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Fulltext Knowledge, attitude, practice and stigma of tuberculosis among healthcare providers in Hospital Ampang

Hafridz Murshid al-Wafi Shahbuddin, Ummi Affah Mahamad, Abdul Aziz Marwan

Malaysian Journal of Medicine and Health Sciences, 2020;16(108):42-46.
MyJurnal

Introduction: Malaysia is an intermediate tuberculosis burdened country as classified by WHO. There was a recent rise in TB incidence. Healthcare providers, especially in secondary or tertiary centers, were constantly exposed to TB infected patients, which is a hazard source for TB infection. Thus, assessment of behavior towards TB is paramount through knowledge, attitude, health-seeking practice, and stigma domains. Method: A cross-sectional survey was carried out between November 2014 and February 2015 among healthcare providers in Medical Department, Hos- pital Ampang. Data were analyzed using SPSS ver 21. Results: Despite overall good knowledge on TB, only 20% of the correspondence knew which patient’s population is at risk of TB infection. Almost all perceived TB as a health threat and willing to seek medical care if they developed TB symptoms. However, a small proportion (5.3%) will keep it a secret if they contracted TB. This is contrasted by the majority that perceived TB patients will not be accept- ed by the community. Conclusion: Knowledge and attitude towards TB was adequate within the healthcare providers in Medical Department, Hospital Ampang despite the presence of some knowledge gaps. However, there was high perceived stigma that needed to be addressed in order for them to deliver the best medical care.

Matched MeSH terms: Social Stigma
Primary care barriers to cataract surgery in the eastern zone of Peninsular Malaysia: an interpretative phenomenological analysis

Nurulain MZ, Ahmad S, Asma H, Abdul M

Med J Malaysia, 2018 04;73(2):67-72.
PMID: 29703868

OBJECTIVE: Cataract is the leading cause of blindness in Malaysia. There is an alarming backlog of cataract extraction surgery as the majority believes they did not require surgery. This study aimed to explore the barriers at the primary care level to cataract surgery from the perspective of patients with severe cataract blindness.
METHODS: Eleven participants were involved in this qualitative research which utilised the interpretative phenomenological analysis approach more renowned in health psychology research. All interviews conducted at their home. The interviews were recorded, typed verbatim, and the transcripts were analysed using NVivo software version 8.0.
RESULTS: The main barriers identified at the primary care level were 1) nondisclosure of their visual problems originated from their belated needs for better sight, delayed awareness of their visual status and social stigma and 2) patient-provider-related issues namely miscommunication and delayed referral. The first main theme explains their belief for not requiring surgery. This has led to their delayed awareness and impeded disclosure of their visual problems to family members or primary care providers. The second main theme reflects the provider-patient-related issues which retarded cataract detection and referral process required for earlier cataract extraction surgery.
CONCLUSION: Thus, the appropriate approach targeting these specific barriers at primary care level will be able to detect, motivate and assist patients for early uptake of cataract extraction surgery to improve their vision and prevent severe blindness.

Matched MeSH terms: Social Stigma
Fulltext Relationship and career challenges faced by people infected with HIV in Malaysia

Tuan Abdullah TN, Mat Min R, Hossain M, Abdullah SS

F1000Res, 2019;8:1994.
PMID: 33214871 DOI: 10.12688/f1000research.21079.3

Background: In Malaysia, there are still lack of studies related to the challenges of people infected with HIV (PIWH). Therefore, this study was conducted to explore the experiences of PIWH and how they cope with HIV. Methods: This qualitative study was based on a social constructivist and grounded theory approach. A total of 12 PIWH were selected by purposive sampling, all of whom participated in semi-structured and audio-recorded interviews, which were supported with non-participant observations and diary entries on three occasions for each participant. The interviews and diaries were transcribed and analysed using the grounded theory approach, which was assisted by utilizing NVIVO-8 to identify the themes related to the experiences of the participants. Results: PIWH experienced challenges related to their career and relationships with family and others. These challenges led to difficulties in gaining employment and career development, as well as feelings of denial, being uncomfortable, rejection, and labelling. They found that their lives were totally and dramatically changed after being tested positive for HIV. Conclusions: Among PIWH, HIV impacted relationships with significant others and career development. The absence of support and acceptance from significant others affected the ability of PIWH to cope with their daily challenges. The results of this study have implications for policymakers in terms of gaining sufficient knowledge and awareness to provide prevention programmes for HIV/AIDS.

Matched MeSH terms: Social Stigma
Fulltext Poor adherence to antiretroviral therapy and associated factors among people living with HIV in Omdurman City, Sudan

Yassin Ibrahim, Rosnah Sutan, Khalib Bin Abdul Latif, Al - Abed A. Al - Abed, Amara, Ahmed, Adam, Ishag

Malaysian Journal of Public Health Medicine, 2014;14(1):90-101.
MyJurnal

Adherence to antiretroviral therapy (ART) plays an important role in the treatment outcomes of human immunodeficiency virus (HIV) infection. Poor adherence would result in failure to prevent viral replication as well as an increased risk of developing drug resistance. Adherence to a life long treatment such as antiretroviral therapy is usually a complicated issue that requires careful and continuous collaboration of patient, family and healthcare provider. The objective of this study was to assess adherence to antiretroviral therapy and its associated factors among people living with HIV. This is a health facility-based cross sectional study conducted among adults’ people living with HIV in Omdurman HIV/AIDS centre, Sudan. Data was collected through direct interview using semi-structured questionnaire. There were only 144/846 (17.02%) who adhered to antiretroviral therapy as prescribed by their doctors. The remaining 51.18% were taking the therapy but not regularly, 31.21% were taking it but currently not and 0.59% stated that they have never taken any antiretroviral therapy. Factors associated with poor adherence that have been identified include female gender (Adj. OR = 3.46 (95%CI: 1.46-8.21), P = 0.005), younger age (Adj. OR = 1.14 (95%CI: 1.02-1.28), P = 0.022), being unemployed (Adj. OR = 5.94 (95%CI: 1.51-23.40), P = 0.011), those who were divorced, separated or widowed (Adj. OR = 11.35 (95%CI: 1.74-73.96), P = 0.011) and respondents who perceived that their health status is poor (Adj. OR = 5.21 (95%CI: 1.44-18.81), P = 0.012) or very poor (Adj. OR = 4.04 (95%CI: 1.27-12.81), P = 0.018). Educational level and social support against HIV-related stigma and discrimination were not significantly associated with adherence. Adherence to antiretroviral therapy among the respondents is very poor. Urgent interventions based on modifiable factors and mainly targeting females and younger age group are needed to improve adherence to antiretroviral therapy among people living with HIV.

Matched MeSH terms: Social Stigma
The implication of stigma on people living with HIV and the role of social support - A case report

Hadi AM, Lee PY, Adibah HI

Malays Fam Physician, 2020;15(2):43-45.
PMID: 32843944

Despite the advancements made in the knowledge and treatment of the human immunodeficiency virus (HIV) since it was first discovered, people living with HIV (PLWH) continue to be stigmatized. This paper presents the case of an HIV-infected patient who delayed the necessary treatment due to stigma and ultimately presented with AIDS. Through social support, however, he was able to overcome his internalized stigma; he was finally willing to start on antiretroviral treatment (ART). This case report addresses the effect of stigma on and the role of social support in the management of an individual with HIV.

Matched MeSH terms: Social Stigma
Fulltext The experiences and challenges in caring for HIV/AIDS patients: a qualitative exploration among Muslim family caregivers in Terengganu, Malaysia

Pei, Lin Lua, Norhayati Mustapha, Ramle Abdullah, Ahmad Kashfi Abdul Rahman

ASEAN Journal of Psychiatry, 2014;15(2):120-130.
MyJurnal

Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school
= 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 120-130.

Matched MeSH terms: Social Stigma
Fulltext Mental health issues : revisited

Osman Che Bakar, Ainsah Omar

Medical Health Reviews, 2009;2009(2):17-26.
MyJurnal

The various shortcomings involving issues related to managing patients with mental health are compared to those with physical health which are mainly attributed to attitude, misconception and stigma attached to mental health. There is a strong need to have a comprehensive collective efforts and a paradigm shift on how to deal with these critical issues especially in the area of Primary care for mentally ill.

Matched MeSH terms: Social Stigma
Fulltext Isu dan cabaran pelajar kurang upaya penglihatan di institusi pengajian tinggi

Raja Nur Fakhriah Raja Zainal B, Aizan Sofia A

Jurnal Psikologi Malaysia, 2018;32:131-145.

Education is one of the most important aspects for every individual including people with visual impairments. Visually impaired students also have the right to a good educational opportunity to higher education. In this regard, this article explores the issues and challenges of visually impaired students in higher learning institution. This study uses a full qualitative approach, a case study in the Klang Valley. In-depth interviews were used in data collection involving 5 students with visual impairment: four males and one female. The findings showed that among the major issues faced by visually impaired students pursuing higher education in tertiary institution were self-esteem, financial and public stigma. In addition, visually impaired students also faced challenges in accessibility, peer-to-peer acceptance and difficulties in learning at the university. In conclusion, this study emphasises on issues and challenges often faced by students with visual impairments at higher learning institution so that appropriate supports and facilities can be effectively provided by the university.

Matched MeSH terms: Social Stigma
Knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among people diagnosed with schizophrenia in a long-term care facility

Alhadidi M, Abdullah KL, Tang LY, Danaee M, Al Hadid LAR

Perspect Psychiatr Care, 2021 Jan;57(1):225-234.
PMID: 32502330 DOI: 10.1111/ppc.12553

PURPOSE: This study assessed the level of knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among patients with schizophrenia in Jordan.
DESIGN AND METHODS: A cross-sectional survey was conducted on 135 patients diagnosed with schizophrenia, who had been admitted to the largest psychiatric hospital in Jordan.
FINDINGS: The participants had a low level of knowledge, insight, and a high level of internalized stigma. No correlation was found between these variables. Meanwhile, the educational level and vacation were found to be predictors of knowledge.
PRACTICE IMPLICATIONS: This can help psychiatric nurses to identify which area needs to be improved to ensure the best service and care is provided to patients diagnosed with schizophrenia.

Matched MeSH terms: Social Stigma*
Fulltext Transgender women in Malaysia, in the context of HIV and Islam: a qualitative study of stakeholders' perceptions

Barmania S, Aljunid SM

BMC Int Health Hum Rights, 2017 10 18;17(1):30.
PMID: 29047415 DOI: 10.1186/s12914-017-0138-y

BACKGROUND: Globally, one of the key groups considered to be at high risk of acquiring HIV are transgender women, often a marginalised group. In the Malaysian context there has been a scarcity of published research relating to transgender women, a sensitive issue in a Muslim majority country, where Islam plays an influential role in society. Furthermore, there has been a paucity of research relating to how such issues relate to HIV prevention in transgender women in Malaysia. Thus, the aim of this study is to explore the attitudes of stakeholders involved in HIV prevention policy in Malaysia towards transgender women, given the Islamic context.
METHODS: In-depth interviews were undertaken with stakeholders involved in HIV prevention, Ministry of Health, Religious Leaders and People Living with HIV, including transgender women. Thirty five participants were recruited using purposive sampling from June to December 2013 within Kuala Lumpur and surrounding vicinities. Interviews were in person, audiotaped, transcribed verbatim and used a framework analysis.
RESULTS: Five central themes emerged from the qualitative data; Perceptions of Transgender women and their place in Society; Reaching out to Transgender Women; Islamic doctrine; 'Cure', 'Correction' and finally, Stigma and Discrimination.
DISCUSSION: Islamic rulings about transgenderism were often the justification given by participants chastising transgender women, whilst there were also more progressive attitudes and room for debate. Pervasive negative attitudes and stigma and discrimination created a climate where transgender women often felt more comfortable with non-governmental organisations.
CONCLUSION: The situation of transgender women in Malaysia and HIV prevention is a highly sensitive and challenging environment for all stakeholders, given the Muslim context and current legal system. Despite this apparent impasse, there are practically achievable areas that can be improved upon to optimise HIV prevention services and the environment for transgender women in Malaysia.

Matched MeSH terms: Social Stigma*
Fulltext Prevalence and correlates of community re-entry challenges faced by HIV-infected male prisoners in Malaysia

Choi P, Kavasery R, Desai MM, Govindasamy S, Kamarulzaman A, Altice FL

Int J STD AIDS, 2010 Jun;21(6):416-23.
PMID: 20606222 DOI: 10.1258/ijsa.2009.009180

HIV-infected prisoners face an inordinate number of community re-entry challenges. In 2007, 102 HIV-infected prisoners in Malaysia were surveyed anonymously within six months prior to release to assess the prevalence and correlates of community re-entry challenges. Staying out of prison (60.8%), remaining off drugs (39.2%), finding employment (35.3%) and obtaining HIV care (32.4%) were the re-entry challenges reported most frequently. Global stigma, negative self-image and public attitudes-related stigma were independently associated with challenges to obtaining HIV care. In multivariate analyses, those with previous incarcerations (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.4-7.6), higher HIV-related symptoms (AOR, 2.0; 95% CI, 1.0-4.1) and higher public attitudes-related stigma (AOR, 2.5; 95% CI, 1.2-5.1) had a significantly higher likelihood of identifying more re-entry challenges. Targeted interventions, such as effective drug treatment, HIV care and public awareness campaigns, are crucial for stemming the HIV epidemic and improving health outcomes among HIV-infected prisoners in Malaysia.

Matched MeSH terms: Social Stigma
Fulltext Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?

Earnshaw VA, Jin H, Wickersham JA, Kamarulzaman A, John J, Lim SH, et al.

AIDS Behav, 2016 Jan;20(1):98-106.
PMID: 26324078 DOI: 10.1007/s10461-015-1168-x

Men who have sex with men (MSM) living in countries with strong stigma toward MSM are vulnerable to HIV and experience significant barriers to HIV care. Research is needed to inform interventions to reduce stigma toward MSM in these countries, particularly among healthcare providers. A cross-sectional survey of 1158 medical and dental students was conducted at seven Malaysian universities in 2012. Multivariate analyses of variance suggest that students who had interpersonal contact with MSM were less prejudiced toward and had lower intentions to discriminate against MSM. Path analyses with bootstrapping suggest stereotypes and fear mediate associations between contact with prejudice and discrimination. Intervention strategies to reduce MSM stigma among healthcare providers in Malaysia and other countries with strong stigma toward MSM may include facilitating opportunities for direct, in-person or indirect, media-based prosocial contact between medical and dental students with MSM.

Matched MeSH terms: Social Stigma*
Fulltext The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons

Culbert GJ, Bazazi AR, Waluyo A, Murni A, Muchransyah AP, Iriyanti M, et al.

AIDS Behav, 2016 05;20(5):1026-38.
PMID: 26400080 DOI: 10.1007/s10461-015-1198-4

Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.

Matched MeSH terms: Social Stigma*
Fulltext Attitudes Toward Addiction, Methadone Treatment, and Recovery Among HIV-Infected Ukrainian Prisoners Who Inject Drugs: Incarceration Effects and Exploration of Mediators

Polonsky M, Rozanova J, Azbel L, Bachireddy C, Izenberg J, Kiriazova T, et al.

AIDS Behav, 2016 12;20(12):2950-2960.
PMID: 27011378

In this study, we use data from a survey conducted in Ukraine among 196 HIV-infected people who inject drugs, to explore attitudes toward drug addiction and methadone maintenance therapy (MMT), and intentions to change drug use during incarceration and after release from prison. Two groups were recruited: Group 1 (n = 99) was currently incarcerated and Group 2 (n = 97) had been recently released from prison. This paper's key finding is that MMT treatment and addiction recovery were predominantly viewed as mutually exclusive processes. Group comparisons showed that participants in Group 1 (pre-release) exhibited higher optimism about changing their drug use, were less likely to endorse methadone, and reported higher intention to recover from their addiction. Group 2 participants (post-release), however, reported higher rates of HIV stigma. Structural equation modeling revealed that in both groups, optimism about recovery and awareness of addiction mediated the effect of drug addiction severity on intentions to recover from their addiction.

Matched MeSH terms: Social Stigma
Fulltext Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia

Earnshaw VA, Jin H, Wickersham J, Kamarulzaman A, John J, Altice FL

Trop Med Int Health, 2014 Jun;19(6):672-679.
PMID: 24666546 DOI: 10.1111/tmi.12306

OBJECTIVES: Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia.
METHODS: An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio-demographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university.
RESULTS: The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio-demographic characteristics and 28% accounted for by stigma-related constructs.
CONCLUSIONS: It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care.
KEYWORDS: HIV/AIDS; Malaisie; Malasia; Malaysia; VIH/SIDA; cuidados sanitarios profesionales; discriminación; discrimination; estigma; homosexuality; professional healthcare students; stigma; stigmatisation; substance abuse; étudiants en profession de soins de santé

Matched MeSH terms: Social Stigma*
Fulltext An assessment of health-care students' attitudes toward patients with or at high risk for HIV: implications for education and cultural competency

Jin H, Earnshaw VA, Wickersham JA, Kamarulzaman A, Desai MM, John J, et al.

AIDS Care, 2014;26(10):1223-8.
PMID: 24625279 DOI: 10.1080/09540121.2014.894616

Stigma perpetuated by health-care providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWIDs), and men who have sex with men (MSM) in multiple clinical contexts and remains unexamined among professional health-care students in Malaysia. This cross-sectional, anonymous, and Internet-based survey assessed the attitudes of medical and dental students toward HIV-infected, PWID, and MSM patients. Survey invitation was emailed to 3191 students at 8 professional schools; 1296 (40.6%) responded and scored their attitudes toward these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0 (most negative) to 100 (most positive). Compared to general patients (mean = 76.50), the mean scores for HIV-infected (mean = 54.04; p < 0.001), PWID (mean = 37.50; p < 0.001), and MSM (mean = 32.13; p < 0.001) patients were significantly lower and significantly different between each group comparison. Within group differences, most notably religion, ethnicity, and personally knowing someone from these populations were associated with significant differences in attitudes. No differences were noted between pre-clinical and clinical year of training. Health-care students represent the next generation of clinicians who will be responsible for future HIV prevention and treatment efforts. Our findings suggest alarmingly negative attitudes toward these patients, especially MSM, necessitating prompt and effective interventions designed to ameliorate the negative attitudes of health-care students toward vulnerable populations, specifically HIV-infected, PWID, and MSM patients in Malaysia.
Site site: online surveys at seven universities: University of Malaya, National University of Malaysia, International Islamic University Malaysia, Universiti Malaysia Sarawak, Penang International Dental College, Universiti Teknologi MARA Malaysia, and Universiti Sains Malaysia.

Matched MeSH terms: Social Stigma*
Fulltext A Moderated Mediation Model of HIV-Related Stigma, Depression, and Social Support on Health-Related Quality of Life among Incarcerated Malaysian Men with HIV and Opioid Dependence

Shrestha R, Copenhaver M, Bazazi AR, Huedo-Medina TB, Krishnan A, Altice FL

AIDS Behav, 2017 Apr;21(4):1059-1069.
PMID: 28108877 DOI: 10.1007/s10461-017-1693-x

Although it is well established that HIV-related stigma, depression, and lack of social support are negatively associated with health-related quality of life (HRQoL) among people living with HIV (PLH), no studies to date have examined how these psychosocial factors interact with each other and affect HRQoL among incarcerated PLH. We, therefore, incorporated a moderated mediation model (MMM) to explore whether depression mediates the effect of HIV-related stigma on HRQoL as a function of the underlying level of social support. Incarcerated HIV-infected men with opioid dependence (N = 301) were recruited from the HIV units in Kajang prison in Malaysia. Participants completed surveys assessing demographic characteristics, HIV-related stigma, depression, social support, and HRQoL. Results showed that the effect of HIV-related stigma on HRQoL was mediated via depression (a1:β = 0.1463, p social support and HRQoL was positive (β = 0.4352, p = 0.0433), whereas the interaction between HIV-related stigma and depression was negatively associated with HRQOL (β = -0.0317, p = 0.0133). This indicated that the predicted influence of HIV-related stigma on HRQoL via depression had negative effect on HRQoL for individuals with low social support. The results suggest that social support can buffer the negative impact of depression on HRQoL and highlights the need for future interventions to target these psychosocial factors in order to improve HRQoL among incarcerated PLH.

Matched MeSH terms: Social Stigma*
Development and Psychometric Properties of a Tuberculosis-Specific Multidimensional Health-Related Quality-of-Life Measure for Patients with Pulmonary Tuberculosis

Abdulelah J, Sulaiman SAS, Hassali MA, Blebil AQ, Awaisu A, Bredle JM

Value Health Reg Issues, 2015 May;6:53-59.
PMID: 29698193 DOI: 10.1016/j.vhri.2015.03.006

BACKGROUND: Various generic instruments exist to assess health-related quality of life (HRQOL) in patients with tuberculosis (TB), but a psychometrically sound disease-specific instrument is lacking.

OBJECTIVES: The present study aimed to develop and psychometrically validate a multidimensional TB-specific HRQOL instrument relevant to the value of patients with pulmonary TB in Iraq with an eye toward cross-cultural application.

METHODS: The core general HRQOL questionnaire is composed of the Functional Assessment of Cancer Therapy-General items. A modular approach was followed for the development of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) questionnaire in which a set of items assessing quality-of-life (QOL) issues not sufficiently covered by the core Functional Assessment of Cancer Therapy-General items, but considered to be relevant to the target population, was added. Moreover, principal-component analysis was used to determine the new subscale structure of the questionnaire.

RESULTS: In addition to the 27 items of the core questionnaire, a set of 20 items referring to disease symptoms related to the site of infection, adverse effects, and additional QOL dimensions such as fatigue, social stigma, and economic burden of the illness was included. Factor analysis demonstrated that the FACIT-TB construct comprised five domains.

CONCLUSIONS: A rigorous method was applied in the development of the FACIT-TB measure to fully understand the impact of TB on patients' QOL. The instrument is psychometrically sound and portrays multiple important dimensions of HRQOL. FACIT-TB is relatively brief, is easy to administer and score, and is appropriate for use in clinical trials and practice.

Matched MeSH terms: Social Stigma
Fulltext Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Focus Group Study and Systematic Development

Wan Mohd Yunus WMA, Musiat P, Brown JSL

Behav Sci (Basel), 2020 Dec 16;10(12).
PMID: 33339086 DOI: 10.3390/bs10120193

Brief face-to-face self-confidence workshops were effective in reducing depression among the public. Technological advances have enabled traditional face-to-face interventions to be adapted using unique technology-mediated platforms. This article details the formative development of a self-confidence web-based seminar (webinar) intervention for workplace depression. The first section discusses a qualitative study that explores the feasibility and acceptability of adapting the self-confidence workshops into a webinar platform on employees in the workplace. The second section describes the systematic development of this new webinar intervention informed by the qualitative study findings, a published systematic review, and previous face-to-face self-confidence workshops. The qualitative study involves three focus groups (n = 10) conducted in a small organization. Three themes were identified relevant to the running of the new self-confidence webinars in the workplace: personal (content, time and duration preference, features of the webinar, individual participation, personalization), interpersonal (stigma from others, engagement with participants/presenter, moderated interaction), and organizational (endorsement from management, work demand). For the intervention development, the format, structure, features, and content of the self-confidence webinar intervention are described. Features such as file sharing, virtual whiteboard, live chat, and poll are explained with the intervention primarily based on cognitive behavior therapy and coping flexibility concepts.

Matched MeSH terms: Social Stigma
Fulltext Validation of the malay version of the Affiliate Stigma Scale among caregivers of patients with mental illness

Yun YS, Jaapar SZS, Fadzil NA, Cheng KY

Malays J Med Sci, 2018 Nov;25(6):127-136.
PMID: 30914886 MyJurnal DOI: 10.21315/mjms2018.25.6.13

Background: Caregivers of patients with mental illness are exposed to stigma. The internalisation of this stigma among caregivers is known as affiliate stigma and can be measured by the Affiliate Stigma Scale (ASS). The aim of this study was to validate the Malay version of the ASS.
Methods: A cross-sectional study was performed from May to December 2017 with 372 caregivers of patients with mental illness. The ASS was first translated into Malay using standard forward and backward translation procedures. The final version of the ASS-Malay (ASS-M) was completed by participants. The data analyses involved assessment of construct validity by exploratory factor analysis, confirmatory factor analysis and construct reliability.
Results: The final model of the ASS-M consists of four factors with 21 items, as compared to the original version, which has three factors with 22 items. The results showed that the final model has good model fit based on RMSEA (0.065) and SRMR (0.055) and a satisfactory composite reliability (affective = 0.827, cognitive = 0.857, behaviour = 0.764, self-esteem = 0.861).
Conclusion: The study showed that the four-factor, 21-item ASS-M model has good psychometric properties. The scale is valid and reliable for measuring affiliate stigma among caregivers of patients with mental illness in Malaysia.

Matched MeSH terms: Social Stigma

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