Malaysian Family Physician最新文献

{"title":"Prevalence and factors associated with psychological distress among adult patients with hypertension in a primary care clinic: A cross-sectional study.","authors":"Wen How Loke,&nbsp;Siew Mooi Ching","doi":"10.51866/oa.131","DOIUrl":"https://doi.org/10.51866/oa.131","url":null,"abstract":"<p><strong>Introduction: </strong>Psychological distress worsens the control of hypertension. This study aims to fill the knowledge gap and evaluate the prevalence and factors associated with depression, anxiety, and stress among patients with hypertension in a primary care clinic.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Klinik Kesihatan Bandar Jerantut on hypertensive patients using a systematic random sampling method. Data were collected from 391 hypertensive patients using a self-administered questionnaire. Multiple logistic regression analysis was performed to identify the associated factors.</p><p><strong>Results: </strong>The response rate was 99.5% (389/391). The mean age of respondents was 60.1 years and 44.7% were male. The prevalence of psychological distress was the highest at 28.8%, followed by anxiety (21.3%), depressive (16.2%), and stress symptoms (13.9%). Uncontrolled blood pressure was significantly associated with depressive (OR: 6.4; 95% CI: 3.32-12.28), anxiety (OR: 4.9; 95% CI: 2.75-8.82), and stress symptoms (OR: 6.3; 95% CI: 3.06-12.98). Worry about the complications of hypertension was significantly associated with depressive (OR: 4.5; 95% CI: 2.08-9.94), anxiety (OR: 10.8; 95% CI: 4.15-28.17), and stress symptoms (OR: 5.3; 95% CI: 2.14-13.22). Other associated factors were physical inactivity, employment, lack of formal education, and low household income.</p><p><strong>Conclusion: </strong>A quarter of hypertensive patients experienced psychological distress in terms of depressive, anxiety, or stress symptoms. We recommend screening for psychological distress among high-risk hypertensive patients, especially those cannot achieve adequate blood pressure control or those who are worried about the complications of hypertension.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"89-98"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357408/pdf/MFP-17-89.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697520","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":"The profile of headaches and migraine amongst medical students and its association to stress level, disability and self-management practices.","authors":"Anuradha Thiagarajan,&nbsp;Noor Azah Aziz,&nbsp;Chai-Eng Tan,&nbsp;Noor Azimah Muhammad","doi":"10.51866/oa1370","DOIUrl":"https://doi.org/10.51866/oa1370","url":null,"abstract":"<p><strong>Introduction: </strong>Migraine is the most common headache affecting young people that impairs their functional ability. This study aimed to determine the frequency of migraines among Malaysian medical students, the association between migraines, stress level, and functional disability among these students, and describe their self-management practices.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among medical students in a private medical school in Penang state. All medical students in the study site were screened for the presence of headache symptoms and the diagnosis of migraine using a self-administered questionnaire comprising International Headache Society (IHS) diagnostic criteria. Other domains that were assessed were perceived stress level and functional disability, which were measured using the Perceived Stress Scale and the Headache Impact Test-6 (HIT-6), respectively. The students' selfmanagement practices for their headaches were determined using a descriptive survey.</p><p><strong>Results: </strong>A total of 374 medical students participated in this study and 157 (42%) students reported experiencing headaches. More than half (n=97, 61.8%) of those with headaches fulfilled the IHS criteria for migraines. Migraines were significantly associated with functional disability compared with non-migraine headaches (p<0.001); however, no significant difference in stress levels were reported between the two groups. During migraine attacks, sleep (n=73, 60.33%) and self-medication (n=56, 69.14%) were the most common self-management practices. Only 11.46% of the 157 students with headaches consulted a doctor.</p><p><strong>Conclusion: </strong>A high proportion of medical students suffered from headaches and more than half of them had migraines. Migraine headaches were associated with significant functional disability. Very few students sought medical consultation and most students chose to self-manage their headaches.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357411/pdf/MFP-17-81.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684649","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":"A cross sectional study on patient satisfaction and its association with length of consultation at the University Malaya Medical Centre Primary Care Clinic.","authors":"Hong Tee Leow,&nbsp;Su May Liew","doi":"10.51866/oa1339","DOIUrl":"https://doi.org/10.51866/oa1339","url":null,"abstract":"<p><strong>Introduction: </strong>Patient satisfaction has been found to be a determinant of patient compliance to medical advice and treatment, medical service utilisation, the doctor-patient relationship, and continuity of care. Assessment of patient satisfaction can be used to evaluate health care services and identify areas to target for quality improvement.</p><p><strong>Methods: </strong>A cross-sectional study was conducted to determine the satisfaction level of patients attending a primary care clinic and its associated factors. Participants' experience of time at the clinic, socio-demographic data, and personal health information were collected. The 18-Item Patient Satisfaction Questionnaire was used to determine patient satisfaction. Univariate and multivariate analyses were employed to identify the factors associated with patient satisfaction.</p><p><strong>Results: </strong>We recruited 327 participants and 50.46% reported satisfaction. The highest satisfaction was reported in the communication domain (80.80% of the maximum score) and the lowest score was reported in the accessibility and convenience domain (66.40%). The only significant positive correlation with total patient satisfaction score was the difference between perceived and expected length of consultation.</p><p><strong>Conclusion: </strong>The only independently associated factor was the difference between perceived and expected length of consultation; therefore, changing how time is spent during consultations may prove useful in improving patient satisfaction.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"71-80"},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357404/pdf/MFP-17-71.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684650","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":"Recommendations and tips for passing the key feature problem examination.","authors":"Siew Kim Kwa,&nbsp;Chow Wei Tan,&nbsp;Aik Chiew Ng,&nbsp;Sheikh Mohd Amin Sheikh Mobarak,&nbsp;Hairel Anuar Selamat","doi":"10.51866/cm0003","DOIUrl":"https://doi.org/10.51866/cm0003","url":null,"abstract":"<p><p>The Key Feature Problem (KFP), is part of the Conjoint MAFP/FRACGP exit examination for Family Medicine specialisation in Malaysia. KFP tests candidates' skills in clinical reasoning and decision making. Over the years, KFP has been the cause of most of the failures in the Part 1 theory examination. This paper aims to highlight common errors committed by candidates and provide recommendations and practical examination technique tips on how to mitigate these errors. A summary of the 26 KFP cases used in the 2020 Conjoint KFP examination demonstrates the breadth and types of cases. From the feedback reports collated from eight assessors involved in this exam, we determined that although inadequate knowledge is probably the main contributor to failure, other easily correctible mistakes made by candidates further aggravate the situation. Common errors include offering more answers than requested, giving duplicate or incomplete answers, and writing answers out of context to the case scenario. The paper concludes with recommendations and sources for effective learning, and provides 12 examination technique tips. The tips include time management, reading carefully through the case, and checking that the answers are congruent with the questions asked.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"2-9"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357407/pdf/MFP-17-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697522","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":"Patients' satisfaction with healthcare services providers and its determinants in the urban family physician program in Iran: A cross-sectional study.","authors":"Mohammad Javad Kabir,&nbsp;Seiyed Davoud Nasrollahpour Shirvani,&nbsp;Hasan Ashrafian Amiri,&nbsp;Ghasem Rajabi Vasokolaei,&nbsp;Seyed Mozafar Rabiee,&nbsp;Zahra Hassanzadeh-Rostami","doi":"10.51866/oa1308","DOIUrl":"https://doi.org/10.51866/oa1308","url":null,"abstract":"<p><strong>Introduction: </strong>The quality of healthcare services can be determined by patient satisfaction as it affects the performance, sustainability, and durability of health services. This study aims to determine patients' satisfaction with healthcare service providers and its determinants in the urban family physician program in Fars and Mazandaran provinces, Iran.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on the populations covered by the urban family physician program in Fars and Mazandaran provinces in 2016. In total, 864 households were selected in each province using random cluster sampling. Socio-demographic variables and underlying factors were gathered. Patient satisfaction levels were evaluated using a validated questionnaire.</p><p><strong>Results: </strong>Of the 1,480 participants with a mean age of 46.9 ± 14.2 years, 53.3% lived in Fars province and 74.2% were female. Furthermore, 67.9% of the patients were satisfied with their healthcare service providers. A higher satisfaction level was observed among the patients who resided in Fars province, lived in cities with <100,000 residents, walked <10 minutes to the family physician's office, had a family physician they previously knew, accepted the family physician, had a positive attitude towards the importance of having a family physician and a referral system, and had adequate knowledge of the family physician program.</p><p><strong>Conclusion: </strong>The results indicated that two-thirds of the patients were satisfied with healthcare service providers. Several socio-demographic variables were associated with the patients' satisfaction levels. Improving the family physician program by providing adequate medical equipment and monitoring physicians' performance could increase patient satisfaction and improve the sustainability of the program.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"99-106"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357410/pdf/MFP-17-99.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40697516","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 report of chronic cough in primary care: a diagnostic challenge and lessons to learn.","authors":"Nurul Husna Azmi,&nbsp;Anifah A Bakar,&nbsp;Mohd Aznan Md Aris,&nbsp;Norhayaty Sharman Khamis Roslee","doi":"10.51866/cr.14","DOIUrl":"https://doi.org/10.51866/cr.14","url":null,"abstract":"<p><p>Cough is one of the most common complaints seen at the outpatient primary health clinic. While the most common aetiologies of chronic cough are asthma, chronic obstructive pulmonary disease, postnasal drip, gastroesophageal reflux disease, drug-induced, and tuberculosis, we often overlook that chronic cough, especially in a young female, can be the initial presenting complaint of an autoimmune disease. In this case report, we present a case of 35-year-old woman with no known prior medical illness who presented with chronic cough for 1 year with no other symptoms initially; but later in the disease course, the patient complained of multiple, symmetrical small joint pain, which led us to the diagnosis of seronegative rheumatoid arthritis.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"107-111"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357402/pdf/MFP-17-107.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684646","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":"Care services for older persons: A scoping review.","authors":"Fatemeh Gavarskhar,&nbsp;Farid Gharibi,&nbsp;Elham Dadgar","doi":"10.51866/rv1221","DOIUrl":"10.51866/rv1221","url":null,"abstract":"<p><strong>Introduction: </strong>With an increasing life expectancy and proportion of older adults, the number of people in need of care services is also increasing. This study aimed to determine and describe various available care services for older persons reported in literature.</p><p><strong>Methods: </strong>English-language articles published between the years of 1990 and 2018 in Scopus, ProQuest, PubMed, and Google Scholar databases or search engines were reviewed. The search resulted in 46,927 articles. All selected studies were systematically evaluated and screened based on title, abstract, and full text related to the study's objective. Finally, 246 articles were included in the study. The care services in older persons care systems were identified from the selected articles and were presented in extraction tables. Final conclusions were made based on the types of services provided and their frequency of citation.</p><p><strong>Results: </strong>The research results showed that numerous systems exist to provide care services for older adults, including long-term care services, home care services, housing for the aged, day care centres, senior centres, nursing homes, and hospice care services. Regarding older adults' care needs and the objectives and missions of each care system, different care services, such as personal care, social support services, medical care services, and nutrition services, have been identified in the service packages.</p><p><strong>Conclusion: </strong>This study describes the diverse care services available for older persons that have been reported in the literature. Further research in different healthcare systems is required regarding what is most essential and lacking in each setting.</p>","PeriodicalId":40017,"journal":{"name":"Malaysian Family Physician","volume":" ","pages":"22-37"},"PeriodicalIF":0.0,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9357416/pdf/MFP-17-22.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40684647","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":"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}