Kim Geok Soh

Perception of Intensive Care Unit stressors by patients in Malaysian Federal Territory hospitals

The Intensive Care Unit (ICU) is a therapeutic place for monitoring critically ill patients. However, it is a stressful area for the patients and it is causing them great anxiety. Previous studies have identified three groups of stressors in ICU namely; physical, psychological and environmental. The aims of this study were to determine the ICU stressors as experienced by patients and to determine the level of stressors felt by patients in ICU. A cross sectional study was done on 70 patients from two tertiary hospitals in Malaysia. A face-to-face interview with structured questionnaire was used for patients. Data collection occurred from 15 December 2006 to 31 January 2007. The five major ICU stressors perceived by patients were pain, being stuck with needles, boredom, missing their spouses and being too hot/cold. The ICU physical stressors were the major items ranked by post ICU patients. The findings from this study provided a set of baseline information to the health care providers, particularly ICU nurses in Malaysia, with which to provide better care for the patients in ICU.

Factors to drive clinical practice improvement in a Malaysian intensive care unit: Assessment of organisational readiness using a mixed method approach

Abstract This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identified as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.

Blood Profiles among Female Undergraduate in Iraq After a 12-Weeks Home-based Intervention Program

The aim of this study is to investigate whether a 12-weeks home-based intervention program could improve blood profiles among female students in Iraq. A 12-week home-based intervention which consisted of physical activity and dietary awareness program was carried out at home. The subjects were 44 sedentary undergraduate female students from Soran University, Iraqi. Both experimental and control groups (n=22 in each group) completed practical tests at baseline pre-test, post-test1, and post-test2, but only the experimental group participants received the 12-weeks intervention program. The blood profiles measured were blood pressure, blood cholesterol, and blood glucose. Results showed that the experimental group demonstrated improvement in diastolic systolic blood pressure after undergone 6 weeks post-test intervention program. The reported f value was (F(2, 84)=-6.636, p=.047, η2=0.091). Significant blood profiles results were reported for diastolic blood pressure and blood glucose. However, the significant results were only reported after the subjects had undergone the 12-weeks intervention program. The reported f values were (F(2, 84)=-7.000, p=.007, ?2=0.163) and (F(2, 84)=-16.182, p=.003, η2=0.188), respectively. As the conclusion, a home-based physical activity and dietary intervention program can positively influence sedentary undergraduate female students’ blood profiles and the benefits can be achieved as early as after 6-weeks.

THE TREND OF ENTERAL FEEDING AMONG CRITICALLY- ILL PATIENTS IN ADULT ICUs IN MALAYSIA

The adequacy of caloric intake is crucial for all critically-ill patients in Intensive Care Units because energy expenditure is higher in these patients compared to normal patients in general wards. Adequate calorie intake will promote positive outcome to the patients while inadequate calorie will lead to malnutrition which will increase the length of stay. The objective of this study was to determine the adequacy of caloric intake received by critically-ill patients in the general ICU in Malaysia. This was a cross sectional study which used a proforma adapted from ICU protocol. There were 132 participants involved in this study. The descriptive statistic and independent t-test were used for the statistical analysis. The results showed that 75.8% (n=100) received adequate or more than calorie prescribed while 24.2% (n=32) received calorie less than the given prescription. Patients that received early feeding were 72% (n=95) and late feeding were 28% (n=37). The continuous feeding method was most commonly used in early feeding patients from Day 1 to Day 3. There was an association between the adequacy of calorie intake and the length of stay (p<0.05). Findings obtained from this study will provide information for the nurses and other health care providers to improve the management of patients so that all patients will receive adequate caloric intake during their stay in ICUs.