Healthcare Professionals' Views for the Content of the Teddy Bear Hospital for a Child Sexual Abuse Prevention Module

Worldwide studies have reported a drastic increase in child sexual abuse (CSA) involving very young children. In Malaysia, several attempts have been made to combat this problem via educational programs. Teachers have reported a lack of confidence in teaching this topic; hence a less threatening approach is needed. The Teddy Bear Hospital (TBH) is an innovation whereby the children bring their teddies while visiting the volunteers assuming healthcare practitioners' role. This execution is effective in reducing the children's anxieties about hospitalization and increasing their health knowledge. Therefore, our objective is to explore healthcare practitioners' (HCP) views for the content of TBH and its approach as a personal safety module toward preventing CSA. Eighteen in-depth-interviews were conducted. Interviews were thematically analyzed. Participants suggest the TBH method as a good approach to teaching prevention of CSA among preschoolers. Four main themes emerged from this study: (1) educating children about personal safety, (2) moral values and faith as a medium to prevent child sexual abuse, (3) addressing social media use in children, and (4) general approach to content delivery. The involvement of parents is crucial. Addressing moral values and faith and usage of social media platforms are also essential factors to look into.

Effectiveness of pretend medical play in improving children's health outcomes and well-being: a systematic review

BACKGROUND

The healthcare setting is stressful for many people, especially children. Efforts are needed to mitigate children's healthcare-related anxiety. Medical play using the Teddy Bear Hospital (TBH) concept can expose children to healthcare settings and help them develop positive experiences in these settings. In this role-playing game, children bring their soft toys and act as parents to the 'sick' teddies in a pretend hospital or clinic play setting. The objective of this systematic review is to evaluate the effectiveness of the TBH in improving children's health outcomes and well-being.

METHODS

We searched the reference lists of included studies from four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) from inception until November 2020. We included pre-post, quasiexperimental and case-control studies, as well as randomised controlled trials (RCTs) that discussed medical play using the TBH concept as an intervention. Studies that involved sick patients and used interventions unlike the TBH were excluded. We assessed the quality of the included studies using the Cochrane Collaboration's 'Risk of bias' tool.

RESULTS

Ten studies were included in this systematic review. Five specifically investigated the TBH method, while the others involved the same concept of medical play. Only three studies were RCTs. All of the studies report more than one outcome-mostly positive outcomes. Two report lower anxiety levels after intervention. Two found better healthcare knowledge, with one reporting increased feelings of happiness regarding visiting a doctor. Two studies found no change in anxiety or feelings, while another two found increased levels of fear and lowered mood after the medical play (which involved real medical equipment).

CONCLUSIONS

The practice of TBH has mostly positive outcomes, with lower anxiety levels and improved healthcare knowledge. Its effectiveness should be verified in future studies using a more robust methodology.

PROSPERO REGISTRATION NUMBER

CRD42019106355.

Quasi-experimental study on the effectiveness of a house officer preparatory course for medical graduates on self-perceived confidence and readiness: a study protocol

INTRODUCTION

Being a house officer (HO) is said to be associated with high levels of stress, leading to mental health problems and sometimes to quitting the medical profession altogether. In Malaysia, the number of HOs completing training on time is slowly declining, with increasing annual dropout rates. Feeling incompetent is one of the contributors towards this growing problem. This study aimed to evaluate the effectiveness of a 3-day pre-HO intervention module in addressing participants' confidence, readiness and psychological well-being in preparation for their HO training.

METHODS AND ANALYSIS

The pre-HO intervention is the 'Medicorp' module that includes clerkship, experience sharing, hands-on skills training, common clinical cases and introduction of the local healthcare system. This is a pre-post quasi-experimental study lasting 1 year, with three assessment time points-at pretraining, immediately after training and 1 month into the participants' HO-ship. The study is currently ongoing and involves 208 participants who attended the course in Malaysia. Participants with known psychiatric illness, working HOs and medical students are excluded. A pretested, self-administered questionnaire that includes baseline sociodemography, adaptation of the International Medical University (IMU) Student Competency Survey and the Depression Anxiety Stress Scale has been adopted, and 1 month follow-up will be conducted by telephone. Data will be analysed using SPSS V.24. The primary outcome is change in confidence level, while the secondary outcomes are changes in the readiness and psychological well-being of the participants.

ETHICS AND DISSEMINATION

This study protocol has received ethics approval from Ethics Committee for Research Involving Human Subjects Universiti Putra Malaysia and the National Medical Research Registry Malaysia. Written informed consent has been obtained from each participant. Results will be disseminated through journals and conferences, especially those involved in medical education specifically looking into the training of medical doctors.

TRIAL REGISTRATION NUMBER

NCT03510195.

PREVENTION OF AEDES BREEDING HABITATS FOR URBAN HIGH-RISE BUILDING IN MALAYSIA

Dengue is endemic in Malaysia; it is found mainly in the urban and suburban areas. Aedes Aegypti and Aedes Albopictus have been incriminated in the transmission of dengue virus in many urban areas of South-East Asia, including Malaysia. Dengue cases that have been reported worldwide were related with high rise buildings especially in residential buildings such as apartments and condominiums. This study aims to identify the breeding habitats resulted from building designs in high-rise apartments in Kuala Lumpur, Malaysia. Inspections were conducted at three dengue-hotspots residential buildings located in Lembah Pantai, Kuala Lumpur. The selection criteria of the study sites were based on the most frequent reports on dengue cases from these three localities. The building elements that Aedes breeding were spotted created semi-permanent areas for Aedes breeding. Findings show the buildings were designed with unreachable rain gutters, making checking and cleaning for mosquito breeding in clogged gutters impossible for local residents. Poor drainage and piping system has found to be the Aedes habitats, too. Of these, surprisingly, uneven surface of the concrete rooftops and floors has also become one of the breeding spots, resulting to water stagnation and liveable areas for Aedes to breed. Correlating this findings not only helps target areas to be identified and focused in community search and destroy programs, but most importantly it contributes to high-rise building design and construction features in Malaysia by taking into considerations long-lasting measures for a holistic sustainable environment.

PREVENTION OF AEDES BREEDING HABITATS FOR URBAN HIGH-RISE BUILDING IN MALAYSIA

Dengue is endemic in Malaysia; it is found mainly in the urban and suburban areas. Aedes Aegypti and Aedes Albopictus have been incriminated in the transmission of dengue virus in many urban areas of South-East Asia, including Malaysia. Dengue cases that have been reported worldwide were related with high rise buildings especially in residential buildings such as apartments and condominiums. This study aims to identify the breeding habitats resulted from building designs in high-rise apartments in Kuala Lumpur, Malaysia. Inspections were conducted at three dengue-hotspots residential buildings located in Lembah Pantai, Kuala Lumpur. The selection criteria of the study sites were based on the most frequent reports on dengue cases from these three localities. The building elements that Aedes breeding were spotted created semi-permanent areas for Aedes breeding. Findings show the buildings were designed with unreachable rain gutters, making checking and cleaning for mosquito breeding in clogged gutters impossible for local residents. Poor drainage and piping system has found to be the Aedes habitats, too. Of these, surprisingly, uneven surface of the concrete rooftops and floors has also become one of the breeding spots, resulting to water stagnation and liveable areas for Aedes to breed. Correlating this findings not only helps target areas to be identified and focused in community search and destroy programs, but most importantly it contributes to high-rise building design and construction features in Malaysia by taking into considerations long-lasting measures for a holistic sustainable environment.