Critical care nurses’ knowledge, attitudes and practices on the usage of physical restrainer

Posted Posted in Original Article

Authors: Swee Geok Lim, Vivian Jeng Tuk Fong.


Background: Physical restraint is any measure or technique that prohibits an individual’s body movement. Although physical restraint is one of the most common methods used to ensure patient safety in the intensive care units, its usage is an arguable practice. Involuntary immobilisation of a patient challenges patient’s rights while over usage of physical restraints can lead to possible harm to the patients. Critical care nurses especially should make accurate decisions regarding the use of physical restrains if they are to ensure patient safety.

Objective: The objective of this study was to determine the knowledge, attitude, and practices of critical care nurses on usage of physical restrainer in a private hospital in Klang Valley.

Methods: This was a cross-sectional, quantitative descriptive study using the Physical Restraint Questionnaire (PRQ) to collect data from 103 registered nurses through simple random sampling in the Critical Care Unit of a private hospital.

Results: A total of 103 critical care nurses participated in this study. The nurses had moderate level of knowledge of physical restraint usage, 43.96 ± 4.05 (36 to 53), positive attitude towards the use of physical restraint, 30.47 ± 2.96 (24 to 39) and good practices on usage of physical restrainers, 38.88 ± 2.73 (29 to 43).

Conclusion: Findings revealed that majority of critical nurses have moderate knowledge, positive attitude and satisfactory practices on usage of physical restraint. However, continuous updates on usage of physical restraint and its legal implications are highly recommended to ensure critical care nurses are better informed before deciding to use physical restraint on their patients.

Keywords: Knowledge, attitude, practices, physical restraint, critical care nurses, acute care units.

Citation: IEJSME 2021 15 (1): 5-18


A Correlational Study between Coping Strategies and Compassion Satisfaction among Crisis Helpline Volunteers

Posted Posted in Original Article

Authors: Kiranjeet Kaur, Puvessha Jegathisan, Cheryl Tham Sin Yi


Within the recent years, crisis helpline organizations in Malaysia have been experiencing a surge in calls, and with the current worldwide anxiety caused by Covid-19, these call volumes are expected to rise. Therefore, volunteers who staff these helplines are continuously placing their Professional Quality of Life (ProQoL) at risk due to the ongoing stressors involved in this service. However, it has been previously noted that the utilization of coping strategies may contribute to the enhancement of a volunteer’s ProQoL. Hence, this study focuses on examining the relationship between three types of coping strategies and the positive aspect of ProQoL, which is compassion satisfaction.

Through the use of a cross-sectional survey design, a total of 118 crisis helpline volunteers within the Klang Valley responded to a self-report online questionnaire consisting of the Coping Strategy Indicator (CSI) and the Professional Quality of Life Scale Version 5. Pearson’s correlation analysis and multiple regression analysis were used to analyse the relationship between the variables.

Problem-solving coping and social support coping demonstrated a positive correlation with compassion satisfaction (r = .677, p < .001) (r = .261, p = .002), whereas avoidance coping demonstrated a negative correlation (r = -.572, p < .001). Correspondingly, problem-solving coping was revealed to be the best predictor towards compassion satisfaction through the regression analysis.

The findings of this study suggests that utilizing adaptive coping mechanisms may produce a more favourable outcome among crisis helpline volunteers as it correlates to a higher satisfaction level. Consequently, organizations would be able to positively benefit from a high satisfaction level within their volunteers as it would reinforce their motivation and efforts to continue engaging in this noble service.

Keywords: coping strategies, professional quality of life, compassion satisfaction, crisis helpline.

Citation: IEJSME 2021 15 (1): 19-27


Medical students’ perspective on social media posts in the International Medical University: A preliminary study

Posted Posted in Original Article

Authors: Kian Hock Tan, Rachel Ley Tan, Jolene Sze Tien Shu, Han Yao Foong, Siok Joan Siek, Kwee Choy Koh, Cheong Lieng Teng.


Background: Social media is a common channel for communication, information and education. However, it is also a potential forum where lapses of professionalism may occur. In this study we aimed to elicit medical students’ perspective on social media practices and their perceived implications of social media posts.

Methods: We conducted a cross-sectional study of Semesters 1 and 9 medical students from the International Medical University (IMU). A score was created consisting of the sum of the Likert scale in the 10-item social media practices questionnaire. Categorical variables were compared using chi-square test, while continuous variables that were not normally distributed were compared using Mann-Whitney U test. Statistical significance was set at p<0.05.

Results: Out of 118 respondents (61% females), 54.2% of them recalled previous instructions regarding the use of social media and 55.1% of them were familiar with the IMU Social Media Guidelines. In general, respondents showed high level of awareness of inappropriate social medial practices, with statistically better awareness among Semester 1 students. Students who reported familiarity with IMU Social Media Guidelines were more aware of inappropriate social media practices. Most respondents were aware of the potential adverse impact of social media posts.

Conclusion: IMU students who participated in our survey generally had a good grasp of what constitutes inappropriate behaviour on social media and its potential future impact. Lower level of awareness of inappropriate social media practices among the Semester 9 students points to the need for periodic reminders of IMU Social Media Guidelines.

Keywords: Medical students, social media, professionalism and medical ethics.

Citation: IEJSME 2021 15 (1): 28-39


Transiliac interpedicular screw rod with sacroiliac joint cannulated screw fixation: A treatment option for sacroiliac joint dysfunction

Posted Posted in Case Study & Report

Authors: Jing Hern Khoo, Yin Teng Ng, Kamarul Izham Kamarudin, Leong Jiahour, Ahmad Fauzey Kassim.


Sacroiliac joint (SIJ) dysfunction refers to the aberrant position or movement of SIJ structures that may cause low back pain. We report a case of right SIJ dysfunction, which was successfully managed by SIJ cannulated screw fixation and transiliac interpedicular screw and rod.

A 30-year-old female was involved in a motor vehicle accident and sustained anterior column of the right acetabulum fracture, right inferior pubic ramus fracture along with right SIJ diasthesis. She presented to us with right hip and lower back pain which led to a clinical diagnosis of right SIJ dysfunction. She underwent right SIJ cannulated screw fixation and transiliac interpedicular rod. Post-operatively, she was able to ambulate better with improving pain score upon subsequent follow-up visits.

Although transiliac interpedicular rod and sacroiliac joint screw fixation have been utilized in cases of unstable pelvic injury, literatures of applying this method of fixation to manage SIJ dysfunction are still limited. This case therefore illustrates the potential of said fixation as a method of providing additional stability in cases of SIJ dysfunction.

Keywords: Sacroiliac joint, pain, dysfunction, transiliac interpedicular screw and rod, stability.

Citation: IeJSME 2021 15(1): 40-42


Knowledge and attitude towards end of life care among nursing students in a private nursing college, Penang

Posted Posted in Original Article

Authors: Swee Geok Lim, Ching Nguk Ngieng, Xie Yen Tan.

Background: End of life (EOL) care is a holistic approach for patients and their families, that involves physical, emotional, spiritual, and social needs. There are approximately 80,000 Malaysians requiring EOL care annually but only 2,000 patients have access to the service. Despite an increasing demand for EOL care in Malaysia, many healthcare professionals are still unfamiliar and inadequately trained in dealing with the EOL issue. The purpose of study is to evaluate the Diploma in Nursing students’ level of knowledge and attitude towards EOL care.

Method: A cross-sectional descriptive study on 127 nursing students from a private nursing college in Penang, through simple random sampling was conducted. The Palliative Care Quiz for Nursing was used to determine the knowledge of EOL care, while Frommelt Attitude Towards Care of Dying Patients-Form B, was used to measure attitude towards EOL care.

Result: Overall, the participants had poor knowledge towards EOL care with mean overall score of 8.18 ± 2.14. The mean overall score for attitude towards EOL care was 117.76 ± 11.12, implying a positive attitude towards EOL care. There was a significant difference in the level of knowledge (t = 5.250, p < 0.001) and attitude (t = 6.184, p < 0.001) according to the years of study.

Conclusion: The student nurses had poor level of knowledge on EOL but positive attitude towards EOL care. Adding an additional module on EOL alone is inadequate; instead emphasis on its relevancy and understanding on how it can be used to improve patient care is of far more importance.

Citation: IEJSME 2020 14 (3): 7-15


Predictive parameters of potential COVID-19 without epidemiological clues and management strategy in resources limited setting

Posted Posted in Original Article

Authors: Kok Wei Poh, Pei Wen Tan, Ji Yin Wong, Cheng Huong Ngan, Yin Jie Ng, Raymund Dass, Tiang Koi Ng.

Managing potential COVID-19 patients is challenging when resources were limited. The objective of this study was to evaluate the predictive parameters and management strategy for potential COVID-19 cases who are without contact or travelling history.

Retrospective study of potential COVID-19 patients without direct contact or travelling history, admitted to Hospital Tuanku Ja’afar Seremban. Patients were riskstratified to either low or medium risk and admitted to designated wards, respectively. They were categorised to severe acute respiratory infection (SARI); influenzalike illness (ILI); dengue fever or viral fever like (DVF); or none. Clinical, laboratory and radiological variables were evaluated for predictive value. Positive cases were isolated to negative pressure isolation rooms and the neighbouring patients underwent surveillance.

812 patients were studied, with 478 fulfilled SARI, ILI, and DVF. 18 (2.2%) of them were COVID-19 positive, and all patients in “none” group were negative. Hypoxia without dyspnoea and medium risk criteria were significant in predicting COVID-19 with p<0.01 (OR 7.18; 95% CI 2.70, 19.13) and p<0.01 (OR 35.77; 95% CI 11.25, 113.71) respectively. Absolute lymphocyte count showed no predictive value (P=0.88 95% CI -0.78, 0.90). Absolute neutrophil count ≥10 x10^9/L cells (OR 0.11; 95% CI 0.01, 0.87) helped to exclude COVID-19. Chest radiograph of 16 (88.9%) COVID-19 patients showed heterogeneous Ill-defined opacities. No nosocomial transmission occurred during this study period.

Conclusion / Implication
Initial attention to predictive parameter, riskstratification, clinical grouping strategy, and proper ward management helps in containment of COVID-19 and resources management without risk of nosocomial transmission.

Citation: IEJSME 2020 14 (3): 16-29


Level of emotional intelligence among nurses

Posted Posted in Original Article

Authors: Chang Angelna, Yung Wei Lai, Swee Geok Lim


Background: Emotional intelligence (EI) is defined as the comprehension, use and the management of one’s emotions in a positive manner to reduce stress, communicate efficiently, empathise with others, overcome challenges, and resolve conflicts. EI is important among nurses as it influences their decision making abilities, clinical judgment, and well-being that directly affect the quality of patient care and outcome.

Objective: The objective of this study was to determine the EI level and its association with demographic variables among nurses in a private hospital in Petaling Jaya, Selangor.

Methods: This was a cross-sectional, descriptive study involving 130 nurses at one of the private hospitals in Petaling Jaya, Selangor, through simple random sampling. Questionnaire consists of Part A (demographic data) and Part B (Wong and Law’s Emotional Intelligence scale (WLEIS), self-assessment tool that consists of 16 items on four components inclusive of self-emotions appraisal (SEA), regulation of emotion (ROE), use of emotion (UOE), and other’s emotion appraisal (OEA) on a set of 7-Likert scale).

Results: Findings showed that 63.1% (n = 82) scored high EI. Nurses’ age and years of nursing experience are significantly associated with their level of EI. No association is found on the nurses’ level of EI with their gender, ethnicity, highest nursing education level, marital status, and current work setting. The null hypothesis was rejected.

Conclusion: Findings showed that most of the nurses have high EI. There is a significant association between the level of EI and demographic variables such as age and years of nursing experience.

Citation: IEJSME 2020 14 (3): 30-44