Displaying publications 1 - 20 of 146 in total

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  1. Moey SF, Mohamed NC, Lim BC
    AIMS Public Health, 2021;8(1):15-31.
    PMID: 33575404 DOI: 10.3934/publichealth.2021002
    Background: In Malaysia, breast cancer accounted for 34.1% of all female cancer cases with women presenting breast cancer at late stages. Breast cancer has a higher five-year survival rate if detected early. An increase of approximately 30% in the five-year survival rate is indicated if breast cancer is detected at stage III compared to stage IV. Thus, survival rate of breast cancer can be increased by creating awareness and encouraging breast cancer screening amongst women. Breast self-examination (BSE) is highly recommended for breast cancer screening due to its simplicity with no incurred cost. The Health Belief Model is used in this study to explain and predict the adoptive behavior of BSE amongst women in Kuantan, Pahang.

    Materials and methods: This study employed a multi-stage sampling method using a simple proportion formula at 5% type 1 error, p < 0.05 and absolute error at 2% which resulted in a sample of 520 participants. The data for the study was obtained using a validated bilingual self-constructed questionnaire and the model constructed using Mplus software.

    Results: Perceived severity, benefits and barriers were found to significantly influence the behavioral adoption of BSE. Married women aged from 45 to 55 years and knowledge were found to significantly moderate the relationship between perceived benefits and behavioral adoption of BSE. Further, self-efficacy was found as the core construct that mediates the relationship between married women aged 45 to 55 years and the behavioral adoption of BSE.

    Conclusion: Self-efficacy is found in the study to influence the behavioral adoption of BSE. This is undeniable as self-efficacy can promote confidence in initiating and maintenance of behavioral change if the perceived change is beneficial at an acceptable cost.

    Matched MeSH terms: Self Efficacy
  2. Siahpush M, Borland R, Yong HH, Kin F, Sirirassamee B
    Addiction, 2008 Mar;103(3):502-8.
    PMID: 18269370 DOI: 10.1111/j.1360-0443.2007.02113.x
    Aim To examine the association of socio-economic position (education, income and employment status) with cigarette consumption, intention to quit and self-efficacy to quit among male smokers in Thailand and Malaysia. Design and setting The data were based on a survey of adult smokers conducted in early 2005 in Thailand and Malaysia as part of the International Tobacco Control-South-East Asia (ITC-SEA) project. Participants A total of 1846 men in Thailand and 1906 men in Malaysia. Measurement Participants were asked questions on daily cigarette consumption, intention to quit and self-efficacy to quit in face-to-face interviews. Findings Analyses were based on multivariate regression models that adjusted for all three socio-economic indicators. In Thailand, higher level of education was associated strongly with not having self-efficacy, associated weakly with having an intention to quit and was not associated with cigarette consumption. Higher income was associated strongly with having self-efficacy, associated weakly with high cigarette consumption and was not associated with having an intention to quit. Being employed was associated strongly with having an intention to quit and was not associated with cigarette consumption or self-efficacy. In Malaysia, higher level of education was not associated with any of the outcomes. Higher income was associated strongly with having self-efficacy, and was not associated with the other outcomes. Being employed was associated moderately with higher cigarette consumption and was not associated with the other outcomes. Conclusion Socio-economic and cultural conditions, as well as tobacco control policies and tobacco industry activities, shape the determinants of smoking behaviour and beliefs. Existing knowledge from high-income countries about disparities in smoking should not be generalized readily to other countries.
    Matched MeSH terms: Self Efficacy*
  3. AlMarri TS, Oei TP, AbRahman RM
    Addict Behav, 2009 Sep;34(9):776-8.
    PMID: 19481874 DOI: 10.1016/j.addbeh.2009.05.009
    The influence of an individuals' belief in their ability to resist drinking alcohol has recognised importance in understanding the pattern of drinking behaviours among Caucasian samples. Measures used to investigate this construct, such as the drinking refusal self-efficacy questionnaire-revised (DRSEQ-R; [Oei, T. P. S., Hasking, P. A., & Young, R. M. (2005). Drinking refusal self-efficacy questionnaire-revised (DRSEQ-R): A new factor structure with confirmatory factor analysis. Drug and Alcohol Dependence, 78, 297-307.]) have been widely used and have established psychometric properties. However, the exploration of the utility of this questionnaire with samples of different ethnicity, religion and living in different countries remains scarce. In the current study, Arab Muslim samples living in the United Arab Emirates and Oman (n=356) and Asian predominately Muslim samples living in Malaysia and Indonesia (n=256) were used. Exploratory and confirmatory factor analysis demonstrated that the DRSEQ-R has a three factor structure. Internal consistency ranged from alpha .96 to alpha .86 and validity was good. This study offers evidence of the utility of this measure with Arab and Asian samples.
    Matched MeSH terms: Self Efficacy*
  4. Phang CK, Mukhtar F, Ibrahim N, Keng SL, Mohd Sidik S
    Adv Health Sci Educ Theory Pract, 2015 Dec;20(5):1115-34.
    PMID: 25697124 DOI: 10.1007/s10459-015-9591-3
    Pursuing undergraduate medical training can be very stressful and academically challenging experience. A 5-week mindfulness-based stress management (MBSM/Mindful-Gym) program was developed to help medical students cope with stress. The aim of this study was to evaluate the effectiveness of the intervention in reducing stress among students in a medical school in Malaysia. Seventy-five medical students participated in the program. They were stratified according to years of studies and randomly allocated to intervention (N = 37) and control groups (N = 38). The following outcome variables were measured at pre- and post-intervention: mindfulness (with Mindful Awareness Attention Scale); perceived stress (with Perceived Stress Scale); mental distress (with General Health Questionnaire), and self-efficacy (with General Self-efficacy Scale). Hierarchical multiple regressions were used to analyse the effect of group (intervention vs. control) on changes in the outcome variables. There were significant improvements at one week post-intervention in all outcome variables: mindfulness (β = 0.19, ΔR2 = 0.04, p = .040, f (2) = 0.05), perceived stress (β = -0.26, ΔR2 = 0.07, p = .009, f (2) = 0.10); mental distress (β = -0.28, ΔR2 = 0.10, p = .003, f (2) = 0.15); and self-efficacy (β = 0.30, ΔR2 = 0.09, p < .001, f (2) = 0.21). Six months after the intervention, those who had joined the program reported higher self-efficacy compared to those in the control group (β = 0.24, ΔR2 = 0.06, p = .020, f (2) = 0.08); but there was no difference in other outcome measures. More than 90% of the participants found the program applicable in helping patients and all reported that they would recommend it to others. This study indicates that the program is potentially an effective stress management program for medical students in Malaysia.
    Matched MeSH terms: Self Efficacy
  5. Azami G, Lam SK, Shariff-Ghazali S, Said SM, Aazami S, Mozafari M, et al.
    Arch Iran Med, 2018 08 01;21(8):356-361.
    PMID: 30113857
    BACKGROUND: The theory if self-efficacy is the central concept of social cognitive theory with emphasis on the constructs of efficacy expectation, outcome expectation. Efficacy expectation is defined as the person's confidence to carry out a specific behavior. Outcome expectation is beliefs that carrying out a specific behavior will lead to a specific outcome. While the benefit of measuring outcome expectations has been established, there has been no large scale within the Iranian context. The purpose of this study is to examine the reliability-validity of the Persian version of the Perceived Therapeutic Efficacy Scale (PTES).

    METHODS: This study was conducted among 160 patients with type 2 diabetes mellitus (T2DM) using a self-administered instrument measuring outcome expectation. We used a methodological study design to assess the validity and reliability of the translated Persian version of the instrument.

    RESULTS: The findings of the present study support the uni-dimensionality of the Persian version of the instrument. The 10 items of the scale account for 73.54% of the total variance and the un-rotated factor loadings ranged from 0.66 to 0.93. Moreover, this study offers support for convergent validity and internal consistency of the scale.

    CONCLUSION: Our study demonstrated good convergent validity, factor structure and internal consistency in a sample of 160 Iranian adults with T2DM. Therefore, the Persian version of the scale is a valid and reliable instrument and can be used in research and clinical settings.

    Matched MeSH terms: Self Efficacy*
  6. Mohammadi S, Karim NA, Talib RA, Amani R
    Asia Pac J Clin Nutr, 2018 5 9;27(3):546-555.
    PMID: 29737801 DOI: 10.6133/apjcn.072017.07
    BACKGROUND AND OBJECTIVES: Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors.

    METHODS AND STUDY DESIGN: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life.

    RESULTS: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group.

    CONCLUSIONS: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.

    Matched MeSH terms: Self Efficacy*
  7. Othman MS, Merican H, Lee YF, Ch'ng KS, Thurairatnam D
    Asia Pac J Public Health, 2015 Mar;27(2):NP2093-100.
    PMID: 23695541 DOI: 10.1177/1010539513489136
    A prospective cross-sectional study was conducted at 3 government hospitals over 6 months to evaluate the confidence level of medical officers (MOs) to perform clinical procedure in nonspecialist government hospitals in Penang. An anonymous self-administered questionnaire in English was designed based on the elective and emergency procedures stated in the houseman training logbook. The questionnaire was distributed to the MOs from Penang State Health Department through the respective hospital directors and returned to Penang State Health Department on completion. The results showed that there was statistically significant difference between those who had undergone 12 months and 24 months as houseman in performing both elective and emergency procedures. MOs who had spent 24 months as housemen expressed higher confidence level than those who had only 12 months of experience. We also found that the confidence level was statistically and significantly influenced by visiting specialist and working together with cooperative experienced paramedics.
    Matched MeSH terms: Self Efficacy*
  8. Ng ST, Tengku-Aizan H, Tey NP
    Asia Pac J Public Health, 2011 Jul;23(4):470-84.
    PMID: 20685663 DOI: 10.1177/1010539510374751
    This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.
    Matched MeSH terms: Self Efficacy*
  9. Yasin SM, Retneswari M, Moy FM, Taib KM, Isahak M, Koh D
    Asian Pac J Cancer Prev, 2013;14(4):2317-23.
    PMID: 23725134
    The role of The Transtheoretical Model (TTM) in predicting relapse is limited. We aimed to assess whether this model can be utilised to predict relapse during the action stage. The participants included 120 smokers who had abstained from smoking for at least 24 hours following two Malaysian universities' smoking cessation programme. The smokers who relapsed perceived significantly greater advantages related to smoking and increasing doubt in their ability to quit. In contrast, former smokers with greater self-liberation and determination to abstain were less likely to relapse. The findings suggest that TTM can be used to predict relapse among quitting smokers.
    Matched MeSH terms: Self Efficacy
  10. Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2013;14(1):57-61.
    PMID: 23534796
    BACKGROUND: Breast cancer is the most common cancer and the second principal cause of cancer deaths among women worldwide, including Malaysia.

    METHODS: A cross-sectional study was carried out among 262 female undergraduate students in University Putra Malaysia using a validated questionnaire which was developed for this study.

    RESULTS: The mean age of respondents was 22∓2.3 years. Most of them were single (83.1%), Malay (42.3%) and 20.7% reported having a family history of breast cancer. Eighty-seven (36.7%) claimed they had practiced BSE. Motivation and self-efficacy of the respondents who performed BSE were significantly higher compared with women who did not (p<0.05).There was no association between BSE practice and demographic details (p<0.05). Logistic regression analysis indicated that women who perceived greater motivation (OR=1.089, 95%CI: 1.016-1.168) and had higher confidence of BSE (OR=1.076, 95%CI: 1.028-1.126) were more likely to perform the screening.

    CONCLUSIONS: The findings show that Malaysian young female's perception regarding breast cancer and the practice of BSE is low. Targeted education should be implemented to improve early detection of breast cancer.
    Matched MeSH terms: Self Efficacy
  11. Ahmadian M, Carmack S, Samah AA, Kreps G, Saidu MB
    Asian Pac J Cancer Prev, 2016;17(3):1277-84.
    PMID: 27039760
    BACKGROUND: Early detection is a critical part of reducing the burden of breast cancer and breast selfexamination (BSE) has been found to be an especially important early detection strategy in low and middle income countries such as Malaysia. Although reports indicate that Malaysian women report an increase in BSE activity in recent years, additional research is needed to explore factors that may help to increase this behavior among Southeastern Asian women.

    OBJECTIVE: This study is the first of its kind to explore how the predicting variables of self-efficacy, perceived barriers, and body image factors correlate with self-reports of past BSE, and intention to conduct future breast self-exams among female students in Malaysia.

    MATERIALS AND METHODS: Through the analysis of data collected from a prior study of female students from nine Malaysian universities (n=842), this study found that self-efficacy, perceived barriers and specific body image sub-constructs (MBSRQ-Appearance Scales) were correlated with, and at times predicted, both the likelihood of past BSE and the intention to conduct breast self-exams in the future.

    RESULTS: Self-efficacy (SE) positively predicted the likelihood of past self-exam behavior, and intention to conduct future breast self-exams. Perceived barriers (BR) negatively predicted past behavior and future intention of breast self-exams. The body image sub-constructs of appearance evaluation (AE) and overweight preoccupation (OWP) predicted the likelihood of past behavior but did not predict intention for future behavior. Appearance orientation (AO) had a somewhat opposite effect: AO did not correlate with or predict past behavior but did correlate with intention to conduct breast self-exams in the future. The body image sub-constructs of body area satisfaction (BASS) and self-classified weight (SCW) showed no correlation with the subjects' past breast self-exam behavior nor with their intention to conduct breast self-exams in the future.

    CONCLUSIONS: Findings from this study indicate that both self-efficacy and perceived barriers to BSE are significant psychosocial factors that influence BSE behavior. These results suggest that health promotion interventions that help enhance self-efficacy and reduce perceived barriers have the potential to increase the intentions of Malaysian women to perform breast self-exams, which can promote early detection of breast cancers. Future research should evaluate targeted communication interventions for addressing self-efficacy and perceived barriers to breast self-exams with at-risk Malaysian women. and further explore the relationship between BSE and body image.
    Matched MeSH terms: Self Efficacy*
  12. Mohd Zin F, Hillaluddin AH, Mustaffa J
    Asian Pac J Cancer Prev, 2017 05 01;18(5):1435-1443.
    PMID: 28612599
    Objective: This study aims to develop, validate and determine the reliability of an interactive multimedia strategy
    to prevent tobacco use among the young (TUPY-S) from an adolescents’ perspective. Methods: A descriptive study
    design was utilized. A modular instruction guideline by Russel (1974) was followed in the entire process, comprising
    a feasibility study, a review of existing modules, specification of the objectives, identification of the construct criterion
    items, learner analysis and entry behavior specification, establishment of the sequence instruction and media selection,
    a tryout with students and a field test. Result: Feasibility was agreed among the researchers and the school authorities.
    Culturally suitable rigorously developed tobacco use preventive strategies delivered using information technology (IT)
    are lacking in the literature. The objective of TUPY-S is to prevent tobacco use among adolescents living in Malaysia.
    Identified construct criterion items include knowledge, attitude, intention to use, self-efficacy, and refusal skill. The target
    population was early adolescents belonging to generation-Z. Content was developed from the adolescents’ perspective
    and delivered using IT in Malay language. Content validity, assessed by six experts in the field and module development,
    was good at 86%. The students’ tryout showed satisfactory face validity subjectively and objectively (85.5%) and
    high alpha Cronbach reliability (0.91). Conclusion: TUPY-S was confirmed to suit early adolescents of the current
    generation living in Malaysia. It demonstrated good content validity among the experts, satisfactory face validity and
    reliability among the target population. TUPY-S is ready to be evaluated for its effectiveness among early adolescents.
    Matched MeSH terms: Self Efficacy
  13. Ali R, Draman N, Mohd Yusoff SS, Norsa'adah B
    Asian Pac J Cancer Prev, 2020 Oct 01;21(10):2971-2978.
    PMID: 33112556 DOI: 10.31557/APJCP.2020.21.10.2971
    OBJECTIVE: To determine the level of self-efficacy for coping with breast cancer among Malaysian women and its association with socio-demographic and clinical variables.

    MATERIALS AND METHODS: This cross-sectional study involved 168 women diagnosed with breast cancer. The inclusion criteria were age >18 years old, having histologically confirmed breast cancer, and being diagnosed between January 1, 2009 to December 31, 2012. The exclusion criteria were being illiterate and having cognitive impairment. For data collection patients' medical records and the Cancer Behaviour Inventory-Brief (CBI-B) Malay version questionnaire were used. Simple and multiple logistic regression methods were used to analyse the data.

    RESULTS: Patients' mean (SD) age was 51.4 (10.8) years old. Most of the patients were Malays, married, diagnosed at stage 2 breast cancer (41%), and completed their breast cancer treatment. The mean score for self-efficacy for coping with breast cancer was 83.67 (95% CI: 81.87, 85.47). The significant factors positively correlated with self-efficacy for coping with breast cancer were higher educational background and a higher family income. However, factors such as a family history of breast cancer and breast surgery reduced the mean score of self-efficacy for coping with breast cancer.

    CONCLUSION: The mean score of self-efficacy for coping with breast cancer in this study was moderate. Self-efficacy for coping with breast cancer in Hospital Universiti Sains Malaysia was not adequate among sufferers and improvement is needed probably by providing education to these patients.

    Matched MeSH terms: Self Efficacy*
  14. Chong MS, Sit JWH, Choi KC, Suhaimi A, Chair SY
    Asian Nurs Res (Korean Soc Nurs Sci), 2023 Aug;17(3):180-190.
    PMID: 37355035 DOI: 10.1016/j.anr.2023.06.004
    PURPOSE: To assess the feasibility of a technology-assisted intervention in a hybrid cardiac rehabilitation program among patients with coronary heart disease.

    METHODS: This study was a two-arm parallel randomized controlled trial. Twenty-eight patients with coronary heart disease were randomly assigned to either the intervention group, receiving a 12-week technology-assisted intervention (n = 14), or the control group (n = 14), receiving usual care. Guided by the Health Belief Model, the intervention group received three center-based, supervised exercise training sessions, a fitness watch that served as a cue to action, six educational videos, and a weekly video call. The Self-efficacy for Exercise, exercise capacity, and Health Promoting Lifestyle Profile II were assessed at baseline and immediately post-intervention (12-weeks).

    RESULTS: Among the 28 patients who participated in this study, 85.7% completed the program, with a relatively low attrition rate (14.3%). The number of exercise training sessions accomplished by the participants in the intervention group was 51.27 ± 19.41 out of 60 sessions (85.5%) compared to 36.46 ± 23.05 (60.8%) in the control group. No cardiac adverse events or hospitalizations were reported throughout the study. Participants in the intervention group showed greater improvement in health-promoting behaviors when compared with the control group at 12 weeks. Within-group effects demonstrated improvement in exercise self-efficacy and exercise capacity among participants in the intervention group. A participant satisfaction survey conducted immediately post-intervention revealed that participants were "very satisfied" (23.1%) and "satisfied" (76.9%) with the technology-assisted intervention.

    CONCLUSIONS: The findings demonstrated that technology-assisted intervention in a hybrid cardiac rehabilitation program was feasible and suggested to be beneficial in improving exercise self-efficacy, exercise capacity, and health promoting behavior among patients with coronary heart disease. A full-scale study is needed to determine its effectiveness in the long term.

    TRIAL AND PROTOCOL REGISTRATION: ClinicalTrials.gov NCT04862351. https://clinicaltrials.gov/ct2/show/NCT04862351.

    Matched MeSH terms: Self Efficacy
  15. Hisham H, Justine M, Hussain H, Hasnan N, Manaf H
    Asian Spine J, 2019 08;13(4):577-583.
    PMID: 30866621 DOI: 10.31616/asj.2018.0172
    Study Design: A quasi-experimental single-blinded study.

    Purpose: To investigate the effects of 'graded exercise integrated with education' on physical fitness, exercise self-efficacy (ESE), and physical activity (PA) levels among subacute and chronic wheelchair-dependent paraplegia patients.

    Overview of Literature: Most of the chronic spinal cord injury (SCI) patients had low physical fitness due to a sedentary lifestyle and lack of ESE after discharge from a rehabilitation program. Education may encourage them to engage with exercise to regain and maintain their physical fitness. However, there is a lack of research to support the effects of exercise integrated with education after an SCI.

    Methods: A total of 44 participants will be assigned to either the experimental group (graded exercise integrated with education) or active control (conventional physical therapy). The experimental group will receive graded strength and aerobic exercise training according to their progression criteria. They will attend an education program during and after the rehabilitation program. The control group will only receive conventional physical therapy during their in-rehabilitation program. This study will be conducted during a period of 16 weeks, consisting of 8 weeks of in-rehabilitation and 8 weeks post-rehabilitation. Statistical analysis will be performed using the IBM SPSS ver. 21.0 (IBM Corp., Armonk, NY, USA) at a significance level of p≤0.05.

    Results: The primary outcome measures will be upper-limb isokinetic strength, isometric grip strength, and cardiorespiratory fitness. The secondary outcomes will be ESE and PA levels.

    Conclusions: An intervention that combines exercise training and education may be warranted to enhance the physical fitness, ESE, and PA levels in SCI patients. This trial was registered with ClinicalTrials.gov (NCT03420170).

    Matched MeSH terms: Self Efficacy
  16. Taresh SM, Morett LM, Zaid SM, Roslan S, Taresh Taleb M, Song P, et al.
    Autism, 2024 Jan;28(1):239-253.
    PMID: 37982401 DOI: 10.1177/13623613231211850
    Preschool teachers can play a critical role in early detection of autism. Equipping preschool teachers with prerequisite knowledge and skills would allow them to identify children with probable autism and referral to diagnostic services. This study aimed to investigate the impact of an educational module (EMiASD) that prepared preschool teachers to identify autism symptoms. The sample included 144 preschool teachers, of which 120 were stratified and randomly assigned to an intervention arm receiving training in EMiASD (n = 60) or a comparison arm receiving standard training (n = 60) using a parallel mixed-methods design. Responses to open-ended questions about video case studies revealed improvement in the identification of autism symptoms in preschool teachers in the intervention arm, in contrast to preschool teachers in the comparison arm. Moreover, significant changes in knowledge, belief, and self-efficacy about autism favoured EMiASD. Overall, these results demonstrate the influence of EMiASD in the Yemeni cultural context.
    Matched MeSH terms: Self Efficacy
  17. Abu Hassan H, Tohid H, Mohd Amin R, Long Bidin MB, Muthupalaniappen L, Omar K
    BMC Fam Pract, 2013;14:164.
    PMID: 24164794 DOI: 10.1186/1471-2296-14-164
    BACKGROUND: Many Type 2 Diabetes Mellitus (T2DM) patients refuse insulin therapy even when they require this modality of treatment. However, some eventually accept insulin. This study aimed to explore the T2DM patients' reasons for accepting insulin therapy and their initial barriers to use insulin.
    METHODS: This qualitative study interviewed twenty-one T2DM patients at a primary care clinic who had been on insulin for more than a year through three in-depth interviews and three focus group discussions. A semi structured interview protocol was used and the sessions were audio-recorded. Subsequently, thematic analysis was conducted to identify major themes.
    RESULTS: The participants' acceptance of insulin was influenced by their concerns and beliefs about diabetes and insulin. Concerns about complications of poorly controlled diabetes and side effects of other treatment regime had resulted in insulin acceptance among the participants. They also had a strong belief in insulin benefits and effectiveness. These concerns and beliefs were the results of having good knowledge about the diabetes and insulin, experiential learning, as well as doctors' practical and emotional support that helped them to accept insulin therapy and become efficient in self-care management. These factors also allayed their negative concerns and beliefs towards diabetes and insulin, which were their barriers for insulin acceptance as it caused fear to use insulin. These negative concerns were related to injection (self-injection, needle phobia, injection pain), and insulin use (inconvenience, embarrassment, lifestyle restriction, negative social stigma, and poor self-efficacy), whereas the negative beliefs were 'insulin could cause organ damage', 'their diabetes was not serious enough', 'insulin is for life-long', and 'insulin is for more severe disease only'.
    CONCLUSIONS: Exploring patients' concerns and beliefs about diabetes and insulin is crucial to assist physicians in delivering patient-centered care. By understanding this, physicians could address their concerns with aim to modify their patients' misconceptions towards insulin therapy. In addition, continuous educations as well as practical and emotional support from others were found to be valuable for insulin acceptance.
    TRIAL REGISTRATION: Universiti Kebangsaan Malaysia FF-214-2009.
    Study site: Primary Care clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Self Efficacy
  18. Tharek Z, Ramli AS, Whitford DL, Ismail Z, Mohd Zulkifli M, Ahmad Sharoni SK, et al.
    BMC Fam Pract, 2018 Mar 09;19(1):39.
    PMID: 29523075 DOI: 10.1186/s12875-018-0725-6
    BACKGROUND: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control.

    METHODS: This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA1c.

    RESULTS: A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P self-efficacy score was shown to be correlated with lower HbA1c(r - 0.41, P self-efficacy scores (b - 0.398; 95% CI: -0.024, - 0.014; P self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.

    Study site: two public primary care clinics (Klinik Kesihatan Taman Ehsan and Klinik Kesihatan Sungai Buloh), Selangor, Malaysia
    Matched MeSH terms: Self Efficacy*
  19. Lee JY, Chan CK, Chua SS, Ng CJ, Paraidathathu T, Lee KK, et al.
    BMC Health Serv Res, 2016 Sep 29;16(1):524.
    PMID: 27683021 DOI: 10.1186/s12913-016-1782-y
    BACKGROUND: The high market penetration of mobile phones has triggered an opportunity to combine mobile technology with health care to overcome challenges in today's health care setting. Although Malaysia has a high Internet and mobile penetration rate, evaluations of the efficacy of incorporating this technology in diabetes care is not common. We report the development of a telemonitoring coaching system, using the United Kingdom (UK) Medical Research Council (MRC) framework, for patients with type 2 diabetes mellitus.

    METHODS: The Intervention for Diabetes with Education, Technological Advancement and Support (IDEAS) study is a telemonitoring programme based on an empowerment philosophy to enable participants to be responsible for their own health decision and behaviour. An iterative cycle of development, piloting, and collating qualitative and quantitative data will be used to inform and refine the intervention. To increase compliance, the intervention will be designed to encourage self-management using simple, non-technical knowledge. The primary outcomes will be HbA1c, blood pressure, total cholesterol, and quality of life and diabetes self-efficacy. In addition, an economic analysis on health service utilisation will be collected.

    DISCUSSION: The mixed-method approach in this study will allow for a holistic overview of using telemonitoring in diabetes care. This design enables researchers to understand the effectiveness of telemonitoring as well as provide insights towards the receptiveness of incorporating information technology amongst type 2 diabetes patients in a community setting.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT02466880 Registered 2 June 2015.
    Matched MeSH terms: Self Efficacy
  20. Lai NM, Teng CL
    BMC Med Educ, 2011;11:25.
    PMID: 21619672 DOI: 10.1186/1472-6920-11-25
    BACKGROUND: Previous studies report various degrees of agreement between self-perceived competence and objectively measured competence in medical students. There is still a paucity of evidence on how the two correlate in the field of Evidence Based Medicine (EBM). We undertook a cross-sectional study to evaluate the self-perceived competence in EBM of senior medical students in Malaysia, and assessed its correlation to their objectively measured competence in EBM.
    METHODS: We recruited a group of medical students in their final six months of training between March and August 2006. The students were receiving a clinically-integrated EBM training program within their curriculum. We evaluated the students' self-perceived competence in two EBM domains ("searching for evidence" and "appraising the evidence") by piloting a questionnaire containing 16 relevant items, and objectively assessed their competence in EBM using an adapted version of the Fresno test, a validated tool. We correlated the matching components between our questionnaire and the Fresno test using Pearson's product-moment correlation.
    RESULTS: Forty-five out of 72 students in the cohort (62.5%) participated by completing the questionnaire and the adapted Fresno test concurrently. In general, our students perceived themselves as moderately competent in most items of the questionnaire. They rated themselves on average 6.34 out of 10 (63.4%) in "searching" and 44.41 out of 57 (77.9%) in "appraising". They scored on average 26.15 out of 60 (43.6%) in the "searching" domain and 57.02 out of 116 (49.2%) in the "appraising" domain in the Fresno test. The correlations between the students' self-rating and their performance in the Fresno test were poor in both the "searching" domain (r = 0.13, p = 0.4) and the "appraising" domain (r = 0.24, p = 0.1).
    CONCLUSIONS: This study provides supporting evidence that at the undergraduate level, self-perceived competence in EBM, as measured using our questionnaire, does not correlate well with objectively assessed EBM competence measured using the adapted Fresno test.
    STUDY REGISTRATION: International Medical University, Malaysia, research ID: IMU 110/06.
    Matched MeSH terms: Self Efficacy*
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