GRANDPARENTING PRACTICES AND THEIR ASSOCIATION WITH PHYSICAL AND MENTAL WELL-BEING AMONG OLDER ADULTS WITH CHRONIC DISEASES IN MALAYSIA: A CROSS-SECTIONAL STUDY Introduction: There is limited understanding of the association of grandparenting with the wellbeing of older adults with chronic diseases. This study aimed to examine grandparenting practices and their association with physical and mental well-being among older adults. Methods: The cross-sectional study was conducted at an outpatient clinic in a tertiary hospital in the Klang Valley, Malaysia. A total of 421 older patients with grandparenting experience were interviewed. The SF-12 Version 2.0 Health Survey was utilised to assess mental and physical wellbeing. Sociodemographic information, chronic disease care and grandparenting practices were evaluated to investigate any potential relationship with physical and mental well-being. Results: Of the participants, 80% were aged 60–74 years; 62.5% were women; and 81.4% completed secondary education. More than half of the participants voluntarily took on the role of grandparenting. The participants showed an impaired physical function but a preserved mental wellbeing. Never missing regular medication due to grandparenting and taking up grandparenting based on the circumstances were related to mental health. However, no factor was significantly associated with physical well-being. Conclusion: Two factors are linked to improved mental well-being. In contrast, there is no significant relationship found between a decline in physical health and grandparenting practices. Further research is needed to determine the causal relationship between physical health challenges and grandparenting practices.

FEASIBILITY OF QUICK RESPONSE-BASED QUALITY IMPROVEMENT PROJECTS IN AN URBAN PRIMARY CARE SETTING: A CROSS-SECTIONAL SURVEY Introduction: Using quick response (QR) codes to disseminate information has become increasingly popular since the declaration of COVID-19 as a pandemic. We aimed to investigate the feasibility of implementing QR-based quality improvement projects in our clinic to improve patients’ medical knowledge, experience and access to care. Methods: We utilised systematic random sampling by recruiting every 25th patient registered in our clinic during data collection. Participants answered a self-administered printed questionnaire regarding their smartphone usage and familiarity with QR code scanning at the patients’ waiting area. Data were analysed using the Statistical Package for the Social Sciences version 26. Results: A total of 323 patients participated (response rate=100%). The participants’ median age was 57 years (interquartile range=41–67). Most participants were women (63.1%). Approximately 90.4% (n=282) used smartphones, with 83.7% (n=261) reporting average or good usage proficiency. More than half (58.0%) accessed medical information via their smartphones, and 67.0% were familiar with QR codes. Multiple logistic regression analyses revealed that familiarity with QR codes was linked to age of <65 years [adjusted odds ratio (AOR)=4.593, 95% confidence interval (CI)=2.351–8.976, P<0.001], tertiary education (AOR=2.385, 95% CI=1.170–4.863, P=0.017), smartphone proficiency (AOR=4.703, 95% CI=1.624–13.623, P=0.004) and prior smartphone usage to access medical information (AOR=5.472, 95% CI=2.790–10.732, P<0.001). Conclusion: Since smartphones were accessible to most primary care patients, and more than half of the patients were familiar with QR code scanning, QR code-based quality improvement projects can be used to improve services in our setting.

The rising healthcare demand during COVID-19 outbreak may endanger patients and forces hospital to plan for future needs. Predictive analyses were conducted to monitor hospital resources at one of the gazetted COVID-19 hospitals in Malaysia. Simultaneously, a real-time observation on patient’s volume was conducted to understand the actual trend of healthcare resource utilisations. All the projections were directly compared to the actual number of patients in-care. This predictive study was done at University Malaya Medical Centre (UMMC) using various sources of data. The projections revealed a steady increase in the number of cumulative cases until April 2020 followed by an exponential increase in the number of cumulative positive cases in Malaysia. When a comparison between the projection and actual data was done, it was found that the initial projections estimated a range that is 50% to 70% higher during the first three phases of Movement Control Order (MCO) compared to the actual number of COVID-19 patients at UMMC. Subsequent projections were done by using recent estimations from the national database and it was estimated that the number of patients treated will be less than 10 each day up until the end of May 2020. The accuracy of this estimation is 95% when compared to the actual number of COVID-19 patients in care. In conclusion, the practice of continuous projections and real-time observation through predictive analysis using mathematical calculations and algorithms is one of the useful tools to facilitate hospital management to allocate adequate resource allocations.
COVID-19

The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.
COVID-19

Early sexual debut, partner violence, pregnancy and sexually transmitted infections contribute to negative health outcomes among adolescents. While the primary care clinics offer accessible sexual and reproductive health (SRH) services to adolescents, it is uncertain whether adolescents are aware of and utilize these services. This study aimed to examine Malaysian adolescents’ knowledge, utilization and barriers to primary care services for SRH. A cross-sectional survey was conducted from August to November 2011 among adolescent from five randomly selected schools in Selangor, Malaysia. A self-administered questionnaire was used to assess their knowledge, attitudes, sexual behaviors and utilization of SRH services. A total of 680 adolescents participated in the study. One in ten of the adolescents were aware of the availability of SRH services, and only 6.9% of them had ever visited a primary care clinic for SRH. About 75% of them felt uncomfortable going to a primary care clinic for SRH services. Knowledge and utilization of primary care clinics for SRH among adolescents in Malaysia is poor.

Introduction: Adolescents below the age of majority require parental consent for treatment or else the treating doctor may be liable for trespass and assault. This creates a dilemma for frontline doctors, as involving parents in the discussion could add yet another barrier to the existing barriers for adolescents in terms of access to healthcare services.

Introduction: Managing adolescent pregnancy in the primary care setting is complex, as it requires doctors to navigate through a combination of medical, social, financial and legal needs. Objective: This study explores the perspectives of private general practitioners on their roles and challenges in managing adolescent pregnancy in Malaysia. Methods: Nineteen private general practitioners in Selangor and Kuala Lumpur participated in in-depth interviews in 2015. A topic guide was used for interview navigation. Participants were asked to discuss their experiences and approaches in managing pregnant adolescents. We used purposive sampling to recruit consenting private general practitioners who had experience in managing adolescent pregnancy. The verbatim transcripts of the audio-recorded interviews were analyzed using thematic analysis. Data reached saturation at the nineteenth in-depth interview. Results: Two themes emerged. Under the theme ‘inadvertent advocator,’ participants described their tasks with regards to building trust, calming angry parents and delivering comprehensive counseling and care related to the sexual and reproductive health of adolescents, including requests for abortions. Theme two, ‘challenges of private general practitioners,’ refers mainly to personal and religious conflicts arising from a request for an abortion and deficiencies in support and multidisciplinary integration within their practice settings. Conclusion: General practitioners practicing in the private sector identify themselves as active players in supporting pregnant adolescents but face many challenges arising from the personal, religious, professional and community levels. Addressing these challenges is important for optimal care delivery to pregnant adolescents in this community