Pusat Pengajian Sains Kesihatan - Tesis

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Job satisfaction and its associated factors among medical and health officers in Terengganu
(2024-06)
Introduction: Understanding job satisfaction is crucial for enhancing higher levels of engagement, dedication, and commitment to work, which will improve the overall quality of healthcare services provided. Thus, this study investigated job satisfaction and its associated factors among medical and health officers working in primary healthcare in Terengganu. Methodology: In this cross-sectional study, medical and health officers from all eight district health offices and state health departments of Terengganu were randomly and proportionately selected as participants. These participants had worked for at least three months in the district health offices and state health departments of Terengganu. The study used the Malay version of the Psychosocial Aspect of Work Questionnaire (PAW-M) which was self-administered using a Google form link. It consists of 15 items that measure three aspects of work: job satisfaction, social support, and the mental stress of work, and scored using a 5-point Likert scale. The data was analyzed using SPSS version 27, and linear regression analyses were applied to identify the factors that are associated with job satisfaction. Results: A total of 200 medical and health officers participated in the study. The study indicates that medical and health officers had a mean (SD) job satisfaction score of 26.41 (4.7). The mean age of the participants was 35.45 (4.80), the mean of social support was 16.67 (2.32) and the mean of mental stress was 17.29 (2.07). The study identifies that satisfied with income (95% CI: 0.118, 2.317, p=0.030), permanent employment status (95% CI: 0.104, 3.403, p=0.037) and social support score (95% CI: 0.979, 1.432, p<0.001) as the significant associated factors for job satisfaction among study participants. Conclusion: The study found that the mean job satisfaction score was 26.1, associated with satisfaction of income, permanent employment status, and social support score. Addressing these factors will boost job satisfaction among medical and health officers and thus improve the quality of healthcare services.
Comparative analysis of notified hand, foot, and mouth disease cases between Kelantan and Penang
(2024-06)
Aziz, Aina Syazwani
Background: Hand Foot and Mouth Disease (HFMD), primarily caused by enteroviruses like EV 71 and CV-A16, remains a significant public health issue in Malaysia, particularly affecting children. Despite extensive efforts to manage HFMD, the incidence rate continues to rise, necessitating further investigation into regional differences and associated risk factors. Objectives: This study aims to estimate the incidence rates and risk factors of notified HFMD cases between the states of Kelantan and Penang from 2017 to 2021. Specifically, it seeks to identify differences in incidence rates and the distribution of cases by age, gender, and race. Methodology: A comparative cross-sectional study design was employed, utilizing secondary data from the Communicable Disease Control Information System (CDCIS) e-Notification. The study population included all notified HFMD cases in Kelantan and Penang from 2017 to 2021. Statistical analyses, including chi-square tests, were conducted using R software to estimate incidence rates and demographic factors between the two states. Results: From 2017 to 2021, 18,243 HFMD cases were reported, with 7,846 in Kelantan and 10,397 in Penang. The average incidence rate was higher in Penang (1.18 per 1,000 population) compared to Kelantan (0.49 per 1,000 population). The incidence was highest among children aged 0-4 years in both states, with significant differences in age distribution (χ2 (3) = 303.48, p < 0.05). Males had a higher prevalence of HFMD in both states, with a statistically significant difference in gender distribution (χ2 (1) = 6.885, p = 0.009). The Malay ethnic group had the highest number of cases in both states, but significant differences were observed in racial distribution (χ2 (4) = 4290.40, p < 0.05). Conclusion: The study reveals significant regional differences in HFMD incidence rates and demographic factors between Kelantan and Penang. The findings highlight the need for targeted public health interventions, particularly focusing on young children and incorporating comprehensive health education tailored to different ethnic groups. Enhanced surveillance systems are crucial for early detection and effective management of HFMD outbreaks.
Risk perception on needlestick injury and effectiveness of the needlestick prevention module among house officers in Kelantan
(2024-05)
Kutubudin, Ahmed Farrasyah Mohd
Introduction: House officers (HOs) face a significant occupational threat from needlestick injuries (NSIs), posing potential risks of exposure to bloodborne pathogens. Understanding the factors influencing NSI risk perception and developing effective training modules are essential for implementing robust preventive measures. This research explores factors influencing NSI risk perception among HOs and evaluates the effectiveness of the Needlestick Injury Prevention Module (N-SIP) in enhancing NSI-related knowledge and risk perception. Objectives: The objectives of this study is to determine the mean perception score on risk of NSI, factors associated with mean the perception score, module development and validation, and effectiveness of the newly developed module. Methodology: This study utilized a cross-sectional design involving 176 HOs, who completed a self administered questionnaire. Linear regression identified associated factors of NSI risk perception scores. Additionally, the N-SIP module was developed using the ADDIE model and underwent content validation by experts and face validation by HOs. A non-randomised interventional design assigned HOs to either the intervention group receiving the N-SIP module or a control group, with NSI risk perception scores assessed at baseline, three weeks, and six weeks post-intervention using validated measures. Statistical analysis, including repeated-measures ANOVA, evaluated changes in perception scores. Results: The study found an overall mean risk perception score of 47.63, indicating a positive score among HOs. The cross-sectional study revealed that gender (b = 1.96; p = 0.002), work experience (b = 2.93; p < 0.001), attending health education on NSI (b = 4.42; p < 0.001), and history of NSI (b = 4.96; p < 0.001) significantly influenced NSI risk perception. The N-SIP module demonstrated high content validity and positive face validity among HOs. The interventional study showed a significant improvement in NSI risk perception scores among the intervention group compared to the control group, with statistically significant increases observed from baseline to three weeks and six weeks post-intervention. No significant changes were observed in the control group over the same period. Conclusion: The study identified key factors influencing HOs' perception of NSI risk, with an overall mean risk perception score of 47.63 indicating a generally positive perception among HOs. The effectiveness of the N-SIP module in enhancing NSI risk perception was demonstrated, with significant improvements observed in the intervention group. Targeted training programs, such as the N-SIP, significantly impact risk perception and promote occupational safety among HOs. These findings underscore the importance of continued efforts to implement and evaluate tailored educational interventions to mitigate NSI risks and improve safety practices in healthcare settings.
Translation, cultural adaptation and validation of perceived nutrition environment measures survey (nems-p) and Its relationship with the glycaemic values (HBA1C) among diabetic patients In Kuala Terengganu district
(2024)
Berahim, Ahmad Syaify
Introduction: The perceptions of diabetic patients on their food environment influence their dietary choices and may impact glycaemic control. The Perceived Nutrition Environment Measures Surveys (NEMS-P) questionnaire is a valid and reliable measure to access perceived food environment. To date, there is no available instrument to measure the perceived food environment in Malaysia and its association with the level of glycaemic control among diabetic patients. Objectives: This study aimed to translate, culturally adapt and validate Malay version of NEMS-P, and to study the relationship between the perceived food environments and the glycaemic values among diabetic patients attending health clinics in Kuala Terengganu district. Methodology: Phase 1 study involved translation, cultural adaptation and validation of the NEMS-P within Malay context. Confirmatory factor analysis (CFA) was conducted involving 200 diabetic patients in Kuala Terengganu and were randomly selected by multi-staged sampling and interviewed using the NEMS-P (Malay). Phase 2 was a cross-sectional study involving 304 diabetic patients and were selected from all three health clinics in Kuala Terengganu by applying the stratified sampling proportional to size method and utilising the validated NEMS-P (Malay). Linear Regression was used for the analysis. Results: The average Content Validity Ratio (CVR) was 0.90, the Scale Content Validity Index (S-CVI) for relevance was 0.81 and the S-CVI for clarity was 0.96, both scale face validity index (S-FVI) for clarity and comprehension were 0.97 and all were acceptable. The constructs which were included in CFA were perceived store consumer environment (PSCE), perceived restaurant consumer environment (PRCE) and perceived home food environment (PHFE) but perceived community nutrition environment (PCNE) was excluded as it did not require construct analysis. The factor loading ranged from 0.3 to 0.9 and the model had acceptable fit. The construct reliability (CR) values ranged from 0.614 to 0.778, the average variance extracted (AVE) 0.171 to 0.469. One inter-factor correlation value was higher than the square root of average variance extracted (AVE). For phase 2, 68.8% of respondents were females with the mean age of 58.77 (SD 10.57). Most respondents entered secondary school (57.9%), married individuals (69.7%) and overweight or obese (72.0%). The proportion of smokers was low (7.6%). All four perceived food environment constructs were included for scoring. The mean score for the PCNE was 9.70 (SD 2.71), PSCE was 37.60 (SD 3.82), PRCE was 4.28 (SD 3.11) and PHFE was 19.53 (SD 4.95). The mean duration (years) of diabetes was 6.71 (SD 5.78) with the mean HbA1c (%) of 8.09 (SD 2.14). There was no significant association between perceived food environments and glycaemic values. Instead, there were other statistically significant factors; age [-0.05% (95% CI: -0.075, -0.025 p-value: 0.001)], married [1.42% (95% CI: 0.407, 2.429 p-value: 0.006)], divorced/separated [1.20% (95% CI: 0.063, 2.331 p-value: 0.039)], smoking [1.25% (95% CI: 0.377, 2.128 p-value: 0.005)] and duration of diabetes [0.10% (95% CI: 0.052, 0.137 p-value: 0.001)]. Conclusion: Malay version of NEMS-P questionnaire is a valid and reliable tool to measure perceived food environment in Kuala Terengganu. There was no statistically significant relationship between perceived food environments and HbA1c values, indicating the need for future research with a more heterogeneous and diverse population.
Cross professional team characteristics, translation and construct validation of teamwork survey questionnaire (TSQ) at Malaysian east coast public Hospital
(2023-03)
Samsudin, Wan Siti Auni Wan
Cross professional teamwork in healthcare refers to the interaction between individuals with different expertise and training backgrounds, working together towards shared patient care goals. Cross professional teamwork is necessary to support integrated service delivery. However, cross professional teamwork has not been given sufficient attention in Malaysia’s developing country context. There is a lack of tools to assess cross professional teamwork for Malaysian settings. This study aimed to translate the English version teamwork survey questionnaire (TSQ) into Malay and perform tool construct validation at a Malaysian east coast public hospital. The TSQ assesses teamwork on domains of integration, climate and efficiency; the tool has been previously used in Swedish and Australian settings. This study’s aim was achieved through a cross-sectional mixed methods study in three phases. Phase 1 and Phase 2 were carried out through qualitative approaches while Phase 3 utilized a quantitative approach. Phase 1 focused on translating the TSQ into Malay language using forwardbackward translation together with the committee approach. Next, a qualitative interview study was conducted in Phase 2 to explore fulfillment of cross professional team characteristics at the hospital’s 16 inpatient wards. A total of 35 interviews were conducted with medical, nursing and allied health professionals; the sample is sufficient for qualitative data saturation. Recordings from interview sessions were transcribed and thematically analyzed. The construct validity and reliability of the Malay version TSQ was determined in Phase 3. In Phase 3, 150 respondents were recruited from wards found to have cross professional team characteristics during Phase 2. A response rate of 98.24% was obtained in filling in the Malay version TSQ, the percentage of recruited respondents being sufficient for statistical analysis. Construct validity was assessed through Principal Component Analysis with Varimax rotation and reliability was tested through the analysis of internal consistency. Findings from Phase 1 indicate the translated Malay version TSQ to have equivalence with the English version. Phase 2 interview findings reveal that inpatient wards generally fulfill cross professional team criteria related to team composition, patient care objectives and professional interactions. Phase 3 construct validation results indicate that three constructs namely team climate, team efficiency and team integration, without any item deletion are valid for the Malay version TSQ. The Cronbach’s alpha value is 0.917 for the translated whole TSQ scale, while the three scale constructs also have reliable Cronbach’s alpha values in the range of 0.703-0.946. Discrepancies for particular words used from the forward backward translation process were resolved without affecting meaning of the original items. Health professionals in this study acknowledge the different professions involved in patient care. However, disciplinary diversity at the respective wards varies depending on patient care specialties and treatment objectives. The Cronbach’s alpha values for the Malay version TSQ factors reflect better team climate and integration values and comparably similar team efficiency value when contrasted with the original tool. In conclusion, the results support usage of the tool as a reliable instrument for assessing cross professional teams in other similar Malaysian public healthcare services. Further research could test the reliability and validity of the Malay version TSQ in other Malaysian regions.

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