledge of BRCA genetic testing. However, their attitude could be termed negative. Therefore, targeted education programs on BRCA genetic testing and risk are needed to improve the knowledge and attitude of nurses and, ultimately, can educate the women and increase health-seeking behaviour among eligible women.

  4. Nasution A, Yusuf A, Lean Keng S, Rasudin NS, P Iskandar YH, Ab Hadi IS
    Asian Pac J Cancer Prev, 2021 Oct 01;22(10):3151-3163.
    PMID: 34710991 DOI: 10.31557/APJCP.2021.22.10.3151
    BACKGROUND: Mobile health technologies are widely being used for delivering health behaviour interventions. However, there is insufficient evidence that they are integrating theory and only a few researchers utilized a qualitative approach in their study.

    OBJECTIVES: This paper aims to identify requirements in developing a breast examination awareness mobile app based on the component of the Health Belief Model (HBM) for integration in health promotion strategy.

    METHODS: A qualitative approach using semi-structured in-depth interview was utilized in this study. A purposive sampling method was conducted among public women attending hospital services, software and content experts in a tertiary teaching hospital in the East coast of Peninsular Malaysia. These interviews were recorded, transcribed and organized using NVIVO 11. The main themes were identified through thematic analysis of the interview transcripts.  Results: A total of 37 participants recruited in this study. The themes that emerged from the analysis are vulnerability, forecasting, reactive, influence, outcome and obstacles. The sub-themes findings supported the HBM's component in terms of the requirement for are an infographic risk factor, video (symptoms, self-examination), info (metastasis, survival, screening, triple assessment, treatment, myth and facts, benefit of early treatment, support groups), features (screening reminder, sharing button, prompt) and mobile app's design.

    CONCLUSION: The research findings could provide a guide for future app development from public women, content and software experts.  The information will be used to develop a breast examination awareness mobile app integrated with health theories.

  5. Yusuf A, P Iskandar YH, Ab Hadi IS, Nasution A, Lean Keng S
    Front Public Health, 2022;10:951641.
    PMID: 36324460 DOI: 10.3389/fpubh.2022.951641
    BACKGROUND: Lack of knowledge, poor awareness, and attitude are barriers to breast cancer (BC) screening participation. The ubiquitous usage of mobile phones makes it a perfect platform for delivering interventions to increase knowledge and awareness in screening, a strategy for early identification of BC. However, although numerous applications for BC prevention are available on major mobile phone platforms, relatively few have been tested in scientific studies to determine their efficacy.

    OBJECTIVE: This study aimed to assess the efficacy of BrAware Apps in increasing the knowledge of BC risk factors, awareness of warning signs and confidence in breast self-examination (BSE) among women in northeast peninsular Malaysia.

    METHODS: A quasi-experimental pre and post-test research design were conducted with 41 women participants in Kelantan, Malaysia, before and after using the BrAware apps. Participants were given an online, adapted Breast Cancer Awareness Measure questionnaire. Post-test was 2 months after using the BrAware apps. Comparison using paired T-tests were conducted to evaluate the change in knowledge of risk factors, warning signs awareness and confidence level for BSE.

    RESULTS: The mean age of women was 39.71(SD = 8.80). The participants' mean knowledge score of BC warning signs differs before using BrAware (mean 70.62, SD 11.74) and after using the BrAware app (mean 79.83, SD 10.15) at the <0.001 level of significance.

    CONCLUSIONS: The BrAware mobile app had a positive effect in increasing the women's knowledge of risk factors of BC, warning signs awareness and confidence level for BSE. It can be concluded that the mobile app may be an adjunct in educating women on BC.

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