Pusat Pengajian Sains Perubatan - Tesis

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Health-related quality of life and its association among medical officers in Selangor
(2025-06)
Ariffin, Khairunnisa
Introduction: Health is a fundamental human right and a vital resource for societal productivity and well-being. For health professionals, particularly medical officers (MOs), maintaining optimal physical, mental, and social well-being is crucial, as it affects both their quality of life (QoL) and the quality of patient care. Despite their essential role, MOs are increasingly affected by occupational stressors, including extended working hours, administrative burdens, job insecurity, and system inefficiencies, which negatively impact their QoL. Objectives: This study aims to assess the QoL of medical officers in Selangor and examine the underlying factors influencing their well-being. The findings are expected to contribute to policy recommendations that enhance work-life balance, reduce psychological distress, and improve healthcare delivery. Methods and Results: 165 MOs were selected through simple random sampling from hospitals and health clinics. Data were collected using an online questionnaire with sociodemographic information and the WHOQOL-BREF to measure QoL. The analysis involved descriptive statistics and linear regression. The mean score for the psychological health domain was 55.45, lower than the general population norm, indicating considerable psychological challenges among MOs. Multiple linear regression analysis identified two significant factors associated with better psychological health: normal body mass index (BMI) and permanent employment status. MOs with a normal BMI scored 3.61 points higher in psychological well-being than those who were overweight (p = 0.030). Additionally, MOs in permanent positions had psychological scores 9.55 points higher than those employed on a contract basis (p = 0.003). These results suggest that physical health and employment stability are important determinants of psychological well-being among MOs. Conclusion: The results highlight the impact of lifestyle and job security on mental health. Holistic interventions addressing work conditions and personal health are essential to improve the quality of life and performance of MOs.
Trend and associated factors of food poisoning outbreaks in secondary schools in Kelantan, from 2022 to 2024
(2025-06)
Sha’ari, Ahmad Zulfahmi
Background: Food poisoning is a recurring challenge in Malaysia’s public health system, consistently ranking among the nation’s top five communicable diseases. In Kelantan, the concern over the increasing trend of food poisoning involving school settings has been growing. Objective: This study aimed to describe the trend of food poisoning outbreak cases, to describe the proportion of food poisoning outbreak cases and to determine the factors associated with food poisoning cases during outbreaks among secondary school students in Kelantan within the same period. Methodology: This study conducted a cross-sectional design to describe the trend and proportion of food poisoning outbreaks reported among secondary school students in Kelantan from 2022 to 2024. For the analysis of associated risk factors, a case-control design with a 1:3 ratio was applied, where student cases from selected outbreaks were compared with matched controls. Data were extracted from the final outbreak reports using the “Borang Siasatan Keracunan Makanan (FWBD/KRM/BG 001), Revision 2008”. Result: The findings showed an upward trend in food poisoning outbreaks from 2022 to 2023, followed by a plateau in 2024. The proportion of outbreaks involving secondary schools was 90.9% in 2022, 44.4% in 2023, and 33.3% in 2024, with an overall combined proportion of 45.9% across the three years. The mean age of affected students was 14.77 years (SD = 1.38), with 62.5% in the lower secondary age group (13-15 years). Schools under the Ministry of Education (MOE) accounted for 73.5% of the cases, and 55.9% of outbreaks occurred in rural areas. Notably, 85.3% of incidents were linked to hostel canteens. Poultry was identified as the leading food vehicle (50.0%), while Salmonella spp. emerged as the most common microbial agent (64.7%). Inadequate cooking and reheating and improper storage were the most frequent critical control point (CCP) failures (64.7%). Male students were found to have a lower likelihood of being affected (AOR = 0.76; 95% CI: 0.60,0.96; p = 0.023). Conversely, consumption of red meat significantly increased the risk of food poisoning (AOR = 4.45; 95% CI: 3.25,6.08; p < 0.001), as did exposure to inadequate cooking and reheating (AOR = 1.50; 95% CI: 1.20,1.89; p < 0.001). Conclusion This study revealed a clear link between food poisoning outbreaks in Kelantan’s secondary schools and specific operational practices within school. While non-modifiable factors like student’s sex influenced susceptibility, the more concerning aspects were preventable factors particularly in cooking, reheating, and storage of high-risk foods such as red meat. These findings highlighted the need for strengthening food safety training for canteen personnel, enforcing strict CCP monitoring, and integrating targeted health literacy for students in preventing future outbreaks.
Occupational safety and health knowledge and its predictors among medical officers in government primary healthcare facilities in Kedah
(2025-06)
Saad, Ahmad Shahril Hafifi
Background : Occupational safety and health (OSH) knowledge is essential in promoting a safe healthcare work environment, especially in primary healthcare settings where medical officers face multifaceted occupational hazards. Despite Malaysia's commitment to OSH through legislative reforms, knowledge gaps remain evident, particularly in primary care. Objectives: This study aimed to assess the level of OSH knowledge among medical officers in Kedah’s primary healthcare and to identify the predictors associated with higher knowledge scores. Methodology: A cross-sectional study involving 173 randomly selected medical officers from government primary healthcare facilities across Kedah was conducted between January and March 2025. A validated self-administered questionnaire was used to measure sociodemographic data, occupational characteristics, and OSH knowledge. Descriptive analysis, one-way ANOVA, simple linear regression (SLR), and multiple linear regression (MLR) were employed to determine predictors. Results: The mean OSH knowledge score was 71.66 (SD=14.16), with only 36.4% of respondents achieving satisfactory knowledge (≥75%). Age, gender, ethnicity, job grade, unit of service, duration of service, and prior OSH training were significantly associated with knowledge levels in univariate analysis. MLR revealed two significant predictors: prior OSH training (Adj. β = -19.37; p < 0.001) and 10–20 years of service (Adj. β = 7.09; p < 0.001). The final model explained 52.5% of the variance in knowledge scores (R² = 0.525). Respondents who had received OSH training scored significantly higher, In contrast, younger officers and those without training showed notable knowledge gaps. Conclusion: This study highlights critical gaps in OSH knowledge among primary healthcare medical officers in Kedah. Structured OSH training and accumulated service experience are associated with adequacy of OSH knowledge. The findings underscore the need for mandatory training, mentoring programs, and curriculum integration to ensure uniform OSH competency among all healthcare personnel.
A structural equation model of physical activity, psychological factors, and life satisfaction among health sciences students in health campus, Universiti Sains Malaysia
(2025-07)
Xie, Yushu
Introduction: With the acceleration of globalization and the continuous increase of social stress, mental health issues are becoming increasingly prominent worldwide, especially among young people. Physical activity is broadly acknowledged as a crucial element for supporting both physical and mental health, proven effective in reducing depression, anxiety, and improving well-being. However, the participation rate in physical activity among university students remains low, and their mental health status is deteriorating. This study focuses on life satisfaction as the primary outcome variable, aiming to explore the mechanisms by which physical activity and psychological factors (self-compassion, body compassion, perceived stress) influence life satisfaction. Objective: This study aims to examine the structural relationships among physical activity, self-compassion, body compassion, perceived stress, and life satisfaction among undergraduate health sciences students at the Health Campus of Universiti Sains Malaysia. Methods：This cross-sectional study utilized self-administered questionnaires to gather data, with undergraduate students recruited through convenience sampling. A total of 300 participants were included. Confirmatory Factor Analysis (CFA) was initially performed to confirm the validity and reliability of the measurement instruments. Due to some participants selecting "Not Sure" in the physical activity questionnaire, it was not possible to calculate the metabolic equivalent (MET) for those cases. As a result, only 240 complete datasets were retained for further analysis. Subsequently, Structural Equation Modeling (SEM) was applied to examine the interrelationships among the study variables. The self-administered questionnaire served as the data collection tool throughout the study. CFA was employed to assess and confirm the psychometric properties of the measurement tools, verifying their reliability and validity before advancing to the modeling stage. The "Not Sure" responses to items in the physical activity questionnaire resulted in missing MET scores, leading to the exclusion of incomplete data. Ultimately, 240 complete datasets were used for SEM analysis to model the associations among the variables, focusing on both direct and indirect effects. This combined approach of initial CFA for validation, followed by SEM for modeling, ensured a thorough and methodical analysis of the study data. Results： The CFA results showed that all instruments had good validity and reliability. All factor loadings exceeded 0.30, and model fit indices for each scale met recommended thresholds (CFI > 0.90, TLI > 0.90, RMSEA < 0.08, SRMR < 0.08). The final SEM model demonstrated a good fit (Comparative Fit Index=0.989, Tucker-Lewis Index=0.979, Standardized Root Mean Square Residual=0.032, Root Mean Square Error of Approximation=0.033). Analysis showed that physical activity did not directly predict life satisfaction (β = 0.081, p = 0.161), but had a positive indirect effect through reducing feelings of helplessness. In the dimensions of body compassion, “acceptance” directly improved life satisfaction, while “defusion” had an indirect effect through stress reduction; “common humanity” did not show a significant effect. Self-compassion positively influenced life satisfaction indirectly through enhanced body acceptance, while self-criticism affected life satisfaction by reducing helplessness and increasing body acceptance. The overall stress level showed a significant negative impact on life satisfaction. Conclusion：This study indicates that the effect of physical activity on life satisfaction is achieved indirectly through the reduction of perceived stress rather than a direct effect. Additionally, improving body acceptance and fostering positive self-compassion play a crucial role in enhancing life satisfaction. Future intervention strategies should consider integrating physical activity with psychological adjustment, focusing on stress reduction and the development of self-acceptance, to more effectively promote the overall well-being of university students.
Trends of medication errors and its associated factors in Malaysia: an analysis from the medication error reporting system, 2016-2023
(2024-12)
Azlan, Wan Mastura Wan Mohamad
Introduction: Assessing factors contributing to medication errors is crucial in healthcare settings, particularly in Malaysia, where medication errors lead to significant patient harm, prolonged hospital stays, increased healthcare costs and even fatalities. This study aimed to describe the trend of medication errors in Malaysia from 2016 to 2023 and to identify associated factors (staff-related factors, medication-related factors, task or technology-related factors, work or environment-related factors, time and location of events) that affected the number of medication errors in Malaysia. Method: A cross-sectional study was conducted using secondary data from the National Medication Error Reporting System (MERS) from January 2016 until December 2023. Cases that met the inclusion criteria, involving medication error reportsِ fromِ Malaysia’sِ governmentِ hospitalsِ andِ clinics,ِ wereِ included,ِ whileِ thoseِ with over 20% missing data for relevant variables were excluded. Medication error trends were analyzed using Joinpoint regression, and associated factors were examined using Poisson regression analysis. Result: Out of 377,089 medication error reports obtained from the National Medication Error Reporting System (MERS) across Malaysia, a total of 372,916 reports qualified to be included and were analyzed in this study. The general characteristics of medication errors showed that the most frequent contributing factors were peak hours (24.9%), followed by distraction (20.2%) and inexperienced personnel (12.3%). The trend of medication error in Malaysia showed a significant increase from January 2016 to April 2021 (APC of 2.2%) but decreased afterward (APC of -1.1%). The significant adjusted associated factors of medication errors were inexperienced personnel (Adj. IRR=1.02; 95% CI=1.01, 1.02), inadequate knowledge (Adj. IRR=1.03; 95% CI=1.02, 1.03), distraction (Adj. IRR=1.02; 95% CI=1.02, 1.03), sound alike medication (Adj. IRR=0.98; 95% CI=0.98, 0.99), heavy workload (Adj. IRR=1.02; 95% CI=1.02, 1.03), peak hour (Adj. IRR=1.02; 95% CI=1.01, 1.02), failure to adhere to work procedure (Adj. IRR=1.06; 95% CI=1.05, 1.06), patient information or record is unavailable or inaccurate (Adj. IRR=1.07; 95% CI=1.07, 1.08), incorrect computer entry (Adj. IRR=1.02; 95% CI=1.01, 1.02), other factors (Adj. IRR=1.03; 95% CI=1.02, 1.03), location of events in the emergency department (Adj. IRR=1.05; 95% CI=1.04, 1.05), in pharmacy (Adj. IRR=0.95; 95% CI=0.94, 0.95), in ward (Adj. IRR=1.01; 95% CI=1.01, 1.01), and in others (Adj. IRR=1.04; 95% CI=1.01, 1.06). Conclusion: The study revealed an overall increase in reported medication errors, with multiple contributing factors. Interventions targeting training for inexperienced personnel, minimizing distractions, and addressing workload during peak hours could enhance medication safety in Malaysia.

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