Comm Med Guideline

INTERNATIONAL MEDICAL UNIVERSITY MALAYSIA
Bachelor of Medicine & Bachelor of Surgery

Intake ME1/10 Semester 5
COMMUNITY FIELD VISIT PROGRAMME
Study Guide (13 February 24 February 2012)
Intake ME1/10 [Sem 5] Community Field Visit Programme - Study Guide International Medical University
INTERNATIONAL MEDICAL UNIVERSITY
UNIVERSITI PERUBATAN ANTARABANGSA
COMMUNITY FIELD VISIT PROGRAMME
STUDY GUIDE
FORWORD The Community Field Visit is designed for the undergraduates to understand how the people and communities play vital roles in understanding health in general. This is a pioneer initiative by the Community Medicine Department, of IMU to introduce health survey in its curriculum. It is designed to understand the people, disease and the environment. The students will also appreciate the Malaysian primary rural health care system. There are three main objective of the programme. The main objective is to participate in the planning of the rural health survey by the students. In this survey the students learn how to prepare the questionnaire, and conduct a survey of a rural community. The students are expected to learn many aspects of the community including socio-demography, income and expenditure, housing, water supply, excreta and waste disposal, vectors and pest controls, working environment, food nutrition and health, and the health seeking behaviors. This information will give the students ideas as to how the communities live and utilize the health services. The second component of the survey is the thematic project which is a research proposal designed for the areas. This research can be any form of research from that area. Third component of the CFV is the visit to the health clinics. The visits allow the students to understand some of the practical aspects they have learned in the classroom. It is important to realize that the CRP programme also teaches skills such as epidemiological skills, statistical skills, leadership skills, and managerial skills. The students learn how to organize themselves and work as teams. I hope that the students will participate fully in the programme and learn from the programme. The students in the field will be supervised by a staff of the Community Medicine Department. In the field the students are expected to behave well and the supervisor will evaluate their performance individually. The fieldwork will be concluded with presentations from students,
Professor Dr. Hematram Yadav Head of Department, Department of Community Medicine
The Community Field Visit Before one can really begin to provide acceptable medical care to the people, one should know and understand their way of life as well as have some knowledge of the diseases present in the community and the environmental (ecological) factors that contribute to disease and death. To achieve this end, a course on the Introduction to Community Health Survey to familiarise the student with various aspects of urban and rural life and also a field exercise - the Community Health Survey. This survey also allows the student to put into practice many of the aspects of social and preventive medicine that has been learnt thus far during their pre-clinical years.
1. Learning Outcomes At the end of the field survey, the student should be able to demonstrate that he/she has acquired adequate knowledge regarding health status of rural communities in Peninsular Malaysia by:
1. 2. 3.
participating in the planning of the rural health survey to be conducted by the group. fully participating in the conduct of a community health survey, contributing to and helping in the production of a group survey report of satisfactory standard, and
4.
presenting, some aspect of life and health in his survey area to the rest of his/her class.
Community Field Visit Planning
Community Field Visit Planning The class will be divided into six groups which will be located in various selected areas. Each group will be under the care of a staff member from the Community Medicine Department. Each group will be divided into sub groups. All groups will be required to perform the following tasks: Health clinic visit Household Survey Health Issues Research Visit to water treatment plants , sewage system, etc. (If time permits) Group members will have the opportunity to learn from all the activities listed above. The coordinator for each group will organize the learning with the facilitation of the supervisor. The responsibility for the production of a satisfactory questionnaire for use in the field will lie with the groups concerned. Review of questionnaires will be conducted by the Staff of the Department of Community Medicine. Groups will arrange for the printing and compilation of their own questionnaires. a) b) c) d)
Conduct of the Community Field Visit Programme Students will be assigned to groups and will travel to the respective clinics to carry out their field survey. They are expected to be at their respective stations for at least TWO days The groups will be introduced to their respective Medical Health Officers and other leaders. Outcome Students will be required to produce a portfolio as evidence of the learning. The portfolio will consists of FOUR parts:
Part 1 : A brief write-up of the administration of the clinics Part 2 : A report on the household survey Part 3 : A brief report on the health issues research Part 4 : A brief report on the visit to water treatment plants & sewage system (if applicable)
SURVEY
Survey
The survey is one of the most widely used research methods in investigating social phenomena such as health seeking behaviour, environmental issues, psychological and disease management. By definition surveys can be anything from a short paper-pencil feedback form to an intensive one-to-one in-depth interview. Survey research encompasses measurement procedures and techniques of gathering data either by direct measurement or by soliciting it from written responses. A survey generally employs methods that involve questioning respondents.
Although there are various approaches in a survey, the questionnaire survey is the most commonly used method. There are many forms of questionnaire surveys like the mail survey, group administered survey, household drop-off survey and internet survey for the questionnaire category while the personal interview and telephone interview are most frequently used methods in the interview category.
Even though the survey exists in various forms, all surveys share some unique characteristics, as follows:
a) A survey involves collection of data from the respondents in some structured form b) information is defined in quantitative form where information is described in terms of variables and c) samples are used to gather information.
Classification of surveys In terms of purpose there are two types of survey; i) descriptive surveys, where the aim is mainly to describe the nature and the characteristics of the population, and ii) analytical surveys intended to determine the relationship between variables . Basically there are two categories of survey designs, namely the cross-sectional and longitudinal surveys. Both of these designs commonly utilize samples. When the entire population is used in a study, the survey is then termed a census. The cross sectional surveys could be either for descriptive or explanatory (analytical) purposes. However the longitudinal survey, where the main concern is establishing causal relationships, is used mainly for analytical purposes.
Intended learning outcome of the Community Survey At the end of the two sessions the student should understand a. the stages of an investigation/survey b. what are variables c. types and sources of data d. types of data collection techniques e. aspects of questionnaire construction f. methods of data processing and analysis
The Research Process Scientific research is characterized by a systematic process which includes: identifying and defining the problem, developing the theoretical framework, research design formulation, data collection, data preparation and analysis, and report writing and presentation.
Identifying and defining the problem Involves discussion with decision makers, interviews with industry expert, analysis the secondary data, and perhaps some qualitative research such as focus groups The development of conceptual and theoretical framework, framing of research questions, identification of research variables, and construction of research hypotheses Research design is a framework or blueprint for conducting research project. Research design includes deciding on: the right paradigm, units of analysis, sampling, instrument and measurement, data collection and analysis Can be either through personal interviewing, observation, questionnaire survey, or document analysis Involves editing, coding, transcription or data entry, data cleaning and verification of data. The data are analyzed to derived information to address the research objectives and/or hypotheses the documentation of the entire research project starting from problem formulation until data analysis, interpretation and recommendations
Developing the theoretical framework
Research design formulation
Data collection
Data preparation and analysis
Report writing and presentation
Learning Methods: i) ii) Lectures\Discussion [Duration : 1 hour] Field Survey [Duration : 3 days]
Stages of an investigation 1. a) Preliminary Steps: Determining the purpose of the study
For the CFV, the purpose is to allow you to gain an insight into the lifestyle, socioeconomic, cultural and other factors which may affect the health status of a community. It also allows you the opportunity to plan and conduct a study and also enables you to understand the problems and limitations of various data sources and methods of data collection.
b)
Formulating the topic
A study of the health status of a community and the various ecological factors which may affect it, either directly or indirectly,
c)
Literature review
General information regarding the demographic and socioeconomic status of the district population can be obtained from the District Office, Health Office or publications of the Department of Statistics such as the annual "Vital Statistics". Library search of relevant journal articles using Medline and other databases.
2.
Planning Stage
a)
Formulate study objectives
After identifying the various factors which you would like to study, you should state clearly the specific objectives under each category so that you know precisely what information you require and in what form.
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Objectives are specific quantifiable milestones that mark progress towards the achievement of a set of broader goals. They are the desired outputs of a system. Objectives of a research project summarizes what is to be achieved by the study. they should be clearly phrased in operational terms, stating exactly what one is going to do. The results have to be compared with the objectives.
Objectives should be stated in "action verbs" which are specific enough to be measured, i.e. to determine, compare, verify, calculate, described and establish. Do not use vague "non-action verbs" such as to appreciate or understand.
General objective is one which is planning for what is to be accomplished by the study in general terms. This is then broken down into smaller logically connected parts or the specific objectives.
b)
List the variables
Define the variables to be collected, selecting those which can be readily obtained. A variable is a characteristic of a person, object or phenomenon, which is measurable. It is a qualitative or quantitative entity that can vary and take on different values.
Types of variables:
1) Independent variable refers to the "cause".
2) Dependent variable refers to the "effect/outcome". E.g. in a study to determine the relationship between mother's smoking habit and birth weight, the mother's smoking habit is the independent variable, while birth weight is the dependent variable.
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3) Confounding variables A potential confounding variable is one which is associated with problem as well as the possible cause of the problem. This variable may weaken or strengthen the apparent relationship between a possible cause and an outcome. E.g. a study shows a relationship between mother's educational level and malnutrition. However, family income is related to the mother's education as well as with malnutrition. Family income is the potential confounding variable.
4) Universal variables Variables which are so often of relevance in investigations of groups or populations, that their inclusion should always be considered. E.g. age, sex, parity, ethnic group, religion, marital status, social class, place of residence (rural/urban)
Defining variables
1) Conceptual definition; defines the variable as it is conceived, e.g. using social class as an indicator of socioeconomic status or excess body weight as an indicator of obesity.
2) Operational definition; defines the characteristic which one wants to measure. It is phrased in terms of objectively, observable facts and should be sufficiently clear and explicit to avoid ambiguity, e.g. using occupation as an indicator of social class and the body mass index as an indicator of obesity.
Scales of measurement
1) Nominal scale consists of two or more categories that are mutually exclusive and presented in the form of counts, e.g. for smoking; never smoked, ex-smoker, smoker. There is no natural order.
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2) Ordinal scale. The categories fall into a natural order and are ranked with the scale showing positions of a ladder, e.g. social class I to V and agreement with a statement (strongly agree, agree, neutral, disagree, strongly disagree). Each class shows the same situational relationship to the class that follows. 3) Binary scale, refers to variable with two outcome, e.g. sex, presence or absence of a disease.
4) Continuos scale refers to variable where there is a continuum of measurements where an infinite number of values exist, e.g. weights, heights, blood glucose readings.
5) Composite scale based on; Combinations of categories e.g. systolic and diastolic blood pressure for hypertension. Use of formula, e.g. length of gestation, average income per capita and obesity indices. Composite scores e.g. raw scores and weighted scores.
a) Selecting the study population
For practical purposes and due to various constraints, areas for the Community Field Visit are usually selected in terms of accessibility. For areas with large populations, some form of sampling have to be conducted. Each house would act as a sampling unit and a sample can be selected using a random sampling method.
b) Sources of data
Primary using questionnaires, either self-administered or by interview. This will be discussed in the next session.
Secondary data is existing data or data which has already been collected.
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Secondary Data 1. 2. 3. 4. 5. Publications with information on population: Death certificates Notifications E.g. sexually transmitted diseases, occupational diseases or injuries Hospital or other records Registers of diseases or people requiring special care, e.g. cancer register, register for handicapped children 6. Personal documents; birth certificates vaccination certificates registration cards
Advantages of secondary data:
Inexpensive Uses existing sources of information Useful in cases where respondents are either unwilling to be questioned or an unavailable. Permits examination of trends in the past.
Disadvantages:
Difficulty in access because of ethical issues pertaining to privacy. Changes in record-keeping procedures or different criteria used. Biased or wrong information recorded, incomplete or missing information.
Procedures for collecting secondary data
a) Determine the range of statistics available b) Verify the definitions used c) Determine the methods of collection and processing used d) Investigate the reliability of the source
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Primary Data Primary data is data which is obtained by the investigator or his team using various methods. 1. Measurement E.g. measurement of weights, blood pressure, blood glucose levels or clinical signs.
2. Questionnaires/Survey Format Obtaining information using interviews or self-administered (with the respondents filling in the form).
I)
Interview :
An interviews is a technique whereby one or more respondents are questioned orally. Interviews produce soft data as opposed to hard data obtained by the various methods of observation or measurement.
a) Unstructured Interviews
In the case of unstructured interviews, this is conducted using a list of topics. Useful as an exploratory tool in the early stages of the survey. Also useful for obtaining the possible responses to a question for the design of more structured questionnaires.
Advantages: More natural and the respondent is more likely to be himself Answered in more depth by the respondent and also allows for probing
Disadvantages: Response may be affected by interviewer Reliability
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b. Structured Interviews
There is complete control of questions and responses. The schedule is designed so that different interviewers will give the same stimuli in the same order. Responses are also recorded in a standardised way.
Advantages: Respondents who don't read or write Awareness of the difficulties respondents have in the understanding of questions Only the person intended responds to the questions Lessens number of unanswered questions and increases response rate Produces additional data through observation Opportunity to ask more interesting open-ended questions
Disadvantages:
Characteristics or actions of the interviewer may affect responses Costly to administer Worry about anonymity by respondents Only record what respondents they think, believe or feel Biased responses
II. Self-Administered Questionnaires
Use of a form that presents written questions that are to be answered in written form by the respondents themselves.
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Ways of administration: By mail Gathering respondents together and giving oral and written instructions, while the forms are filled by the respondents themselves. Hand delivery of questionnaires to respondents and collecting them later.
Advantages: Less expensive than interview Requires less skill to administer Eliminates bias introduced in terms of variations in the way interviewers question respondents Allows respondents to be more honest by providing anonymity
Disadvantages: Difficult with illiterate or semiliterate respondents Lower rate of response than interviews Little control over who answers the questions or how long they take to answer No way of determining whether questions are understood and interpreted in the same way by different respondents Pertinent questions aspects in Questionnaire Construction I . Is the questionnaire the best method for collecting your data? Alternative methods? 2. If yes, list the major areas to be covered. 3. Each question should have a specific purpose for being included in the questionnaire. Why was it asked? What will be done with the information? 4. Quality of information will be maximised if. wording and sequence are designed to motivate the respondent and facilitate recall should be interesting (avoid questions which are difficult to answer, time-consuming, embarrassing or personally threatening) 5. Logical flow; from general to specific, impersonal to personal, easy to difficult 6. Respect for respondent's dignity and privacy 7. Ensure confidentiality
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Items in questionnaire should be categorised according to the information sought. Questions can elicit four types of responses:
1. Attitudes (what people say they want)
a. Should all abortions be outlawed? b. How do you feel about the legalisation of abortion? c. Do you agree or disagree with this statement "Anyone who wants an abortion should be able to get it"?
2. Beliefs (what people think is true)
a. Do you think that breastfeeding will prevent you from becoming pregnant?
3. Behaviour/ Practice (what people do)
a. Are you currently taking birth control pills? b. Have you ever had an abortion?
4. Attribute (what people are, their current status)
a. Are currently working? b. How many children do you have?
The purpose of the study should be clearly stated in order to decide whether the questions are to be used to tap attitudes, beliefs, behaviour or attributes.
Open-ended versus close-ended questions
Open-ended questions: leaves respondents free to answer in any way they choose.
Close-ended questions present respondents with a choice of possible answers.

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Advantages of open-ended questions:
Stimulate free thoughts, solicits suggestions from respondents, probe respondent's memories, clarifies certain issues.
Very useful for exploratory studies to find the most salient aspects of a topic, in preparation for developing questions in a later survey.
Disadvantages:
Respondent must recall past experience, reorganise them and find terms to express them. For respondents with low educational levels, they may have difficulty in answering such questions.
Probing is often necessary to avoid incomplete, uninterpretable or irrelevant answers.
Close-ended questions with ordered choices
Here answer choices are provided, with each choice a graduation of some thought or behaviour. The respondents has to find the most appropriate place in the spectrum for his response; e.g.;
a) How do you feel about this statement?
Strongly agree / agree / neutral / disagree / strongly disagree.
b) "No one should wait more than 15 minutes before being seen by a doctor in the emergency unit".
c) "Do you always come to the diabetic clinic for your follow-up?" (behaviour) Always / frequently / sometimes / rarely
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Advantages:
Responses are suited for may forms of statistical analysis.
Useful for determining the intensity of feeling, degree of involvement, frequency of participation.
Disadvantage:
Limited to the specific topic to be answered in a specific way and therefore faces the risk of missing important aspects not previously considered.
Close-ended questions with unordered responses
Here respondents must choose from a few discrete unordered categories and selecting the one that best reflects his situation.
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Data Analysis
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Data Analysis using SPSS Part 1 : Constructing tables and charts using SPSS
The data on hospital service quality is used to demonstrate the procedure for constructing tables and charts using SPSS.
In SPSS, the various types of graphs and charts are under the Graph command.
i)
Bar Chart for categorical variable
Plotting the bar chart to show the ethnicity of the respondents SPSS Command:- Graphs Bar Simple Push the selected variable into the category axis.
Plotting the bar chart to show the ethnicity of the respondents
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Result:
50
40
30
20
10
Percent
0 malay chinese iban bidayuh melanau others
race
ii)
Multiple Bar Chart for categorical variable
Plotting the bar chart to show the ethnicity of the respondents SPSS Command :- Graphs Bar Clustered Push the main variable into the Category Axis box and the secondary variable into Defined Clusters by box.
Plotting clustered bar chart using SPSS
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Result:
50
40
30
20
10
gender
male
Count
0 malay chinese iban bidayuh melanau others
female
race
Graphical presentation for continous data Histogram, Stem and Leaf, and Box plot for continuous variable are commonly used ghrapical presentation for continous data.
Patients assessment on The clinic staff behave professionally is used in the following illusttation. SPSS Command :- Analyze Descriptive Statistics Explore Push the selected variable into the dependent List box Click Plot tick Factor levels together, Stem and Leaf, and Histogram click OK.
Plotting histogram, stem and leaf plot, and box plot using SPSS
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Histogram
Stem-and-Leaf Plot
Frequency Stem & Leaf 1.00 Extremes (=<1.0) 6.00 2 . 000 .00 2. 15.00 3 . 0000000 .00 3. 56.00 4 . 0000000000000000000000000000 .00 4. 74.00 5 . 0000000000000000000000000000000000000 .00 5. 38.00 6 . 0000000000000000000 .00 6. 13.00 7 . 000000 Stem width: 1 Each leaf: 2 case(s)
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Box Plot
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1 0
N=
203
rq1
Constucting frequency distribution table for categorical data
Patients ethnicity is used in the following illustration. SPSS Command :- Analyze Descriptive Statistics Frequency Push the selected variable into the Variable(s) List box click OK.
Frequency distribution table using SPSS
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Results
Ethnicity Frequency 80 12 53 14 13 31 203 Percent 39.4 5.9 26.1 6.9 6.4 15.3 100.0 Valid Percent 39.4 5.9 26.1 6.9 6.4 15.3 100.0 Cumulative Percent 39.4 45.3 71.4 78.3 84.7 100.0
Valid
malay chinese iban bidayuh melanau others Total
Constructing frequency distribution table for continuous data The procedure involves two stages: Create the class interval Construct frequency table using class interval
Patients age is used in the following illustration.
The following table describes the range of the patients age.

Descriptive Statistics N age Valid N (listwise) 203 203 Minimum 18 Maximum 56 Mean 25.45 Std. Deviation 7.663
Patients age will be renamed as age category, where the categorization is done using the following classification less than 25 years. 25 less than 35 years 35 - less than 45 years Above 45 years
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Creating class interval SPSS Command :- Transform Recode Into Different Variables Push the selected variable into the Numeric Variable(s) box Give new name Click Old and New Values Define the values Click Continue Click OK
Constructing frequency distribution table
Patients age category is used in the following illustration.
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SPSS Command :- Analyze Descriptive Statistics Frequency Push the selected variable into the Variable(s) List box click OK.
Results
AGE CATEGORY Frequency 152 29 12 10 203 Percent 74.9 14.3 5.9 4.9 100.0 Valid Percent 74.9 14.3 5.9 4.9 100.0 Cumulative Percent 74.9 89.2 95.1 100.0
Valid
1.00 2.00 3.00 4.00 Total
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Part 2 : Inferential Statistical Test Chi-Square Goodness of fit using SPSS
Tthe management of Kuching General Hospital would like to know whether the proportion of female patients is about 50% of the total patient population. Based on the data collected, the customer service department test the following hypothesis.
The null hypothesis H0: The percentage of female patients in Kuching General Hospital is 50% of the total number of patients. The alternate hypothesis Ha: The percentage of female patients in Kuching General Hospital is NOT 50% of the total number of patients. SPSS Command : - Analyze Non Parametric Test Chi-Square Push the selected variables into the Test Variable(s) List box Select All categories equal under expected value Click OK.
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Results
gender male female Total Observed N 92 111 203 Expected N 101.5 101.5 Residual -9.5 9.5
Test Statistics Chi-Squarea df Asymp. Sig. gender 1.778 1 .182
a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 101.5.
Decision: The p-value is 0.182. Since the p-value is less than 0.05 (the ), the decision is not to reject the null. Thus there is not enough evidence to conclude that the percentage of female patients in Kuching General hospital is not 50% of the total number of patients.
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One sample t-Test Using SPSS
The one sample t-test will be used to test the mean age of the patients getting treatment at the Kuching General Hospital.
Step 1
The Null Hypothesis Ho : The mean age of the patients coming for treatment at Kuching General Hospital is at least 30. ( 30)
Step 2
The Alternate Hypothesis Ha : The mean age of the patients coming for treatment at Kuching General Hospital is less than 30. ( < 30)
Note : 30 is an arbitrarily selected value. SPSS Command :- Analyze Compare Means One sample Test Push the selected variables into the Test Variable(s) List box Define Test Value as 30 Click Options Select Confidence Interval as 95% Click Continue Click OK.
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Results:
One-Sample Statistics N age 203 Mean 25.45 Std. Deviation 7.663 Std. Error Mean .538
One-Sample Test Test Value = 30 95% Confidence Interval of the Difference Upper Lower -5.61 -3.49
age
t -8.463
df 202
Sig. (2-tailed) .000
Mean Difference -4.55
Decision: The mean age of the 203 patients is 25.45 years The p-value is 0.000 Since the p-value (0.000) is less than 0.05 (the ), the decision is to reject the null. Thus it can be concluded that the mean age of the patients coming for treatment at Kuching General Hospital is less than 30 years.
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Chi Square test comparing two groups using SPSS
The respondents for the survey consist of both male and female patients while their scorings on knowledge of hospital staff were grouped into two categories, 4 and below and greater than 4. The administrator of the hospital would like to know who gave better rating, male or female patients.
The null hypothesis H0: The percentage of female patients that gave a minimum score of 4 for hospital staffs knowledge is the same as the proportion of male patients that gave similar scores.
The alternate hypothesis Ha: The percentage of female patients that gave a minimum score of 4 for hospital staffs knowledge is NOT the same as the proportion of male patients that gave similar scores.
To test this hypothesis a two tailed test is required. Both the null and alternate hypothesis does not specify any direction (eg greater or less than).
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SPSS Command :-Analyze Descriptive Cross Tab Push the selected variables into the rows and Column List box Click Cells Tick Observed for counts and Column for Percentages Click Continue Click Statistics Select Chi-Square Click Continue Click OK.
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Results:
gender * Knowledge of Hospital Staff Crosstabulation Knowledge of Hospital Staff Minimum Score of score of 4 above 4 29 63 43.9% 37 56.1% 66 100.0% 46.0% 74 54.0% 137 100.0%
Total 92 45.3% 111 54.7% 203 100.0%
gender
male
female
Total
Count % within Knowledge of Hospital Staff Count % within Knowledge of Hospital Staff Count % within Knowledge of Hospital Staff
There is a difference in the proportion in the sample
Chi-Square Tests Value .075b .015 .075 df 1 1 1 Asymp. Sig. (2-sided) .784 .901 .784 Exact Sig. (2-sided) Exact Sig. (1-sided)
Pearson Chi-Square Continuity Correctiona Likelihood Ratio Fisher's Exact Test Linear-by-Linear Association N of Valid Cases
.881 .075 203 1 .784
.451
a. Computed only for a 2x2 table b. 0 cells (.0%) have expected count less than 5. The minimum expected count is 29.91.
P-value is 0.784 Since the p-value is greater than 0.05, there is not enough evidence to conclude that the percentage of female patients that gave a minimum score of 4 for hospital staffs knowledge is different from the proportion of male patients that gave similar scores. Thus it can be concluded that both the assessment by the male and female patients are similar.
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Chi Square test for comparing more than two groups using SPSS Referring to the scenario in 15.2.1, if the administrator of the hospital would like to know who gave better rating, Government servants, private sector employees, or students, the following hypothesis need to be tested
The null hypothesis Ho : There is no association between patients assessment on Hospital staffs knowledge and their employment..
The alternate hypothesis Ha: There is a significant association between patients assessment on Hospital staffs knowledge and their employment.
SPSS Command:- Analyze Descriptive Cross Tab Push the selected variables into the rows and Column List box Click Cells Tick Observed for counts and Row for Percentages Click Continue Click Statistics Select Chi-Square Click Continue Click OK.
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Results
Employment * Employees are knowledgable Crosstabulation Employees are knowledgable Satisfied Not Satisfied 5 13 27.8% 72.2% 12 29 29.3% 70.7% 49 95 66.0% 34.0% 66 137 32.5% 67.5%
Total 18 100.0% 41 100.0% 144 100.0% 203 100.0%
Employment
Goverment Private Students
Total
Count % within Count % within Count % within Count % within
Employment Employment Employment Employment
Chi-Square Tests Value .531a .539 .498 203 df 2 2 1 Asymp. Sig. (2-sided) .767 .764 .480
Pearson Chi-Square Likelihood Ratio Linear-by-Linear Association N of Valid Cases
a. 0 cells (.0%) have expected count less than 5. The minimum expected count is 5.85.
P-value is 0.767 Since the p-value is greater than 0.05, there is not enough evidence to conclude that the patients assessment on Hospital staffs knowledge and their employment are associated.
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Independent sample t-test using SPSS The independent sample t-test is used to compare the difference between two distinct groups (eg male and female) rating on particular phenomena.
The following table provides the mean score and standard deviation of respondents assessment on the knowledge of the hospital staff according to gender.
Knowledge of hospital staff Minimu m 1 2 Maximu m 7 7
N Mean Std. Deviation Male 92 4.87 1.233 Female 111 4.88 1.068
The null hypothesis Ho : There is no difference between the male and female respondents assessment on hospital staff knowledge.
The alternate hypothesis Ha: There is a significant difference between the male and female respondents assessment on hospital staff knowledge..
SPSS Command :- Analyze Compare Mean Independent Sample T-Test Push the selected variables into the Test Variable List box Push gender into the Grouping variable box Define Group (1 and 2 in this case) Click OK.
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Results
Independent Samples Test Levene's Test for Equality of Variances t-test for Equality of Means Mean Difference -.01 -.01
F Knowledge of hospital staff Equal variances assumed Equal variances not assumed 1.127
Sig. .290
t -.082 -.081
df 201 181.322
Sig. (2-tailed) .934 .935
Note: The independent sample t-test requires the assumption of equality of variance. However in the event this assumption cannot be fulfilled SPSS will perform some correction and compute the test value and associated probability value based on this correction.
In this example, the Levene Test provides evidence that the assumption of equality of variance is met. Thus the p-value of the first row will be used to test the research hypothesis.
Decision: The p-value is greater than 0.05, do not reject the null, there is not enough evidence to conclude the alternate There is no difference in the male and female respondents assessment on hospital staff knowledge.
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Paired T-Test using SPSS
As an initiative to create awareness regarding the services provided by the Kuching Genaral Hospital, the management organizes seminars to educate the public on the different types of services as well as the constrains faced by the hospital. Prior to the seminar a group of randomly selected patients were asked to assess the quality of services on 25 specific items among which knowledge of the staff is one of them. The same group of people were asked to assess again the service quality of the Kuching Hospital after attending the seminar. The following table provide the mean score and standard deviation of respondents, assessment on the knowledge of the hospital staff before and after attending the seminar.
Descriptive Statistics N Knowledge of staff (assessment before attending seminar) Knowledge of staff (assessment after attending seminar) Valid N (listwise) 203 Minimum 1 Maximum 7 Mean 4.88 Std. Deviation 1.143
203 203
4.00
7.00
6.1724
.67106
The null hypothesis Ho : There is no difference in the assessment on hospital staff knowledge before and after attending seminar.
The alternate hypothesis Ha: There is a significant difference in the assessment on hospital staff knowledge before and after attending seminar.
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SPSS Command :- Analyze Compare Means Paired Sample T Test Push the selected variables into the Test Pair(s) List box Click OK.
Results Paired Samples Statistics Mean Knowledge of staff (assessment before attending seminar) Knowledge of staff (assessment after attending seminar) N Std. Deviation 1.143 0.671
4.88 203 6.17 203
Paired Samples Test Paired Differences
Mean Knowledge of staff (assessment before attending seminar) Knowledge of staff (assessment after attending seminar) -1.2956
Std. Deviation 1.27500
t -14.480
df 202
Sig. (2-tailed) .000
Decision: The p-value is smaller than 0.025, reject the null and conclude the alternate hypothesis. There is a difference in the assessment on hospital staff knowledge before and after attending seminar.
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REPORT WRITING AND PRESENTATION
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Introduction Communicating the results of the survey is important. A useful survey that is not communicated is equal to incomplete work no matter how impressive the findings are. As far as a research work is concern, the research result is, and has to be communicated in a detail written report and presentation. Written report and presentation differs. In written report students are required to report every evidences and findings with discussions, an oral presentation stresses on the main concern providing information that clearly reveal what the audience wants to know at the end of the presentation.
The following diagram is a guidance to writing a proper research report and for presentation preparations. Problem definition, Approach, Research Data Analysis Interpretations, Conclusions, Report Preparation Oral Presentation
Figure 1: The report preparation and presentation
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Report Format For better organization of the report, it is suggested that the content is divided into 3 parts that are the preliminary pages, the contents and finally the references. For better understanding, please refer as follows:
PART I The preliminary pages i. ii. iii. iv. v. vi. vii. viii. ix. x. Title Page Acknowledgements Letter of transmittal Letter of authorization Table of contents List of tables List of graphs List of appendices List of exhibits Executive summary a. Major findings b. Conclusions c. Recommendations
In this first part of the report, the contents are as listed above. Each of the elements in this part must be paid equal attention as the actual content of the result because these few front pages are the pages which audience flips through before they concentrate on the other content. Particular clients may analyze these elements seriously as it plays role to elicit a good first impression of the whole research done.
Cover page. The title page should indicate what the study is all about besides including the information such as name, address and telephone about the researcher or organization conducting the research, the name that it is prepared for, and the date of the release.
Acknowledgements. Throughout the process, there are many parties who involved directly and indirectly contributing success to the research effort. These parties need to be acknowledged to appreciate their contributions apart as a motivation factor to gain their cooperation for future research.
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Table of contents. This page shows the list of the contents with reference pages. Table of content is necessary to inform of the topics covered in the whole research done. List of tables, List of graphs, List of appendices, List of exhibits are included in the table contents to help audience to refer to desired references as they go through the report.
Executive Summary. Executive summary must include the major finding, conclusion and recommendation, must be based on the whole report without any new material added and ideal length suggested by Ghauri and Gronhoug (2002) is three pages or 5 percent of the whole report. Executive summary is necessary to help busy managers to read through the report with comprehensive explanation of the overall findings.
In Part II of the report, the contents are presented into five main chapters. The second part of the report includes the elements as follows;
PART II The Contents Chapter 1: Introduction The Problem Definition Problem Statement Research Questions & Research Objectives Significance of the study Definition of terms Limitation of the Study Literature Review Literature review on past research Methods and Material Research Design Measurement Instrumentation Sampling
Chapter 2:
Chapter 3:
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Chapter 4:
Data Analysis and Findings Results Interpretations of data Conclusions and Recommendations Discussions on the findings Recommendation
Chapter 5:
Chapter One: Introduction The first chapter is basically the introductory part of the report. Here, the problem is defined, followed by the problem statement. The problem should be clearly defined as the clear problem statement tells researcher what to do next. Research questions should be address followed by research objectives. Without objectives, researcher will not have a clear direction of what the want to achieve towards the end of the day. It also serves as a measure to indicate if the research has been successfully conducted and proven to achieve the objectives stated. Significance of the study stresses the importance of the study. Definition of terms lists the terms and short explanation to familiarize with the terms used in the report. Limitation of the study can also be included here.
Chapter Two: Literature Review In this chapter, the theoretical background of the problem area as well as the study is presented with reference to the related literature. There has to be proper reasoning on the findings with the help of prior studies and findings.
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Chapter Three: Methods and Material Here, the researcher is informing the reader of research design, measurement, instrumentation and the sampling used in the research. The research designs, exploratory, descriptive or causal would suggest whether to use qualitative or quantitative methods for data collections and analysis. Instrumentations is another important element to inform the sources where the measurement is obtained or data adopted from. The number of respondents and who are the respondents is also explained in this chapter.
Chapter Four: Data Analysis and Finding Among all, this is the integral part of the report as in this chapter the researcher or writer will be revealing the results with the interpretations of the findings. Data can be analyzed using the suitable software such as SPSS. Data can be presented in many forms. Tables and charts are among the most frequently used tools to present the results. The results will be properly and meaningfully interpreted to yield interesting findings. The findings are discussed in relation to theories and past research findings.
Chapter Five: Conclusions and Recommendations Chapter five is the final chapter. Discussions of findings are usually done here, either is supporting the findings of previous study or otherwise before the writer can come up with a conclusion. The writers biases and desires should not influence the conclusions. Recommendations are usually provided as well. These recommendations may come from the researchers idea on how the decision maker should address the problem and make their decisions to overcome the problem at hand. The final part, Part III, of the report is the references. This section normally includes the list of references, a sample of questionnaire and other supportive documents for the readers reference. Many have problems writing the references using the right format following the types of sources; journals, periodicals, books or articles. One may choose to use the common referencing format such as APA and Harvard system.
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PART III References i. Appendices (list of references) ii. Sample of questionnaire
Principles of Report Writing
Report writing process is done based on a few principles and guidelines. Report is written to provide clear understanding of the problem an organization is facing. The following criteria should be emphasized when writing a good report:
i. Audience The best reports are those that are written with particular audiences in mind. First, it must be in consideration that who will read the report and it highlights the importance of the executive summary.
ii. Clarity Without clarity, the report can be meaningless and a waste of effort. Research are conducted for various purposes and if the written report by researchers are not clear to tell the story of the actual situation, decision makers may end up making wrong decisions.
iii. Simplicity Language used should be kept simple but comprehensive. Using difficult words or specific jargons should be avoided to ensure the report is well understood by all. Avoid including unnecessary information. In fact, reports are not judged according to their length. The quality counts.
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iv. Organized The report format must be in sequence to show the direction of the research conducted. Each element must be organized and discussed accordingly. Tables and graphs should be used to visualize the result. The appearance should also be presentable and shows professionalism in the work.
v. Tenses Wrong usage of tenses can be confusing as well. The tenses should be consistent throughout where record of the past should be written in past tense. Present tense is used in the discussions of the general truth or referring readers to the tables or figures.
vi. Check A good written report needs to be read through and re-check by other persons to avoid mistakes that might be overlooked by the writers. Re-checking is useful as the content of the report is understood as the way it is intended. For example, if the reader interprets the discussions in the report wrongly, it shows that the discussions or words use might not be suitable to reflect the actual meaning that the author trying to convey to the audience.
Oral Presentation One of the most satisfying things in research is completing a proper research work using good methodology, correct analysis of data, valid findings and proper conclusions. Oral presentation of the report is not of less importance as presentation help to highlight the results of the lengthy report. Normally, the presentation of good report will take up to fifteen to twenty minutes. The time is just enough to cover important findings and results. Presenting the research results might be very challenging, especially between keeping the audience to listen attentively and delivering the right results and facts. Presenter tend to get carried away if he or she gets too excited and lose focus of the actual purpose why oral presentation of the research report is done. Great ideas have no value unless it is communicated well to its audience.
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There are many other factors to consider in making the presentation impressive while to keep audience interested includes the presenter dressing, voicing projection and tone variations, selection of words, speed of talking, eye contact, and use of visual aids. In fact, most oral presentations are graded on content and its delivery. Content refers to the quality, logical flow of the presentation, appropriateness, avoidance of generalities, and absence of mistakes. Delivery on the other hand concerns on the audience attentiveness, clarity of visual aids, appropriate appearance, persuasiveness of arguments and body language. Audience rejects psychologically presentations whose presenter with monotonous voice like as if he or she is reading out the text. Due to that, being spontaneous without losing focus requires a very good preparation and rehearsals before the presentation takes place. The following are some tips for effective presentation.
Principles of Oral Presentation
i. Preparation Nothing comes perfect and that highlights the need of preparations of the oral presentation. Preparation helps presenter to plan what to say, when to speak, when to answer questions, how to control the situation, how to use the visual aids and how to attract attention of the audience. Planning the whole presentation not only will make the presentation to run smooth. Good planners always have a back up plan. For example, if the slide projector is not working, the back up plan is to refer on the hand outs or transparencies to enable the presenter to proceed with the presentation despite the failure of the technical support.
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ii. Organizing the content The presenter should introduce themselves and appropriately address the audience when starting the presentation. It will be useful to provide a clear outline of what is going to be presented in the following 15 or 20 minutes. Not only it will make the presentation more directional, it helps audience to have the idea of the presentation is all about. Keep it short and simple as the purpose is to only provide a brief idea of the whole presentation.
iii. Voice Voice projection must be reasonably clear but shouting have to be avoided. If microphone is provided, the amount of sound have to be controlled where the presenter need not to speak too loud. Voice variation is necessary when stressing the important points. The speeds of the words uttered have to be in control as well. If people speaks too fast and tend to repeat words, it shows that they are nervous and the voice projection can be a disaster.
iv. Body Language Body language speaks louder than what a person is saying. Therefore, showing positive posture will show off confidence during the presentation. The gestures should be appropriate according to the purpose. For example, a descriptive gesture is used to clarify or enhance verbal communication whereas an emphatic gesture is suitable when emphasizing what have been said. On the other hand, a prompting gesture is essential for eliciting a desired response from the audience.
Having a good eye contact is extremely important. This is one of the best ways to persuade the audience. Maintaining good eye contact is believed to be useful for the presenter to gain continual commitment from audience for the whole session of the presentation. Above all, the sense of humor is helpful to keep the boredom away.
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v. Language Terms and terminologies are sometimes necessary to be used though avoiding research jargons are recommended. Therefore, if these terms and difficult words need to be used, it must then be explained. Avoid using short forms and filler words. Simple words should be used to ensure the delivery of information is free of confusion and misunderstanding.
vi. Time management Presentation that takes too long may distract audience interest and have the high tendency of unnecessary contents. Presenters should manage their presentation time by allocating periods of each topic presented. For example, the allocation of time for a 20-minutes presentation can be as follows: Objective and research question with relation to past studies and importance 3 minutes How the study is carried out, sources and arguments 2 minutes Findings and conclusion 10 minutes Questions and answers 5 minutes
vii. Visual aids Visual aids facilitate good understanding. Tables and graphs should be used to help listeners to see the whole picture and make quick comparisons and evaluations. Evaluating the result themselves during the presentation and make direct comparison is harder if they were to do it themselves, given the short time.
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Rules and Regulation
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GUIDELINE ON PORTFOLIO WRITING & ASSESSMENT
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1.
A copy of the report of the portfolio shall be submitted to the Department of Community Medicine within FOUR weeks of completion of the fieldwork.
2.
Use the format given BELOW in preparing the portfolio.
SECTION 1 Clinic Visit Introduction to the Health Care System in Malaysia. Description of the health clinic (Organisational Structure etc). Roles and responsibilities of the staff at the clinic. Primary and extended health care provided at the clinic. Reflection on the clinic visit (what did you learn, etc)
SECTION 2 Household Survey Introduction to the kampung or village the survey done. Desription of the household survey (Purpose, Research Objectives, Significance etc) Methods and Material Findings Discussion Conclusion &Limitation
SECTION 3 Research Project Introduction . Literature review Methods and Material Findings Discussion Conclusion &Limitation
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Example : Front Cover Format
60 mm
COMMUNITY HEALTH VISIT HULU BERNAM SELANGOR Date :
Group Members Name: 1. Tan xxx xxx 2. Mohd xxx 3.
MBBS PHASE 1 DEPARTMENT OF COMMUNITY MEDICINE INTERNATIONAL MEDICAL UNIVERSITY
60 mm
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Evaluation
Field Visit
Name : _________________________________ Student ID : _________________________
Group Leader Rating Criteria Attendance Participation Motivation Communication Skills Teamwork Leadership 1 2 3 4 5 Total Score
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Portfolio
Criteria Clinic Visit Introduction to the Health Care System in Malaysia. Description of the health clinic (Organisational Structure etc). Roles and responsibilities of the staff at the clinic. Primary and extended health care provided at the clinic. Reflection on the clinic visit (what did you learn, etc) Total Household Survey Introduction to the kampung or village the survey done. Desription of the household survey (Purpose, Research Objectives, Significance etc) Methods and Material Survey Findings Discussion Conslusion &Limitation Reflection Total Research Project Introduction (Purpose, Research Objectives, Significance etc) Methods and Material Survey Findings Discussion Conslusion &Limitation Reflection Total
Marks
Score Remarks
10 20 20 30 20 100
10 20 10 20 20 10 10 100
10 20 30 20 10 10 100
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Presentation
Criteria Presentation Planning of Presentation Sequance Communication Discussion Audio and Visual Aids Total
Marks
Score
Remarks
10 20 20 30 20 100
Overall Evaluation Marks Distribution i) Participation in the Field Visit : 30% ii) Portfolio and presentation : 70%
Areas of assessment Presentation Clinic Visit House Hold Survey Mini Health Research Presentation Total
Weight
Score
Remarks
20 30 30 20 100
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Appendix 2 : Example of Instrument for Health Related Research
1)
Research on Hypertension
1 Id No.: 2 Place Data Collected: A. Socio Demographic Data 3 Age: 4 Gender: 5 Ethnicity: 6 Education Level: 7 Household Income: 8 Marital Status: 9 Occupation: 10 Smoking Status: 11 Alcohol Intake: B. Examination Results 12 BP reading: First: Latest: 13 Height: 14 Weight: 15 BMI:
Month/Year Month/Year
Reading Reading
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16 Waist circumference: 17 Fundoscopy: C. Laboratory Test Results 18 FBC: 19 Urinalysis: 20 Lipid Profile: D. Management 21 (a) Non Pharmacological Yes Weight reduction Decrease sodium intake Reduce alcohol intake Stop Smoking Healthy Eating Increase Physical exercise 22 (b) Phramacological Yes Diuretics blockers ACE Inhibitors Others No No
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Research on Pap Smear 1 Id No.: 2 Place Data Collected: A. Socio Demographic Data 3 Age: 4 Ethnicity: 5 Education Level: 6 Occupation: 7 Household Income: 8 Marital Status: 9 Smoking Status: 10 Alcohol Intake: 11 OCP Usage: 12 No. of Pregnancies: 13 FH of Cx Cancer: B. Pap Smear Result 14 First pap smear taken:
14(a) Year 15 Latest pap smear taken: 15(a) Year 16 Total no. of pap smears taken:
Result
Result
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C. Physical Examination 17 Height: 18 Weight: 19 BMI:
Research on Breastfeeding
1 Id No.: 2 Place Data Collected: 3 Age of Infant: A. Socio Demographic Data 4 Date of Birth: 5 Ethnicity: 6 Education Level: 7 Occupation: 8 Household Income: 9 Marital Status: B. Obstetric History 10 Place of Delivery: 11 Parity: 12 Mode of delivery:
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13 Attend B/F Class: 14 Intention to B/F: C. Infant History 15 Gender: 16 Birth Weight: 17 Gestational Age: D. Breastfeeding Practice 18 Ever breastfed: 19 Exclusive breastfed for 1 month: 20 Exclusive breastfed for 3 months: 21 Exclusive breastfed for 6 months:
Research on Child Disability
1 Id No.: 2 Place Data Collected: A. Type of Disability 3 Type of Disability 4 Age of Diagnosis B. Data on Child 3 Date of Birth: 4 Ethnicity:
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5 No. of Children in Family: 6 Order of Child in Family: C. Data on Father 7 Ethnicity: 8 Education Level: 9 Occupation: 10 Household Income: 11 Smoking Status: 12 Alcohol Intake: D. Data on Mother 13 Ethnicity: 14 Education Level: 15 Occupation: 16 Smoking Status: 17 Alcohol Intake: E. Management of Child 18 Was Denver Chart Used: 19 Was Reassessment Done: Was Child Referred to 20 Hospital:
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Research on Child Disability
1 Id No.: 2 Place Data Collected: A. Socio Demographic Data 3 Age: 4 Gender: 5 Ethnicity: 6 Education Level: 7 Occupation: 8 Household Income: 9 Marital Status: 10 Alcohol Intake: B. Smoking History 14 Years of Smoking: 15 Cig. Smoked per Day: 16 Ever Tried to Quit Smoking: C. Physical Examination 17 Height: 18 Weight: 19 BMI:
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Appendix 1
Example of Household Survey Instrument A. SOCIO-DEMOGRAPHY A1. The household: Wife/Husband Child Father/ Mother Others A2. Sex: Male Female A3. Age (completed years): A4. Ethnicity: Malay Chinese Indian Others A5. Marital status: Single (never married) Married Divorced/Separated Widow A6. Education level: Primary Secondary Tertiary (Diploma/Degree) A7. Literacy level: Literate Semi-literate Illiterate 1 2 3 1 2 3 B2. Material used in wall construction: Brick Wood Brick and wood Others 1 2 3 9 1 2 3 4 B. HOUSING B1. Type of house: Bungalow Semi-detached Terrace Apartment Others 1 2 3 4 9 C3. What is the main protective measure used against mosquitoes: Personal measures Environmental measures Insecticide s A combination None 1 2 3 4 5 C2. Do you take any steps to Yes No overcome this problem: 1 2 1 2 3 9 A11. No. of members in household: Yes No 1 2 1 2 3 4 A8. Occupation Pensioner Professional Self employed Skilled manual/Clerical Unskilled manual Housewife Unemployed Student 1 2 3 4 5 6 7 8 B4. Availability of electricity: Yes No 1 2 B3. No. of bedrooms in the house:
B5. Availability of piped water supply: Yes No 1 2
A9. Monthly household income (RM): A10. Type of family: Nuclear Extended Others 1 2 9
B6. Availability of proper sewage system: Yes No C. VECTORS AND PESTS C1. Is any vector or pests a problem in and around the house: 1 2 1 2
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D. WORKING ENVIRONMENT (Head of household on current occupation) D1. What is your current field of work: Agricultural Manufacturing Office Services Retired Unemployed Others D2. Who is your employer: Government Private Self Not applicable D3. No. of years in this field: E5. If 'yes', how many members in D4. Are yo aware of the risk related to your work: Yes No D5. Have you ever suffered from work related sickness or injury: Yes No E. FOOD, NUTRITION and HEALTH E1. Do you have knowledge on health lifestyle and a balanced diet: Yes No 1 2 E9. Breastfeeding practice: Exclusive breastfeeding Mixed breastfeeding Infant formula 1 2 3 1 2 1 2 E7. How many cigarettes smoked a day: E8 - E12 (Wife of head of household regarding youngest child) E8. How old is your youngest child (months): Private clinic Traditional medicine Others F2. If you are sick, do you seek Yes No medical massistance: 1 2 E6. How many years smoked: the household that smokes: F. HEALTH SEEKING BEHAVIOUR F1. Do you know where is the nearest clinic from the house: Yes No 1 2 1 2 3 9 E4. Anyone in the household that Yes No smokes: 1 2 1 2 3 4 5 6 9 E3. Anyone in the family suffers from a chronic disease: (diabetes, hypertension, CV disease) Yes 1 No 2 E2. Do you emphasise on a balanced diet: Yes No E11. If you failed to breastfeed, what is the main reason: Insufficient milk Mother is working Mother is pregnant Infant formula available Inconvenience to mother Child prefers formula milk Child not staying with mother Child taking solid food Other reasons 7 8 9 1 2 3 4 5 6 E10. If breastfed, how long did you breastfeed for (months):
F3. Where do you normally seek medical assistance: Government clinic 1 2 3 9
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Operational Definitions: Head of household: As identified by the household members or the main person who makes major decisions for the household or its members. Household: A group of person who live together and make common provision for food and other essentials of living. The people in the group may be related or unrelated or a combination of both. A household may consist of only one person or it may be a multi member household. (A3) Age: The actual age in number of completed years of age at last birthday. (A4) Ethnicity: If parents are of mixed ethnicity, to follow the same ethnicity as the father. (A7) Literacy level: Literate - able to read a newspaper and write a simple letter in any one language. Semi-literate - Able to read but not able to write. Illiterate - Not able to read or write. Infant formula - As having received liquid or semi-solid food from a bottle with a nipple/teat. (A8) Occupation: Professional - doctor, lawyer, architect, etc. Less professional - manager, shopkeeper, teacher, etc. Skilled Manual & Clerical - secretary, electircian, mechanic, farmer, machinist, carpenter, etc. Unskilled Manual - labourer, driver maid, etc. (A10) Type of family: Nuclear - immediate family of parents and children. Extended - family of more than two generations, e.g. grandparents and in-laws. (B4) Piped water Proper water supply given by the water supply authoroties e.g. JBA. Water is safe to consume. (C) Vector or pest They include mosquitoes, lizard, fly, rat, termites, ants and cockroach. (C3) Protective measures: Personal measures - measures taken by the individual to protect from being directly affected (bitten) by the pest or vector. Environmental measures - measures taken by the household to eliminate/ reduce the presence of vectors/ pests in the house and its vicinity. Insecticides - Include aerosal spray, mosquito coils and electrical devices. E10 Breastfeeding practice Exclusive - As having received only breast milk from the mother, or expressed breast milk, and no other liquids or solids with the exception of drops or syrups consisting of vitamins, mineral supplements or medicines. Mixed - As having received both breast milk and solid or semi-solid food together with formula milk.
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INTERNATIONAL MEDICAL UNIVERSITY MALAYSIA

Bachelor of Medicine & Bachelor of Surgery

Study Guide (13 February 24 February 2012)

INTERNATIONAL MEDICAL UNIVERSITY

UNIVERSITI PERUBATAN ANTARABANGSA

COMMUNITY FIELD VISIT PROGRAMME

Professor Dr. Hematram Yadav Head of Department, Department of Community Medicine

Community Field Visit Planning

Developing the theoretical framework

Research design formulation

Data preparation and analysis

Report writing and presentation

Stages of an investigation 1. a) Preliminary Steps: Determining the purpose of the study

Formulating the topic

Formulate study objectives

List the variables

1) Independent variable refers to the "cause".

a) Selecting the study population

Advantages of secondary data:

Procedures for collecting secondary data

Disadvantages: Response may be affected by interviewer Reliability

II. Self-Administered Questionnaires

1. Attitudes (what people say they want)

2. Beliefs (what people think is true)

3. Behaviour/ Practice (what people do)

4. Attribute (what people are, their current status)

a. Are currently working? b. How many children do you have?

Open-ended versus close-ended questions

Close-ended questions present respondents with a choice of possible answers.

Advantages of open-ended questions:

Probing is often necessary to avoid incomplete, uninterpretable or irrelevant answers.

Close-ended questions with ordered choices

a) How do you feel about this statement?

Strongly agree / agree / neutral / disagree / strongly disagree.

Responses are suited for may forms of statistical analysis.

Close-ended questions with unordered responses

Bar Chart for categorical variable

Plotting the bar chart to show the ethnicity of the respondents

0 malay chinese iban bidayuh melanau others

Multiple Bar Chart for categorical variable

Plotting clustered bar chart using SPSS

0 malay chinese iban bidayuh melanau others

Constucting frequency distribution table for categorical data

Frequency distribution table using SPSS

malay chinese iban bidayuh melanau others Total

Patients age is used in the following illustration.

The following table describes the range of the patients age.

Constructing frequency distribution table

Patients age category is used in the following illustration.

1.00 2.00 3.00 4.00 Total

Part 2 : Inferential Statistical Test Chi-Square Goodness of fit using SPSS

Test Statistics Chi-Squarea df Asymp. Sig. gender 1.778 1 .182

One sample t-Test Using SPSS

Sig. (2-tailed) .000

Mean Difference -4.55

Chi Square test comparing two groups using SPSS

Total 92 45.3% 111 54.7% 203 100.0%

There is a difference in the proportion in the sample

.881 .075 203 1 .784

Total 18 100.0% 41 100.0% 144 100.0% 203 100.0%

Goverment Private Students

Count % within Count % within Count % within Count % within

Employment Employment Employment Employment

Name : _________ Student ID : _