Malaysian Family Physician最新文献

{"title":"A multi-faceted intervention to improve screening of erectile dysfunction for men with diabetes mellitus in public health clinics: A pilot study.","authors":"Chai Li Tay,&nbsp;Chirk Jenn Ng","doi":"10.51866/oa.74","DOIUrl":"https://doi.org/10.51866/oa.74","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) is common in men with diabetes and is associated with coronary artery disease and psychological distress. However, discussion of ED in primary care consultations is uncommon. Interventions, such as audit and feedback, mandate of management, and workshop on men's sexual health, have been proposed to improve ED screening in public health clinics. This study aimed to pilot test a multi-faceted intervention to increase ED screening among men with diabetes and to improve knowledge and confidence in ED screening among primary healthcare providers (PHPs).</p><p><strong>Methods: </strong>We conducted an interrupted time-series quasi-experimental study with PHPs at public health clinics in Perak, Malaysia from February 2019 to February 2020. Doctors, nurses, and assistant medical officers involved in diabetes care were recruited. The intervention was conducted between July and September 2019 and comprised two phases: audit and feedback, and mandate from management (phase 1), and an interactive face-to-face workshop (phase 2). The primary outcome measure was monthly ED screening rate, and the data were retrieved from health records and the clinical diabetes registry. The PHPs completed a questionnaire on ED knowledge and confidence in ED screening before and after the workshop.</p><p><strong>Results: </strong>The total number of attendances by patients with diabetes was 50,325 during the study period, of which 21,413 were by men. A total of 30 PHPs participated in the training workshop: 7 (23.3%) doctors, 12 (40%) medical assistants, and 11 (36.7%) nurses. The mean duration of employment at a health clinic was 7 ± 5 years. The majority of the participants were male (56.7%), Malay (80%), married (76.7%), and had no experience with working in a urology department (76.7%). There was a significant improvement in the mean knowledge score (39.0 ± 11.4 vs. 63.6 ± 6.2, p<0.001) and median confidence level in ED screening from 2 (IQR 2-3) to 4 (IQR 4-4) after the workshop (p<0.001). After phase 1, the rate of ED screening increased from a baseline of between 10.3% (February 2019) and 12.7% (June 2019) before intervention to between 15% (July 2019) and 18.9% (September 2019) and was maintained between 18% (October 2019) and 17.9% (December 2019) after phase 2. Subsequently, the ED screening rate declined from 14.6% (January 2020) to 10.9% (February 2020).</p><p><strong>Conclusion: </strong>This study found that audit and feedback with mandate from management increased ED screening and detection rate. The workshop improved the participants' knowledge and confidence in ED screening but did not further increased ED screening. The improved practice was sustained for 6 months after the intervention, while the detection rate of ED persisted. We propose regular audit and feedback with mandate from management to sustain the practice of ED screening in men with diabetes.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"38-45"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357399/pdf/MFP-17-38.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge on postpartum type-2 diabetes mellitus screening among pregnant women with gestational diabetes mellitus in Malaysia.","authors":"Halimatus Sakdiah Minhat,&nbsp;Puganeswary Thangarajah,&nbsp;Norliza Ahmad","doi":"10.51866/oal262","DOIUrl":"https://doi.org/10.51866/oal262","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the effectiveness of postpartum type 2 diabetes mellitus (T2DM) screening to detect and manage T2DM among women with a history of gestational diabetes mellitus (GDM), the uptake remains low, indicating the potentially low level of relevant knowledge. This study aims to identify the prevalence of postpartum T2DM screening and its associated factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 116 pregnant women with GDM who attended antenatal care follow-up at government health clinics in Seremban District, Negeri Sembilan. Multistage cluster sampling was performed to recruit the respondents from 6 mukims and 10 public health clinics. The data were collected using a validated and pre-tested questionnaire, with Cronbach's alpha values ranging from 0.81 to 0.95 for each section of the questionnaire. Data were collected through face-to-face interviews during the respondents' routine antenatal follow-ups for blood sugar monitoring.</p><p><strong>Results: </strong>Poor knowledge on postpartum T2DM screening (55.2%) was observed, which was significantly predicted by low educational level (AOR = 6.898, 95% CI 3.62-9.055) and low selfefficacy (AOR = 17.905, 95% CI 5.470-58.611).</p><p><strong>Conclusion: </strong>Most of the respondents had poor knowledge regarding postpartum T2DM screening, which was predicted by low education and self-efficacy. The findings highlight the need for continuous education and health promotion during antenatal follow-up targeting women with GDM with low self-efficacy and education level in order to ensure better adherence to screening.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"64-70"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357405/pdf/MFP-17-64.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liew Su May (1970–2021): A champion of evidence-based primary care medicine","authors":"S. Liew","doi":"10.51866/ob.001","DOIUrl":"https://doi.org/10.51866/ob.001","url":null,"abstract":"","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82769159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with sexual dysfunction among middle-aged women in a multi-ethnic country: A cross sectional study in Malaysia.","authors":"Yin Yee Tey,&nbsp;Siew Mooi Ching,&nbsp;Mari Kannan Maharajan,&nbsp;Kai Wei Lee,&nbsp;Zhen Yee Chow,&nbsp;Pei Wen Chua,&nbsp;Chin Xuan Tan,&nbsp;Shi Nie Lim,&nbsp;Chun Han Tan,&nbsp;Hui Zhu Thew,&nbsp;Vasudevan Ramachandran,&nbsp;Fan Kee Hoo","doi":"10.51866/oa.86","DOIUrl":"https://doi.org/10.51866/oa.86","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia.</p><p><strong>Methods: </strong>The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents' ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (0R=16.60, 95% CI=2.54-108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (0R=0.13, 95% CI=0.08-0.24).</p><p><strong>Conclusion: </strong>Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"56-63"},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357414/pdf/MFP-17-56.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Influencing Pap Smear Screening Uptake among Women Visiting Outpatient Clinics in Johor.","authors":"Suzane Shiyun Chin,&nbsp;Nor Adlina Jamonek Jamhuri,&nbsp;Norhayati Hussin,&nbsp;Nizatul Laili Md Zubir,&nbsp;Jih Ren Tan,&nbsp;Stanley Chun Wai Chan","doi":"10.51866/oa.35","DOIUrl":"https://doi.org/10.51866/oa.35","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the benefits of cervical cancer screening, Pap smear uptake remains variable in Malaysia, with Johor previously reported as the state with the lowest uptake. This study aims to fill the gap in epidemiological knowledge and assess factors affecting the uptake of Pap smear screening among women in Johor.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in several government and private clinics across Johor, including Pagoh, Muar, Batu Pahat, Kulai, and Johor Bahru districts. Data was collected from 452 women using self-administered questionnaires, and logistic regression was performed to determine factors associated with Pap smear uptake.</p><p><strong>Results: </strong>Findings showed that 48.5% of the women reported having undergone Pap smear screening in the previous 3 years, and 40.0% and 51.3% of respondents accurately answered questions on symptoms and risk factors of cervical cancer, respectively. Increasing age (OR_ad. 2.322, 95% CI 1.708-3.158), being married (OR_adj 4.860, 95% CI 1.100-21.476), parity of ≥5 (OR_adj 8.381, 95% CI 1.326-52.958), young age at first pregnancy (OR_adj 0.932, 95% CI 0.877-0.991), knowledge of cervical cancer symptoms (OR_adj. 1.745, 95% CI 1.065-2.857), support from family (OR_adj 3.620, 95% CI 2.081-6.298), and contraception use (OR_adj 2.220, 95% CI 1.314-3.750) were significantly associated with increased Pap smear uptake among women visiting outpatient clinics in Johor.</p><p><strong>Conclusion: </strong>Pap smear uptake remains suboptimal in Johor, and broad-based awareness campaigns tailored towards improving knowledge of cervical cancer with family involvement are crucial to improving uptake among women in Johor.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"46-55"},"PeriodicalIF":0.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357417/pdf/MFP-17-46.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case scenario: Management of major depressive disorder in primary care based on the updated Malaysian clinical practice guidelines","authors":"Uma Visvalingam, Umi Adzlin Silim, M. A. Ahmad Zahari, Firdaus Abdul Gani, Noormazita Mislan, N. Redzuan, Peter Kuan Hoe Low, S. Y. Tan, Masseni Abd Aziz, Aida Syarinaz Ahmad Adlan, Suzaily Wahab, Aida Farhana Suhaimi, Nurul Syakilah Embok Raub, Siti Mariam Mohtar, Mohd Aminuddin Mohd Yusof","doi":"10.51866/cpg1328","DOIUrl":"https://doi.org/10.51866/cpg1328","url":null,"abstract":"Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81444036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"23rd Family Medicine Scientific Conference 2021","authors":"","doi":"10.51866/fmsc2021","DOIUrl":"https://doi.org/10.51866/fmsc2021","url":null,"abstract":"","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84530382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lo, the ever confounding nipple shadow!","authors":"W H Boo,&nbsp;Y C Chan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The discovery of a solitary pulmonary nodule (SPN) on chest imaging can be alarming for both the clinician and the patient. In the absence of a uniform guideline, managing SPN is nothing short of challenging for primary care physicians (PCPs). We present a case here of a patient presenting with prolonged cough who also displayed unilateral SPN on her chest radiograph. Through further examination, this presence was later shown to be a nipple shadow simulating SPN, and the patient was spared unnecessary testing and psychological distress.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735879/pdf/MFP-15-79.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38719060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"We need a research plan.","authors":"Chirk Jenn Ng","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735886/pdf/MFP-15-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38721632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of the Patient Activation Measure® (PAM®)-13 Malay version among patients with Metabolic Syndrome in primary care.","authors":"N H Bahrom,&nbsp;A S Ramli,&nbsp;M R Isa,&nbsp;N Baharudin,&nbsp;S F Badlishah-Sham,&nbsp;M S Mohamed-Yassin,&nbsp;H Abdul-Hamid","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Patient Activation Measure (PAM) is one of the most extensively used, widely translated, and tested instruments worldwide in measuring patient activation levels in self-management. This study aimed to determine the validity and reliability of the PAM-13 Malay version among patients with Metabolic Syndrome (MetS) attending a primary care clinic.</p><p><strong>Methods: </strong>This work is a cross-sectional validation study among patients with MetS attending a university primary care clinic in Selangor. The PAM-13 Malay version underwent a validation process and field testing. Psychometric properties were examined using principal component analysis (PCA) with varimax rotation, scree plot, Monte Carlo simulation, internal consistency, and test-retest reliability analyses.</p><p><strong>Results: </strong>The content of the PAM-13 Malay version and the original version were conceptually equivalent. The questionnaire was refined after face validation by 10 patients with MetS. The refined version was then field-tested among 130 participants (response rate 89.7%). The Kaiser-Meyer-Olkin test was 0.767, and Bartlett's test of sphericity was ≤0.001, indicating sampling adequacy. Two factors were identified and labeled as (1) Passive and Building Knowledge, and (2) Taking Action and Maintaining Behavior. These labels were chosen as they were conceptually consistent with the items representing the levels of activation in PAM-13. The validated PAM-13 Malay version consisted of 13 items, framed into two domains. The overall Cronbach's α was 0.79, and the intraclass correlation coefficient was 0.45.</p><p><strong>Conclusions: </strong>The PAM-13 Malay version is valid, reliable, and fairly stable over time. This questionnaire can be used to evaluate the levels of activation among patients with MetS in primary care in Malaysia.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"22-34"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735884/pdf/MFP-15-22.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38721635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}