Displaying publications 1 - 20 of 69 in total

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  1. Chew KS, Kueh YC, Abdul Aziz A
    BMC Med Educ, 2017 Mar 21;17(1):58.
    PMID: 28320367 DOI: 10.1186/s12909-017-0897-0
    BACKGROUND: Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making.

    METHODS: This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format.

    RESULTS: For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6.

    CONCLUSION: The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

  2. Kuan G, Kueh YC, Abdullah N, Tai ELM
    BMC Public Health, 2019 Jun 13;19(1):751.
    PMID: 31196195 DOI: 10.1186/s12889-019-7109-2
    BACKGROUND: Health-promoting behaviour is an important concept for health education. Unfortunately, there is a dearth of validated instruments to measure levels of health-promoting behaviour in the Malaysian context. The purpose of this study was to validate a Malay-language version of the Health-Promoting Lifestyle Profile II (HPLP-II) using a confirmatory approach.

    METHODS: Participants were 997 university undergraduate students, with a mean age of 21 years (SD = 1.58). The majority of the participants (80.4%) were female. Health-promoting behaviour was assessed using the 52-item HPLP-II, which measures six components of health-promoting behaviour outcomes. HPLP-II was translated into the Malay language using standard forward and backward translation procedures. Participants then completed the HPLP-II Malay version (HPLP-II-M). Confirmatory factor analysis (CFA) was conducted using Mplus 8.0 software on the six domains of HPLP-II-M model.

    RESULTS: The CFA result based on the hypothesised measurement model of six factors was aligned with the original HPLP-II, except for two low loading items which were subsequently removed from the CFA analysis. The final CFA measurement model with 50 items resulted in a good fit to the data based on RMSEA and SRMR fit indices (RMSEA = 0.046, 90%CI = 0.045, 0.048, SRMR = 0.062). The construct reliabilities for the HPLP-II-M subscales were acceptable, ranging from 0.737 to 0.878.

    CONCLUSION: The HPLP-II-M with six components of health-promoting behaviour outcomes and 50 items was considered valid and reliable for the present Malaysian sample.

  3. Ibrahim MF, Kuan G, Hashim HA, Hamzah NA, Kueh YC
    BMC Public Health, 2021 10 07;21(1):1798.
    PMID: 34620133 DOI: 10.1186/s12889-021-11869-4
    BACKGROUND: This study aimed to verify a translated Malay version of the Achievement Emotions Questionnaire for Physical Education (AEQ-PE) by assessing the level of achievement emotions in six constructs among the Malaysian primary school pupils using the Confirmatory Factor Analysis (CFA).

    METHODS: A total of 607 Malay pupils, comprising 240 (39.5%) boys and 367 (60.5%) girls aged between 10 and 11, were recruited from 10 schools to answer the questionnaire, which measured their views on 24 items through a five-point Likert scale. The AEQ-PE was translated into Malay language (AEQ-PE-M) using forwarding to backward translation techniques. Certain phrases were adopted in accordance with the local culture and vocabulary appropriate for primary school pupils. CFA was performed using the Mplus 8.0 software, and the final model demonstrated high reliability in terms of the composite reliability and Cronbach's alpha.

    RESULTS: Analysis of the CFA showed an acceptable fit indices in CFI (0.936), TLI (0.926), RMSEA = 0.039 (90% CI, 0.034, 0.045) and SRMR (0.049) of the AEQ-PE measurement model. All of the items in the original AEQ-PE version were retained and deemed suitable for Malay primary school pupils.

    CONCLUSION: The AEQ-PE-M with 24 items was a suitable tool for measuring the level of school children's involvement in determining achievement emotions and their motivation towards physical education.

  4. Yao L, Zhou K, Zhou Y, Kueh YC, Liu H, Liu Z, et al.
    BMC Public Health, 2024 Jan 10;24(1):151.
    PMID: 38200518 DOI: 10.1186/s12889-023-17596-2
    BACKGROUND: Self-efficacy has been recognized as a critical component in people's participation and maintenance of physical activity. This study aims to validate the Chinese version of the Exercise Self-Efficacy Scale (ESE) among Chinese children and adolescents using confirmatory factor analysis (CFA).

    METHODS: A cross-sectional study was conducted on two primary and two secondary schools in central China. The ESE scale was translated into Chinese (ESE-C) using the standard forward-backward translation method. Data were analyzed using Mplus 8 for the CFA.

    RESULTS: The final model showed a satisfactory level of goodness-of-fit (CFI = 0.918; TLI = 0.905; SRMR = 0.043; RMSEA = 0.066), indicating a good construct validity of the ESE-C for children and adolescents in mainland China. Furthermore, the final ESE-C model achieved composite reliability values of 0.963 and average variance extraction values of 0.597, indicating sufficient convergent and discriminant validity. Besides, the Cronbach's alpha value was 0.964, demonstrating excellent internal consistency of the ESE-C scale.

    CONCLUSION: The ESE-C scale is a valid instrument for assessing exercise self-efficacy among children and adolescents in mainland China.

  5. Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, et al.
    Body Image, 2020 Mar;32:199-217.
    PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006
    The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
  6. Swami V, Tran US, Stieger S, Aavik T, Ranjbar HA, Adebayo SO, et al.
    Body Image, 2023 Sep;46:449-466.
    PMID: 37582318 DOI: 10.1016/j.bodyim.2023.07.010
    The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.
  7. Ng PY, Nafi SNM, Jalil NAC, Kueh YC, Lee YY, Zin AAM
    Croat Med J, 2023 Feb 28;64(1):29-36.
    PMID: 36864816
    AIM: To assess the association of the expression of apolipoprotein B (apoB) and 4-hydroxynonenal (4HNE) with the clinicopathological data of patients with colorectal cancer (CRC).

    METHODS: We obtained 80 CRC histopathological specimens sent to the Pathology Laboratory of Hospital Universiti Sains Malaysia from 2015 to 2019. Data on demographic factors, body mass index (BMI), and clinicopathological characteristics were also collected. Formalin-fixed paraffin-embedded tissues were stained by using an optimized immunohistochemical protocol.

    RESULTS: Patients were mostly older than 50 years, male, Malay, and overweight or obese. A high apoB expression was observed in 87.5% CRC samples (70/80), while a high 4HNE expression was observed in only 17.5% (14/80) of CRCs. The expression of apoB was significantly associated with the sigmoid and rectosigmoid tumor sites (p =0.001) and tumor size 3-5 cm (p =0.005). 4HNE expression was significantly associated with tumor size 3-5 cm (p =0.045). Other variables were not significantly associated with the expression of either marker.

    CONCLUSION: ApoB and 4HNE proteins may play a role in promoting CRC carcinogenesis.

  8. Vadivelu S, Ma ZF, Ong EW, Hassan N, Nik Hassan NFH, Syed Abdul Aziz SH, et al.
    Dig Dis, 2019;37(2):100-107.
    PMID: 30384376 DOI: 10.1159/000494386
    BACKGROUND: Gastroesophageal Reflux Disease Questionnaire (GERDQ) and Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) are reliable tools for evaluation of GERD.

    AIM: We aimed to test validity and reliability of Malay language translations of GERDQ and QOLRAD in a primary care setting.

    METHODS: The questionnaires were first translated into the Malay language (GERDQ-M and QOLRAD-M). Patients from primary care clinics with suspected GERD were recruited to complete GERDQ-M, QOLRAD-M, and Malay-translated 36-item short-form health survey (SF-36 or SF-36-M), and underwent endoscopy and 24-h pH-impedance test.

    RESULTS: A total of 104 (mean age 47.1 years, women 51.9%) participants were enrolled. The sensitivity and specificity for GERDQ-M cut-off score ≥8 were 90.2 and 77.4%, respectively. Based on this cut-off score, 54.7% had a high probability of GERD diagnosis. GERD-M score ≥8 vs. < 8 was associated with erosive esophagitis (p < 0.001), hiatus hernia (p = 0.03), greater DeMeester score (p = 0.001), and Zerbib scores for acid refluxes (p < 0.001) but not non-acid refluxes (p = 0.1). Mean total scores of QOLRAD-M and SF-36-M were correlated (r = 0.74, p < 0.001). GERDQ-M ≥8, erosive esophagitis, and DeMeester ≥14.72 were associated with impaired QOLRAD-M in all domains (all p < 0.02) but this was not seen with SF-36.

    CONCLUSIONS: GERDQ-M and QOLRAD-M are valid and reliable tools applicable in a primary care setting.

  9. Lim BC, Kueh YC, Arifin WN, Ng KH
    MyJurnal
    Objective: To determine the factor structure of the Health Promoting Behaviours (HPB) component of Health Promoting Lifestyle Profile-II among undergraduate students in Universiti Sains Malaysia (USM) by confirmatory factor analysis (CFA).
    Methods: A cross sectional study was conducted among undergraduate students. The data was collected in the USM campus using a proportionate cluster sampling method. The HPB questionnaire was handed to students in the lecture hall and collected immediately when the lecture finished. CFA was conducted using robust maximum likelihood estimation due to violation of multivariate normality assumption. A three-factor model was tested for measurement model validity and construct validity.
    Results: A total of 788 students participated in the study. CFA of a 21-item, three-factor model yielded an adequate goodness-of-fit values. The measurement model also showed a good convergent and discriminant validity after model re-specification.
    Conclusion: The health promoting behaviours scale was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the health promoting behaviours components of a healthy lifestyle among Malaysian undergraduate students. It was recommended to further conduct cross-validation studies in other Malaysian public universities to provide additional empirical evidence to support its use.
  10. Kuan G, Morris T, Kueh YC, Terry PC
    Front Psychol, 2018;9:14.
    PMID: 29459837 DOI: 10.3389/fpsyg.2018.00014
    Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14,F2,62= 5.03,p= 0.01, η2= 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for performance in other fine motor skills.
  11. Wu J, Kuan G, Lou H, Hu X, Masri MN, Sabo A, et al.
    Front Psychol, 2023;14:1134703.
    PMID: 37691784 DOI: 10.3389/fpsyg.2023.1134703
    INTRODUCTION: Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.

    METHODS: A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed.

    RESULTS: A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.

    CONCLUSION: Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.

  12. Kueh YC, Abdullah N, Kuan G, Morris T, Naing NN
    Front Psychol, 2018;9:1096.
    PMID: 30018580 DOI: 10.3389/fpsyg.2018.01096
    Measurement equivalence is often assumed across comparison groups, a pervasive problem related to many self-report instruments. Measurement equivalence, also known as measurement invariance, implies that a measure has the same meaning across different groups of people. In this study, we aimed to examine the measurement and structural invariance among gender of the Malay version of the Physical Activity and Leisure Motivation Scale for Youth (PALMS-Y-M). Seven-hundred-and-eighty-three secondary school students (female = 57.3%, male = 42.7%) with mean age 14.5 years (standard deviation = 1.25) from Kota Bharu, Malaysia, volunteered to participate in this study and completed the PALMS-Y-M, consisting of 28 items with seven subscales. We conducted the confirmatory factor analysis (CFA) and invariance tests on the seven motives of the PALMS-Y-M model. The hypothesized model consisted of 28 observed items and seven latent variables. We used estimator robust to maximum likelihood, MLR to examine the hypothesized measurement and structural invariance. Measurement invariance was tested for three different levels. We first established the configural invariance model, then we compared the metric invariance model and the scalar invariance model with the less restrictive model. Then structural invariance was tested for factor variance, covariance, and means. Findings provided evidence for full measurement and structural invariance of the PALMS-Y-M in males and females. The final CFA model fit the data well for males [comparative fit index (CFI) = 0.922, root mean square error of approximation (RMSEA) = 0.048, standardized root mean residual (SRMR) = 0.050] and females (CFI = 0.922, RMSEA = 0.047, SRMR = 0.053). When invariance of both factor loadings and item intercepts holds in PALMS-Y-M, underlying factors consisting of different motives for participating in PA can be meaningfully compared across gender. Accurate and valid measurement of PALMS-Y-M across comparison groups is crucial for future research that involves examining motives to physical activity in different genders and other socio-cultural variables.
  13. Liu KT, Kueh YC, Arifin WN, Kim Y, Kuan G
    Front Psychol, 2018;9:2402.
    PMID: 30618907 DOI: 10.3389/fpsyg.2018.02402
    This study's purpose was to examine the structural relationship of the transtheoretical model (TTM) and the amount of physical activity (PA) among undergraduate students in health and medicine at Universiti Sains Malaysia. A cross-sectional study was carried out among students who took part in the co-curricular program. Co-curricular program includes activities that take place outside of the regular lectures or tutorials in the University. Students recruited through purposive sampling were informed that their participation was entirely voluntarily. Those interested completed the self-administered questionnaire, which consisted of the decisional balance, processes of change, self-efficacy, stages of change scales, and Godin leisure-time exercise questionnaire. Data were analyzed using Mplus version 8 for descriptive statistics and structural equation modeling analysis for inferential statistics. A total of 562 students participated in the study. The majority of the students was female (79.0%) and Malay (73.3%) and average of exercise sessions per week was 2.62, with a mean of 43.37 min per exercise session. The final structural model fit the data well based on several fit indices (SRMR = 0.046, RMSEA (CI: 90%) = 0.061 (0.045, 0.078), RMSEA p = 0.130). The model showed that stages of change significantly affected self-efficacy (p < 0.001), pros (benefits of exercise; p < 0.001), cons (barriers to exercise; p = 0.022), and processes of change (p < 0.001). The model also showed significant inter-relationships among the TTM constructs and supported seven hypotheses. Among all the variables examined, only processes of change significantly affected PA (p < 0.001). However, stages of change (p < 0.001) and pros (p =< 0.001) had significant indirect effects on PA via processes of change. The findings support that individuals' stages of change affect their self-efficacy level, or the ability to make positive and negative decisions and perform behavior accordingly. The study confirms that making correct decisions and taking action accordingly can increase PA levels.
  14. Shuai Y, Wang S, Liu X, Kueh YC, Kuan G
    Front Psychol, 2023;14:1284378.
    PMID: 38162969 DOI: 10.3389/fpsyg.2023.1284378
    Personality is considered to be a factor affecting athletic performance. However, inconsistency in the research results regarding size and even direction of the relationship. An evaluation of the evidence of the relationship between personality and athletic performance was conducted in order to summarize the evidence available. A systematic literature search was conducted in March 2023. Sport performance and the Big Five personality model were identified in our research. We used PubMed, Web of Science, Embase, Cochrane Library, Wang Fang (Chinese), Wei Pu (Chinese), and CNKI (Chinese) databases for the systematic literature search (Prospero registration number: CRD42022364000), screened 4,300 studies, and found 23 cross-sectional studies eligible for inclusion in this review. The results of this systematic analysis show that, besides neuroticism, openness, conscientiousness, extraversion, and agreeableness are all positively correlated with sports performance. Conscientiousness and extraversion are the two main personalities in team sports. Openness and agreeableness show different results in different sports, and it is not clear to which project they are beneficial. The value of personality as a possible predictor of athletic performance is generally positive. Therefore, professionals such as applied sports psychologists, coaching personnel, athletes, and sports administrators must comprehensively grasp the significance of personality's role in achieving success in major competitions. Considering these facts, sports practitioners should promote personality screening and personality development programs.
  15. Kueh YC, Morris T, Borkoles E, Shee H
    PMID: 26286395 DOI: 10.1186/s12955-015-0303-8
    Quality of life (QoL) is an important aspect of wellbeing for people with chronic conditions like type 2 diabetes, making it a noteworthy outcome. Knowledge about diabetes, attitudes, and self-management of diabetes are key factors that might directly or indirectly impact QoL. However, little is known about the inter-relationships between diabetes knowledge, attitudes, self-management and QoL among people with type 2 diabetes mellitus (T2DM). The aim of this study was to examine a model describing the relationship between diabetes knowledge, attitudes, self-management, and QoL of people with T2DM that is based on previous research linking pairs of these variables.
  16. Njaka S, Mohd Yusoff D, Anua SM, Kueh YC, Edeogu CO
    Heliyon, 2021 Feb;7(2):e06130.
    PMID: 33644447 DOI: 10.1016/j.heliyon.2021.e06130
    Quarry workers are commonly afflicted with musculoskeletal disorders (MSDs). This health problem has been recognized as a significant threat to the quarry workers' safety but is rarely reported, particularly in Nigeria. Therefore, this study aimed to assess the prevalence of MSDs and their associated factors among quarry workers.

    METHOD: A cross-sectional study was conducted, and data were collected using a self-administered Standard Nordic Musculoskeletal Questionnaire. A total of 266 participants were selected through systematic random sampling method among male and female quarry workers in Ebonyi State, Nigeria. The data were analysed using SPSS version 26, and descriptive statistics were used to determine the prevalence and types of MSDs. Simple and multiple logistic regressions were used to identify the factors associated with MSDs.

    RESULTS: The results revealed that majority of the respondents (89.8%) had MSDs, with the most common types being lower back pain (83.1%) and elbow pain (45.9%). Based on multiple logistic regression modelling, BMI (Adjusted OR 0.17, 95% CI 0.06,0.55, p = 0.003), age (Adjusted OR 1.14, 95% CI 1.07, 1.23, p < 0.001), work experience (Adjusted OR 2.08, CI 1.00, 4.30, p = 0.049), Vibration exposure (Adjusted OR 0.45, CI 0.27, 0.74, P = 0.002), working hour (Adjusted OR 6.84, CI 0.84, 53.4, p = 0.007) and break time (Adjusted OR 0.95, 95% CI 0.91,0.98, p = 0.006) were significantly associated with MSDs.

    CONCLUSION: MSDs are prevalent among the quarry workers in Ebonyi State, Nigeria. Thus, there is an urgent need to increase the workers' and employers' awareness of appropriate ergonomic and personal measures needed to improve the workers' safety and well-being.

  17. Ibrahim MF, Kuan G, Hashim HA, Hamzah NA, Kueh YC
    PMID: 33450935 DOI: 10.3390/ijerph18020622
    The objective of this study was to validate the translated Malay version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-M) scale among Malaysian primary school children using the confirmatory factor analysis (CFA). The Q-LES-Q-M measures the level of enjoyment and satisfaction experienced with relation to physical health, feelings, homework, and leisure. The participants were 607 Malay students, 240 (39.5%) boys and 367 (60.5%) girls, with an age range from 10 to 11 years old. The original version of the Q-LES-Q was translated into the Malay language by forward to backward translation procedures with consideration for the local culture and suitable vocabulary for primary school students. The participants then completed the Q-LES-Q-M. CFA was performed using Mplus 8 software. Using CFA, the initial model did not result in a good data fit. Further analysis of the CFA suggested some changes to the model to improve the fit indices. Model modification included the deletion of three problematic items and co-varying some error items. This resulted in improved fit indices and 40 items remained in the final model. The final model showed good reliability based on two indicators of composite reliability (CR) and Cronbach's alpha (CA). The factors with their CR and CA were physical activity (CR = 0.857, CA = 0.854), feelings (CR = 0.808, CA = 0.813), homework (CR = 0.837, CA = 0.837) and leisure (CR = 0.742, CA = 0.737). The final measurement consists of 40 items. The retained items were deemed suitable for Malay primary school children. The revised Q-LES-Q-M with 40 items is suitable for measuring the levels of children's involvement in determining the enjoyment and satisfaction of learning and physical activity.
  18. Konter E, Kueh YC, Kuan G
    PMID: 32635576 DOI: 10.3390/ijerph17134834
    While courage is widely attributed to athletic pursuits, it has received little scientific attention from both researchers and applied practitioners. A reliable measurement is required to examine courage in sports and competitive activities. Therefore, this research aimed to adapt the original Turkish Sports Courage Scale-31 into American English (SCS-AE). The SCS-31 measure was translated from Turkish into the American English language by the Brislin forward and backward translation technique and language validity. Then, the translated SCS-AE was administered to 548 American university college students (Mean age = 19.02, SD = 1.21). All participants played a sport (e.g., football, soccer, basketball, gymnastics). Based on confirmatory factor analyses (CFA), 31 items of SCS-AE were reduced to 24 items with four factors (i.e., assertiveness, determination, mastery, and venturesome). The fit indices were satisfactory (RMSEA = 0.06, CFI = 0.97, SRMR = 0.06, NFI = 0.96 and NNFI = 0.97). The internal consistency measured by Cronbach alpha, ranging from 0.73 to 0.78, were considered acceptable. The convergent validity and discriminant validity of SCS-AE were also achieved. Our findings indicate strong support for research using the four-factor model of the SCS-AE and adequate support for the five-factor model with sufficient caution regarding the internal consistency of the self-sacrifice factor. While cultural differences in courage perception might exist between these countries, the findings showed more similarities than differences in courage. Results indicated that the SCS-AE is usable for research purposes in the suggested format. Future directions are discussed using the SCS-31 and SCS-AE for research.
  19. Rizal H, Hajar MS, Muhamad AS, Kueh YC, Kuan G
    PMID: 31690004 DOI: 10.3390/ijerph16214283
    Brain Breaks Physical Activity Solutions (BBPAS) is a web-based structured physical activity (PA) video that is specifically designed for school settings and can stimulate a student's health and learning. The purpose of this study is to measure the effect of BBPAS on the stages of change, decisional balance, processes of change, self-efficacy and leisure-time exercise among Malay ethnic primary school children. A validated Malay version of three of the five constructs was derived with sound validity and was used in the present study. A total of 159 male and 163 female children aged 10 to 11 years old, mean (SD) = 10.53 (0.50), were recruited from two schools in Kelantan, Malaysia. Purposive sampling was used to divide the children into intervention (n = 177) and control (n = 145) groups. Children in the intervention group underwent BBPAS activity for an accumulated 30 min per week, while children in the control group were not involved in the BBPAS intervention. Mixed factorial analysis of variance (ANOVA) was used to examine the effect of BBPAS on the study variables. A mixed ANOVA showed significant changes (time effect) on cognitive process, F(1, 320) = 5.768, p-value = 0.017; behavioural process, F(1, 313) = 5.736, p-value = 0.017; and internal feeling, F(1, 312) = 6.050, p-value = 0.014. There was also a significant difference between groups on cons, F(1, 316) = 7.504, p-value = 0.007. A significant interaction effect was observed for stages of change, F(1, 319) = 7.861, p-value = 0.005; pros, F(1, 316) = 31.311, p-value = 0.001; internal feeling, F(1, 312) = 4.692, p-value = 0.031; and behavioural process, F(1, 313) = 7.312, p-value = 0.007. In conclusion, BBPAS was successful in improving four of the five constructs, and thus, should be recommended to be used in schools throughout Malaysia.
  20. Hidrus A, Kueh YC, Norsa'adah B, Kuan G
    PMID: 32024257 DOI: 10.3390/ijerph17030922
    Exercise self-efficacy (ESE) is one of the psychological constructs in the Transtheoretical Model (TTM). The objective of the present study is to assess the validity and reliability of the Malay version of Exercise self-efficacy scale (ESE-M) among Malaysians with type 2 diabetes mellitus (T2DM). A cross-sectional study design with convenience sampling method using a self-administered questionnaire was carried out. Participants were invited to complete the ESE-M with 18 items. Confirmatory factor analysis (CFA) was conducted and composite reliability (CR) was computed using Mplus 8. A total of 331 Malaysians with T2DM with a mean age of 63 years old (Standard Deviation = 0.57) completed the questionnaire. Most of the participants were male (52%) and Malay (89.4%). Two initial CFA models (single factor and three factors) of ESE-M scale were tested and they did not fit to the data well. Several re-specifications of the models were conducted. The final model for the ESE-M showed improvement on the value of model fit indices for the single factor model (comparative fit index (CFI) = 0.952, Tucker and Lewis index (TLI) = 0.938, standardised root mean square (SRMR) = 0.044, root mean square error of approximation (RMSEA) = 0.054) and three factors model (CFI = 0.891, TLI = 0.863, SRMR = 0.049, RMSEA = 0.081). The CR for the self-efficacy factor was 0.921 (single factor), while CR for internal feelings, competing demands and situational (three factors) were 0.762, 0.818 and 0.864, respectively. The final model of single factor ESE-M showed better fit to the data compared to the three factors ESE-M. This indicated that the single factor ESE-M is more suitable to be adopted for future study among Malaysians with T2DM.
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