Pusat Pengajian Sains Kesihatan - Tesis
Browse
Recent Submissions
- PublicationKnowledge, attitude, and practice of telemedicine among attendees in outpatient clinics at Hospital Pakar USM Kelantan(2025-06)Zulkifli, NurfarihahIntroduction: Telemedicine has become an increasingly important modality in delivering healthcare services, especially in the post COVID-19 era. Despite growing uptake, limited data exist on patient knowledge, attitudes, and behaviors regarding telemedicine use in public tertiary hospitals in East Coast Malaysia. Objective: This study aimed to determine the prevalence of good knowledge, attitude, and practice (KAP) and to identify associated factors toward telemedicine among outpatient clinic attendees at Hospital Pakar USM Kelantan. Methodology: A cross-sectional study was conducted between October 2024 and June 2025 involving 255 participants, systematically sampled from four outpatient clinics. A previously validated Bahasa Malaysia KAP instrument was used to assess telemedicine-related knowledge, attitude and practice. Data were analyzed descriptively and using multivariable logistic regression. Results: A total of 255 participants from outpatient clinics at Hospital Pakar USM were included in the study. The prevalence of good knowledge, attitude, and practice toward telemedicine was 60.4%, 75.7%, and 52.2% respectively. Telemedicine practice was reported by only 52.2% of participants, despite generally high knowledge and positive attitudes. Multivariable logistic regression revealed that younger age (AOR = 0.95, 95% CI: 0.96–0.98, p < 0.05), being married (AOR = 2.86, 95% CI: 1.34–6.24, p < 0.05), and having a history of telemedicine use (AOR = 2.82, 95% CI: 1.27–6.98, p < 0.05) were significantly associated with good knowledge of telemedicine. Younger age (AOR = 0.95, 95% CI: 0.92–0.97, p < 0.05) and being married (AOR = 3.69, 95% CI: 1.51–9.34, p < 0.05) were significantly associated with good attitude. Meanwhile, younger age (AOR = 0.97, 95% CI: 0.95–0.99, p < 0.05) and a history of telemedicine use (AOR = 3.11, 95% CI: 1.42–7.43, p < 0.05) were significant predictors of good practice toward telemedicine. Conclusion: Although knowledge and attitude toward telemedicine were relatively high, findings highlight a moderate uptake gap, particularly among older and higher-income individuals. Interventions targeting digital literacy and guided exposure to telemedicine may help improve utilization in these subgroups. These findings can inform targeted components of Malaysia’s digital health roadmap, including integration into tele-primary care expansion and public hospital teleconsultation protocols. Given the single-center design and exclusion of acutely ill patients, findings may not fully represent the broader outpatient population in Malaysia.
- PublicationTrend and factors associated with stillbirth at Hospital Pakar Universiti Sains Malaysia (HPUSM) from 2019 to 2023(2025-06)Hassan, Nazirul Munir AbuBackground: Stillbirth remains a major public health challenge, especially in low- and middle-income countries. Despite being a tertiary referral center, stillbirths continue to occur at Hospital Universiti Sains Malaysia (HPUSM), underscoring the need to identify preventable risk factors through focused investigation. Objective: This study aimed to describe the incidence rate trend of stillbirth and to determine the factors associated with stillbirth among deliveries at Hospital Universiti Sains Malaysia (HPUSM) from 2019 to 2023. Methodology: This was a case-control study using record review from the Department of Obstetrics and Gynaecology, Hospital Universiti Sains Malaysia (HPUSM), conducted between October 2023 and May 2024. Relevant data were collected using a standardized proforma and analysed using SPSS software version 29. The data were analysed using descriptive statistics, simple logistic regression, and multiple logistic regression. Results: A total of 46,012 deliveries were included for trend analysis, with the stillbirth incidence ranging from 5.06 to 7.24 per 1,000 births over the five-year period, showing a fluctuating trend. For the association analysis, 196 stillbirth and 268 randomly selected live birth were included. Multiple logistic regression analysis revealed that advanced maternal age (aOR = 1.11; 95% CI: 1.05, 1.18; p < 0.001) and abruptio placenta (aOR = 12.89; 95% CI: 1.55, 107.12; p = 0.018) were significantly associated with higher odds of stillbirth. Conversely, anemia (aOR = 0.34; 95% CI: 0.13, 0.91; p = 0.033), low birth weight (aOR = 0.28; 95% CI: 0.15, 0.55; p < 0.001), and lower gestational age (aOR = 0.66; 95% CI: 0.55, 0.79; p < 0.001) appeared as protective factors against stillbirth. Conclusion: Advanced maternal age, anemia, low birth weight, preterm delivery, and abruptio placenta were significantly associated with stillbirth. Strengthening antenatal surveillance and timely management of high-risk pregnancies are essential to reduce stillbirths and improve the quality of care at HPUSM.
- PublicationKnowledge, attitude, and determinants of sugar sweetened beverage consumption in Malaysia(2025-06)Abidin, Muhamad Syafiq Zainulweekly.ِ Theِmultipleِ logisticِ regressionِ analysesِ revealedِ thatِmaleِ genderِ (Adjustedِ ORِ =ِ 2.43;ِ 95%ِ CI:ِ 1.56,ِ 3.77)ِ andِ non-degreeِ educationِ levelِ (Adjustedِ ORِ =ِ 1.69;ِ 95%ِ CI:ِ 1.05,ِ 2.71)ِ wereِ significantlyِ associatedِ withِ higherِ SSBِ consumptionِ (9ِ timesِ orِ moreِ perِ week),ِ whileِ B40ِ householdِ incomeِ wereِ significantlyِ associatedِ withِ higherِ SSBِ consumptionِ (9ِ timesِ orِ moreِ perِ week)ِ whenِ comparedِ toِ M40ِ andِ T20ِ groupِ (Adjustedِ ORِ =ِ 0.09ِ toِ 0.53;ِ pِ <ِ 0.05).ِ Theِ studyِ underscoresِ theِ influenceِ ofِ knowledgeِ andِ sociodemographicِ factorsِ onِ dietaryِ behaviourِ andِ highlightِ theِ needِ forِ targetedِ interventionsِ focusedِ onِ menِ andِ socioeconomicallyِ disadvantagedِ populationsِ toِ reduceِ SSBِ intakeِ andِ promoteِ healthierِ lifestylesِ evenِ amongِ thoseِ whoِ areِ alreadyِ aware.
- PublicationPressure injury prevention barriers and its associated factors among critical care nurses at tertiary hospitals in Perak(2025-06)Yusoff, Muamar Iskandar MohamedIntroduction: Pressure injuries (PIs) remain a significant challenge in critical care settings, where patient acuity and workload are high. Preventing PIs is a multidisciplinary responsibility, with nurses playing a crucial frontline role. Understanding the barriers to PIs prevention is vital for designing effective interventions. This study aimed to identify the perceived barriers to pressure injury prevention and their associated factors among critical care nurses at tertiary hospitals in Perak, Malaysia. Methods: A cross-sectional study was conducted among nurses working in the critical care units of three tertiary hospitals in Perak. Data were collected using a validated self-administered questionnaire assessing perceived barriers across domains such as knowledge and attitude, organizational factors, and training. Descriptive statistics, univariate analysis, and multiple logistic regression were employed using SPSS Version 29. Results: The study revealed that perceived barriers were highly prevalent. The top three barriers were high in-service turnover, lack of family/caregiver cooperation, and unavailability of preventive devices. Nurses who had no access to pressure injury prevention guidelines reported significantly higher barriers. Furthermore, nurses working in general ICUs perceived more barriers than those in NICU, HDU, and CCU. Conclusion: Pressure injury prevention in critical care units is hindered by multiple systemic and individual factors. Addressing these challenges requires targeted strategies, including guideline accessibility, staff retention policies, training reinforcement, and family engagement. These findings highlight the need for institutional and policy-level interventions to enhance preventive practices and improve patient safety outcomes.
- PublicationDistribution and incidence of confirmed measles infection and its relationship with vaccination status in Kelantan, 2016-2023(2025-06)Fauzi, Mohd Fittri Fahmiand good vaccination coverage, Kelantan has recorded recurrent outbreaks, calling into question the adequacy of local population immunity and the role of vaccination to contracting measles risk in Kelantan population. Objective: To describe the distribution of confirmed measles infection, to examine the state and specific incidence rate trends of confirmed measles infection, and to describe the relationship between vaccination status and confirmed measles infection in Kelantan from 2016 to 2023. Methods: A cross-sectional study of surveillance data from the SM2 e-Measles system was undertaken. All 5495 suspected cases notified from January 2016 to December 2023 were analysed. Incidence rates were calculated with Department of Statistics mid-year population denominators and presented by year, district, sex, age and ethnicity. Multivariable logistic regression examined the relationship between vaccination status and confirmed infection, adjusting for age, sex, ethnicity and contact history. Results: Only 398 notifications (7.2%) were laboratory-confirmed. Annual incidence fell from 21.1 per million (2016) to 17.5 (2017), rose sharply to 69.0 (2019) driven by an Orang Asli outbreak in Gua, declined to zero in 2021 during COVID-19 restrictions, and rebounded to 28.5 in 2023, with Pasir Puteh emerging as a new hotspot (11.3 / 100 000). Infants less than 1 year persistently recorded the highest incidence, peaking at 127.4 / 100 000 in 2020. Although the Orang Asli ethnic constitute only a small proportion of all notifications, more than half of the Orang Asli cases investigated (56.4%) were confirmed measles, compared with 6.0% among Malays and 2.1% in other ethnic groups. After adjustment with each covariate, incomplete vaccination (AOR 3.97, 95% CI: 2.69, 5.97) and unvaccinated (AOR 3.51, 95% CI 2.39, 5.27) remained strong predictors of confirmed measles infection compared to complete vaccination. Contact with a measles positive case (AOR 14.80, 95%CI: 9.36, 23.40) and Orang Asli ethnicity (AOR 15.4, 95%CI: 10.5, 22.6) were the other major independent risk factors. Conclusions: This epidemiological analysis of confirmed measles cases in Kelantan from 2016 to 2023 highlights that, despite high national vaccination coverage, significant immunity gaps remain, especially among unvaccinated or partially vaccinated individuals and within marginalized communities such as the Orang Asli. The findings highlighted the crucial role of complete vaccination in reducing confirmed measles infection risk and the need for targeted immunization drives, culturally tailored outreach, and enhanced surveillance efforts to prevent future outbreaks and achieve sustained elimination of measles in the state.