KNOWLEDGE, VIEWS, PRACTICE AND SELF-EFFICACY REGARDING COPPER INTRAUTERINE CONTRACEPTIVE DEVICE USAGE AMONG PUBLIC PRIMARY CARE DOCTORS IN SARAWAK: A CROSS-SECTIONAL STUDY Introduction: Intrauterine contraceptive device (IUCD) insertion is a reversible and effective way to reduce unplanned pregnancy. Doctors play a key role in IUCD usage. This study aimed to assess knowledge, views, practice and self-efficacy regarding copper IUCD usage among public primary care doctors in Sarawak. Methods: A cross-sectional study was conducted in all public primary care clinics in Sarawak. A self-administered online survey form was distributed to doctors in the eligible clinics. Results: A total of 312 doctors participated in the survey. Most of them (81.4%) worked in a clinic where IUCDs were available. The median knowledge score among the medical officers was 15 (maximum score: 20). The knowledge score was correlated with the length of primary care experience and was higher among the doctors who had prior IUCD training and ever had inserted IUCDs. The doctors were concerned about the side effects of IUCDs, especially perforation and pelvic inflammatory diseases, and were negatively influenced by the additional counselling time required when recommending IUCDs. They recognised IUCD usage as a long-term and reversible contraception method. Most (69.2%) doctors had inserted IUCDs before, but only 45.9% had inserted five or more IUCDs. The self-efficacy of the doctors regarding IUCD insertion was moderate (63% of the total score). Conclusion: The knowledge and self-efficacy of the public primary care doctors in Sarawak were moderate. Although IUCDs were widely available, the number of IUCD insertions was relatively small. Further research is warranted to quantify IUCD usage and identify its barriers among nurses and patients.

A medical narrative is a physician-patient dialogue, where the physician listens carefully to fragments of the patient’s story, while interpreting their hidden messages and word sequences, as well as observing their gestures and body language. This aspect of the therapeutic relationship contributes to deciphering symptoms which are not apparent in the conventional interview and contributes to a much broader perspective of illness and health. The arts and the humanities have always been inseparable from each other in medical education. In this biomedical revolution, the humanities are needed now more than ever before to bridge the divides that separate the physician from the patient, from self, from colleagues, and society. Narrative Medicine (NM) which aims to treat the whole person, and not just the illness, is an emerging patient-centred discipline in medical schools that can humanise medical care and promote empathy. NM helps medical students cope with the suffering of their patients as well as their own emotions by reducing the anxiety and threat that come with illness, thereby providing a psychologically-sound foundation for the development of self-reflection and empathy. NM facilitates medical students’ adoption of patients’ perspectives with the hope of ultimately leading to more humane, ethical and empathetic healthcare for their patients. The discipline of NM is critically examined in this review paper from the perspective of external and internal stakeholders.