Résumé
@#Malaysia seeks to transform its public healthcare sector to manage the growing number of people with diabetes. Patient engagement is a critical clinical competency for healthcare providers treating people with diabetes. In this study, we investigate the perceptions of and ability to practice patient engagement among doctors and nurses working in Malaysia’s primary healthcare system. Semi-structured interviews were conducted with nine non-specialist doctors and ten nurses working in primary healthcare clinics. Further, 12 key informants with specialist knowledge about diabetes care and the healthcare system in Malaysia were interviewed. The interviews were analyzed using qualitative content analysis. Three main themes emerged: 1) understanding barriers to self-care and treatment, 2) perceived training needs and skills within patient engagement and empowerment, and 3) challenges to the practice of patient engagement. A range of barriers was identified in healthcare providers’ ability to practice patient engagement. Future efforts should seek to improve competencies within patient engagement, identification of especially psychosocial barriers to self-care and empowerment. Yet, available manpower and time also influence whether patient engagement is practiced.
Résumé
Introduction: Changes in dietary habits are known to be associated with changes in health outcomes. This study determined food choices among Malaysian adults using secondary data of the Malaysian Adults Nutrition Survey (MANS) in 2003 and MANS in 2014. Methods: A total of 6,742 and 3,000 adults aged 18 to 59 years participated in MANS 2003 and MANS 2014, respectively. Both studies used a semi-quantitative food frequency questionnaire (FFQ) to assess habitual food intake. Results: Overall, the prevalence of adults consuming rice twice daily were 97.3% and 86.9% in 2003 and 2014, respectively. While the percentage of urban dwellers who consumed rice daily differed significantly between 2003 (96.7%) and 2014 (86.9%), the percentage remained quite similar among rural adults in 2003 (97.8%) and 2014 (96.3%). Other top ten food items consumed daily were sugar (2003, 58.5% vs 2014, 55.9%), marine fish (40.8% vs 29.4%), green leafy vegetables (39.9% vs 43.2%) and sweetened condensed milk (35.2% vs 29.3%). In both surveys, a higher percentage of men consumed rice, sugar and sweetened condensed milk on a daily basis compared to women, a higher proportion of whom daily consumed green leafy vegetables and marine fish. Majority of the adults reported drinking plain water daily. Other beverages taken daily were tea, coffee and chocolate-malt drinks. Conclusion: Rice, sugar and sweetened condensed milk were among the top food items consumed daily in 2003 and 2014. Educational efforts to improve dietary intake of Malaysian adults is recommended.