Malaysian Nurses Research Articles

Social Support Moderates the Impact of Stress and Role Conflict on Life Satisfaction among Malaysian Nurses

Objective: This study examined the influence of role conflict and job stress on life satisfaction among nursing staff in Malaysian healthcare institutions, with social support as a moderator. Methods: To achieve the objectives of this study, the researchers prepared a questionnaire to collect the requisite data. The researchers sampled three hundred and thirty-five (335) nurses selected randomly from Malaysian healthcare institutions. Results: The findings reveal that social support plays an important moderating role between nurses’ job stress and life satisfaction. Conclusion: Nursing staff requires greater flexibility and support from friends, supervisors, and family to reduce stress levels and balance roles.

Clinical Placement Among Malaysian Nursing Students: What Are Their Challenges?

Introduction: Nursing is a theory-practice course that requires high-quality and effective clinical education experiences. Clinical placement is one of the most important parts of nursing education; that can be challenging, stressful, and causes unpredictable changes. However, studies describing the challenges during clinical placement faced by nursing students are scarce. This study aimed to explore the challenges of Malaysian nursing students during a clinical placement at hospitals. Methods: A phenomenology qualitative study was conducted among nursing students at a public university in Malaysia. A semi-structured interview was used to collect data from October 2020 until November 2020. All interviews were recorded, transcribed, and analysed using thematic analysis. Results: Five themes emerged from this study: 1) attitude of the nurse, 2) patient’s distrust, 3) student’s issues, 4) learning environment, and 5) theory-practice gaps. Conclusion: This study revealed that nursing students face many challenges during their clinical postings. Therefore, various methods could be applied to increase the quality of practical sessions. Additionally, further research is needed to assess the coping strategies used by nursing students in dealing with the challenges during their clinical placement and the effectiveness of the interventions taken by the authority in helping the students.

Perceived Stress During COVID-19 Pandemic: The Malaysian Nurses Experience

Research shows that nurses are one of the most vulnerable categories of professionals to develop stress and other problems due to the nature of their job. Thus the objective of this study is to describe the perceived stress experienced during the COVID-19 pandemic among Malaysian nurses. A cross-sectional study was conducted through an online form involving 319 randomly selected nurses from a teaching hospital on the east coast of Pahang, Malaysia, between January to December 2022. The perceived stress was measured using the Malay version 10-item Perceived Stress Scale, PSS-10 questionnaire. Descriptive and linear regression analysis was applied to measure the mean score of perceived stress and the association between perceived stress scores and other factors in this population. The study found that the total mean score of PSS-10 among the respondents was 19.1 ± 5.8. The three items with the highest mean scores were under the subscales “lack of self-efficiency” of the questionnaire (item-4, item-7, and item 5), while the item with the lowest mean scores belonged to subscales “perceived helplessness” (item-10). However, further analysis performed shows no significant association between perceived stress towards COVID-19 with sociodemographic and work-related factors among respondents. This study concluded that lack of self-efficiency was perceived as the main stress experienced by Malaysian nurses during the COVID-19 pandemic. Thus, it is pivotal that the nurse’s manager and higher authority of the organization focus on improving the efficiency of these nurses through targeted programs focusing on problem-solving, emotional and on-the -job management plan, along with accessibility to resources, a positive work environment and support.

Assessing Malaysian Nurses' Knowledge of Blood Transfusion Procedures and Identifying Knowledge Gaps: A cross-sectional study

This cross-sectional study aimed to evaluate the knowledge of 316 nurses in a Malaysian public hospital regarding blood transfusion procedures. Convenience sampling was used to select nurses involved in patient care. Data collection employed a validated questionnaire with 33 questions across four sections. Descriptive analysis using SPSS revealed knowledge gaps, particularly in transfusion and adverse reaction management. Findings showed 56.3% with good knowledge, 42.7% with moderate knowledge, and 0.9% with insufficient knowledge. The study emphasizes the importance of targeted education and continuous training to enhance nurses' transfusion-related knowledge and ensure safe practices. Limitations include scope and self-reported data.

Cultural Competence among Malaysian Nurses

Cultural Competence among Malaysian Nurses

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic.

This study explores the effect of working duration on nurses and their ill-being (ie, anxiety, depression, fatigue, and sleepiness), intention to leave, and the quality of nursing care. A questionnaire survey was employed for a convenience sample of 400 nurses at Malacca General Hospital in Malaysia who voluntarily participated in this cross-sectional study. The Statistical Package for the Social Sciences (SPSS) was used to treat and analyze the data. Descriptive statistics were generated, and Post Hoc analyses and ANOVA tests were conducted. Findings indicated that working hours duration was significantly associated with nurses' anxiety (F (4, 394) = 10.362, p <0.001), depression (F (4, 395) = 23.041, p< 0.001), fatigue (F (4, 395) = 24.232, p< 0.001), sleepiness (F (4, 395) = 4.324, p < 0.002), quality of nursing care (F (4, 395) = 16.21, p <0.001) and intention leave their job, (F (4, 395) = 50.29, p <0.001). The results also revealed that working more than 14 hours was negatively associated with their perceived quality of nursing care and positively associated with their perceived ill-being and intention to leave. Shift length is an important issue, and nursing managers must consider shift length as it can adversely correlate with the nurses' perceptions of work and life.

The mechanism of anger and negative affectivity on the occurrence of deviant workplace behavior: An empirical evidence among Malaysian nurses in public hospitals.

Employees' work experience significantly impacts their cognition and workplace actions. Anger and negative affectivity are two personality traits that have been linked to workplace deviant behavior conduct. This study aimed to empirically analyze the deviant workplace behavior and its antecedents among Malaysian nurses in public hospitals. A cross-sectional design was employed in this study. The survey questionnaires were distributed proportionately to staff nurses in six government hospitals in 2020, with a total of 387 nurses selected using a simple random sampling. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used for data analysis. Trait anger triggered deviant workplace behavior in Malaysian nurses, thus supporting the argument that the personality trait could increase deviant behavior (β = 0.245, p = 0.000). At the same time, there was no evidence that negative affectivity could influence deviant behavior in the workplace among nurses in selected public hospitals in Malaysia (β = 0.074, p = 0.064). The Malaysian nurses had positive affectivity, related to positive emotions like happiness, work interest, and attentiveness. On the other hand, the nurses were suffering from high levels of emotional tiredness. Further research should highlight a deeper understanding of Malaysian nurses' work experiences and workplace stress affecting their physical and mental health.

Do Contextual and Demographic Factors Help Malaysian Nurses Prepare in Dealing with the COVID-19 Pandemic?

As of 11 October 2020, Sabah comprised a quarter of all COVID19 cases reported in Malaysia since the start of the pandemic last January 2020. In this pandemic, nurses serve in vital roles to mitigate the effects of COVID-19. This study aims to explore the nurses’ preparedness in managing the COVID-19 outbreak situation in Sabah, Malaysia, examining the contextual (e.g., participated in an actual major disaster event) and demographic factors (e.g., age and working experience that may influence nurses’ preparedness for managing the COVID-19 pandemic). A total of 317 nurses in Sabah, Malaysia were involved in this study. The Emergency Preparedness Information Questionnaire (EPIQ) contained 41 items and was used to assess civilian nurses’ perceived familiarity with 9 competency dimensions of preparedness. The mean scores of nurses’ preparedness indicated a moderate level of nurses’ preparedness in managing the COVID-19 pandemic (mean ranging from 2.89 to 3.79). The results indicated that there was a significant difference between the nurses who actively participate in an actual major disaster event and who were not active in a total of preparedness and all dimensions (t = 2.79, df = 285, p = 0.006) (except in familiarity with decontamination and familiarity with special populations), across working experience (F(2,291) = 5.09, p = 0.007) (except familiarity with Incident Command System and role), and age among nurses ((F(3,290) = 2.68, p = 0.047)) (total of preparedness, familiarity with ethical issues in triage, epidemiology, and surveillance, and psychological issues). Overall, this study has made a significant theoretical contribution, as well as in clinical implications in the field of nursing practice, by addressing the impact of contextual and demographic factors on nurses’ preparedness in managing the COVID-19 outbreak situation. This study will help nurses to understand the skills, abilities, knowledge, and actions needed to respond, mitigate, and prepare for emergencies during pandemics and disasters.

Translation and Validation of Malay Version 5-Items Brief Illness Perception Questionnaire, BIP-Q5 towards COVID-19 among Malaysian Nurses

Introduction: Currently, own individual perception is recognized as one of the important factors in the prevention of disease, including coronavirus disease, COVID-19. Given the massive impact of COVID-19 on all population’s life, including nurses as one of the main health services providers in the country, this study aims to translate and validate the Malay Version 5-Items Brief Illness Perception Questionnaire, BIP-Q5 towards COVID-19 among Malaysian nurses. Materials and Methods: Forward and backward translations and pretesting of the BIP-Q5 to Malay were conducted among nurses, subject matter experts, and language professionals. The validations process was elicited through an online cross-sectional study involving 56 nurses based on a ~10:1 subject-to-items ratio sample size estimations. Results: The principal component analysis (PCA) revealed one best component with eigenvalues more than one, confirming the questionnaire’s original version. There are five items within the single component, and all are with weightage of over 43%. The scree plot supported the findings, which showed that at least one factors are suitable to be retained. The overall Cronbach’s α coefficient was 0.7 and the intraclass correlation coefficient was 0.659. The Kaiser-Meyer-Olkin was 0.655, and Bartlett’s test of sphericity p-value was <0.001. Conclusion: This study showed that the translated Malay Version 5-Items Brief Illness Perception Questionnaire, BIP-Q5 has a good psychometric property, and is a valid and reliable tool to be used to measure illness perceptions towards COVID-19 among Malaysian nurses.

Malaysian nurses' knowledge and attitudes regarding BRCA genetic testing.

Breast cancer genetic (BRCA) testing for cancer susceptibility is an emerging technology in medicine. This study assessed the knowledge and attitude of nurses regarding BRCA genetic testing in a tertiary teaching hospital in Malaysia. A descriptive cross-sectional study was conducted among 150 nurses using a simple random sampling technique in a tertiary teaching hospital in northeast peninsular Malaysia. Data were collected using a self-administered questionnaire consisting of socio-demographic data, assessing nurses' knowledge and attitude regarding BRCA genetic testing. Fisher exact test analysis was used to determine the association between socio-demographic characteristics with knowledge and attitude level. In addition, the overall knowledge and attitude were analysed using the sum score of each outcome based on Bloom's cut-off point. Of the 150 nurses, 66.7% had high knowledge level about BRCA genetic testing, and 58% were positive towards genetic testing. The participants' mean age was 28.9 years (SD = 6.70). Years of working experience (p = 0.014) significantly influenced knowledge level on BRCA genetic testing, whereas speciality working experience (p <0.001) significantly influenced BRCA genetic testing attitudes. The results show that most nurses have adequate knowledge of BRCA genetic testing. However, their attitude could be termed negative. Therefore, targeted education programs on BRCA genetic testing and risk are needed to improve the knowledge and attitude of nurses and, ultimately, can educate the women and increase health-seeking behaviour among eligible women.

Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience.

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses’ knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50–74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses’ overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion.

Primary care nurses' challenges, opportunities, and facilitators of elder abuse intervention in Malaysia.

To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia. Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis. Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse. A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.

Malaysian Nurses' Knowledge of Radiation Protection: A Cross-Sectional Study.

Radiology is a vital diagnostic tool for multiple disorders that plays an essential role in the healthcare sector. Nurses are majorly involved in a healthcare setting by accompanying patients during the examination. Thus, nurses tend to be exposed during inward X-ray examination, requiring them to keep up with radiation use safety. However, nurses' competence in radiation is still a concept that has not been well studied in Malaysia. The study aimed to define the level of usage understanding and radiation protection among Malaysian nurses. In this research, a cross-sectional survey was conducted among 395 nurses working in hospitals, clinics, and other healthcare sectors in Malaysia. The survey is based on the developed Healthcare Professional Knowledge of Radiation Protection (HPKRP) scale, distributed via the online Google Forms. SPSS version 25.0 (IBM Corporation) was used to analyze the data in this study. Malaysian nurses reported the highest knowledge level in radiation protection with a mean of 6.03 ± 2.59. The second highest is safe ionizing radiation guidelines with 5.83 ± 2.77, but low knowledge levels in radiation physics and radiation usage principle (4.69 ± 2.49). Therefore, healthcare facilities should strengthen the training standards for all nurses working with or exposed to radiation.

Mental Health Correlates Among Older Persons Residing in Malaysian Nursing Homes During the COVID-19 Pandemic.

Mental Health Correlates Among Older Persons Residing in Malaysian Nursing Homes During the COVID-19 Pandemic.

Moderating Effect of Demographic Characteristics on the Relationship between Work Life Quality and Turnover Intention: A Cross-Sectional Study.

AIMThis study aimed to investigate the moderating effect of demographic variables (sex, age, marital status, years of experience, level of education, and income) on the relationship between quality of work life and turnover intention in Malaysian nurses.METHODA descriptive, and cross-sectional design using Brook’s quality of nursing work life questionnaire (self-reported) and Porter’s anticipated turnover scale was implemented to collect data from 430 randomly selected Malaysian nurses in a teaching hospital’s medical, surgical, and special units. The data were analyzed using the structural equation model smart partial least squares and Statistical Package for Social Sciences software services.RESULTSThe nurses had a moderate level of quality of work life and high level of turnover intention. Sex, number of children, and work wards/units had a moderating effect on turnover intention, after its interaction with quality of work life (p < .05).CONCLUSIONThe study findings highlighted the factors having a moderating effect on turnover intention after its interaction with quality of work life . This knowledge is beneficial for providing guidance to nursing leaders or healthcare departments in hospitals to improve nurses’ quality of work life and decrease their turnover intention. Addressing and understanding the demands and needs of nurses in the work environment and the family structure within a quality of work life could affect nurse’s retention, leading to a decrease in their turnover intention.

Spiritual Care Competence among Malaysian Staff Nurses

Background: Perceptions and levels of understanding of spiritual care vary among nurses, which may affect their competency to meet the patient’s spiritual needs. Therefore, determining nurses' perception of spiritual care is the first important step in addressing the spiritual needs of patients, and may also help nursing management in developing spiritual care education and training programs.Purpose: This study aimed to assess the competence of Malaysian nurses toward providing spiritual care and identify the relationship between nurses’ spiritual care competence and their sociodemographic factors. Methods: This study employed a cross-sectional design to assess nurses' competence in spiritual care by using a simple random sampling method which involved 271 staff nurses from a public hospital in Northeast of Peninsular Malaysia. Spiritual care competence scale in Bahasa Malaysia version was used for data collection. Data analysis was performed using descriptive (frequency, percent, mean, standard deviation) and inferential (Chi-square and Pearson’s correlation test) statistics.Results: This study showed that 69.7% of staff nurses had an average level of competence toward providing spiritual care for the patients (M=95.44, SD=4.34). The highest mean difference among the domains was personal support and patients counseling (MD=5.789), while the lowest mean difference was assessment and implementation of spiritual care (MD=1.258). Furthermore, there was no significant relationship between spiritual care competence and sociodemographic factors (gender, age, marital status, educational level, nurses' experience, race, religion, and previous participation in training spiritual care programs).Conclusion: The majority of nurses have an average level of competence toward providing spiritual care. There is no significant relationship between nurses’ spiritual care competence and sociodemographic factors.

FACTORS INFLUENCING NURSES’ PARTICIPATION IN CLINICAL RESEARCH : A CROSS-SECTIONAL SURVEY IN HOSPITAL PUTRAJAYA, MALAYSIA

Background: Although the nurses in Malaysia are shouldering an important daily responsibility for providing optimal nursing care to the patients, Bashar (2019) had noted that a majority of nurses who were working in a public teaching hospital in Malaysia had rarely applied evidence-based practice (EBP) when discharging their daily duties and responsibilities, despite having a positive attitude toward evidence-based nursing (EBN). Therefore, it seems likely for these Malaysian nurses to be encountering many barriers in their involvement in clinical research [and also in research utilization (RU)]. Objective: This cross-sectional survey utilized a self-administered questionnaire within a study population of the Malaysian nurses working in a government hospital to determine the level of involvement of nurses in clinical research at Hospital Putrajaya from May to August 2015, which led to an assessment of the level of association between a list of pre-specified demographic and job-related characteristics and the involvement of nurses in clinical research, in order to identify any plausible factors which might have an association with either facilitating or hindering these nurses from their involvement in clinical research. Methods: After having prepared and validated the self-administered questionnaires for this study, they were then distributed to a total of 406 nurses working in Hospital Putrajaya. This self-administered questionnaire was specifically designed to achieve the objectives of this study which aimed to collect the baseline socio-demographic information of the respondents, and also information pertaining to their nursing practice and their participation in activities that were related to nursing research. Results: This study had found that among 406 nurses from Hospital Putrajaya who received the questionnaires, a total of 300 nurses had completed this questionnaire, meaning that the response rate was 300/406 or 73.9%. The baseline socio-demographic characteristics of the respondents were mostly female (94.3%), of Malay ethnicity (94.0%), with a mean age of 30.9 years, having an average 7.9 years of service and were married (77.3%). Most of these respondents were Staff Nurses (75.2%), followed by Community Nurses (13.1%), Sister-KUP (7.7%) and Sister (4.0%). A majority of the respondents reported that they were not interested in doing research (59.7%) and the two main reasons for their lack of interest in doing research was that they had no interest in research (41.7%) and also they did not have enough time to do research (25.7%). Less than half of the nurse respondents were previously involved in research (31.5%), in several specific areas such as clinical trials (36.6%) and also research in the field of preventive medicine (19.4%).The reason for them not being involved in research before was that (i) they had no opportunity to do research (43.7%) and (ii) they were not interested in research (27.4%). Only 19.9% of the respondents had received additional training in statistics, 14.9% of them had previously used a statistical package for analyzing data, and 3.4% of them had a prior experience of publishing research articles in scientific journals. They also reported that they did not read journals regularly (58.1%) and were not confident in interpreting medical literature (69.0%). Conclusion: Our findings in this study had shown that both the proportion of Malaysian nurses who were interested in clinical research (40.3%) and also those with prior experience in conducting clinical research (31.5%) remained very low. Results of this study also showed that these Malaysian nurses might have encountered various barriers in their quest for their involvement in clinical research and utilizing these findings in their daily nursing practice. Two of the most important barriers identified by this study are (i) the lack of having undergone appropriate training in research methodology and also (ii) the lack of the necessary statistical expertise for analyzing research findings. Hence, this study provides valuable information for formulating strategies to increase nurses’ participation in research activities at Hospital Putrajaya by providing more research training opportunities, and enhancing the level of awareness and increasing the accessibility to these resources by the nurses. It is our sincere hope that the results obtained from this study can be aptly utilized for promoting quality and ethical research among the nurses at Hospital Putrajaya by providing adequate support to and facilitating their future research endeavours.

Missed nursing care in the Malaysian context: A cross-sectional study from nurses' perspective.

To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses. Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors. A cross-sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses. The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00-5.00), which differed across 24 nursing care elements. Basic nursing care and communication-related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p<.001). No significant association was found between missed nursing care and nurses' intention to leave (p>.05). The occurrence of missed nursing care was noted to be low. Practical strategies such as an acuity-based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care.

Relationship between Personal Values, Work Experience and Nursing Competencies among Cancer Care Nurses in Malaysia.

Oncology nurses are an essential component of cancer care teams. Nurses play a vital role in ensuring that cancer patients comply with their cancer treatment. In the cancer care nursing context, competency is not merely being skilled, but also implies the characteristic of being able to perform effectively. In addition to the need for competence, nursing is a discipline rich in values including human dignity, caring, humanity, and respect for personal privacy. Research from a variety of disciplines indicates that values often influence human behaviour in professional and work settings. It is often believed, therefore, that nurse’ values and work experience influence and contribute to their work performance. Few studies have attempted to examine these relationships, particularly in the context of cancer care nursing. The purpose of this study was to determine the relationship between personal values, work experience and competency among cancer care nurses in Malaysia. Quantitative surveys were used to collect the data. A total of 845 cancer care nurses from 38 public hospitals in Peninsular Malaysia participated in the study. Descriptive statistics and Pearson Product-Moment Correlations were used to analyse the data. The findings revealed positive and significant relationships between personal values and competency (r = 0.59, p < 0.01) and work experience and competency (r = 0.11, p < 0.047). The findings support the assertion that Malaysian nurses’ values and work experience are related to performance-related competency.

The relationship between work-life balance, the need for achievement, and intention to leave: Mixed-method study.

To examine the mediating role of employee well-being on the relationship between work-life balance practices, the need for achievement and intention to leave among nurses in Malaysia. Work-life balance practices are associated with employee perceptions of the need for achievement and well-being which subsequently influence their intention to leave the organization. This study contributes new knowledge to nursing studies on work-life balance in an Asian and Islamic society where the expectations for women are to focus on family rather than career. A cross-sectional, explanatory mixed methodology. This is a two-phase study conducted between 2015-2017 with 401 nurses in East Malaysia. In Phase 1, researchers surveyed 379 nurses to test eight hypotheses and in Phase 2 researchers interviewed 22 nurses to explore the results of Phase 1. Phase 1 revealed job satisfaction mediates the relationship between work-life balance practices (e.g. flexibility and choice in working hours, supportive supervision), financial success, and intention to leave. However, life satisfaction and money as a motivator did not mediate such relationships. Phase 2 identified four important factors that cast light on survey results: working conditions of Malaysian nurses; inadequate compensation in the public healthcare sector; team-based practices; and pressure on senior nurses in both administrative and clinical roles. This is one of the first studies to investigate work-life balance issues among nurses in Malaysia. Outcomes of this study extend the debates on work-life balance and employee well-being in an Asian Islamic social context. The use of flexible working arrangements and collectivist teamwork approaches, improving compensation and employment benefits and eliminating the 'time-based job promotion' policy may help to mitigate work-life balance issues and intention to leave among nurses in Malaysia.