Needle Stick and Sharp Injuries among Health Care Workers in Kelantan: A Retrospective Six-Year Cohort Study

@#Introduction: The prevalence of needle stick and sharp injuries (NSSIs) still high among healthcare workers and many of them, without reason had defaulted the post management follow up. Thus, the aim of the study was to determine factors associated with default follow up among healthcare workers sustained NSSIs in Kelantan. Method: A retrospective cohort study using secondary data from Sharp Injury Surveillance notification system within period of six years started from January 2010 was done. Data were collected using proforma and analysed using SPSS version 22.0. Two hundred and seventy cases were selected by using multistage random selection method. Binary logistic regression analysis was used to determine the factors. Result: Majority of reported NSSIs involved female, with the mean age of 33 years. Most of them were intern that had less than ten years’ experience. Most of the accident occurred during office hours at tertiary healthcare setting during venepuncture for blood or intravenous fluid management. The workers with age less than 40 years and those who work at hospital setting have higher possibility to default the follow up with (Adj. OR 2.80; 95% CI: 1.12,7.00; p = 0.027) and (Adj. OR 4.65; 95% CI: 1.77,12.33; p = 0.002) respectively. Conclusion: NSSIs can occur at all level of occupational setting particularly among those who has less experience and work at tertiary healthcare setting. Thus, an intensive precaution action should focus on them since they are also the group that has higher odd to default the post management follow up.

Patients’ Expectations and Perceptions of Services Provided by Primary Health Clinics in Kota Bharu, Kelantan, Malaysia

@#Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangible dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in delivering a quality healthcare services.

Factors Associated with Poor Perceptions of Graphic Warning Signs (GWS) on Cigarette Package among Adult Smokers in Kelantan

@#Introduction: Initially, studies showed that graphic warning signs (GWSs) on cigarette packages encouraged smoking cessation. However, there have been recent concerns over the effectiveness of GWSs to change smoker perceptions and behavior over time. Our goals were to assess the latest perceptions of GWSs among smokers in Kelantan and to determine the factors associated with them. Methods: This cross-sectional study was conducted among respondents who attended outpatient clinics in a teaching hospital in Kelantan. Their perceptions were analyzed with a validated Malay questionnaire containing four domains: fear, influence, credibility, and picture content. Results: The average smoking age was 17 (3.04) years old. The mean smoking time was 11 (7.49) years. The average daily cigarettes smoked was 8 (6.26). Most respondents perceived low levels of fear (83%), poor picture content (65.5%), low influence (87.6%), and low levels of credibility (70.1%) in GWSs. Those with low levels of education were significantly associated with poor perceptions of GWSs. Conclusion: Despite vigorous efforts by the government to discourage smoking in Kelantan, smokers still poorly perceive GWSs. More effective health-promotion strategies are essential to influence smokers in this area.

Measuring Health Clinics’ Workload Pressure in Kelantan Using the Workload Indicator of Staffing Needs

@#Introduction: Proper distribution of human resources is an important factor ensuring high-quality performance and sustained service quality. The aim of this study was determining the workload pressure among medical officers in health clinics (HCs) in Kelantan. Method: A record review survey was conducted between January and April 2019 using human resources data for 2018 involving HCs in Kelantan. It included all the HCs in Kelantan and excluded community clinics. Workload pressure was determined using a tool known as Workload Indicator of Staffing Needs, developed by World Health Organization. A high workload pressure was defined as a ratio between required and acquired medical officers of less than 1. The data were presented descriptively using as frequencies and percentages. Results: All 85 HCs in Kelantan were involved in the study; 90% (9/10) of the Kelantan districts recorded high workload pressure. Moreover, 68.2% (58/85) HCs had high workload pressure. Tanah Merah, Tumpat, Pasir Mas, and Kota Bharu had the most HCs with high workload pressure, and most such HCs were found in areas with a high-density population, requiring huge coverage. Conclusion: The Kelantan State Health Department should develop better human resource distribution strategies to ensure the sustainability of quality care in HCs.

The Unmet Needs Among Parents of Disabled Children at Support Institutions in Kelantan, Malaysia

Abstract@#Introduction: Parents of a disabled child might require extra basic needs which most of the time are unmet due to several factors. Thus, understanding the unmet needs could help the respective institution to provide and prioritise the needs required. Methods: A cross-sectional study was conducted between September to December 2013 to determine the proportion of unmet needs among parents of children with disabilities at support institutions in Kelantan, Malaysia. Biological parents of disabled children aged between 2 to 18 years old were included in the study. A 35item validated Malay version of the Family Needs Survey was used in this study. A scoring of 4-point Likert scale was used; the prevalence of unmet needs was determined based on the proportion of those who scored “3” from each domain. Results: A total of 226 parents were involved in the present study. The mean age of parents and children were 44.6 (8.99) and 10.2 (4.85) years old respectively. The most common type of disabilities was learning disability (n=151, 66.8%). The unmet need for information has the highest prevalence (97.8%), followed by the unmet need for social support (93.8%). Conclusion: Parents with disabled children require information to guide them in managing their children. Findings from this study may better enable policymakers to devote resources in assisting parents, and service providers in designing appropriate interventions in fulfilling the unmet needs of these parents.

Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program / 가정의학회지

BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

A Preliminary Study on the Reliability of the Malay Version of PedsQL™ Family Impact Module among Caregivers of Children with Disabilities in Kelantan, Malaysia

Background: No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context. Methods: The study was conducted in 2009. The questionnaire was translated forward and backward before it was administered to 44 caregivers of CWD to determine the internal consistency reliability. The test for Cronbach’s alpha was performed. Results: The internal consistency reliability was good. The Cronbach’s alpha for all domains was above 0.7, ranging from 0.73 to 0.895. Conclusion: The Malay version of the PedsQL™ Family Impact Module showed evidence of good internal consistency reliability. However, future studies with a larger sample size are necessary before the module can be recommended as a tool to measure the impact of disability on Malay-speaking Malaysian families.