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[Will we learn from Southeast Asia? Enormous wage differences, censorship, strike prohibition, long waiting lists for health care...]

Olsson A

Vardfacket, 1997 May 20;21(5):22-7.
PMID: 9516800
Matched MeSH terms: Waiting Lists*
Fulltext Comparison of anterior tooth size discrepancies among different malocclusion groups

Asma, A.A.A.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):73-79.
MyJurnal

Discrepancies between tooth sizes can cause orthodontic problems such as crowding and improper occlusion. By identifying these problems, better orthodontic treatment outcome can be achieved. The aim of this study is to identify anterior tooth size discrepancies among 4 different types of malocclusion i.e. Class I; Class II division 1 (II/1); Class II division 2 (II/2); and Class III. Methods: A retrospective study was carried out using 200 orthodontic study models where 50 study models were taken for each of the 4 malocclusion groups. The samples were selected using random sampling technique based on the orthodontic waiting list in the Orthodontic Department, Dental Faculty, UKM. All anterior teeth were measured by the same examiner at the largest mesio-distal dimension, using a digital caliper recorded up to 0.01 mm. Comparison between the 4 groups of malocclusion were made intra-arch using individual tooth size measurement and inter-arch using Anterior Bolton Index (ABI). Results: For the intra-arch assessment, Class II/1 had significantly the largest upper and lower anterior tooth size except for its upper canine and lower central incisor. Class III group had insignificantly the smallest mandibular anterior teeth compared to other malocclusion groups. For inter-arch assessment, Anterior Bolton Index (ABI) of all samples was 79.2 ± 3.94%. The highest ABI was noted in Class II / 2 of 80.3 ± 4.71%. However, no significant differences were found among the 4 malocclusion groups (p>0.05). Conclusion: Most of the anterior teeth in Class II division 1 were the largest of all. No significant difference in the inter-arch tooth size discrepancies were detected among all malocclusion
groups.

Matched MeSH terms: Waiting Lists
Fulltext Customer waiting time in Labor Department, Kuala Terengganu: A queuing approach

Norsyafiqah Mohamad, Masnita Misiran, Zahayu Md Yusof

Journal of Academia Universiti Teknologi MARA Negeri Sembilan, 2020;8(2):22-32.
MyJurnal

Businesses adopt queuing mechanism as it can improve efficiency and provide economic use of
resources. Some business segment that normally adapted queuing theory include assessing staff
scheduling, productivity, performance, and customers waiting time. This article will adopt queuing
theory to current service provided by Department of Labour, Kuala Terengganu. As the department is
committed to provide quality services to its customer, the level of satisfaction and current queueing
time need to be investigated. To achieve this, four elements in queueing theory – arrival rate, the
queuing discipline, the service and also the cost structure are utilized. Arrival rate is measured as way
in which customer arrives at this department and entered for receiving a service. Single server queuing
model is known as infinite queue length model (exponential service) was used in this study. This model
is based on certain assumptions about queuing, as the arrivals are described by Poisson probability
distribution and arrive from infinite population. This study has demonstrated that, majority of the
customers are dissatisfied with services offered and the major cause of dissatisfaction is the long waiting
time. Sunday shows the busiest day at Department of Labour, Kuala Terengganu when there are too
many customers and duty officer faced a hectic day on Sunday, followed by Thursday and Wednesday.
Department of Labour, Kuala Terengganu needed to do the other internal procedures for reducing
waiting times and thus ensuring an effective services system. This study recommended of adding a new
checkout counter and hiring another employee to help duty officer improve the operation at Department
of Labour, Kuala Terengganu.

Matched MeSH terms: Waiting Lists
Fulltext Wait time analysis to optimize number of opened counters

Noraini Noordin, Nurul Elfieqah Rostam, Nur Ariena Farhana Noor Hamizan

ESTEEM Academic Journal, 2020;16(2):1-10.
MyJurnal

The Morning Shift (MS) flow of passengers on Thursday is similar to any other day in the week at an urban train station. However, passenger congestion occurring in the Evening Shift (ES) affects the system behaviour. The system has been showing this characteristic over the years. However,
only one counter is opened. This counter also sells different types of tickets. Thus, the system is not cost-effective. The study aims to determine the optimal number of counters that should be opened on Thursday. In order to solve this problem, the study has applied Poisson Queuing Simulation (PQ) to the MS and ES data. Findings indicate that running one or two counters in MS
maintains the mean of wait time in-queue and in-system at less than one minute, while the mean of in-queue and in-system passengers is also at one person. Extra cost has to be incurred to hire another teller; thus, one counter is optimal. For ES, the service rate was only slightly higher than the arrival rate. Based on the mean number of in-queue and in-system passengers, there was no way that one counter can efficiently service the queue that was formed. A simulation was done to determine if there was a need to set up a two-counter or a three-counter system. Although a two-counter system will be idle 47% of the time, it was not cost-effective for the management to two
extra tellers for a three-counter system. The management must take future corrective measures. Based on the findings, one counter is optimal for MS, but cost-effectiveness tests must confirm that two counters are optimal for ES. Besides, the management should also identify actions that can be taken during the 47% idle system time in ES.

Matched MeSH terms: Waiting Lists
Alternate careers for medical graduates and house officers in Malaysia

Naicker AS, Vinoshn DK, Yuliawiratman BS, Alaga A, Kevin Ng WS, Naicker MS, et al.

Med J Malaysia, 2021 03;76(2):183-189.
PMID: 33742626

INTRODUCTION: In recent years, many unresolved issues pertaining to house officers in Malaysia have led to a longer waiting time and a 'glut' of medical graduates with a surprising 20% dropout amongst those who join the housemanship programme. This appears to reflect the changing times, mindsets and work expectations of millennials who comprise this cohort reflecting a need to consider possibilities of career shifts especially so in these uncertain times. This study explores the perceptions, awareness and interest in alternative career options amongst recent graduates and house officers.
MATERIALS AND METHODS: This was a study done between 2018 and 2019 using a questionnaire which was shared on various social platforms. Data analysis was done using Excel spreadsheet.
RESULTS: A total of 450 house officers and 657 medical graduates responded. Expectedly 66.8% claimed lifelong passion whilst another 12.1% claimed family influence as their reason to do medicine. Most were aware of their career challenges and 40% of them were keen to consider career change and reskilling indicating a possible shift from traditional expectations of a medical career.
CONCLUSION: Whilst medicine is often considered a true calling, current challenges will require mental and emotional flexibility to explore other career opportunities. Thus, engagement programmes should be directed at medical graduates and house officers to identify and support those open to career transitions. This will help address current issues of internship bottleneck and rising dropout rates amongst internees. Early career change engagements will give them insight into their true career goals whilst opening up opportunities for those who wish to change.

Matched MeSH terms: Waiting Lists
Fulltext Reasons For Seeking Orthodontic Treatment A Pilot Study

Abdullah, A.A.A., Yassin, Z., Zamzam, N.

Ann Dent, 2001;8(1):-.
MyJurnal

This pilot survey was conducted to determine the main reason and the motivating factors which, influence patients in seeking orthodontic treatment. 115 patients aged 11-30 years old were taken from the orthodontic waiting list at the Dental Faculty, University Malaya dated December 1999 - May 2000. A structured questionnaire was designed and the survey of patients was carried out using the telephone. The desire to have a better dental appearance was the main reason (65 %) given by patients who were seeking orthodontic treatment. The most important motivating factor that influences patients in seeking orthodontic treatment was to attain straight teeth (48 %). In conclusion, patients seek orthodontic treatment mainly due to psychological reason, which is to improve dental appearance and aesthetic. Perceived needs of an orthodontic patient should also be taken into consideration before commencing orthodontic treatment to increase chances of mutually satisfying result for both the orthoqontist and patient.

Matched MeSH terms: Waiting Lists
A before-after study to evaluate the effect of pharmacy workflow redesign to improve pharmacy waiting time and reduce medication near misses in Malaysia

Liew JES, Chong Cheng Y, Tai NL, Pereira A, Manivannan V, Khoo SL, et al.

Int J Pharm Pract, 2024 Feb 15;32(1):83-90.
PMID: 38289996 DOI: 10.1093/ijpp/riad083

OBJECTIVES: This study aimed to evaluate the effectiveness of workflow redesign (eaST system) on pharmacy waiting time and near-missed events. We also investigated other factors that may potentially affect these study outcomes.
METHODS: A quasi-experimental (before-after) study design was adopted. Pre-intervention data were collected over 7 months (January-July 2017). Subsequently, the workflow redesign (eaST system) was implemented and the effect of the intervention (August 2017-February 2018) was evaluated. Univariate analysis was used to compare the differences between pre-intervention and post-intervention of pharmacy waiting time and near-missed events. Significant factors affecting study outcomes were analysed using linear regression analysis.
KEY FINDINGS: A total of 210,530 prescriptions were analysed. The eaST system significantly increases the percentage of prescriptions dispensed within 30 min per day (median = 68 (interquartile range (IQR) = 41) vs. median = 93 (IQR = 33), P < 0.001) and reduced the mean percentage of near-missed events (mean = 50.71 (standard deviation (SD) = 23.95) vs. mean = 27.87 (SD = 12.23), P < 0.001). However, the eaST system's effects on related outcomes were conditional on a three-way interaction effect. The eaST system's effects on pharmacy waiting time were influenced by the number of prescriptions received and the number of PhIS server disruptions. Conversely, the eaST system's effects on near-missed events were influenced by the number of pharmacy personnel and number of controlled medications.
CONCLUSIONS: Overall, the eaST system improved the pharmacy waiting time and reduced near-missed events.

Matched MeSH terms: Waiting Lists
Hospital waiting time: the forgotten premise of healthcare service delivery?

Pillay DI, Ghazali RJ, Manaf NH, Abdullah AH, Bakar AA, Salikin F, et al.

Int J Health Care Qual Assur, 2011;24(7):506-22.
PMID: 22204085

This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem.

Matched MeSH terms: Waiting Lists*
Liver transplantation--patient selection and timing

McCormick A, Sultan J

Med J Malaysia, 2005 Jul;60 Suppl B:83-7.
PMID: 16108182

Liver transplantation has been successfully used in the treatment of a large number of liver diseases. The largest patient group comprises patients with end stage decompensated liver disease. Decompensation is defined as the presence of cirrhosis and one or more of the following: jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome or bleeding oesophageal varices. In general patients in this category should be considered for liver transplantation, if available. Guidelines for liver transplant assessment have been published by both the British Society of Gastroenterology and the American Association for the Study of Liver Disease. These guidelines provide a good basis for patient selection. As new information becomes available the indications for individual diseases may change somewhat. One of the most important changes in recent years was the introduction of the MELD/PELD scoring system. This is the model for end stage liver disease which provides a reasonably robust estimate of prognosis for individual patients. Prior to this patient waiting time on the transplant list was one of the principal determinants of priority for liver allocation. The MELD scoring system has been widely adopted with the aim of allocating the available livers to patients in the greatest clinical need.

Matched MeSH terms: Waiting Lists
Fulltext Assessment of diabetic patient waiting time in a primary healthcare clinic

Mohd Shaiful Ehsan Shalihin, Iskandar Firzada Osman, Muhammad Hapizie Bin Din

IIUM Medical Journal Malaysia, 2020;19(2):41-48.
MyJurnal

Introduction: Long waiting time is a common issue complained by diabetic patients that came for an
early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in
a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for
improvement. Methods: This audit was conducted for four weeks using a universal sampling method in
November 2017. All diabetic patients who attended the clinic during this period were included except those
who required longer period such as critically ill patients or those who came for repeat medication or
procedures. The arrival and departure time for each station was captured using the modified waiting time
slip, which is manually filled at every station. The waiting and consultation time for registration, screening,
laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into
the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered
within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was
20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other
stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58
minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor
tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file
tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.

Matched MeSH terms: Waiting Lists
Fulltext Can Mindfulness Help to Alleviate Loneliness? A Systematic Review and Meta-Analysis

Teoh SL, Letchumanan V, Lee LH

Front Psychol, 2021;12:633319.
PMID: 33716901 DOI: 10.3389/fpsyg.2021.633319

Objective: Mindfulness-based intervention (MBI) has been proposed to alleviate loneliness and improve social connectedness. Several randomized controlled trials (RCTs) have been conducted to evaluate the effectiveness of MBI. This study aimed to critically evaluate and determine the effectiveness and safety of MBI in alleviating the feeling of loneliness. Methods: We searched Medline, Embase, PsycInfo, Cochrane CENTRAL, and AMED for publications from inception to May 2020. We included RCTs with human subjects who were enrolled in MBI with loneliness as an outcome. The quality of evidence was assessed using Cochrane's Risk of Bias (ROB) tool and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). A random-effects model was used for meta-analysis. Results: Out of 92 articles identified, eight studies involving 815 participants were included in this study. Most (7/8) trials conducted a minimum of 8 weeks of MBI. Most of the trials (5/8) used UCLA-Loneliness Scale. A pooled analysis combining three trials and compared with wait-list showed significant improvement in loneliness score reduction using the UCLA-R scale with MD of -6.33 [95% confidence interval (CI): -9.39, -3.26]. Subgroup analysis with only two Cognitively-Based Compassion Training (CBCT) trials also showed similar MD of -6.05 (95% CI: -9.53, 2.58). The overall quality of evidence (GRADE) was low. Conclusions: Mindfulness intervention with an average length of 8-week duration significantly improved the population's loneliness level with no mental health issue. However, this evidence had a low GRADE level.

Matched MeSH terms: Waiting Lists
Fulltext An audit of the caseload and waiting time for orthodontic treatment in a university setting

Abang Abdullah AA, Ruslan R, Mohd. Yashin SH

Malaysian Dental Journal, 2011;32(1):17-20.
MyJurnal

Objective: To audit the amount and complexity of case load and the waiting time for orthodontic treatment in Orthodontic Department of Universiti Kebangsaan Malaysia (UKM).
Materials and Methods: This study involved three waiting list records in Orthodontic department, UKM and 484 patients’ record were selected using Random Sampling technique. Demographic data of the patients were noted. Data on date of patient’s visit to ‘Klinik Rawatan Utama’ (KRU), Screening clinic and first orthodontic treatment (removable/fixed) clinics were also recorded. The severity of referred cases were graded using complexity scale (Russle et al, 1999).
Results: Patients were mostly female (76%) with age ranging from 10 to 52 years old. 75% of the referred cases were complex cases. From the year 2002-2007, 35% were referred for removable and 65% were referred for fixed clinic. In average, orthodontic screening waiting time was 6.9 ± 2.5 month. Patient would received removable and fixed appliance treatment after 4.4 ± 1.0 months and 14.5 ± 9.8 months respectively.
Conclusions: Most patients were referred to fixed waiting list. The waiting time from 2002 until 2007 for orthodontic treatment in UKM was longest for fixed followed by screening. The shortest waiting time was for the removable treatment.
Study site: Orthodontic Department of Universiti Kebangsaan Malaysia (UKM)

Matched MeSH terms: Waiting Lists
Fulltext Evaluation of drive-through pharmacy service in Queen Elizabeth Hospital Malaysia

Liew JES, Abdul Gapar AAB, Shim LT

J Pharm Policy Pract, 2020;13:27.
PMID: 32537169 DOI: 10.1186/s40545-020-00221-7

Background: In 2015, the drive-through pharmacy was first introduced in Queen Elizabeth Hospital (QEH), Malaysia as one of the pharmacy value-added services. Therefore, it is imperative to review the service for further amelioration to fulfil patients' needs and expectations.
Objective: The aim of this study is to evaluate the drive-through pharmacy service in Queen Elizabeth Hospital, Malaysia.
Methods: A cross-sectional observational study was conducted from July to December 2018. The questionnaire was developed and underwent thorough validation process which yielded a Cronbach's alpha reliability score of 0.9130. Satisfaction was calculated by mean percentage score (0% (dissatisfied) to 100% (satisfied). All data were analysed descriptively and thematic analysis was used in analysing open-ended question.
Results: Compliance in obtaining medication was at 96.3% with a given two-week grace collection period. Insufficient quantity of medications (33.3%) was the highest near-missed medication errors occurred at the drive-through pharmacy. The mean satisfaction percentage score for all patients were 76.6% ± 8.1. A total of 69.2% (n = 83) were "very satisfied" while 30.8% (n = 37) were "satisfied" with the service. Among the reasons for satisfaction are convenience in getting medication refills (n = 74, 62%), short waiting time (n = 75, 63%) and knowledgeable dispensers (n = 87, 73%). A handful of patients were "dissatisfied" with the opening hours (n = 14, 11.7%) and the location of the drive-through pharmacy service (n = 19, 15.8%).
Conclusion: Compliance in medication collection is acceptable within stipulated grace period. Despite low occurrence, identification of near-missed medication errors provides useful insights for future improvement of the service. Generally, our patients are satisfied with the service. However, we need to re-evaluate on the opening hours and location of the service.

Matched MeSH terms: Waiting Lists
Knowledge, perceptions and clinical application of the shortened dental arch concept among Malaysian government dentists

Kasim SKM, Razak IA, Yusof ZYM

Int Dent J, 2018 Feb;68(1):31-38.
PMID: 28782099 DOI: 10.1111/idj.12325

AIM: To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice.
BACKGROUND: The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice.
METHODS: A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software.
RESULTS: The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients <60 years of age, without molar support, can attain acceptable chewing function and that SDA treatment does not lead to loss of occlusal vertical dimension (P < 0.05). A larger number of participants with ≤5 years of work experience than with >5 years of work experience perceived that the SDA concept enables simpler treatment planning (P < 0.05). Finally, a larger number of participants who graduated abroad than who graduated locally observed that patients without molar support had temporomandibular joint problems (P < 0.05).
CONCLUSION: Although Malaysian government dentists have good knowledge and perceptions of the SDA concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs.

Matched MeSH terms: Waiting Lists
Do patients' perceptions exceed their expectations in private healthcare settings?

Suki NM, Lian JC, Suki NM

Int J Health Care Qual Assur, 2011;24(1):42-56.
PMID: 21456497 DOI: 10.1108/09526861111098238

PURPOSE: The purpose of this paper is to investigate whether patients' perceptions exceed expectations when seeking treatment in private healthcare settings in the Klang Valley Region of Malaysia.
DESIGN/METHODOLOGY/APPROACH: A survey was conducted among 191 patients in the Klang Valley Region of Malaysia to measure service quality of the private healthcare setting in Malaysia using SERVQUAL 5 dimensions model by Parasuraman et al. and three additional dimensions of the human element, when it comes to rendering good healthcare services, i.e. courtesy, communication and understanding of customers.
FINDINGS: The results revealed that the customers' perceptions did not exceed their expectations, as they were dissatisfied with the level of healthcare services rendered by private healthcare settings in that they felt that the waiting time of more than an hour to receive the service was excessive and, when there was a problem, the healthcare provider did not provide a response fast enough.
RESEARCH LIMITATIONS/IMPLICATIONS: Only eight service quality dimensions were studied. The sample investigated is relatively small, where three private healthcare settings were selected.
PRACTICAL IMPLICATIONS: It is recommended that hospital management should look into highlighted areas for which patients have high expectations.
ORIGINALITY/VALUE: The paper adds to the existing body of research on healthcare service quality, particularly on patients' perceptions and expectations. Survey results should be useful for continuous quality improvement.

Matched MeSH terms: Waiting Lists
The clinical effectiveness of cognitive behavior therapy and an alternative medicine approach in reducing symptoms of depression in adolescents

Charkhandeh M, Talib MA, Hunt CJ

Psychiatry Res, 2016 05 30;239:325-30.
PMID: 27058159 DOI: 10.1016/j.psychres.2016.03.044

The main aim of the study was to investigate the effectiveness of two psychotherapeutic approaches, cognitive behavioral therapy (CBT) and a complementary medicine method Reiki, in reducing depression scores in adolescents. We recruited 188 adolescent patients who were 12-17 years old. Participants were randomly assigned to CBT, Reiki or wait-list. Depression scores were assessed before and after the 12 week interventions or wait-list. CBT showed a significantly greater decrease in Child Depression Inventory (CDI) scores across treatment than both Reiki (p

Matched MeSH terms: Waiting Lists
Treatment Barriers Associated with Amphetamine-Type Stimulant (ATS) Use in Malaysia

Singh D, Narayanan S, Shanmugam T, Vicknasingam B

J Psychoactive Drugs, 2021 Mar 22.
PMID: 33749541 DOI: 10.1080/02791072.2021.1900627

People who use amphetamine-type stimulant (ATS) are known to face barriers in seeking treatment. We sought to identify these barriers and gender differences in barriers (if any) faced by them. A convenience sample of 386 respondents who use ATS was recruited from five formal drug rehabilitation centers for this cross-sectional study. The majority were male (83%), with 17% being female. The barriers most frequently cited by both men and women were: the perception that ATS use needed no treatment, fears of community discrimination, peer influence, and long waiting time to get into a treatment programme. One-third of the sample held that the mandated treatment programmes were ineffective, based on past experience. In terms of male-female differences, long waiting time discouraged significantly more women than men, whereas more men than women asserted that formal treatment programmes were ineffective. We also found no significant differences in barriers faced by ATS users and those using ATS with other illicit substances. Outreach initiatives to minimize the impact of treatment barriers, coupled with offering separate treatment protocols and facilities, will encourage people who use ATS to seek treatment voluntarily.

Matched MeSH terms: Waiting Lists
Basal Cell Carcinoma Surgery in general practice: Is there a role for the local General Practitioner?

Keah SH, Ng SC

Malays Fam Physician, 2020;15(3):10-21.
PMID: 33329859

Basal cell carcinoma (BCC) is a common disease of the skin caused principally by prolonged solar radiation exposure. It is normally a malignancy with favorable prognostic features and is potentially curable by standard excision. In White populations with high disease incidence, general practitioners (GPs) play a vital role in diagnosing and managing BCC, including surgical excision. Dedicated care at the primary care level by adequately trained GPs is conceivably cost effective for the health system and more convenient for the patient. In Asia and other parts of the world with low incidence, this valuable role of GPs may appear to be inconsequential. In this regard, any justification for the involvement of local GPs in BCC surgery is debatable. This article aims to provide a clinical update on essential information relevant to BCC surgery and advance understanding of the intricate issues of making a treatment decision at the primary care level.
Case Report: Madam Tan, a 71-year-old Malaysian Chinese lady, otherwise healthy, presented to her local GP with a complaint of a nodule over the left cheek that had been there for more than a decade. Her concern was that the lesion was growing and had become conspicuous. She had spent most of her life as a farmer working in her orchard.Upon examination, she had an obvious dome-shaped nodule over the left cheek measuring approximately 1.8 cm in diameter. The lesion was firm, pigmented, well-demarcated, and slightly ulcerated at the top. Clinically, she was diagnosed with a pigmented nodular basal cell carcinoma of the left cheek. Examination of the systems was unremarkable.She requested that the consulting GP remove the growth. The cost for specialist treatment and waiting time at the local hospital were her concerns.
Clinical Questions: Can the basal cell skin cancer be excised safely and effectively in the local primary care setting? What are the crucial preoperative concerns?

Matched MeSH terms: Waiting Lists
Fulltext Patients' Perception Towards Health Education Services Received at the Enhanced Primary Healthcare Facilities: A Qualitative Exploration

Jaafar N, Perialathan K, Zulkepli MZ, Mohd Zin Z, Jonoi PE, Johari MZ

J Prim Care Community Health, 2020 12 11;11:2150132720980629.
PMID: 33300405 DOI: 10.1177/2150132720980629

BACKGROUND: The present Malaysian healthcare system is burdened with increasing cases of non-communicable diseases (NCDs) and its risk factors. Health care providers (HCPs) have to provide both treatment and health education to ensure optimal outcome. Health education is a vital component in addressing and managing chronic diseases. This study intends to explore patient's perspective on health education services received from HCPs, focusing at the secondary triage in government primary healthcare facilities.
METHODS: This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach.
RESULTS: A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs.
CONCLUSION: Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients' attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.

Matched MeSH terms: Waiting Lists
Caregivers' perceptions towards oral healthcare services for elders living in Malaysian nursing homes-A qualitative study

Letchumanan D, Mohamad Norpi N, Yusof ZYM, Razak IA, Abu Kasim NH, Abdullah NA, et al.

Gerodontology, 2020 Dec;37(4):332-341.
PMID: 32115787 DOI: 10.1111/ger.12466

OBJECTIVE: To assess the perceptions of caregivers towards oral healthcare services received by elders in Malaysian nursing homes and to identify challenges and suggestions for improvement.
BACKGROUND: Caregivers play an important role in the oral health care of elders in nursing homes.
METHODS: This study employed a qualitative approach using the nominal group technique (NGT) to obtain caregivers' feedback in nursing homes in Malaysia. Data were manually transcribed, summarised into keywords/key phrases, and ranked using weighted scores.
RESULTS: In total, 36 caregivers (21 from government and 15 from private nursing homes) participated in the NGT sessions. Overall, caregivers were satisfied with the low treatment cost, the quality of treatment, and the availability of dental visits to nursing homes. Caregivers were dissatisfied with the frequency of dental visits, long waiting times at government dental clinics, and inadequate denture hygiene education for elders in nursing homes. The challenges faced by caregivers were elders' poor oral health knowledge and attitude and lack of elders' trust of caregivers to look after their oral health. Suggestions for improvement were to increase the frequency of dental visits to nursing homes, provide oral health education to elders and caregivers, and give treatment priority to elders at dental clinics.
CONCLUSION: Despite being satisfied with the basic oral healthcare services received by elders in Malaysian nursing homes, caregivers raised some issues that required further attention. Suggestions for improvement include policy changes in nursing home dental visits and treatment priority for elders at government dental clinics.

Matched MeSH terms: Waiting Lists

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