RESEARCH DESIGN AND METHODS: A search strategy was applied in six databases and grey literature. Inclusion criteria were primary observational studies on informal caregiving for care recipients aged 60 years and above, in the English language. Informal caregivers were those not formally hired and multimorbidity referred to presence of at least two health conditions. From a total of 2,101 titles, 230 abstracts were screened, and 19 articles were included. Quality assessment was conducted with application of the Newcastle-Ottawa-Scale.
RESULTS: Health-related and caregiving-related outcomes have been assessed for informal caregivers of older adults with multimorbidity. Caregiver subjective burden was most commonly evaluated and often reported to be low to moderate. In association with care recipient multimorbidity, caregiver burden, quality of life, and perceived difficulty in assisting the older adults were examined in 14 of the studies with mixed results. Studies were heterogeneous, with nonuniform definitions of informal caregivers and multimorbidity as well as measurement tools.
DISCUSSION AND IMPLICATIONS: This narrative review found that caring for older adults with multimorbidity impacts caregivers, although overall evidence is not conclusive. Despite caregiving-related outcomes being most commonly assessed among the caregivers, particularly subjective burden, findings suggest that it is worthwhile to examine other outcomes to enrich the evidence base.
METHODS: This was a cross-sectional study conducted among the public secondary school teachers in the central region of Peninsular Malaysia from May to July 2013. A total of 150 and 203 teachers were recruited to perform exploratory factor analysis and confirmatory factor analysis (CFA), respectively. Reliability testing was evaluated on 141 teachers via internal consistency and two-week interval test-retest.
RESULTS: The 12-item three-factor structure of MSPSS-M was revised to 8-item two-factor structure. The revised MSPSS-M demonstrated excellent fit in CFA with adequate divergent and convergent validity and good factor loadings (0.80-0.90). The revised MSPSS-M also displayed good internal consistency with Cronbach's alpha of 0.91, 0.93 and 0.92 and good test-retest reliability with intraclass correlation of 0.89, 0.88 and 0.88 in the total scale, family and friends factors, respectively.
CONCLUSION: The revised 8-item MSPSS-M is a reliable and valid tool for assessment of perceived social support among teachers.
DESIGN: This was a cross-sectional study conducted among women in Kuala Lumpur, Malaysia. Sociodemographic characteristics, physical activity status, perceived depression and health-related quality of life were assessed via a self-administered questionnaire. Fasting blood samples were taken for the analysis of 25-hydroxyvitamin D, parathyroid hormone, fasting blood glucose and full lipid profile. Complex samples multiple logistic regression analysis was performed.
SETTING: Public secondary schools in Kuala Lumpur, Malaysia.
SUBJECTS: Seven hundred and seventy female teachers were included.
RESULTS: The mean age of participants was 41·15 (95 % CI 40·51, 41·78) years and the majority were ethnic Malays. Over 70 % of them had vitamin D deficiency (<20 ng/ml or <50 nmol/l) and two-thirds were at risk for depression. In the multivariate analysis, ethnic Malays (adjusted OR (aOR)=14·72; 95 % CI 2·12, 102·21) and Indians (aOR=14·02; 95 % CI 2·27, 86·59), those at risk for depression (aOR=1·88, 95 % CI 1·27, 2·79) and those with higher parathyroid hormone level (aOR=1·13; 95 % CI 1·01, 1·26) were associated with vitamin D deficiency, while vitamin D deficiency was negatively associated with mental health-related quality of life (Mental Component Summary) scores (aOR=0·98; 95 % CI 0·97, 0·99).
CONCLUSIONS: Vitamin D deficiency is significantly associated with depression and mental health-related quality of life among women in Kuala Lumpur, Malaysia.
DESIGN AND SAMPLE: Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis.
RESULTS: Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse.
CONCLUSION: A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.