Background: The Negative Acts Questionnaire (NAQ-R) is a widely used measure of workplace bullying. However, studies examining its psychometric properties for use among Malaysian junior doctors have not been published. The study aims to determine its validity and reliability in assessing bullying among a Malaysian sample. Methods: The NAQ-R was administered to 1,119 junior doctors working in twelve government hospitals accredited for housemanship training within the central zone of Malaysia. A subset of participants (n=50) completed the NAQ-R twice at an interval of two weeks. Exploratory factor analysis was conducted to assess construct validity, using polychoric factor analysis with varimax rotation. To determine reliability, Cronbach’s alpha was computed to assess internal consistency reliability, while intraclass correlation coefficient was calculated to examine test retest reliability. Results: Analysis yielded a one-factor structure of the NAQ-R, consistent with the interpretation of factors provided by the original instrument. The factor was labelled “workplace bullying” and accounted for 68.0% of the variance in the junior doctor group. Factor loadings ranged from 0.68 to 0.90. The Cronbach’s alpha for the NAQ-R items ranged from 0.96 to 0.97, and the Cronbach’s alpha for the overall scale was 0.97. Meanwhile, the ICC for the NAQ-R items ranged from 45.6% to 93.7%, and the ICC for NAQ-R total score was 93.4%. These indices denote high internal consistency reliability and excellent test-retest reliability respectively. Conclusion The NAQ-R has adequate psychometric properties and can be used to measure workplace bullying among Malaysian junior doctors.
Occupational Stress

Introduction: Musculoskeletal disorders (MSDs) was found to be high among nurses especially those working in the hospital. One of the risk factors of MSDs is psychosocial factors apart from physical and ergonomic factors. However, limited study was found specifically looking at this association among nurses working at tertiary university hospital especially in Malaysia. Hence, the objective of this study is to assess the association between organizational psychosocial risk factors with MSDs among nurses working at tertiary university hospital. Methods: A cross-sectional study was conducted with a total of 550 respondents among nurses in University Malaya Medical Centre working from all nursing working department. Samples was selected using Stratified Random Sampling based on nursing working location ratio. A multiple logistic regression was conducted to determine the association between organizational psychosocial factors with MSDs among study population. Results: Multiple logistic regression revealed that supervisors support was associated with MSDs (AOR 0.309, 95%CI 0.133-0.716) even after controlled with confounders such as age, number of children, income, history of musculoskeletal disease, employment grade, total employment duration, work schedule type and selected ergonomic factors. On the other hand, other psychosocial factors which includes decision latitude, psychological job demand, co-worker support, and job insecurity were found not be significant. Conclusion The findings highlighted the relationships between organizational psychosocial factors and MSDs among nurses at tertiary university hospital specifically the role of supervisor support as a protective factor against MSDs among this working population. Hence, hospital top management should incorporate this element as one of the components in their program to reduce MSDs among nurses in the hospital.
Musculoskeletal Diseases

Background: Noise-induced hearing loss (NIHL) is one of the most prevalent occupational disease globally. The objective of this study was to determine the effectiveness of a training and education program in increasing knowledge, attitude and practice (KAP) towards NIHL prevention among vector control workers. Methods: This is a cluster-randomized controlled trial design involving 183 vector control workers from nine district health offices in the state of Perak, Malaysia. Both groups were followed-up for a period of 3 months. Changes in KAP score towards NIHL was measured at intervals of 1 month and 3 months post-intervention. Data was analyzed according to Per-Protocol (PP) principles. Results: Both intervention and control groups showed increase in mean scores for all three domains (knowledge, attitude and practice) after 1 month but a larger improvement was seen in the intervention group for the attitude and practice domain in comparison to the control group. For the practice domain, the intergroup mean difference was 0.35% with 95% CI of -5.2 to 4.5. The greatest improvement was seen in attitude domain where the intergroup mean difference was 0.9% (95% CI -4.1, 2.3). At 3 months post-intervention, a greater improvement was observed in the intervention group compared to the control group for all 3 domains. The largest improvement was seen in the practice domain where the intergroup mean difference was -4.2 (95% CI -9.1, 0.7). Conclusion The training and education program was effective in maintaining the existing knowledge, attitude and practice of vector controls towards noise-induced hearing loss (NIHL). Continuous training and education is needed to cultivate good safety behaviour at workplace.
Health Education