BackgroundSynergistic integration of predictors and elements that determine the success of total quality management (TQM) implementations in hospitals has been the bane of theoretical development in the TQM research area. Thus, this paper aims to offer a systematic literature review to provide a foundation on which research on TQM can be built and to identify the predictors of successful TQM in the health-care context.Materials and methodsA systematic literature survey was adopted in this paper, involving the review of 25 relevant researched articles found in the databases Science Direct, EBSCO, MEDLINE, CINAHL and PubMed.ResultThe systematic literature survey reveals five variables to be core predictors of TQM, signifying how important these variables are in the successful implementation of TQM in the health-care context. Also, it is revealed that the identified core predictors have positive effects on an improved health-care system. However, the systematic survey of the literature reveals a dearth of studies on TQM in the health-care context.ConclusionAs TQM has become an important management approach for advancing effectiveness in the health-care sector, this kind of research is of value to researchers and managers. Stakeholders in the health sectors should introduce and implement TQM in hospitals and clinics. Nevertheless, this study has limitations, including that the databases and search engines adopted for the literature search are not exhaustive.

Background This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals. Methods The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group. Results The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p < 0.05). Overall, using the four procedures as surrogates, the interprofessional learning approach in HAIC intervention showed improvement among the participants in the experimental group following structured instructions. The IPSS approach in HAIC clearly shows its relevance in improving learning outcomes. Conclusions Well-designed interprofessional simulated scenarios can be effective in skills training in improving KAP in HAIC among health professionals.

Background: Out-of-pocket (OOP) payments is a principal means of financing health care throughout both developed and developing countries. Over-reliance on OOP payments may pose an undesirable effect from an equity perspective, where equity in financing is an important policy objective of the health care system. Objectives:To assess the progressivity of OOP payments for health care among Malaysian households.Methods: This paper used cross-sectional nationally representative data derived from the Malaysian Household Expenditure Survey (HES) 2014/15, which comprised of 14,473 households. Progressivity measures deviation from proportionality in the relation between OOP payments and ability to pay (ATP). This paper combined evidence from proportion approach, graphical measures (concentration curve) and summary indices (Gini coefficient, concentration index and Kakwani index) to demonstrate the progressivity of OOP health payments among Malaysian households.Result: More than two-third (77%) of Malaysian households surveyed reported to have made OOP health payments. The average shares of OOP payments from household consumption was 1.65% and was increasing across the household consumption quintiles. The OOP payments distribution was progressive demonstrated by all three approaches. The household consumption and burden of OOP payments was concentrated among the richer populations, with positive Gini coefficient and concentration index. The Kakwani index of OOP payments was 0.0910, indicates mildly progressive OOP payments in Malaysia. Conclusion:The OOP health payments in Malaysia has a progressive distribution. However, reducing progressivity trend should be monitored by the policymakers, and to decide further strategies on policy improvements pertaining to the country's health financing.

Introduction: Internet addiction is an increasingly worrying phenomena affecting people globally especially the youths. This study aimed to determine the prevalence of internet addiction among undergraduate students in a Malaysian public university and its associated factors. Materials and Methods: A cross-sectional study involving 322 undergraduate students, identified through cluster sampling was conducted using a pretested, self-administered questionnaire. The questionnaire includes socio-demography, use of information technology gadgets and internet usage. Internet Addiction test (IAT) was used to identify internet addiction. Data was analysed using SPSS version 22. Results: From 322 respondents, 25 (7.8%) were categorised as addictive internet users, while 182 (56.5%) were problematic internet users. The commonest online activity includes social networking (86.6%), entertainment (77.3%) and educational purposes (77.0%). From multivariate analysis, problematic and addictive internet use was significantly more common among male students (AOR=2.47, 95% CI [1.43, 4.26]), those who received study loan (AOR=1.93, 95% CI [1.10, 3.39]) and other types of funding (AOR=3.95, 95% CI [1.59, 9.80]) compared to those on scholarships, and those who spent between four to ten hours a day accessing the Internet (AOR=2.43, 95% CI [1.13, 5.23]) compared to those using the Internet for two hours or less a day. Conclusion: The prevalence of problematic and addictive internet use among respondents were higher compared to previous researches among Malaysian adolescents. It is recommended that an awareness programme on responsible use of the internet be conducted to prevent students from becoming addicted which may impact negatively on their educational performance and social life.

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Background: Coronary artery bypass grafting (CABG) is the best treatment option for coronary heart disease. It improves survival and quality of life (QOL) for patients with multivessel coronary artery disease and those with more advanced coronary artery disease, left ventricular dysfunction, or diabetes. The purpose of this study is to measure the QOL among patients after CABG surgery and its associated factors. Materials and Methods:A cross-sectional study was conducted in a cardiothoracic centre in Malaysia involving 184 respondents. A pretested, self-administered questionnaire which included the validated SF-36 Health Survey was filled by respondents who met the inclusion and exclusion criteria. Non parametric test was used to identify factors associated with QOL among the respondents. Significance level was set at 0.05. Result:The total number of respondents was 184 with response rate of 100%. From the analysis, the mean(SD) score of the eight domains of SF-36 ranges between 58.8(25.4) and 82.7(23.5), where the lowest score was physical functioning domain while the highest score was bodily pain and social functioning domain. The mean(SD) age of respondents was 59. 86(8.17). Majority of respondents were male (82.6%), Malay (43.5%), Muslims (45.1%), married (85.9%), received minimal primary education (96.7%) and retired/unemployed (48.9%). Age, gender, religion, educational level and employment status, showed to have significant association with at least one domain of QOL including physical component score (PCS) and mental component score (MCS) with statistical significant set at P<0.05. Conclusion:Quality of life scores showed to be higher compared to coronary artery disease patients. Several sociodemographic characteristics (employed, married, high education level) were associated with good quality of life domains among the respondents.

Background Interprofessional learning (IPL) is a key challenge in Malaysia in incorporating the current profession-specific medical education into the interprofessional learning curriculum. Safe practices would be enhanced with improved collaboration among the health professionals when they learn with, from, and about each other. The main objective of this study was to determine the significant differences in self-assessment, attitude, and perception of interprofessional learning among doctors and nurses in a teaching hospital in Klang Valley, Malaysia. The second objective was to determine if there is any significant difference in the selected demography factors, mean and total scores between doctors and nurses in self-assessment, attitude, and perceptions of IPL aspects. Methods A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79. Results The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses’ also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants’ and non-participants of IPL training sessions; p = 0.009. Conclusions This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.

Background: Anaemia is a common health problem among pregnant women in Malaysia and has a significant health consequence to mother and their infants. The provision of iron supplements and an array of health educational strategies to pregnant women are the most widely practice in Malaysia public health measures. In Malaysia currently, the implementation of health education methods and materials on anaemia in pregnancy given to the antenatal mothers differ throughout the country. The aim of this study is to develop, implement and evaluate the effects of a theory-based health educational intervention on the haemoglobin level among anaemic pregnant women. Materials and Methods: This study uses a quasi-experimental study design and conceptualized based on the Health Belief Model (HBM). It will involve two groups of antenatal mothers (control and intervention) from two health clinics in the district of Sepang, Selangor. There will be 81 pregnant women with anaemia per group that met the inclusion and exclusion criteria. Data will be collected using self-administered questionnaire. The primary outcome variable is differences in haemoglobin levels between the intervention and control groups in the third trimester. Secondary outcome include knowledge regarding anaemia, HBM constructs, dietary iron intake and level of compliance towards iron supplementation. Both groups will be receiving routine antenatal care and practice. Additionally, the intervention groups will be given a validated theory-based health education intervention on anaemia in pregnancy. Univariate, bivariate and multivariate analysis will be performed. All hypotheses tests were two-sided and level of significance was set at 0.05. Discussion: If the theory based health education intervention is effective in improving the outcome for pregnant women with anaemia, this approach could be taken into consideration to improve the anaemia in pregnancy after further research.