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

Any medical diagnosis should take a multimodal approach, especially those involving tumour-like conditions, as entities that mimic neoplasms have overlapping features and may present detrimental outcomes if they are underdiagnosed. These case reports present diagnostic pitfalls resulting from overdependence on a single diagnostic parameter for three musculoskeletal neoplasm mimics: brown tumour (BT) that was mistaken for giant cell tumour (GCT), methicillin-resistant Staphylococcus aureus osteomyelitis mistaken for osteosarcoma and a pseudoaneurysm mistaken for a soft tissue sarcoma. Literature reviews revealed five reports of BT simulating GCT, four reports of osteomyelitis mimicking osteosarcoma and five reports of a pseudoaneurysm imitating a soft tissue sarcoma. Our findings highlight the therapeutic dilemmas that arise with musculoskeletal mimics, as well as the importance of thorough investigation to distinguish mimickers from true neoplasms.
Adult ; Aneurysm, False ; diagnosis ; Biopsy ; Bone Diseases ; diagnosis ; Bone Diseases, Metabolic ; diagnosis ; Bone Neoplasms ; diagnosis ; Cell Proliferation ; Diagnosis, Differential ; Diagnostic Errors ; prevention & control ; Female ; Giant Cell Tumors ; diagnosis ; Humans ; Hyperparathyroidism ; complications ; Leukocytosis ; diagnosis ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Neoplasms ; diagnosis ; microbiology ; Osteomyelitis ; diagnosis ; microbiology ; Osteosarcoma ; diagnosis ; Sarcoma ; diagnosis ; Soft Tissue Neoplasms ; diagnosis ; Tibia ; pathology