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Fulltext Postpartum depression among Malay women from a rural area in Kedah, north-west of Peninsular Malaysia: prevalence and risk factor

Wan Mahmud WMR, Hayati MR, Bashah B, Amir A, Mahmood NM

Malaysian Journal of Psychiatry, 2005;13:3-19.

Background: Community based epidemiological data on postpartum depression in Malaysia is scarce. Aim: To determine the prevalence and risk factors for developing postpartum depression among Malay women from a rural area in Kedah, North West of Peninsular Malaysia. Method: We screened 185 women at 4-12 weeks postpartum attending the selected health centers using the Malay versions of Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory II (BDI-11). Those scoring 12 and / or 9/10 on BDI-11 were interviewed using the Composite International Diagnostic Interview (CIDI) and the 17-items Hamilton Rating Scale for Depression (HDRS-17). All diagnoses were based on the Tenth Edition of the International Classification for Disease: Diagnostic Criteria for Research (ICD-I0: DCR-10). Results: The prevalence of postpartum depression was 21.08%. The condition was found to be significantly linked to polygamous marriages, high number of life events and financial problems over the last one year prior to delivery, and low scores on the Malay version of the MOS Social Support Survey and all its components (overall support index, informational support, affectionate support/ positive social interactions and instrumental support). Conclusions: Postpartum depression is indeed a reality among Malay women in rural areas In Kedah, North West of Peninsular Malaysia. These findings have implications for policies regarding maternal and childcare programs.

Matched MeSH terms: Ambulatory Care Facilities
Help seeking behaviour among men with erectile dysfunction in primary care setting

Ab Rahman AA, Al-Sadat N, Low WY

Journal of Men's Health, 2011;8 Suppl 1:S94-S96.
DOI: 10.1016/S1875-6867(11)60033-X

Background: To examine the self-reported erectile problem and help-seeking behaviour among men.
Methods: A cross-sectional study was carried out among 1331 men aged 40 years and above who attended public primary care clinics in an urban district in Malaysia. Questions were asked regarding presence of erectile problem, help-seeking behaviour and treatment sought.
Results: The mean age was 54.7 (±8.3), ranging from 40 to 79 years. Among the subjects, 69.5% (n = 925) had erectile dysfunction (ED); however, only 54.8% reported having difficulty with erection. The subjects with severe ED had higher proportion of self-reported ED (90.8%) than moderate (75.7%) and mild ED (27.4%). More than two-third of the subjects (67.2%) have spoken to someone about their difficulty; of these, 54.1% spoke to their spouse or partner, 6.3% to friends and 5.3% to family members. Only 32.4% had initiated the discussion with their doctor, whereas only 10.5% reported that their doctor had raised the issue. Among the men who did not seek any help, reasons were: ED normal part of aging (37.9%), due to health condition (32.2%), ED was caused by medication (9.4%) and they were embarrassed (7.3%). Only 4.4% had sought treatment. More than one third participants (35%) had used Sildenafil while most had used other traditional medicines such as Tongkat Ali, massage and Chinese herbs.
Conclusions: Self-reported erectile problem among men is common. However, ED is not a health condition that patients would commonly discuss with their doctors despite the fact that they are already seeing doctors for various other medical reasons. © 2011 WPMH GmbH.

Matched MeSH terms: Ambulatory Care Facilities
Anti-CCP antibodies: A better diagnostic tool for rheumatoid arthritis

Dollah R, Yaacob A, Ismail AH, Che Hussin CM

International Medical Journal (Tokyo), 2011;18(1):53-57.

Objective: The assay for anti-cyclic citrullinated peptide (anti-CCP) antibody is a recent test of interest due to low diagnostic specificity of rheumatoid factor in the diagnosis of rheumatoid arthritis. To determine the sensitivity and specificity of anti-CCP antibodies in rheumatoid arthritis patients using American College of Rheumatology (ACR) criteria as a gold standard.
Design: A cross sectional study was conducted from January 2008 to December 2008 on 100 patients with rheumatoid arthritis and 153 patients with arthritis or arthralgia but not fulfilling ACR criteria for rheumatoid arthritis.
Materials and Methods: Serum from each subject was tested for anti-CCP antibodies and IgM rheumatoid factor (IgM RF) by an enzyme linked immunosorbent assay (ELISA). Sensitivity and specificity of the tests were evaluated using the ACR criteria as the gold standard. Data was analyzed using SPSS version 12.0 software. The association between the two categorical variables were tested using chi-square test. The differences between the two groups were tested using independent t-test. Results: The sensitivity of anti-CCP antibodies was 71% with 94.8% of specificity. For rheumatoid factor the sensitivity was 85% and the specificity was 74.5%. Positive predictive value for anti-CCP antibodies was 89.9% whereas for rheumatoid factor it was 68.5%. The sensitivity of ACR criteria with inclusion of anti- CCP antibodies was 100% and specificity of 94.8% (95%CI: 91.3%, 98.2%).
Conclusion: Anti-CCP antibody has a higher diagnostic accuracy compared to the RF. Anti-CCP antibody is a useful laboratory marker to support the diagnosis of rheumatoid arthritis and to differentiate patients with rheumatoid arthritis from rheumatoid arthritis-like symptoms. Therefore, it is suggested that anti-CCP antibodies should be included as another laboratory supportive criterium besides RF test in ACR criteria in the diagnosis of RA.
Study site: family medicine clinic, rheumatology clinic and immunology laboratory of Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Anaemia among primary care patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD): a multicentred cross-sectional study

Idris I, Tohid H, Muhammad NA, A Rashid MR, Mohd Ahad A, Ali N, et al.

BMJ Open, 2018 12 22;8(12):e025125.
PMID: 30580276 DOI: 10.1136/bmjopen-2018-025125

OBJECTIVES: This study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors.
DESIGN, SETTING AND PARTICIPANTS: This cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing.
RESULTS: The prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia.
CONCLUSION: Anaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care.

TRIAL REGISTRATION NUMBER: NMRR-15-660-24324.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Home Blood Pressure Monitoring Has Similar Effects on Office Blood Pressure and Medication Compliance as Usual Care

Muhammad J, Jamial MM, Ishak A

Korean J Fam Med, 2019 Sep;40(5):335-343.
PMID: 30636386 DOI: 10.4082/kjfm.18.0026

BACKGROUND: Home blood pressure monitoring is recommended to achieve controlled blood pressure. This study evaluated home blood pressure monitoring-improvement of office blood pressure control and treatment compliance among hypertensive patients.
METHODS: A randomized controlled trial was conducted from December 2014 to April 2015. The home blood pressure monitoring group used an automatic blood pressure device along with standard hypertension outpatient care. Patients were seen at baseline and after 2 months. Medication adherence was measured using a novel validated Medication Adherence Scale (MAS) questionnaire. Office blood pressure and MAS were recorded at both visits. The primary outcomes included evaluation of mean office blood pressure and MAS within groups and between groups at baseline and after 2 months.
RESULTS: Mean changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and MAS differed significantly within groups. The home blood pressure monitoring group showed greater mean changes (SBP 17.6 mm Hg, DBP 9.5 mm Hg, MAS 1.5 vs. SBP 14.3 mm Hg, DBP 6.4 mm Hg, MAS 1.3), while between group comparisons showed no significant differences across all variables. The adjusted mean difference for mean SBP was 4.74 (95% confidence interval [CI], -0.65 to 10.13 mm Hg; P=0.084), mean DBP was 1.41 (95% CI, -2.01 to 4.82 mm Hg; P=0.415), and mean MAS was 0.05 (95% CI, -0.29 to 0.40 mm Hg; P=0.768).
CONCLUSION: Short-term home blood pressure monitoring significantly reduced office blood pressure and improved medication adherence, albeit similarly to standard care.

Matched MeSH terms: Ambulatory Care
Fulltext Demographic and socioeconomic factors associated with access to public clinics

Makmor T., Khaled, T., Ahmad Farid O., Nurul Huda M.S.

JUMMEC, 2018;21(1):28-33.
MyJurnal

Introduction: Providing adequate and equal access to healthcare is a key goal towards achieving universal health coverage. However, social and demographic inequalities in accessing health care services exist in both developed and developing countries. This study examined the demographic and socio-economic factors associated with the lack of access to public clinics in the Greater Kuala Lumpur area.
Materials and Methods: The study employed a survey involving 1032 participants. Data were collected using self- administered questionnaires distributed between October and December 2015 in the Greater Kuala Lumpur area.
Results: Of the 1032 participants, 535 were public clinic users. A quarter (25.8%) of the users stated that they did not have access to public clinics in their residential area. A multiple logistic analysis showed that the elderly, the women, those from ethnic minority groups, those of lower family income, and the private sector workers were more likely not to have access to public clinics than their counterparts.
Conclusions: The existing level of accessibility to public clinics could be improved by increasing the number of clinics. Clinics should be established to focus more on reaching the elderly, the women, the ethnic minority groups, the poorer families, and the private sector employees.

Matched MeSH terms: Ambulatory Care
Fulltext Assessment of diabetic patient waiting time in a primary healthcare clinic

Mohd Shaiful Ehsan Shalihin, Iskandar Firzada Osman, Muhammad Hapizie Bin Din

IIUM Medical Journal Malaysia, 2020;19(2):41-48.
MyJurnal

Introduction: Long waiting time is a common issue complained by diabetic patients that came for an
early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in
a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for
improvement. Methods: This audit was conducted for four weeks using a universal sampling method in
November 2017. All diabetic patients who attended the clinic during this period were included except those
who required longer period such as critically ill patients or those who came for repeat medication or
procedures. The arrival and departure time for each station was captured using the modified waiting time
slip, which is manually filled at every station. The waiting and consultation time for registration, screening,
laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into
the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered
within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was
20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other
stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58
minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor
tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file
tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.

Matched MeSH terms: Ambulatory Care Facilities
Long term visit-to-visit variability of systolic blood pressure and cardiovascular disease events in a primary care setting: a 10-year retrospective cohort study [Abstract OS 04-05]

Ching SM, Chia YC, Lim HM

J Hypertens, 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e56.
PMID: 27753921

Conference abstract:
OBJECTIVE: This study aims to determine the relationship of long term visit to visit variability (VVV) of SBP and cardiovascular disease (CVD) in a primary care setting.
DESIGN AND METHOD: This is a retrospective study of a cohort of 1416 patients over a period of 10 years (1998-2007). Demographic data, three monthly clinic BP readings and CVD events were captured from patient records. We derived the mean BP and VVV of SBPs for each subject and divided them into three groups defined as non hypertension, developed hypertension along the 10-year follow-up and persistent hypertension. We examined differences in cardiovascular events across these groups.
RESULTS: Mean age of the participants at baseline was 56.5 ± 10.1 years, 34.6% were males. Table 1 describes mean SBP, BPV and CVD events of the study population.Those with both low mean SBP and low BPV have the lowest CVD events, conversely those with both high mean SBP and high BPV have highest CVD events. In those patients with the same mean SBP, whether high or low, those with higher BPV have more events than those with lower BPV. However patients with low mean SBP but high BPV have more CVD events compared with those patients with high mean SBP but low BPV (p = 0.04) suggesting BPV is more important than mean SBP in causing CVD events.We used ROC of VVV SBP to identify the cut off point of 12.9 mmHg as the indicator for increase in CVD events.
CONCLUSIONS: In our study, we found that patients with hypertension have higher BPV than normotensive subjects. Furthermore those with higher BPV also had more CVD events. As such, we should prioritize lowering not only mean systolic BP but lowering BPV as well. Long term VVV SBP should be another target in the management of patients with hypertension.

Matched MeSH terms: Ambulatory Care Facilities
Triage of urology referrals and outpatient service during COVID-19 pandemic: experience from a single centre in Malaysia

Ong LK, Sivaneswaran L, Mohd Najib A, Devindran M, Say BL, Rohan MJ

Med J Malaysia, 2020 07;75(4):400-402.
PMID: 32724002

In Malaysia, COVID-19 pandemic recorded considerable number of cases. Many hospitals have been converted into COVID-19 centres to manage these cases. The Penang General Hospital was designated as a hybrid hospital to manage both COVID-19 and non-COVID-19 cases. Consequently, services across specialties, including urology have been affected. Triage of referrals was necessary to ensure optimum patient care, thus we designed a triage system to address this situation. A record screening system of patients was also implemented to limit outpatient appointments. We share this early experience in managing urology patients during this pandemic.

Matched MeSH terms: Ambulatory Care
The prevalence of depression among elderly patients attending a rural primary health care clinic

Mohd Noor N, Mohd Sidik S

Family Physician, 2003;12:30-35.

Introduction: Depression is an important problem in primary care practice and is the commonest psychiatric disorder among the elderly.
Aim: To assess the prevalence of depression among the elderly patients attending a rural primary health care clinic in Malaysia and to identify its associated factors.
Method: The Geriatric Depression Scale (GDS) questionnaire was used as a screening instrument. Patients with positive GDS scores for depression were further assessed for Major Depression.
Results: 14% of the patients were found to have depression. The associated factors identified were gender, marital status, educational level, total family monthly income, living arrangement and if they had someone to confide in. Further clinical evaluation using the DSM IV Criteria for major depression revealed that two-thirds of the patients with depression were suffering from major depression.
Conclusion: The prevalence of depression among the elderly patients at a rural primary health care clinic was high. Primary health care doctors and staff should take extra care to detect depression when managing elderly patients.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Morbidity patterns in elderly patients presenting to a family practice

Teoh LC, Chan SC

Family Physician, 2003;12(1):24-28.

The morbidity patterns of elderly patients presenting to a family physician clinic was studied by the attending physician completing a questionnaire on all elderly patients aged 60 and above attending the clinic between 1st January to 31st March 2000. 612 elderly patients registered during the study period. The most common presentations included upper respiratory tract infections (21.6%), hypertension and diabetes mellitus (18%), gastritis/dyspepsia (5.0%) and injuries (5.0%), Musculoskeletal complaints (backache, gout, osteoarthritis) and anxiety were also among the top 10 most common presenting complaints. Injuries were mainly soft tissue injuries and sprains sustained at home. Some were preventable.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Group A streptococcal skin infection in childhood

Jamal F, Minhaj AA, Kasim MS, Zainal Z, George R

Family Practitioner, 1985;8(2):53-56.

Bacterial skin infection was studied in 239 children between the ages of 1 and 12 years in an urban squatter area in Kuala Lumpur over a period of three months (January - March 1983). 62 children presented with dermatological problems, 33 of which were clinically diagnosed as pyoderma. Microbiological examination of swabs from the lesions yielded mixed growth from 54.5% (18/33) specimens. Beta-haemolytic streptococci were isolated from 63.6% (21/33) and Staphylococcus aureus from 54.5% (18/33) specimens. All streptococcal isolates were grouped with a commercial kit, the Streptex (Wellcome). 81% (17/21) belonged to Lancefield's group A, 90% of which were not M or T typable by the standard international set of antisera. Urine analysis, pharyngeal swab culture and determination of anti-streptococcal antibody titre were also performed for children with positive skin cultures for group A streptococcus. 6% (2/33) of children with impetigo developed acute glomerulonephritis, requiring hospitalization.
Study site: Growth and nutrition clinic, squatter area, Kuala Lumpur, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Improving typhoid management: An example of clinical audit

Jackson AA

Family Physician, 1994;6:4-6.

Audit has improved certain aspects of management of typhoid fever detected through Klinik Perubatan Masyarakat at Hospital Universiti Sains Malaysia. We audited records of clinic patients who were blood culture positive for Salmonella typhi. For August to October 1992, we found 10 out of 31 cases (32%) were not admitted. Some of these were patients who defaulted, while some were managed as outpatients but not notified. We took action to educate the medical officers. For November 1992 - March 1993 we found 8 out of 24 cases (33%) were not admitted. Although the admission rate was no better, there was a non significant improvement in rate of notification by doctors. Defaulters were now the main problem, and so we took action to improve their follow-up, by using the clinic staff nurse. For April - August 1993, only 1 out of 16 cases (6%) was not admitted. This was a significant improvement (p=0.03)

Study site: Klinik Perubatan Masyarakat at Hospital Universiti Sains Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Screening for hemoglobinopathies among patients in a government hospital and health clinics in Perlis, Malaysia

Chin YM, Esa E, Mohd Yacob A, Ramachandran S, Zakaria Z

Journal of Medical Science & Technology, 2014;3(2):82-86.

The hemoglobinopathies include all genetic diseases of hemoglobin (Hb) and fall into two main groups: the thalassemias and structural hemoglobin variants (abnormal hemoglobins). Thalassemia is a public health problem in Malaysia. About 4.5% of the Malays and Chinese are β-thalassemia carriers. We performed hemoglobin analysis on a total of 499 patients from a Government Hospital and Health Clinics in the state of Perlis, Malaysia. About 91.4% of the patients were Malays. All patients had microcytic hypochromic anemia except for a few who went for thalassemia screening. Female patients outnumbered male patients in the ratio of 3.5:1. About 75.7% of the female patients were of childbearing age (17 - 40 years) and a majority of them were there for their antenatal checkup. Using our screen tests (full blood count, high performance liquid chromatography (HPLC), and agarose gel electrophoresis), the common hemoglobinopathies detected were HbE trait (19.3%), β-thalassemia trait (14.6%), HbH disease (1.8%), Hb Constant Spring (1.6%), Homozygous HbE (1.4%), and HbE- β-thalassemia (1.4%). Thalassemia is preventable through screening and education programmes, and prenatal diagnosis. Thalassemia screening is provided free of charge at various government hospitals and health clinics throughout the country.
Key words: Hemoglobinopathies screening, β-thalassemia trait, HbE trait, Thalassemic diseases

Matched MeSH terms: Ambulatory Care Facilities
Psychiatric morbidity and attitudes towards mental illness among patients attending primary care clinic of Hospital Universiti Kebangsaan Malaysia

Riana AR, Che Bakar O, Omar A

Malaysian Journal of Psychiatry, 2008;17:30-43.

The prevalence of psychiatric morbidity among patients attending primary care clinics is high and their attitudes towards psychiatry are often negative. The objectives of this study were to assess the prevalence of psychiatric morbidity and attitudes towards mental illness in relation to socio-demographic factors among primary care patients. A cross-sectional study was conducted on 245 patients attending the primary care clinic of Hospital Universiti Kebangsaan Malaysia at Bandar Tasik Selatan. A two-stage case identification process was used to detect psychiatric morbidity. The Malay translation of General Health Questionnaire-30 (GHQ-30) was used for screening and the Structured Clinical Interview for DSM-IV (SCID) was used to generate Axis-1 diagnosis. The Attitudes Towards Mental Illness Questionnaire was used to assess their attitudes towards mental illness. 8.2% of patients were found to have psychiatric morbidity, and they were significantly associated with the younger age group (p<0.05). Nevertheless, there was no significant association between psychiatric morbidity and sex, race, marital status, educational level, and social class of patients. The attitudes towards mental illness were significantly associated with age, race, marital status, educational level, social class and the presence of family history of psychiatry illness (p<0.05). There was no significant association between attitudes towards mental illness and patients'sex. Primary care doctors need to be equipped with psychiatry knowledge in order not to miss patients with psychiatry morbidity. Patients with psychiatry morbidity significantly believed in supernatural causes of mental illness compared with those without psychiatric morbidity. Keywords: Primary care, psychiatric morbidity, attitude towards psychiatry

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Self-perceived stigma and its effect on quality of life among Malaysians living with human immunodeficiency virus

Nadia AB, Leelavathi M, Narul Aida. S, Diana M

Medicine & Health, 2017;12(2):230-243.
MyJurnal

Human Immunodeficiency Virus (HIV) epidemic remains a significant burden in Malaysia. Stigma related to HIV and its effect on the quality of life (QOL) of persons living with HIV (PLHIV) remains under-reported. The aim of the present study was to assess self-perceived stigma amongst PLHIV attending an urban community clinic and its influence on their QOL. Data was collected using HIV Stigma Scale and WHO-QOL HIV BREF Scale. The overall stigma experienced by PLHIV in this community was higher than previous studies (mean ± SD; 103.37 ±18.14). Majority participants had fear disclosing their disease status, while personalized stigma or the experience of prejudice and rejection was the least experienced. The overall QOL was low and was significantly impaired in social relationship domain (mean ± SD; 12.72 ± 3.59). However, their ability to perform daily activities was not affected by the illness (mean ± SD; 14.48 ± 2.91). PLHIV with higher spiritual values demonstrate lower perception of negative self-image and inferiority (r= -0.54). This finding was unique to PLHIV in this study and suggested the importance of spirituality and personal beliefs on their self-esteem. In conclusion, stigma remains as a significant problem among PLHIV in this community. Primary care offers the best platform to promote a holistic management of PLHIV, where the integration between counselors, religious experts, family and non-governmental associations could come together. The management of PLHIV is unique in every community, hence individualized approach based on cultural norms and beliefs could assist in the overall management of PLHIV.
Keywords: HIV, quality of life, social stigma

Matched MeSH terms: Ambulatory Care Facilities
Fulltext The benefits of cognitive behavioral therapy (CBT) on diabetes distress and glycemic control in type 2 diabetes

Seyed-Reza, A., Norzarina, M.Z., Kimura, L.W.

Malaysian Journal of Psychiatry, 2015;24(2):18-28.
MyJurnal

Introduction: This study was designed to determine the effectiveness of combined group Cognitive-Behavioral Therapy (CBT) in improving diabetes distress and glycemic control among 60 adults with type 2 diabetes.
Methods: Half the participants were the experimental group (n = 30), and the other half was the control group (n = 30). Group therapy consisted of eight sessions for three months. Measures obtained at pre-test and post-test included the Diabetes Distress Scale (DDS-17) and blood examination to examine the level of HbA1c.
Result: The results indicated that group CBT had significant effects on the amelioration of diabetes distress and level of HbA1c among the participants of the experimental group.
Conclusion: The effectiveness of group CBT in the maintenance of good diabetic control in people who are suffering from type 2 diabetes was successfully demonstrated.
Study site: Pusat Sejahtera (Universiti Sains Malaysia Clinic), Pulau Pinang, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Setting up a men's clinic has never been an easy task. I have done it, and here is my story

Ismail Bin Mohd Tambi M

Asian J Androl, 2011 Jul;13(4):607-8.
PMID: 21399648 DOI: 10.1038/aja.2010.128
Matched MeSH terms: Ambulatory Care
Fulltext Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting

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 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: Ambulatory Care Facilities
Fulltext Do patients with type 2 diabetes mellitus know about specific dietary recommendations?

Tohid H, Saharuddin A, Teh RJ, Noor Azimah M, Wan Farzihan WA, Mohd Radzniwan AR

International Medical Journal Malaysia, 2017;16(2):93-99.
MyJurnal

INTRODUCTION: Diabetic patients generally have a good idea about healthy diet however their awareness regarding specific dietary recommendations is questionable. Thus, this paper aims to examine the awareness regarding specific dietary components among diabetic patients at a primary care clinic and its influence on self-reported dietary practice.
MATERIALS AND METHODS: The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire (English-Malay version) was used. It was adapted with additional questions to assess respondents’ awareness on: (1) healthful eating plan, (2) the quantity of one serving of fruits and vegetables, (3) choices and the allowed quantity of high fat food intake, (4) meaning of carbohydrate, and (5) carbohydrate spacing per day.
RESULTS: From the 360 respondents, 85.0% knew about healthful eating plan. However, those who were unaware of the meaning of carbohydrate, carbohydrate spacing, the allowed high fat food intake, and the quantity of one serving of fruits and vegetables were 34.1%, 47.5%, 40.0%, and 30.8% respectively. Generally, the dietary practice reported by those who knew ‘one serving of fruits and vegetables’ (p<0.001), ‘allowed quantity of high fat food intake’ (p=0.001), ‘meaning of carbohydrate’ (p<0.001), or ‘carbohydrate spacing’ (p<0.001) was significantly different than those who were unaware of these terms.
CONCLUSION: Although most respondents knew about healthful eating plan, majority of them were unaware of the specific dietary components, suggesting superficial dietary knowledge. Unfortunately, poor dietary awareness significantly influenced their self-reported dietary practice which could be considered as inaccurate. Thus, strategies to improve their dietary knowledge is necessary at the primary care setting.
Keywords: Type 2 diabetes mellitus, diet, awareness, self-care, primary care
Study site: Klinik Kesihatan Sungai Buloh, Selangor, Malaysia

Matched MeSH terms: Ambulatory Care Facilities

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