Mizanur Rahman

Background: Adolescents in rural indigenous communities often lack culturally appropriate sexual and reproductive health (SRH) education. This study compared the short‐term effectiveness of a web‐based SRH intervention versus conventional face‐to‐face education among 260 rural Bidayuh adolescents aged 16–19 in Sarawak. Methods: Using a non‐randomized, two‐district quasi‐experimental design (one district assigned to each arm to minimize contamination), knowledge was assessed via a validated questionnaire at baseline, 1 month, and 3 months. All 260 enrolled participants were analyzed under an intention‐to‐treat approach using a repeated‐measures ANCOVA (arm × gender × time); 15 participants (5.8%) were lost to follow‐up by 3 months. Results: Knowledge scores did not differ between arms at baseline or 1 month, but diverged significantly by 3 months, favoring the web‐based arm (68.12% vs. 59.13%; adjusted difference = −8.67 percentage points, 95% CI = [−12.61 to −4.74] (conventional minus web‐based; the web‐based arm scored higher), p < 0.001), reflected in a significant Arm × Time interaction, F (2, 747) = 7.47, p = 0.001. This advantage was numerically larger among females ( Δ = −11.48, p < 0.001) than males ( Δ = −5.87, p = 0.050), though the three‐way interaction did not reach conventional significance ( p = 0.053). Sensitivity analyses (per‐protocol; multiple imputation) produced consistent estimates. Discussion: Knowledge retention over 3 months was better in the web‐based arm, with a numerically larger effect among females. These findings may be associated with digital SRH education promoting longer‐lasting knowledge among rural indigenous adolescents, but should be interpreted cautiously given the non‐randomized, two‐cluster design, which cannot fully separate intervention effects from district‐level differences. Conclusion: Self‐regulated digital platforms may be a promising addition to school‐ and community‐based SRH programs in conservative rural settings, alongside strategies to promote engagement and reinforcement, pending confirmation in a randomized, multi‐site trial.

Background: Job frustration among mental health nurses can have determinant impact on staff wellbeing, retention, and quality of care. However, little is known about the factors contributing to job frustration and the coping strategies used by mental health nurses in Oman. An alarming sign of stress and discontent at work is the high intention to leave among mental health nurses in Oman. Aim: This study aimed to explore the factors contributing to job frustration and the adaptation strategies used by mental health nurses in Oman. Method: A qualitative descriptive design was adopted for this study. Forty-two participants who were purposively selected after obtaining consent were involved in six focus group discussions, divided equally between mental health nurses ( n = 21) and mental health nursing leaders ( n = 21) within a mental healthcare setting in Oman. Data were transcribed verbatim, translated where necessary, and analyzed using thematic analysis supported by NVivo 14 software. Ethical approvals were obtained from relevant institutional ethics committees in Malaysia and Oman. Results: Three main themes emerged: external factors (workplace environment, obligatory and blame culture, reciprocal communication, and job insecurity), internal factors (role perception and engagement, effort–reward imbalance, work–life balance, and self-efficacy) that contribute to job frustration, and adaptation strategies (personal and professional-oriented approaches). For both participant groups, perceived lack of recognition, communication obstacles, and leadership difficulties were major sources of frustration. Conclusion: Individual, organizational, and contextual factors lead to job dissatisfaction among mental health nurses in Oman. In mental health settings, addressing perceived limitation in leadership styles, communication procedures, workplace culture, and employee support systems may lessen job dissatisfaction and enhance employee retention and welfare.

In hospitals around the globe, there exists a tripartite culture of leadership and performance in their daily operations. Job performance among healthcare workers often depends on hospital organizational culture, psychosocial conditions, and leadership. This study examined how organizational culture mediates the relationship between transformational leadership and job performance in public hospitals in Malaysia. A cross-sectional survey was conducted among 1,187 doctors, nurses, and medical assistants from 11 public hospitals in Malaysia. A validated self-administered questionnaire was used to assess organizational culture, transformational leadership, and job performance among doctors, nurses, and medical assistants in eleven (11) selected public hospitals in Malaysia. These data were collected and analyzed using hierarchical multiple linear regression and partial least squares structural equation modeling. These statistical methods were used to estimate the direct, indirect, and moderating effects on job performance among healthcare workers. Organizational culture, however, showed the strongest direct association with job performance (β = 0.987, p < .001). Transformational leadership was strongly associated with organizational culture (β = 0.869, p < .001) and had a large positive indirect effect on job performance via culture (β = 0.858, p < .001), despite a small negative direct effect (β = −0.224, p = .042). The model explained 64.6% of the variance in job performance. Therefore, Organizational culture is the primary proximal determinant of job performance and the key pathway to transformational leadership. Improving job performance in public hospitals in Malaysia should prioritize leadership development and culture-building.

Background and objectives: Job performance among healthcare workers depends on organisational and psychosocial conditions in hospitals. This study examined how transformational leadership, organisational culture, and workplace harassment jointly shape multidimensional job performance in public hospitals in Malaysia. Methods: A cross-sectional survey was conducted among 1,187 doctors, nurses, and medical assistants from 11 public hospitals. Validated self-administered scales captured transformational leadership, workplace harassment, organisational culture, and job performance. Hierarchical multiple linear regression and partial least squares structural equation modelling were used to estimate the direct, indirect, and moderating effects. Results: Organisational culture showed the strongest direct association with job performance (β = 0.987, p < .001). Transformational leadership was strongly associated with organisational culture (β = 0.869, p < .001) and had a large positive indirect effect on job performance via culture (β = 0.858, p < .001), despite a small negative direct effect (β = −0.224, p = .042). Workplace harassment showed no significant direct or mediated effects in the overall structural model. The model explained 64.6% of the variance in job performance. Conclusion and recommendations: Organisational culture is the main proximal determinant of job performance and the key pathway for transformational leadership. Performance improvement in public hospitals should prioritise leadership development, culture-building, and strong anti-harassment systems.

Background: Population aging is accelerating in middle-income countries; however, evidence on the psychosocial factors associated with later-life quality of life (QoL) remains limited in Southeast Asian settings. Psychological distress, self-determination, and social capital have each been linked to well-being in older populations, but few studies have examined these constructs together among retirees in geographically dispersed, multiethnic populations. This study examined the associations between psychological distress, self-determination, social capital, catastrophic health expenditure (CHE), and QoL among retirees in Sarawak, Malaysia. Methods: A cross-sectional survey was conducted among 1,410 retirees aged 60 years and above across nine districts in southern, central, and northern Sarawak. QoL was measured using the WHOQOL-BREF; psychological distress using the Depression, Anxiety, and Stress Scales-21; self-determination through basic psychological need satisfaction comprising autonomy, competence, and relatedness; and social capital using bonding and bridging indicators. CHE was assessed using health-related out-of-pocket expenditure thresholds. Partial Least Squares Structural Equation Modelling with 10,000 bootstrap resamples examined direct associations, statistical mediation pathways, and moderation effects. Hierarchical multiple regression assessed incremental variance explained by sociodemographic, health-related, and psychosocial variables. Results: The PLS-SEM model explained 56% of the variance in QoL. Self-determination showed the strongest positive association with QoL (β = 0.546, p < .001), followed by social capital (β = 0.352, p < .001). Psychological distress was negatively associated with self-determination (β = -0.379, p < .001) and social capital (β = -0.327, p < .001). Significant indirect associations were observed between psychological distress and QoL through self-determination (β = -0.207, 95% bootstrap confidence interval [BCa] CI: -0.233, -0.181) and social capital (β = -0.115, 95% BCa CI: -0.135, -0.097). CHE showed small, non-significant main direct and indirect associations with QoL. A small CHE by social capital interaction was observed for self-determination (β = -0.06, p = .013), requiring cautious interpretation. Hierarchical regression showed that health-related variables and CHE produced a large incremental increase in explained variance across Qol domains, while psychosocial variables added a further substantial 20–30%. Conclusions: In this cross-sectional sample, QoL was more strongly associated with psychological distress, self-determination, and social capital than with CHE. Self-determination appeared to be the strongest statistical pathway linking psychological distress with QoL. Healthy aging strategies may benefit from greater attention to mental health, autonomy, competence, relatedness, and social connectedness. Longitudinal studies are needed to clarify temporal relationships and causal mechanisms.

Background: Adolescent sexual and reproductive health (SRH) education requires accurate knowledge, understanding of risks, and supportive access to well-being. Objectives: This review aims to assess how knowledge about sexual and reproductive health (SRH) influences adolescent behaviour, identifying barriers, effective strategies, and communication methods. It evaluates interventions like school-based programs and online resources to empower informed decision-making among adolescents regarding SRH. Method: A systematic search from January 2013 yielded 14 articles, mostly quantitative studies involving adolescents aged 14-19. A narrative analysis identified two main themes: (i) Enhancing SRH knowledge, attitudes, and skills for positive outcomes and innovative intervention strategies. The findings were organized by Endnote 20. Results: The key findings of the review highlight the effectiveness of interventions in improving adolescents’ knowledge, attitudes, and skills related to sexual and reproductive health (SRH). These interventions have shown success in enhancing adolescents’ understanding of SRH issues, fostering positive attitudes toward SRH topics, and building self-efficacy for safe sexual practices. Furthermore, the review highlights the importance of innovative and targeted intervention strategies, such as technology-driven approaches, customized interventions, and the synergistic combination of multiple strategies, to effectively address the diverse needs for SRH of adolescents and promote positive outcomes for SRH. Conclusions: This review emphasizes the impact of SRH interventions on adolescent well-being, advocating for tailored gender-specific approaches, policy integration, and long-term efficacy evaluations for sustained positive outcomes.

Background: Patients undergoing maintenance hemodialysis (MHD) in Arabic-speaking regions, particularly in Palestine, face unique sociopolitical and cultural barriers affecting their care and quality of life. Existing assessment tools rarely address the multi-level determinants of support within these populations, highlighting the need for a culturally validated instrument based on the Social-Ecological Model (SEM). Objective: To develop and validate an Arabic-language questionnaire grounded in the SEM to assess the multi-level (community, interpersonal, organizational, and policy) support factors influencing MHD patients in the Gaza Strip. Methods: A cross-sectional study was conducted from November 2024 to February 2025 at three governmental dialysis centers in Gaza, enrolling 101 Arabic-speaking adult MHD patients through systematic random sampling. The validation process encompassed item analysis, content and face validity, and psychometric testing, including exploratory factor analysis (EFA), assessment of convergent and discriminant validity which includes average variance extracted, factor loadings, composite reliability, Cronbach’s alpha, Fornell-Larcker criterion, cross-loadings, and Heterotrait-Monotrait ratio. Results: The EFA identified a four-factor structure corresponding to Community, Interpersonal, Organizational, and Policy Support, explaining 65.15% of the variance. The final validated questionnaire comprised 31 items, with the Community Support domain demonstrating the strongest psychometric properties (factor loadings: 0.821–0.923; Cronbach’s alpha = 0.972; AVE = 0.796). While Interpersonal and Organizational domains showed acceptable reliability and validity, the Policy Support domain displayed marginal construct validity. Overall, the instrument had strong content, face, convergent, and discriminant validity. Conclusion: The Arabic SEM-based questionnaire is a reliable and valid tool for assessing multi-level support factors among MHD patients in Arabic-speaking contexts. It enables comprehensive evaluation for research and clinical practice. Future research should confirm its structure using confirmatory factor analysis, extend validation to diverse Arab populations, and examine temporal stability.

Introduction: The rapid global rise in electronic cigarette (e-cigarette) use has led to increasing research interest, yet factors influencing its adoption remain underexplored in Malaysia. This study investigates sociodemographic and psychosocial determinants of e-cigarette use in the Samarahan and Kuching divisions of Sarawak, Malaysia. Methods: A cross-sectional study was conducted among smokers aged 18 and above. A total of 474 participants were recruited using cluster sampling. Data collection was performed through face-to-face interviews using a structured questionnaire. Hierarchical multinomial logistic regression was applied to identify key predictors of e-cigarette use. Results: Among participants, 27.8% were e-smokers, 25.8% were switchers, and 46.4% were dual smokers. The analysis revealed that females were more likely to be e-smokers (AOR = 5.889, p < .001) and switchers (AOR = 2.647, p = .021) than males. Additionally, degree holders were more likely to be e-smokers than dual smokers (AOR = 4.106, p = .025). Psychosocial factors, such as subjective norms (AOR = 1.435, p = .023) and perceived usefulness (AOR = 1.616, p = .016), were significant predictors of e-cigarette use. Conclusion: Sociodemographic and psychosocial factors, such as gender and education, influence e-cigarette use in Sarawak. These findings provide valuable insights for designing targeted public health strategies to regulate e-cigarette use and support smoking cessation efforts in Malaysia.

Understanding organizational culture, knowledge of employment rights, and positive attitudes towards people with disabilities is crucial for creating inclusive workplaces. This Malaysian study compared the perspectives of employers, employees, and community members with disabilities using a cross-sectional design and convenience sampling of 595 respondents. Data on demographics, organizational culture, legislative knowledge, and attitudes were collected via a validated survey and analyzed using descriptive statistics, one-way analysis of variance (ANOVA), and multiple linear regression in JAMOVI and SPSS, with a p-value<.05 indicating significance. The study found a moderately supportive organizational culture for employing people with disabilities, with the highest scores in supportive work environments and inclusive culture. Employers and employees perceived greater top management commitment and inclusivity than community members with Down syndrome. Legislative knowledge and positive attitudes significantly shaped perceptions of a supportive and inclusive workplace. Muslim participants reported greater support and disability-accommodating human resource (HR) practices than those of other religions. The findings underscore the need for targeted training and awareness programs on disability rights to enhance inclusivity among all stakeholders in Malaysia.