ADHERENCE TO CUPPING PRACTICE GUIDELINES AMONG CUPPING PRACTITIONERS IN MALAYSIA
DOI:
https://doi.org/10.61841/5ks98074Keywords:
adherence, bekam, cupping, practice guideline,, MalaysiaAbstract
--Bekam (or cupping) practice guideline has been published by Traditional and Complementary Medicine Division Ministry of Health Malaysia, first edition of 2011, mainly to focus on proper handling of patients and clinical wastes to ensure safety of both practitioners and patients, in supplementary of optimizing patient care. This cupping practice guideline covers treatment criteria, treatment procedures, documentations and practice facilities. However, there is a scarce research revealing this issue as currently there are profuse emergences of blood borne infection diseases such as HIV/AIDS, Hepatitis B and C due to its invasiveness. Therefore, this study aimed to determine adherence towards practice guidelines among cupping practitioners in Malaysia, as well as to identify factors associated with it. A cross sectional study with random sampling was conducted among 114 cupping practitioners from all over Malaysia using self-administered adherence to practice guideline questionnaire, which consisted of 18 items with 5 Likert scales ranging from “never” to “very often”. “Adherence to practice guideline” in this study is defined as practitioners who scored 90 marks to all 18 components of standard precautions in practice guidelines with cut-off point of 90. The mean age was 38 years old with majority of them were male (64.9%), Malay (99.1%), degree holder with various background (27.8%) and part timer (69.9%). Mean duration of working experience was 4 years. A total of 45.6% of respondents attended cupping training from as short as 1 day to 3 years in getting their certificate. Adherence to practice guideline among respondents was 5.3%. The highest adhered practice was wearing gloves during treatment (86.0%), while the lowest was documenting the estimated amount of blood that was released during cupping (19.4%). Multiple linear regression revealed part timers were less adhered to practice guideline as compared to full timers (P<0.001), and higher education (PhD, master and degree) were significantly higher in adherence score as compared to primary and secondary school leavers (P=0.001). Although Malaysian practitioners have lower adherence towards practice guidelines, they practiced well in most of the adherence components per se. Specific measures addressing those issues should be disseminated and implemented to augment the adherence towards practice guidelines.
Downloads
References
1. Tradisional BP. Garis Panduan Amalan Perubatan Tradisional & Komplementari : Bekam. 2013.
2. Jadhav DK. Cupping Therapy : An Ancient Alternative Medicine. J Phys Fitness, Med Treat Sport. 2018;3(1):1–4.
3. El-shanshory M, Hablas M, Shebl Y, Fakhreldin R, Attia M, Ayat M, et al. Al-hijamah ( wet cupping therapy of prophetic medicine ) significantly and safely reduces iron overload and oxidative stress in thalassemic children : a novel pilot study. J Blood Med. 2018;241–51.
4. Institute for Public Health (IPH). National Health & Morbidity Survey (NHMS 2015) Traditional & Complimentary Medicine. Vol. Volume IV, Ministry of Health. 2015.
5. Shaneyfelt TM, Mayo-smith MF, Rothwangl J. Are Guidelines Following Guidelines ? The Methodological Quality of Clinical Practice Guidelines in the Peer-Reviewed Medical Literature. Am Med Assoc. 1999;281(20):1900–5.
6. Lugtenberg M, Burgers JS, Besters CF, Han D, Westert GP. Perceived barriers to guideline adherence : A survey among general practitioners. BMC Fam Pract. 2011;12(98).
7. Ament SMC, Groot JJA De, Maessen JMC, Dirksen CD, Weijden T Van Der, Kleijnen J. Sustainability of professionals ’ adherence to clinical practice guidelines in medical care : a systematic review. BMJ Open. 2015;
8. Haile TG, Engeda EH, Abdo AA. Compliance with Standard Precautions and Associated Factors among Healthcare Workers in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia. J Environ Public Health [Internet]. 2017/01/16. 2017;2017:2050635. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28191020
9. Al-yousef HM, Wajid S, Sales I. Knowledge , attitudes , and perceptions of cupping therapy ( CT ) in Saudi Arabia-a cross-sectional survey among the Saudi population . Biomed Res. 2018;29(January):3351– 5.
10. Kim T, Hyung K, Choi J, Soo M. Adverse events related to cupping therapy in studies conducted in Korea : A systematic review. Eur J Integr Med [Internet]. 2013;1–7. Available from: http://dx.doi.org/10.1016/j.eujim.2013.06.006
11. Malaysia M of H. Traditional and Complementary Medicine (T&CM) Act. 2015.
12. Yousafzai MT, Janjua NZ, Siddiqui AR, Rozi S. Barriers and Facilitators of Compliance with Universal Precautions at First Level Health Facilities in Northern Rural Pakistan. Int J Health Sci (Qassim). 2015;9(4):389–99.
13. Mcgovern PM, Vesley D, Kochevar L, Gershon RRM, Rhame S, Anderson E. Factors Affecting Universal Precautions Compliance. 2000;15(1):149–61.
14. Chang DTS, Lai NM, Ng NSQ, Ho WP, Tan TY, Chua J, et al. Adherence To Major Standard Precautions : An Audit Of Venepuncture And Intravenous Cannula Insertion In The Paediatric Unit Of Hospital Sultanah Aminah , Johor Bahru. Malaysian J Paediatr Child Heal. 2012;
15. Luo Y, He GP, Zhou JW, Luo Y. Factors impacting compliance with standard precautions in nursing, China. Int J Infect Dis [Internet]. 2010;14(12):e1106–14. Available from: http://dx.doi.org/10.1016/j.ijid.2009.03.037
16. Report A. Traditional an Complementary Division (T&CMD) Annual Report 2015. 2015.
17. Chirali IZ. What to Expect During and after Cupping Therapy. Tradit Chinese Med Cupping Ther Third Ed. 2014;87–90.
18. Sudhakar V, Chandrashekar J. Dental health care waste disposal among private dental practices in Bangalore City, India. Int Dent J. 2008;58(1):51–4.
19. Razali SS, Ishak MB. Clinical waste handling and obstacles in Malaysia. J Urban Environ Eng. 2010;4(2):47–54.
20. Beyamo A, Dodicho T, Facha W. Compliance with standard precaution practices and associated factors among health care workers in Dawuro Zone , South West Ethiopia , cross sectional study. BMC Health Serv Res. 2019;4:4–9.
21. Aziz NA, Rahman AA, Othman N. Knowledge of blood-borne infectious diseases and the practice of universal precautions amongst health-care workers in a tertiary hospital in Malaysia. Southeast Asian J Trop Med Public Health. 2010;(September).
22. Nazli SN, Karuppannan S, Omar D. Knowledge and Awareness of Clinical Waste Management among Medical Practitioners in Hospital Batu Pahat, Johor. Int J Innov Manag Technol. 2014;5(2):5–8.
23. T&CM Division. Annual Report 2011 T&CM. 2011.
24. Kermode M, Jolley D, Langkham B, Thomas MS, Holmes W, Gifford SM. Compliance with Universal/Standard Precautions among health care workers in rural north India. Am J Infect Control. 2005;33(1):27–33.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.