Level of fear towards COVID-19 and its determinants among healthcare providers in Malaysia: A cross-sectional study.

Introduction: Malaysia is one of the hardest-hit countries by COVID-19 in Asia. The rapidly rising number of cases had sparked fear among healthcare providers. This study aimed to assess the determinants of fear towards COVID-19 among healthcare providers in primary care settings. Method: This online-based cross-sectional study was conducted among 1280 healthcare providers aged ≥18 years from 30 primary care clinics in the state of Selangor, Malaysia. The Fear of COVID-19 Scale was used to assess the level of fear, and the results were analysed using multiple linear regression. Results: The mean age of the respondents was 36 years, and the mean working experience was 11 years. The majority of the respondents were women (82.4%) and Malays (82.3%). The factors that were significantly correlated with higher levels of fear were underlying chronic disease (ß=1.12, P=0.002, 95% confidence interval [CI]=0.08, 3.15), concern about mortality from COVID-19 (ß=3.3, P<0.001, 95% CI=0.19, 7.22), higher risk of exposure (ß=0.8, P<0.001, 95% CI=0.14, 5.91), concern for self at work (ß=2.8, P=0.002, 95% CI=0.08, 3.10) and work as a nurse (ß=3.6, P<0.001, 95% CI=0.30, 7.52), medical laboratory worker (ß=3.0, P<0.001, 95% CI=0.12, 4.27) and healthcare assistant (ß=3.9, P<0.001, 95% CI=0.17, 5.73). The level of fear was inversely correlated with a higher work-related stress management score (ß=-0.9, P<0.001, 95% CI=-0.14, -5.07) and a higher sleep quality score (ß=-1.8, P<0.001, 95% CI=-0.28, -10.41). Conclusion: Family physicians should be vigilant and identify healthcare providers at risk of developing COVID-19-related fear to initiate early mental health intervention.

Development and implementation of a community-based COVID-19 assessment centre in Selangor: A descriptive study.

Introduction: With the rising number of COVID-19 cases in Malaysia and the overwhelming strain on the tertiary healthcare system, home isolation has been introduced by the Ministry of Health Malaysia to reduce the admission of patients with mild COVID-19 to tertiary and low-risk quarantine centres. COVID-19 assessment centres (CACs) have been set up to provide initial assessment, triaging and monitoring of patients with COVID-19 prior to and during their home isolation. In this study, we aimed to share our experience in setting up CACs in Selangor, Malaysia. Method: We described the steps taken in developing assessment tools and guidelines for assisting healthcare providers in safely monitoring patients with COVID-19 undergoing home isolation. Results: A total of 26,826 patients were clinically assessed from 1 to 28 February 2021 in various CACs in the state. The majority of the cases seen in the CACs were under category (CAT) 1 and 2. Only 0.2% (n=53) of the cases were categorised as severe COVID-19 (CAT 3 and above). Conclusion: CACs coordinated by primary care providers play an important role in triaging, assessing and monitoring patients with COVID-19 undergoing home isolation in the community. There needs to be a better partnership between various stakeholders and the private healthcare sector to improve the services. The usage of a pulse oximeter in home monitoring of all patients with COVID-19 in Selangor needs to be seriously considered.

Practice of Disciplinary Methods and Factors Associated With Belief for Physical Punishment Among Malaysian Parents: Findings From NHMS 2016.

The belief in the effectiveness of physical punishment is an important predictor for its use. The objectives of this study was to describe the factors associated with the belief for physical punishment toward children 1 to 5 years of age among Malaysian parents. Data was collected as part of the Malaysian National Health and Morbidity Survey (NHMS) 2016. The respondents were asked if they believed that physical punishment is needed to raise a child properly. A total of 60.0% of Malaysian parents believed in the need for physical punishment, with 54.3% practising it. Parents who believed in physical punishment had more than 2 times a higher likelihood of practising it (odds ratio 2.57) than those who did not. Parents need to be taught to respond positively to children's behavior and anger management strategies in difficult parenting situations.

Awareness, knowledge, attitudes and practices on the management of diabetes mellitus patients with periodontitis amongst Malaysian primary care practitioners.

INTRODUCTION: The bi-directional relationship between periodontitis (PD) and diabetes mellitus (DM) has been confirmed. Medical practitioners (MPs) serve an important role in relaying this information to patients. This study aimed to investigate the awareness, knowledge, attitudes and practices (KAP) in the management of DM patients with PD in primary care clinics under the Ministry of Health (MOH) of Malaysia. MATERIALS AND METHODS: A self-administered questionnaire on KAP in the management of DM patients with PD was posted to 725 medical officers (MOs) and family medicine specialists (FMSs) in MOH clinics in Kedah, Terengganu, Johor and Negeri Sembilan. Collected data were tabulated and analysed using descriptive and regression analyses (simple and multiple). Statistical significance was defined as p < 0.05. RESULTS: A total of 549 MPs responded. The majority of MPs were MOs (92.6%) and female (75.8%). FMSs had a greater awareness of PD when compared to MOs (p = 0.002). All MPs had good knowledge, except for the incorrect notion that excessive sugar causes PD (94.3%). Overall, FMSs had better knowledge when compared to MOs (p=0.026). The majority of MPs agreed that 'they should update their knowledge on the association between systemic disease and PD' (89.6%) and claimed that 'it was not their responsibility to examine DM patients for PD' (83.1%). Most MPs did not enquire or examine for PD in their DM patients. More FMSs (67.5%) referred patients to dentists compared to MOs (31.6%). CONCLUSION: Most MPs have sufficient knowledge on PD, but a negative attitude in the management of PD in DM patients. The reasons for not referring included workload and patients refusing referral.

Empanelment: A foundational component of primary health care.

Empanelment is a foundational strategy for building or improving primary health care systems and a critical pathway for achieving effective universal health coverage. However, there is little international guidance for defining empanelment or understanding how to implement empanelment systems in low- and middle-income countries. To fill this gap, a multi-country collaborative within the Joint Learning Network for Universal Health Coverage developed this empanelment overview, proposing a people-centered definition of empanelment that reflects the responsibility to proactively deliver primary care services to all individuals in a target population. This document, building on existing literature on empanelment and representing input from 10 countries, establishes standard concepts of empanelment and describes why and how empanelment is used. Finally, it identifies key domains that may influence effective empanelment and that must be considered in deciding how empanelment can be implemented. This document is designed to be a useful resource for health policymakers, planners and decision-makers in ministries of health, as well as front line providers of primary care service delivery who are working to ensure quality people-centered primary care to everyone everywhere.