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.

Aim: To examine the trend of youth depression diagnosed in a healthcare group in Singapore over a 6-year period. Methods: This is a retrospective analysis of the medical records of patients who had been diagnosed with depression from Jan 2013 to Dec 2018 in a healthcare group in Singapore. The yearly trend of depression diagnosis among the youths (10-24 years of age) was compared with adults (25-64 years of age) and the elderly (≥ 65 years of age). The mean age at diagnosis, distribution of gender, ethnicity and clinical care settings among the subgroup of youth patients were compared across the years using analysis of variance or Pearson’s chi-square test. Results: A total of 4701 youths, 15243 adults and 6908 elderly patients were included in the analysis. Between 2013 and 2018, the rise in depression diagnosis in the youth was greater than in the adult and elderly populations, and the mean age at diagnosis decreased from 49.7 ± 0.3 (mean ± SE) years in 2013 to 39.6 ± 0.3 years in 2018. Among the youths, more females had been diagnosed with depression than males and females displayed a larger increase in diagnosis of depression. There was also a larger increase in the diagnosis of depression in primary care compared to emergency departments, outpatient specialist clinics and in-hospital wards. Conclusion Youth depression is a major health problem in Singapore. There is a need for the expansion of resources in a variety of avenues for depressed youths to seek help.