Pusat Pengajian Sains Perubatan - Tesis
Browse
Recent Submissions
- PublicationPerceptions, problems faced and coping behaviour : a qualitative exploration among patients with breast cancer attending Hospital USM, Kubang Kerian, Kelantan(2018-07)Jafar, Noor HayatiPatients with breast cancer face many challenges which include coming to terms with the diagnosis, managing treatment regimens, dealing with the side effects of treatment, conducting self-care and rehabilitation. In addition, the underlying belief of the disease influenced their health seeking behaviours. Each individual may have different coping strategies in order to overcome her problem. The study aimed to explore perceptions, problems, and coping behaviours among patients with breast cancer, and to develop Self-study Health Education Module for patients with breast cancer. Patients were purposively recruited from the Outpatient Oncology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Selected patients were interviewed in-depth until saturation were achieved. All interviews were tape-recorded and transcribed verbatim. Qualitative data were managed by Nvivo 10.0 software. Descriptive analysis was performed using SPSS version 22. A total of 34 patients took part in the study. Majority were married (85.3%), Malay (88.2%), age between 40 to 59 years old (70.6%), secondary school education (73.5%), housewife (61.8%), diagnosed with right breast cancer (52.9%) and with monthly income of less than RM 1500 (67.6%). The qualitative findings were divided into three sections which included patients’ perceptions regarding breast cancer, their problems and coping behaviours in patients with breast cancer. The themes raised from patients’ perceptions regarding breast cancer were cancer is viewed cancer as a death penalty; cancer treatment is terrifying and cancer as curable disease. The themes emerged regarding problems faced among patients with breast cancer were emotional, physical, and social relationship changes, economical restraint, and prioritise traditional over modern medicine. Three main themes emerged regarding coping behaviours were emotional-focused coping, spiritual-focused coping and problem-focused coping. Based on the study findings and literature search, a new Self-study Health Education Module was developed. Eleven experts viewed the module as good, very informative, helpful, suitable to implement and easy to understand. Mean scores of evaluations ranged from 3.5 (graphics are interesting) to 4.2 (module in line with objectives). Ten patients viewed the module as good, very interesting, clear, helpful, and easy to understand. Mean scores of evaluations ranged from 4.2 (pictures are interesting) to 4.8 (information are sufficient, beneficial). Health professional should also spend more time on counselling, conducting seminar and others activities to educate and improve awareness regarding breast cancer.
- PublicationDevelopment and validation of IYCF-CCPQ to assess knowledge, attitude and practice (KAP) on infant and young child feeding and factors associated with the kap scores among child care providers in Kelantan(2019-01)Zakria, Najihah MahfuzahAdequate nutrition is critical to child health. There is a need to identify the knowledge, attitude, and practice (KAP) on infant and young child feeding among child care providers. Pre-existing questionnaires are unsatisfactory due to a different target population, weak theory, and lack of confirmatory analysis. Our objectives were t o develop and validate a new questionnaire that will be use d to assess the KAP and its associated factors among child care provider s in Kota Bharu. This study consists of two phases which Phase 1 developed and validate a new questionnaire, meanwhile Phase 2 involved assessment of KAP and its associated factors. The questionnaire was developed based on literature review, experts’ opinion and theoretical framework. Response process was assessed via cognitive debriefing and pretesting. Psychometric validation was carried out among 200 child care providers outside Kota Bharu. Purposive sampling was applied. Item Response Theory and Exploratory Factor Analysis were used for internal structure validity . Internal consistency rel iability was conducted for all domains. For Phase 2, a cross-sectional study involved 150 child care providers in Kota Bharu. Multistage random sampling was applied. Level of KAP was determined and its associated factors were identified through multiple linear regression and chi-square analysis. As a result, the new questionnaire consists of 218 final items with 3 domains (99 items on knowledge, 77 items on attitude, and 42 items on practice) and named as ‘Borang Kaji Selidik Pemakanan Bayi dan Kanak-Kanak dalam kalangan Pengasuh’ or IYCF-CCPQ. IYCF-CCPQ had good psychometric properties. Internal consistency by marginal reliability ranging from 0.74 to 0.91 for domain knowledge. Reliability for domain attitude ranging from 0.89 to 0.90. Breastfeeding and formula feeding knowledge score (BFFKS) was 69.42 (SD 11.31), complementary feeding knowledge score (CFKS) was 76.99 (SD 9.31), breastfeeding and formula feeding attitude score (BFFAS) was 143.61 (SD 12.10); and complementary feeding attitude score (CFAS) was 176.69 (16.07). Exclusive breastfeeding experience (adjusted b=7.09; 95%CI 1.69,12.48; p=0.001) and number provider per centre (adjusted b=-0.41; 95%CI -0.77,-0.06; p=0.022) did had association with BFFKS. Being married had significant association with BFFKS (adjusted b=6.01; 95%CI 2.32,9.71; p<0.001), BFFAS (adjusted b=5.33; 95%CI 1.40,9.26; p=0.008) and CFAS (adjusted b=7.69; 95%CI 2.94,12.45; p=0.002). Increased total working hours per day (adjusted b=2.53; 95%CI 1.06,4.00; p<0.001) did have association with CFKS. Diploma or higher qualification did influence CFKS (adjusted b=3.13; 95%CI 0.08,6.19; p=0.046), BFFAS (adjusted b=5.33; 95%CI 21.40,9.26; p=0.008) and CFAS (adjusted b=10.74; 95%CI 5.69,15.79; p<0.001). Job scope less than five did influence CFKS (adjusted b=4.67; 95%CI 1.79,7.54; p=0.001), BFAS (adjusted b=3.94; 95%CI 0.29,7.58; p=0.036) and CFAS (adjusted b=8.24; 95%CI 3.53,12.94; p<0.001). Source information from health staff did influence CFKS (adjusted b=3.16; 95%CI 0.05,6.27; p=0.048). Meanwhile, pamphlet source had association with CFAS (adjusted b=5.89; 95%CI 0.79,11.00; p=0.025). There was a significant association of educational level (X2=8.12(3),p=0.044) and exclusive breastfeeding (p=0.041, fisher exact test) with the practice of handling express breastmilk. Meanwhile, hygenic practice did have association with educational level (p=0.048, fisher exact test). In conclusion, the IYCF-CCPQ is reliable and valid to be used to assess KAP among child care providers on infant young child feeding. Overall KAP was satisfactory and identified significant factors help in improving child care providers’ KAP in future.
- PublicationEvaluation of high-dose rate (HDR) radiobiologic dose-equivalent web tool for cervical cancer(2024-07)Shafizan, Haziq AsyraafFollowing successful precision and timing accuracy phases, the next step is a comprehensive evaluation of the web application versus the Microsoft Excel template. Testing with clinical data ensures robustness. Documentation and training for medical physicists are essential. Implementation will start with a pilot group, followed by full-scale deployment. Evaluation of BED and EQD2 values reveals minimal deviations, indicating high comparability. For target tissue, BED deviation is 0.048% and EQD2 is 0.008%. The bladder shows a BED deviation of 0.055% and EQD2 of 0.073%. The rectum has a BED deviation of 0.014% and EQD2 of 0.029%. For the sigmoid, the BED deviation is 0.035% and EQD2 is 0.142%. All deviations are within the 3% tolerance limit. The web application completes the full treatment in 138.69 seconds, compared to 202.67 seconds for Excel, with a TER of 1.46. For the first additional patient, the web application takes 96.84 seconds, while Excel takes 107.11 seconds, giving a TER of 1.11. For the second additional patient, the web application takes 94.77 seconds versus 78.66 seconds for Excel, with a TER of 0.83. Despite occasional exceptions, the web application is generally more time-efficient and reliable.
- PublicationNurses’ perceptions of patient handoffs and its predictors in public hospitals with specialists in Kelantan: a cross-sectional study(2023-06)Nawawi, Mohd Hanif MohdIntroduction: Understanding the significance of proper handoff process will help to reduce medical errors and enhance patient safety concerns. Thus, the purpose of this study was to investigate nurses' perceptions of patient handoffs in public hospitals with specialists in Kelantan and its predictors. Methodology: This cross-sectional study examined nurses from three specialist hospitals in Kelantan, Malaysia. The nurses were proportionately and randomly selected from the hospitals and included in the study. The nurses had at least six months of work experience and worked shifts at public hospitals with specialists in Kelantan. The study used a self-administered questionnaire with 26 items from six domains, which was validated and scored using a 5-point Likert scale. The data was analyzed using SPSS version 25 and linear regression analyses were used to identify predictors of nurses' perceptions of handoffs. Results: A total of 418 nurses participated in the study. The results indicate that nurses hold a positive view of handoffs, with a mean score ± SD of 3.53 ± 0.31. The mean age of the participants was 41.06 ± 6.26 years, the mean working experience was 16.80 ± 6.12 years and the mean handoff duration was 24.39 ± 10.68 minutes. The study identifies the paediatric department (95% CI: -0.195, -0.053, p <0.001), in-service formal training on handoff (95% CI: 0.016, 0.161, p <0.05) and satisfaction with the handoff process (95% CI: 0.234, 0.425, p <0.001) as the most significant predictors of nurses' perceptions. Conclusion: The study found that nurses generally perceived patient handoffs positively, with predictors including the paediatric department, handoff training and satisfaction with the process. To maintain good handoff practices, ongoing education, teamwork, audits and safety-focused culture are important.
- PublicationThe prevalence of drug-resistant tuberculosis (DR-TB) and risk factors for unfavourable treatment outcomes in Selangor and Wilayah Persekutuan Kuala Lumpur (WPKL), Malaysia(2023-06)Zaman, Mohd Fahmin KamarulIntroduction: Drug-resistant TB (DR-TB) is a global public health burden that causes high morbidity and mortality among the population. The increase in DR-TB cases has become evident in Malaysia over the past few years. Effective and systematic treatment can save lives; however, unfavourable treatment outcomes are a barrier. This study aims to determine the prevalence rate and the associated factors with unfavourable treatment outcomes among DR-TB patients in Selangor and WPKL from 2016 to 2020. Methods: This study has two components: prevalence rate and case-control analysis, utilizing secondary data obtained from the National Tuberculosis Surveillance Database (MyTB). All reported DR-TB cases in MyTB between 2016 and 2020 that met the study criteria were analysed. The case group consists of 181 DR-TB cases with unfavourable treatment outcomes, whereas the control group consists of 222 DR-TB cases with favourable treatment outcomes. Multiple logistic regression was used for data analysis. Results: There was an increment in the prevalence rate of DR-TB cases in Selangor and WPKL from 2016 to 2020, from 0.31 to 1.83 per 100,000 population. DR-TB cases with unfavourable treatment outcomes accounted for 42%. The significant factors associated with unfavourable treatment outcomes among DR-TB cases were male (AdjOR 2.38; 95% CI: 1.44, 3.94), single and divorced (AdjOR 1.61; 95% CI: 1.03, 2.49), receive no formal education (AdjOR 3.09; 95% CI: 1.49, 6.41), HIV positive (AdjOR 2.87; 95% CI: 1.40, 5.87), DR-TB category for RR- TB (AdjOR 3.34; 95% CI: 1.90, 5.86) and MDR/ Pre-XDR/ XDR-TB (AdjOR 2.57; 95% CI: 1.52, 4.33). Conclusion: Therefore, unfavourable treatment outcomes among DR-TB cases should be tackled through holistic public health interventions involving commitment from all stakeholders. Future studies need to explore other parameters as well as drive efforts to start capturing additional significant variables in the surveillance database for all TB cases.