Displaying publications 1 - 20 of 39 in total

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  1. Sattar K, Yusoff MSB, Arifin WN, Mohd Yasin MA, Mat Nor MZ
    Med Educ Online, 2023 Dec;28(1):2165892.
    PMID: 36621960 DOI: 10.1080/10872981.2023.2165892
    BACKGROUND: Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.

    METHODS: We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.

    RESULTS: From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.

    CONCLUSION: The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.

  2. Zakaria SF, Shafei MN, Arifin WN
    Cureus, 2023 Sep;15(9):e44742.
    PMID: 37809199 DOI: 10.7759/cureus.44742
    INTRODUCTION: Occupational safety and health are of utmost importance in the palm oil industry, particularly in Malaysia where palm oil plantation workers face various hazards. This study aimed to translate and validate a risk perception questionnaire specifically designed to assess the perceptions of safety and health risks among palm oil plantation workers in Terengganu, Malaysia.

    METHODOLOGY: The original risk perception questionnaire, consisting of 22 items, was translated into the local language and culturally adapted. The translation process involved forward translation, expert panel discussions, and back translation to ensure linguistic equivalence. The translated questionnaire was then administered to a sample of palm oil plantation workers in Terengganu, Malaysia, for validation purposes. Confirmatory factor analysis (CFA) was conducted to assess the model fitness of the questionnaire, and Cronbach's Alpha coefficient was calculated to determine the internal consistency reliability of the final model.

    RESULTS: The translated risk perception questionnaire demonstrated good model fitness as indicated by CFA results (X2=224, df=79, p-value<0.0001, root mean square error of approximation (RMSEA)=0.07, goodness of fit index (GFI)=0.929, comparative fit index (CFI)=0.902). The questionnaire's final version has one factor comprising 13 items, selected based on factor loadings and theoretical relevance. The internal consistency reliability of the 13-item questionnaire was satisfactory, with a Cronbach's Alpha coefficient of α=0.77.

    CONCLUSION: The 13-item risk perception questionnaire demonstrated a good model fit and acceptable internal consistency reliability. It shows that the questionnaire is a valid and reliable tool to evaluate the level of risk perception on safety and health among palm oil plantation workers in Malaysia.

  3. Goni MD, Hasan H, Naing NN, Wan-Arfah N, Deris ZZ, Arifin WN, et al.
    J Immigr Minor Health, 2023 Aug;25(4):870-881.
    PMID: 36695987 DOI: 10.1007/s10903-022-01443-4
    This study was aimed at demonstrating the impact of a health education intervention on reducing the incidence of influenza-like illnesses symptoms among Malaysian Hajj pilgrims. This study utilizes a quasi-experimental study in the evaluation of the impact of the intervention. Participants were recruited during Hajj orientation courses organized by private Hajj companies. Participants from two companies were assigned to an intervention group and control group, respectively. The intervention group received a smartphone-based health education intervention guided by the Health Belief Model (HBM), while the control group received a regular Hajj guide intervention smartphone application before departure to Hajj. Data on the incidence of influenza-like illnesses (ILI) were collected from participants from two Hajj companies before and after returning from Hajj. Data analysis was conducted using SPSS with descriptive analysis, and analytical tests were conducted at 5% significance level. A total of 102 pilgrims completed the study in both intervention and control groups. The incidence of ILI and Non-ILI symptoms were statistically significant when the intervention and control groups (p = 0.049) were compared. In conclusion, health education has an impact on reducing the incidence of ILI and non-ILI among Hajj pilgrims.
  4. Norsa'adah B, Yaacob NM, Abdullah S, Kueh Yee C, Ab Hamid SA, Ghazali AK, et al.
    Malays J Med Sci, 2023 Feb;30(1):1-6.
    PMID: 36875186 DOI: 10.21315/mjms2023.30.1.1
    Health and medical research are important parts of the curriculum of medical and health programmes in universities and play an important role in the functioning of organisations related to health care. There is a shortage of well-trained health and medical research statisticians. This article describes the courses and structure of the Master of Science in Medical Statistics programme at Universiti Sains Malaysia (USM), as well as the graduates' achievements. It is a 2-year programme that prepares qualified and competent graduates in statistical methods and data analysis for research in health and medical sciences. The Biostatistics and Research Methodology Unit, School of Medical Sciences, USM has been running the programme since 2003. It is currently the only medical statistics programme available in Malaysia. There have been 97 graduates since 2005, with an employment rate of 96.7% and a successful subsequent doctorate rate of 21.1%. Most of the students returned to their previous employments, mainly with the Ministry of Health of Malaysia and several others became lecturers, statisticians or research officers. The employability of graduates from this programme is very high and their professional future is bright. We hope our graduates will impart their knowledge and skills to the nation.
  5. Hanis TM, Arifin WN, Musa KI, Rodzlan Hasani WS, Che Nawi CMNH, Shahrani SA, et al.
    Malays J Med Sci, 2022 Dec;29(6):123-131.
    PMID: 36818910 DOI: 10.21315/mjms2022.29.6.12
    BACKGROUND: Understanding the risks of COVID-19 mortality helps in the planning and prevention of the disease. This study aimed to determine the risk factors for COVID-19 mortality in Malaysia.

    METHODS: Secondary online data provided by the Ministry of Health, Malaysia and Malaysia's national COVID-19 immunisation programme were used: i) COVID-19 deaths data; ii) vaccination coverage data and iii) population estimate data. Quasi-Poisson regression was performed to determine the risk factors for COVID-19 mortality.

    RESULTS: Four risk factors were identified: i) vaccination status (partial versus unvaccinated, incidence rate ratio [IRR]: 0.59; 95% CI: 0.54, 0.64; complete versus unvaccinated, IRR: 0.50; 95% CI: 0.45, 0.56; booster versus unvaccinated, IRR: 0.13; 95% CI: 0.05, 0.26); ii) age group (19 years old-59 years old versus above 60 years old, IRR: 0.90; 95% CI: 0.84, 0.97; 13 years old-18 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.04, 0.19; 6 years old-12 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.03, 0.22; below 5 years old versus above 60 years old, IRR: 0.11; 95% CI: 0.04, 0.23); iii) gender (male versus female, IRR: 1.23; 95% CI: 1.14, 1.32) and iv) comorbidity (yes versus no, IRR: 2.13; 95% CI: 1.96, 2.32).

    CONCLUSION: This study highlighted the risk factors for COVID-19 mortality and the benefit of COVID-19 vaccination, especially of booster vaccination, in reducing the risk of COVID-19 mortality in Malaysia.

  6. Arifin WN, Yusof UK
    Diagnostics (Basel), 2022 Nov 17;12(11).
    PMID: 36428900 DOI: 10.3390/diagnostics12112839
    In medical care, it is important to evaluate any new diagnostic test in the form of diagnostic accuracy studies. These new tests are compared to gold standard tests, where the performance of binary diagnostic tests is usually measured by sensitivity (Sn) and specificity (Sp). However, these accuracy measures are often biased owing to selective verification of the patients, known as partial verification bias (PVB). Inverse probability bootstrap (IPB) sampling is a general method to correct sampling bias in model-based analysis and produces debiased data for analysis. However, its utility in PVB correction has not been investigated before. The objective of this study was to investigate IPB in the context of PVB correction under the missing-at-random assumption for binary diagnostic tests. IPB was adapted for PVB correction, and tested and compared with existing methods using simulated and clinical data sets. The results indicated that IPB is accurate for Sn and Sp estimation as it showed low bias. However, IPB was less precise than existing methods as indicated by the higher standard error (SE). Despite this issue, it is recommended to use IPB when subsequent analysis with full data analytic methods is expected. Further studies must be conducted to reduce the SE.
  7. Hanis TM, Ruhaiyem NIR, Arifin WN, Haron J, Wan Abdul Rahman WF, Abdullah R, et al.
    Diagnostics (Basel), 2022 Nov 16;12(11).
    PMID: 36428886 DOI: 10.3390/diagnostics12112826
    This study aims to determine the feasibility of machine learning (ML) and patient registration record to be utilised to develop an over-the-counter (OTC) screening model for breast cancer risk estimation. Data were retrospectively collected from women who came to the Hospital Universiti Sains Malaysia, Malaysia for breast-related problems. Eight ML models were used: k-nearest neighbour (kNN), elastic-net logistic regression, multivariate adaptive regression splines, artificial neural network, partial least square, random forest, support vector machine (SVM), and extreme gradient boosting. Features utilised for the development of the screening models were limited to information in the patient registration form. The final model was evaluated in terms of performance across a mammographic density. Additionally, the feature importance of the final model was assessed using the model agnostic approach. kNN had the highest Youden J index, precision, and PR-AUC, while SVM had the highest F2 score. The kNN model was selected as the final model. The model had a balanced performance in terms of sensitivity, specificity, and PR-AUC across the mammographic density groups. The most important feature was the age at examination. In conclusion, this study showed that ML and patient registration information are feasible to be used as the OTC screening model for breast cancer.
  8. Arifin WN, Yusof UK
    Stat Med, 2022 Jan 18.
    PMID: 35043447 DOI: 10.1002/sim.9311
    Diagnostic tests play a crucial role in medical care. Thus any new diagnostic tests must undergo a thorough evaluation. New diagnostic tests are evaluated in comparison with the respective gold standard tests. The performance of binary diagnostic tests is quantified by accuracy measures, with sensitivity and specificity being the most important measures. In any diagnostic accuracy study, the estimates of these measures are often biased owing to selective verification of the patients, which is referred to as partial verification bias. Several methods for correcting partial verification bias are available depending on the scale of the index test, target outcome, and missing data mechanism. However, these are not easily accessible to the researchers due to the complexity of the methods. This article aims to provide a brief overview of the methods available to correct for partial verification bias involving a binary diagnostic test and provide a practical tutorial on how to implement the methods using the statistical programming language R.
  9. Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM
    Pak J Med Sci, 2021 7 23;37(4):1221-1229.
    PMID: 34290812 DOI: 10.12669/pjms.37.4.4004
    Background and Objectives: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature.

    Methods: We searched PubMed and Scopus for attributes of MP, using terms, "Professionalism," "Medical Students," and "Undergraduate Medical Education". We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included.

    Results: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1) Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted "respect" as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, "communication" 5 (45.45 %) studies and "honesty" and "integrity" 4 (36.36%). (2) Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine's elements of MP, viz, "altruism, accountability, excellence, duty, honor and integrity, respect for others."

    Conclusions: Themes exemplified MP's most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.

  10. Musa KI, Arifin WN, Mohd MH, Jamiluddin MS, Ahmad NA, Chen XW, et al.
    PMID: 33809958 DOI: 10.3390/ijerph18063273
    To curb the spread of SARS-CoV-2 virus (COVID-19) in Malaysia, the government imposed a nationwide movement control order (MCO) from 18 March 2020 to 3 May 2020. It was enforced in four phases (i.e., MCO 1, MCO 2, MCO 3 and MCO 4). In this paper, we propose an initiative to assess the impact of MCO by using time-varying reproduction number (Rt). We used data from the Johns Hopkins University Centre for Systems Science and Engineering Coronavirus repository. Day 1 was taken from the first assumed local transmission of COVID-19. We estimated Rt by using the EpiEstim package and plotted the epidemic curve and Rt. Then, we extracted the mean Rt at day 1, day 5 and day 10 for all MCO phases and compared the differences. The Rt values peaked around day 43, which was shortly before the start of MCO 1. The means for Rt at day 1, day 5, and day 10 for all MCOs ranged between 0.665 and 1.147. The average Rt gradually decreased in MCO 1 and MCO 2. Although spikes in the number of confirmed cases were observed when restrictions were gradually relaxed in the later MCO phases, the situation remained under control with Rt values being stabilised to below unity level (Rt value less than one).
  11. Hadie SNH, Yusoff MSB, Arifin WN, Kasim F, Ismail ZIM, Asari MA, et al.
    BMC Med Educ, 2021 Jan 14;21(1):50.
    PMID: 33446203 DOI: 10.1186/s12909-020-02467-w
    BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia.

    METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses.

    RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P

  12. Goni MD, Naing NN, Hasan H, Wan-Arfah N, Deris ZZ, Arifin WN, et al.
    Front Public Health, 2021;9:594204.
    PMID: 34277530 DOI: 10.3389/fpubh.2021.594204
    This study was aimed to develop and evaluate the efficacy of a health education program for increasing knowledge, changing attitudes, and promoting prevention practices to reduce the incidence of RTIs among Malaysian Hajj pilgrims. A quasi-experimental study was done among 130 Hajj pilgrims attending Hajj orientation course organized by a private Hajj tour companies. Hajj pilgrims assigned to intervention group (n = 65) and control group (n = 65). Data were collected baseline and after return from Hajj using a validated questionnaire. Mixed design repeated measure ANOVA was used to analyse the effect of group, time, and group-time interaction on the dependent variables. There was a significant improvement in knowledge, attitude and practice scores in the intervention group compared to the control group. Based on the findings of the interaction of time and group, there was a significant statistical difference for post intervention for knowledge (p = 0.005), attitude (p = 0.041), and practice (p = 0.002). The newly-established health education intervention smartphone application was effective in improving KAP toward RTIs prevention among pilgrims.
  13. Lim BC, Kueh YC, Arifin WN, Ng KH
    PLoS One, 2021;16(4):e0250627.
    PMID: 33909664 DOI: 10.1371/journal.pone.0250627
    BACKGROUND: Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

    METHODS: In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

    RESULTS: The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

    CONCLUSION: The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

  14. Goni MD, Naing NN, Hasan H, Wan-Arfah N, Deris ZZ, Arifin WN, et al.
    BMC Public Health, 2020 Nov 10;20(1):1684.
    PMID: 33172429 DOI: 10.1186/s12889-020-09756-5
    BACKGROUND: Respiratory tract infections are one of the common infection associated with Hajj pilgrimage that is of great public health and global concern. This study is aimed at determining the factor structure of the knowledge, attitude, and practice questionnaire for the prevention of respiratory tract infections during Hajj by confirmatory factor analysis (CFA).

    METHODS: A multistage cluster sampling method was conducted on Malaysian Umrah pilgrims during the weekly Umrah orientation course. A total of 200 Umrah pilgrims participated in the study. The knowledge, attitude and practice (KAP) questionnaire was distributed to pilgrims at the beginning of the orientation and retrieved immediately at the end of the orientation. Data analysis was done using R version 3.5.0 after data entry into SPSS 24. The robust maximum likelihood was used for the estimation due to the multivariate normality assumption violation. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains.

    RESULTS: CFA of a 25-item in total, the two-factor model yielded adequate goodness-of-fit values. The measurement model also showed good convergent and discriminant validity after model re-specification. A two-factor model was tested for measurement model validity and construct validity for each of the attitude and practice domains. The result also showed a statistically significant value (p 

  15. Ramlay MZ, Saddki N, Tin-Oo MM, Arifin WN
    PMID: 32731318 DOI: 10.3390/ijerph17155407
    Currently, the availability of a functional oral health literacy instrument in the Malay language is limited. This study aimed to cross-culturally adapt Oral Health Literacy Instrument (OHLI) into the Malay language and to determine its psychometric properties in Malaysian adults. Cross-cultural adaptation of the OHLI into the Malay version (OHLI-M) was conducted according to a guideline, followed by a cross-sectional study among outpatients in a selected health clinic. The psychometric evaluations were the comparison of the OHLI-M scores by education levels and last dental visits, the correlation of the reading comprehension section of OHLI-M with the Malay version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA-M), the correlation of OHLI-M with decayed, missing, and filled teeth (DMFT) and Community Periodontal Index (CPI), and the test-retest reliability of OHLI-M. A total of 195 outpatients participated in this study. The OHLI-M scores were significantly different between participants with different levels of education and timing since last dental visit. Participants with lower secondary school qualification and below, and those whose last dental visit was more than two years ago or never, had significantly lower OHLI-M scores. There was a positive correlation between the reading comprehension scores of the OHLI-M and the S-TOFHLA-M (Spearman's rho = 0.37, p < 0.001). There was no significant correlation between the OHLI-M scores and the DMFT index scores or the CPI scores. The internal consistency was good (Cronbach's alpha = 0.83 to 0.88). The test-retest reliability was excellent (intraclass correlation = 0.80 to 0.86). The OHLI-M showed good validity and reliability among adults in Malaysia.
  16. Johari MI, Yusoff K, Haron J, Nadarajan C, Ibrahim KN, Wong MS, et al.
    Sci Rep, 2020 Jun 25;10(1):10599.
    PMID: 32587371 DOI: 10.1038/s41598-020-67806-9
    An amendment to this paper has been published and can be accessed via a link at the top of the paper.
  17. Hassim SR, Arifin WN, Kueh YC, Yaacob NA
    Int J Environ Res Public Health, 2020 May 28;17(11).
    PMID: 32481559 DOI: 10.3390/ijerph17113820
    BACKGROUND: At present, the validity and reliability evidence of the Malay version of the Smartphone Addiction Scale (SAS-M) is only available by exploratory factor analysis (EFA). The aim of this study is to validate and determine the psychometric properties of the SAS-M by confirmatory factor analysis (CFA).

    METHODS: A cross-sectional study was conducted among 323 medical students in Universiti Sains Malaysia. The students were given questionnaire forms consisting of socio-demographic information, the SAS-M and the Malay version of the Internet Addiction Test (MVIAT). The CFA was conducted using robust maximum likelihood estimator. The internal consistency reliability was determined by Raykov's rho coefficient. The concurrent validity was assessed by the Pearson's correlations between the factor scores of the SAS-M and the MVIAT.

    RESULTS: The analysis showed the five-factor model of the SAS-M has an acceptable model fit after the inclusion of 12 correlated errors (SRMR = 0.067, RMSEA 0.059 (90% CI: 0.054, 0.065), CFI = 0.895, TLI = 0.882). The factor loadings ranged from 0.320 to 0.875. The internal consistency reliability was good (Raykov's rho = 0.713 to 0.858) and it showed good concurrent validity with the MVIAT.

    CONCLUSIONS: The CFA showed that the SAS-M is a valid and reliable self-administered questionnaire to measure the level of smartphone addiction among medical students.

  18. Liu KT, Kueh YC, Arifin WN, Ismail Ibrahim M, Shafei MN, Kuan G
    PMID: 32316170 DOI: 10.3390/ijerph17082748
    Decisional balance (DB) is the perceived positive aspects (advantages) and negative aspects (disadvantages) that are associated with behavioural change. Behavioural change is dependent on an individual's thoughts after considering the advantages of engaging in exercise. When the benefits exceed the barriers, people are more likely to make changes after cognitively evaluating the functional aspects. The purpose of the present study is to determine the validity and reliability of the DB scale among Malaysian university students using a confirmatory factor analysis (CFA). A cross-sectional study was carried out among students who took part in the co-curricular program. By using the purposive sampling method, students were recruited and given written informed consent forms after acknowledging they understood the purpose of the study. The DB scale, which consists of two factors, namely, advantages and disadvantages, was used as the instrument in the study. The advantages referred to the benefits of participating in exercise, whereas the disadvantages referred to the barriers to exercise. The 10-item, self-administered questionnaires were distributed to participating students. Data were analysed using Mplus 8 for the CFA. A total of 562 students (females = 444, males = 118) with a mean age of 19.81 years (SD = 1.22) participated in the study. Most of the students were engaged in regular physical activity for at least three exercise sessions (mean = 2.62) per week, and the average duration per session was 43 minutes. The hypothesised measurement model of DB did not fit the data well; thus, the measurement model was re-specified. The final measurement model fit the data well (comparative fit index (CFI) = 0.960, Tucker-Lewis index (TLI) = 0.943, standardised root mean square residual (SRMR) = 0.055, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 (0.047, 0.074), RMSEA p-value = 0.096). The composite reliability values of 0.757 for the advantages and 0.792 for the disadvantages were acceptable. The 10-item DB scale with two factors displayed a good model fit for the data with good scale reliability. This could be beneficial for Malaysian undergraduate students in making decisions before engaging in physical activity. The benefits of, and barriers to, exercise could be an important component that affects their decision making.
  19. Hidrus AB, Kueh YC, Arifin WN, Konter E, Kuan G
    PMID: 32155904 DOI: 10.3390/ijerph17051736
    Sports courage is one of the most important attributes to help competitive athletes overcome anxiety, nervousness, and other psychological obstacles, but this field of study is still being overlooked by most athletes and coaches. The purpose of this study is to validate the Malay language version of the Sports Courage Scale (SCS-M) for Silat athletes using confirmatory factor analysis (CFA). Data were collected during 9th UPSI International Pencak Silat Championship in Malaysia. A total of 258 competitors (male = 66.7%, female = 33.3%), with a mean age of 18 years (SD = 2.6), volunteered to participate in this study. The original SCS with 50 items underwent forward and backward translations into the Malay language and was pre-tested with ten martial arts athletes. Then, Silat athletes were asked to complete the translated SCS-M questionnaire. There were five factors in the SCS-M (i.e., mastery, determination, assertiveness, venturesome, and self-sacrificial behaviour). The first hypothesised model with 50 items did not result in a good fit to the data (RMSEA = 0.06, CFI = 0.93, NFI = 0.87, NNFI = 0.93, RMR = 0.14, SRMR = 0.09). A total of 17 problematic items were identified and were removed iteratively. The final measurement model with 33 items fit the data well (RMSEA = 0.06, CFI = 0.94, NFI = 0.89, NNFI = 0.94, RMR = 0.05, SRMR = 0.07). The reliability of each subscale based on Cronbach's alpha ranged from 0.64 to 0.76. The convergent and discriminant validities were achieved for the final measurement model. The revised version of SCS-M with 33 items was considered valid and reliable for measuring the sports courage in Silat athletes in Malaysia.
  20. Goni MD, Naing NN, Hasan H, Wan-Arfah N, Deris ZZ, Arifin WN, et al.
    BMC Public Health, 2020 Mar 02;20(1):189.
    PMID: 32114986 DOI: 10.1186/s12889-020-8269-9
    BACKGROUND: Hajj pilgrimage faces numerous challenges including a high prevalence of respiratory tract infection as well as its prevention strategies. The aim of this study was to develop and validate a questionnaire to evaluate knowledge, attitude and practice (KAP) towards respiratory tract infections (RTIs) prevention among Malaysian Hajj pilgrims.

    METHODS: This study was conducted among Malaysian Umrah pilgrims in Malaysia from Kuala Lumpur and Kelantan. The questionnaire then underwent a series of validation process that included content, face validity and exploratory part. Item response theory (IRT) analysis was utilized for the validation of the knowledge domain. The attitude and practice were validated using the exploratory factor analysis (EFA).

    RESULTS: The validation process resulted in a questionnaire that comprised of four main sections: demography, knowledge, attitude, and practice. Following IRT analysis of the knowledge domain, all items analyzed were within the acceptable range of difficulty and discrimination. The Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) was 0.72 and 0.84 for attitude and practice domain respectively and Bartlett's test of Sphericity for both domains were highly significant (P  0.3). The Cronbach's alpha for reliability of the knowledge, attitude and practice domains all showed acceptable values of > 0.6 (0.92, 0.77 and 0.85).

    CONCLUSION: The findings of this validation and reliability study showed that the developed questionnaire had a satisfactory psychometric property for measuring KAP of Malaysian Hajj pilgrims.

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