Search Results (8)

Background/Objectives: Idiopathic clubfoot is a complex pediatric foot deformity. The Ponseti technique is widely regarded as the standard for correcting deformities, and treatment compliance is essential for preventing relapse. Examining psychosocial effects on parents and/or children during clubfoot treatment provides valuable insights for improving compliance. This scoping review will map the existing literature on the psychological and social effects experienced by parents and/or children with idiopathic clubfoot. It also aims to examine the assessment tools used to measure these impacts and identify factors influencing treatment compliance. Methods: This review will adhere to the Joanna Briggs Institute (JBI) guidelines for scoping reviews. The search will include databases such as Scopus, Web of Science, EBSCOhost, MEDLINE, and PsycINFO and focus on studies published in the last 10 years. This review will include quantitative, qualitative, and mixed-method studies that investigate the psychological and social effects experienced by parents or affected children of any age with idiopathic clubfoot. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) extension guidelines. The screening and data extraction process will involve two independent reviewers. The analysis will be descriptive and qualitative. Results: The findings will be presented in tables and a narrative summary. Conclusion: This review may guide health practitioners in developing evidence-based interventions to improve treatment adherence. Full article

(1) Background: The ability to communicate with patients and their relatives is a crucial skill for a physician. Unfortunately, many physicians and medical students are not well-equipped in this area. Therefore, this study aims to better understand the views on critical components of physician-patient communication to improve their skills. (2) Methods: This qualitative study utilized focus group discussions (FGDs) and in-depth interviews (IDIs). Through a purposive sampling technique, 32 medical students and physicians from the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (FMHS UPM) and Universiti Putra Malaysia Teaching Hospital (HPUPM), as well as patients and relatives from government and private hospitals or clinics were recruited. All sessions were audio-recorded, transcribed, and analyzed thematically. (3) Results: Seven themes were identified: professionalism, content of communication, verbal, non-verbal and paraverbal communication skills, environment, and visual communication. Good eye contact, providing treatment plans, and ensuring patient privacy and confidentiality were emphasized by physicians and medical students. In comparison, patients and relatives focused on the prognosis of disease, physician’s empathy and advice, and physician’s skills in building rapport with their patients and relatives. (4) Conclusion: The critical components that were highlighted by both professionals and laymen in the study should be practiced to ensure effective communication between physician and patient. There were different expectations in terms of the content of information between both groups. Patients and relatives were more interested in the physician’s advice regarding their diet, care plans, physical activities, and daily routine. They were also focused on the prognosis of the disease, which indicates how quickly they would get better. Meanwhile, physicians and medical students were concentrating on management and treatment strategies, such as what additional procedures should be considered and what medications might work best for their patients. We also found that the patients and relatives had a lack of awareness on confidentiality issues. These findings provide an insight on the improvement of medical training and patient education to improve patient care. Patients have a right to privacy protection, and physicians should be well trained to carry out all procedures and treatment plans to ensure patients are treated with respect. Full article

We previously reported on the effects of a lactobacilli probiotic (SynForU-HerCare; two capsules/day of 9.5 log CFU/capsule) in improving symptoms of vaginal irritation, discharge and burning in pregnant women with vaginal candidiasis upon administration for 8 weeks, accompanied by improved emotional and social quality of life parameters. Thus, the present study aimed to analyse vaginal microbiota and inflammatory changes in hope to better understand the improved clinical symptoms as observed previously. Patients in the probiotic group showed a decreased abundance of Candida glabrata after 8 weeks (p = 0.009) in the lower vaginal region, while patients in the placebo group did not show any changes over time. In the higher vaginal and cervicovaginal regions, patients in the placebo group showed a decreased abundance of Candida albicans only within 4 weeks (p < 0.05) but no changes in abundance of C. glabrata over time, while patients in the probiotic group showed a continuous decreased abundance of C. albicans and C. glabrata over 8 weeks (p < 0.05). Patients in the placebo group also had a decreased abundance of Lactobacillus crispatus over 4 weeks (p = 0.023) in the lower vaginal region and a decreased abundance of L. jensenii over 8 weeks in the cervicovaginal region (p = 0.001). Meanwhile, patients in the probiotic group had an increased abundance of L. crispatus in the lower vaginal region after 8 weeks (p = 0.012) and Lactobacillus jensenii over 4 weeks in the cervicovaginal region (p < 0.001). Inflammation may have occurred in both low and high vaginal regions, predominantly observed by the increased concentration of pro-inflammatory cytokine TNF-alpha in patients from the placebo group (p < 0.05), while the administration of probiotics has shortened the period of inflammation as observed from the reduced need for anti-inflammatory cytokine IL-4 and IL-10 over time (p < 0.05). Taken together, our present new data further support previous findings that probiotic SynForU-HerCare had a beneficial effect against vaginal candidiasis in pregnant women via modulation of the vaginal microbiota and microenvironment. Full article

In the practice of medicine, resilience has gained attention as on of the ways to address burnout. Qualitative studies have explored the concept of physician resilience in several contexts. However, individual qualitative studies have limited generalizability, making it difficult to understand the resilience concept in a wider context. This study aims to develop a concept of resilience in the context of physicians’ experience through a meta-synthesis of relevant qualitative studies. Using a predetermined search strategy, we identified nine qualitative studies among 450 participants that reported themes of resilience in developed and developing countries, various specialties, and stages of training. We utilized the meta-ethnography method to generate themes and a line-of-argument synthesis. We identified six key themes of resilience: tenacity, resources, reflective ability, coping skills, control, and growth. The line-of-argument synthesis identified resilient physicians as individuals who are determined in their undertakings, have control in their professional lives, reflect on adversity, utilize adaptive coping strategies, and believe that adversity provides an opportunity for growth. Resilient physicians are supported by individual and organizational resources that include nurturing work culture, teamwork, and support from the medical community and at home. Our findings suggest that resilience in physicians is dynamic and must be supported not only by physician-directed interventions but also by organization-directed interventions. Full article

Physician burnout has been recognized as a public health crisis. However, there is a paucity of burnout studies in the context of medical internship. We assessed the prevalence and relationship between various training characteristics, personal variables, resilience, and coping with burnout in a cross-sectional study involving 837 interns from ten hospitals across Malaysian healthcare system. The instrument package included demographic questions, the Connor–Davidson Resilience Scale, Brief COPE and the Copenhagen Burnout Inventory. A total of 754 (90.1%) interns completed the inventories. We found a high prevalence of personal-related (73.3%), work-related (69.1%), and patient-related (43.4%) burnout among Malaysian interns. Multivariable analysis showed female gender (odds ratio (OR):1.50; 95% confidence interval (CI): 1.02–2.20), prior work experience (OR: 1.56; 95% CI: 1.05–2.30), and irregular spirituality routines (OR: 1.97; 95% CI: 1.30–2.99) were associated with increased odds of personal-related burnout. Irregular spirituality routines (OR: 2.24; 95% CI: 1.49–3.37) were associated with work-related burnout, while living with other people (OR: 1.77; 95% CI: 1.15–2.73) was associated with patient-related burnout. Lower resilience levels and avoidant copings were associated with personal-, work-, and patient-related burnout. Burnout prevalence among interns is high. The findings support the value of individual-targeted alongside organizational-targeted intervention in burnout reduction. As burnout is prevalent in both years of internship training, ongoing burnout prevention and wellbeing measures are deemed necessary. Full article

Medical training is intensive and predisposes students to psychological distress and burnout. Unaddressed burnout in medical training may persist in the internship phase and impact the quality of patient care. While some associations have been established, the link between some individual factors and training characteristics with distress and burnout in medical training remained unclear. In this study, we aim to examine the prevalence of psychological distress and burnout, and its association with gender, training phase, funding status, cumulative grade points average (CGPA), and coping strategies among medical students. The study applied a multicenter cross-sectional study design and convenience sampling on medical students from two medical schools from Malaysia and India. We used a self-reporting instrument that includes demographic details, the 12-item General Health Questionnaire (GHQ), the Copenhagen Burnout Inventory (CBI), and the Brief Coping Orientation to Problems Experienced (Brief COPE). A total of 748 medical students participated in the study. The prevalence of psychological distress, personal-related, work-related, and patient-related burnout were 33.0%, 56.1%, 35.0%, and 26.2%, respectively. Being male, clinical year, self-funded, and having a CGPA of more than 3.50 predicted psychological distress and burnout with mixed results. Maladaptive coping mechanisms consistently predicted the risk of psychological distress and burnout by more than two times. The findings indicate that primary and secondary mental health interventions have a role in medical training. A systematic intervention should incorporate coping skills training alongside institutional-targeted intervention. Full article

As the coronavirus disease 2019 (COVID-19) trajectory remains unknown, online learning (OL) has replaced face-to-face teaching strategies in education institutions. Research and training focus on harnessing educators, but less is understood at the students’ ends. This study examines the OL readiness components, self-regulation, enablers, and barriers to OL at home among medical students during the COVID-19 pandemic through an explanatory mixed-method study. We conducted a cross-sectional study with 178 students and an in-depth interview with 10 students from a public medical school in Malaysia. We found that while all students owned at least one learning device, 22.5% of the students did not have a learning space at home. 21.9% students did not have Wi-Fi access, and 11.2% did not receive mobile broadband coverage at home. Despite these barriers, students had a suitable OL self-regulation level. Significantly higher self-regulation was observed among pre-clinical year students, students with higher grades, and students who had designated learning space at home. We found that high-immediacy and low-bandwidth applications such as WhatsApp and Telegram, and YouTube as the most accessible and easiest platforms to navigate in OL. Our qualitative findings yielded a conceptual model of OL enablers at learners, educators, and institution levels. This framework may serve as one of the guides in faculty development planning and policymaking, especially in promoting a more socially inclusive OL. Full article

Coronavirus disease 2019 (COVID-19) has become a global health threat and has placed an extraordinary demand on healthcare workers around the world. In this study, we aim to examine the prevalence of burnout and its associated factors and experience among Malaysian healthcare workers during the COVID-19 pandemic through an embedded mixed-method study design. We found that more than half of Malaysian healthcare workers in this sample experienced burnout. Direct involvement in COVID-19 screening or treatment, having a medical condition, and less psychological support in the workplace emerged to be the significant factors in personal-, work-, and patient-related burnout. Participants described their workloads, uncertainties caused by the pandemic, challenging work–family balance, and stretched workplace relationships as the sources of burnout. Exhaustion appeared to be the major symptom, and many participants utilized problem-focused coping to deal with the adversities experienced during the pandemic. Participants reported physical-, occupational-, psychological-, and social-related negative impacts resulting from burnout. As the pandemic trajectory is yet unknown, these findings provide early insight and guidance for possible interventions. Full article