Displaying publications 21 - 36 of 36 in total

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  1. Al Sawad AA, Lim SK, Tang LY, Rashid AA, Chew BH
    BMC Nephrol, 2022 Dec 01;23(1):384.
    PMID: 36457069 DOI: 10.1186/s12882-022-03016-x
    BACKGROUND: There is growing evidence that self-management behaviour can improve outcomes for patients with chronic kidney disease (CKD). However, no measures are available in Malay to effectively assess the self-management of CKD. The aim of this study was to translate, culturally adapt and validate the Malay Chronic Kidney Disease Self-Management (MCKD-SM) instrument for Malay-speaking health professionals and patients.

    METHODS: This study was carried out in two phases: the translation and cultural adaptation phase and the validation phase. The instrument was translated from English to Malay and then adapted and validated in a sample of 337 patients with CKD stages 3-4 attending a nephrology clinic in a tertiary hospital in Malaysia. Structural validity was evaluated by exploratory factor analysis. The instrument's reliability was assessed by internal consistency and test-retest reliability. The correlations between the MCKD-SM and kidney disease knowledge and the MCKD-SM and self-efficacy were hypothesised a priori and investigated.

    RESULTS: The MCKD-SM instrument has 29 items grouped into three factors: 'Understanding and Managing My CKD', 'Seeking Support' and 'Adherence to Recommended Regimen'. The three factors accounted for 56.3% of the total variance. Each factor showed acceptable internal reliability, with Cronbach's α from 0.885 to 0.960. The two-week intra-rater test-retest reliability intraclass correlation coefficient values for all items ranged between 0.938 and 1.000. The MCKD-SM scores significantly correlated with kidney disease knowledge (r = 0.366, p 

  2. Al Raimi AM, Chong MC, Tang LY, Chua YP, Al Ajeel LY
    Comput Inform Nurs, 2022 Sep 01;40(9):648-657.
    PMID: 35994240 DOI: 10.1097/CIN.0000000000000927
    Bronchial asthma among children is a common chronic disease that may impact quality of life. Health education is one of the strategies to improve knowledge and quality of life. This study aims to assess the effect of health education via a mobile application in promoting the quality of life among schoolchildren with asthma in urban Malaysia during the COVID-19 era. A quasi-experimental, pre- and post-intervention design was used in this study involving a total of 214 students, randomly assigned into two groups (an intervention group and a control group). The control group received face-to-face health education, whereas the experimental group received health education via a mobile application. The findings showed that the total score of quality of life improved from a mean total score at pre-intervention of 5.31 ± 1.27 to post-intervention of 5.66 ± 1.28 for the control group, compared with the experimental group with a mean total score of quality of life at pre-intervention of 5.01 ± 1.36 and post-intervention of 5.85 ± 1.29. A comparison between the experimental and control groups using an independent t test showed statistically significant differences in their mean quality of life scores. The effect of health education via a mobile application showed a statistically significant improvement in the mean quality of life score from pre- to post-intervention ( F1,288 = 57.46, P < .01). As recommended, the use of mobile technology in health education improved the quality of life of schoolchildren with asthma as compared with the traditional methods of a face-to-face lecture and/or a handbook. Thus, educational modules using mobile applications do improve quality of life.
  3. Gunarathne TGNS, Tang LY, Lim SK, Nanayakkara N, Damayanthi HDWT, Abdullah KL
    PMID: 35564935 DOI: 10.3390/ijerph19095540
    People with end stage renal disease and undergoing hemodialysis experience a high symptom burden that impairs quality of life. This study aimed to assess the prevalence, dynamicity and determinants of symptom burden among middle-aged and older adult hemodialysis patients. A descriptive cross-sectional study together with a longitudinal assessment was used. A total of 118 and 102 hemodialysis patients were assessed at baseline and at a 6-month follow-up. Validated questionnaires were used to assess the symptom burden, stress, illness perception and social support. Multiple linear regression analysis was used to determine the factors associated with symptom burden. The median number of symptoms experienced was 21 (Interquartile Range (IQR); 18−23) and 19 (IQR; 13−22) at baseline and 6 months, respectively. Having elevated stress (β = 0.65, p ≤ 0.005) and illness perception (β = 0.21, p = 0.02) were significantly predicted symptom burden at baseline (F (4, 112) = 55.29, p < 0.005, R2 = 0.664). Stress (β = 0.28, p = 0.003), illness perception (β = 0.2, p = 0.03), poor social support (β = −0.22, p = 0.01) and low body weight (β = −0.19, p = 0.03) were the determinants for symptom burden at 6 months (F (5, 93) = 4.85, p ≤ 0.005, R2 = 0.24). Elevated stress, illness perception level, poor social support and low post-dialysis body weight were found to be determinants for symptom burden. Attention should be given to psychosocial factors of hemodialysis patients while conducting assessment and delivering care to patients.
  4. Yu X, Lim KS, Tang LY, Tang V, Lim YH, Fong SL, et al.
    Epilepsy Behav, 2023 Oct;147:109395.
    PMID: 37619469 DOI: 10.1016/j.yebeh.2023.109395
    BACKGROUND: Caregivers of adults with epilepsy (AWE) play an important role in the healthcare pathway of AWE and are described as the "co-client." Being caregivers can be stressful and the negative impacts might accumulate over time, affecting their quality of life and well-being.

    OBJECTIVES: This qualitative study aimed to explore the lived experience of caregivers of AWE in Malaysian families and understand their caregiving challenges. Individual semi-structured interviews were held with 12 primary caregivers of AWE. Interpretative Phenomenological Approach (IPA) was used. The interview transcripts were analyzed using NVivo12 software.

    RESULTS: Primary caregivers of AWE were parents or siblings, with ages ranging from 56 to 80 years old and years of caregiving from 24 to 40 years. Most AWE (58%) were intellectually disabled and fully dependent on ADL needs. Two categories of themes emerged, including four themes on caregiver burden, i.e., physical, emotional, and social burdens, and challenges in future planning of care, and two themes on coping strategies (problem- or emotional-focused). In future planning of care, most caregivers especially parents carried a burden of responsibility and were reluctant to depend on others or institutional services.

    CONCLUSION: The caregiving burden among caregivers for adult AWE was not confined to current burdens only but also challenges in future planning. A better understanding of the caregiving burden for AWE and coping strategies is needed to provide tailored psychoeducation or psychosocial intervention to support this population.

  5. Rubbai YS, Chong MC, Tang LY, Abdullah KL, Mohammad WT, Mohajer S, et al.
    BMC Palliat Care, 2024 Aug 30;23(1):217.
    PMID: 39210456 DOI: 10.1186/s12904-024-01543-y
    BACKGROUND: Despite increasing interest in quality end-of-life care (EOLC), critically ill patients often receive suboptimal care. Critical care nurses play a crucial role in EOLC, but face numerous barriers that hinder their ability to provide compassionate and effective care.

    METHODS: An integrative literature review was conducted to investigate barriers impacting the quality of end-of-life care. This review process involved searching database like MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EBSCO, and ScienceDirect up to November 2023. Search strategies focused on keywords related to barriers in end-of-life care and critical care nurses from October 30th to November 10th, 2023. The inclusion criteria specified full-text English articles published between 2010 and 2023 that addressed barriers perceived by critical care nurses. This integrative review employs an integrated thematic analysis approach, which combines elements of deductive and inductive analysis, to explore the identified barriers, with coding and theme development overseen by the primary and secondary authors.

    RESULTS: Out of 103 articles published, 11 articles were included in the review. There were eight cross-sectional descriptive studies and three qualitative studies, which demonstrated barriers affecting end-of-life care quality. Quality appraisal using the Mixed Method Appraisal Tool was completed by two authors confirmed the high credibility of the selected studies, indicating the presence of high-quality evidence across the reviewed articles. Thematic analysis led to the three main themes (1) barriers related to patients and their families, (2) barriers related to nurses and their demographic characteristics, and (3) barriers related to health care environment and institutions.

    CONCLUSION: This review highlights barriers influencing the quality of end of life care perceived by critical care nurses and the gaps that need attention to improve the quality of care provided for patients in their final stages and their fsmilies within the context of critical care. This review also notes the need for additional research to investigate the uncover patterns and insights that have not been fully explored in the existing literature to enhance understanding of these barriers. This can help to inform future research, care provision, and policy-making. Specifically, this review examines how these barriers interact, their cumulative impact on care quality, and potential strategies to overcome.

  6. Ayat Ali AS, Lim SK, Tang LY, Rashid AA, Chew BH
    Sci Prog, 2021;104(2):368504211026159.
    PMID: 34143698 DOI: 10.1177/00368504211026159
    The complexity of chronic kidney disease (CKD) and its treatments have made self-management behaviors inevitably challenging. However, supplementing education with self-management skills may improve numerous health outcomes in people with nondialysis CKD. This study protocol describes a randomized controlled trial (RCT) aimed to evaluate the effects of a nurse-led self-management support program as an intervention for kidney disease knowledge and CKD self-management behaviors among people with pre-dialysis CKD. In Phase 1, people with CKD stage 3-4 and their family members are involved in co-designing, development and pilot testing of a theory-based self-management intervention. In Phase 2, we perform a cross-cultural adaptation of the Kidney Disease Knowledge Survey, CKD Self-Management and Self-efficacy for Managing Chronic Disease questionnaires. In Phase 3, a parallel RCT will be conducted to evaluate the intervention where 154 participants with CKD stage 3-4 will be randomly assigned to either the intervention (n = 77) or control group (n = 77). The intervention group will receive 6-week self-management program from a nurse-coach in addition to standard usual care, while the control group will receive only standard usual care. Outcome measures include kidney disease knowledge, CKD self-management behavior, self-efficacy, quality of life, blood pressure control and adherence to CKD diet as indicated by 24-h urine urea nitrogen, 24-h urine sodium and net endogenous acid production. Data will be collected at baseline and 12-week post-baseline. The between- and within-group intervention effects will be estimated using the Generalized Estimating Equations. The self-management intervention offers strategies to delay CKD progression and to encourage motivation to better self-manage at home. This study integrates self-management education and psychosocial support with culturally relevant scenarios, and evaluates important self-reported and objective outcomes.Clinical Trials Registration: www.ClinicalTrials.gov, identifier: NCT03974646.
  7. Lee WL, Lim ZJ, Tang LY, Yahya NA, Varathan KD, Ludin SM
    Comput Inform Nurs, 2021 Nov 02;40(4):244-250.
    PMID: 34740221 DOI: 10.1097/CIN.0000000000000854
    The COVID-19 pandemic has rerouted the healthcare ecosystem by accelerating digital health, and rapid adoption of eHealth is partly influenced by eHealth literacy (eHL). This study aims to examine patients' eHL in relation to their "technology readiness"-an innate attitude that is underexplored in clinical research. A total of 276 adult inpatients with hypertension, diabetes mellitus, and coronary heart disease were surveyed cross-sectionally in 2019 using self-reported questionnaires: eHealth Literacy Scale and Technology Readiness Index (2.0). The study found moderate eHL (mean, 27.38) and moderate technology readiness (mean, 3.03) among patients. The hierarchical regression model shows that lower eHL scores were associated with patients of minor ethnicity (Malaysian Chinese), with an unemployed status, and having >1 cardiovascular risk (β = -0.136 to -0.215, R2 = 0.283, Ps < .005). Technology readiness is a strong determinant of eHL (ΔR2 = 0.295, P < .001) with its subdomains (optimism, innovativeness, and discomfort) significantly influencing eHL (|β| = 0.28-0.40, Ps < .001), except for the insecurity subdomain. Deployment of eHealth interventions that incorporate assessment of patients' eHL and technology readiness will enable targeted strategies, especially in resource-limited settings hit hard by the pandemic crisis.
  8. Salleh NS, Tang LY, Husain M, Lim Abdullah K, Kueh YC
    Malays J Med Sci, 2024 Jun;31(3):217-228.
    PMID: 38984240 DOI: 10.21315/mjms2024.31.3.17
    BACKGROUND: Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD.

    METHODS: Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL.

    RESULTS: Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL.

    CONCLUSION: Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.

  9. Yu X, Lim KS, Tang LY, David P, Ong ZQ, Wong KY, et al.
    Epilepsy Behav, 2025 Jan 23;164:110262.
    PMID: 39854827 DOI: 10.1016/j.yebeh.2025.110262
    OBJECTIVES: Caregiving for adults with epilepsy (AWE) imposes a different degree and scope of challenges than for children and teenagers with epilepsy, and it remains understudied. This study aimed to identify the types of caregiver burdens, needs, and coping strategies in caregiving for AWE.

    METHODS: Previous studies relevant to this topic were identified from 7 databases. Searches were performed in PubMed, CINAHL, Web of Science (WOS), Scopus, Psychology and Behavioral Science Collection (PBSC), Embase, PsychINFO from 1 Jan 1980 to 31 December 2023. The findings were reported according to caregiver burden, caregiver needs, and coping strategies.

    RESULTS: 22 studies were included in this review, including 14 quantitative and 8 qualitative studies. Six types of burdens were identified: psychological, physical, medical, economic, social, and family. The predominantly reported burden was the psychological burden in developed and developing countries. However, caregivers in developing countries reported additional physical, social, and economic burdens due to cultural and socioeconomic factors. Furthermore, inaccessible and unaffordable health care with a lack of medical knowledge exacerbated the challenges. Stigma and misconceptions led to more psychological distress and social restriction. There is a need for psychological, social, and family support as well as medical information to promote self-efficacy among caregivers. Most caregivers develop their own coping strategies for dealing with caregiving stress.

    CONCLUSION: The caregiving burden for AWE is an understudied area that needs to be addressed by healthcare professionals. The caregivers are experiencing unaddressed psychological and other types of burdens, together with a lack of appropriate interventions and healthcare information.

  10. Abdul Halain A, Tang LY, Chong MC, Ibrahim NA, Abdullah KL
    J Clin Nurs, 2022 Mar;31(5-6):497-507.
    PMID: 34254377 DOI: 10.1111/jocn.15962
    AIMS AND OBJECTIVES: To map research-based psychological distress among the family members with patients in the intensive care unit (ICU).

    BACKGROUND: Having a loved one in the ICU is a stressful experience, which may cause psychological distress for family members. Depression, anxiety and stress are the common forms of psychological distress associated with ICU patient's family members. Directly or indirectly, psychological distress may have behavioural or physiological impacts on the family members and ICU patient's recovery.

    DESIGN: The study was based on the five-stage methodological framework by Arksey and O'Malley (International Journal of Social Research Methodology, 2005, 8, 19) and were guided by the PRISMA-ScR Checklist.

    METHODS: A comprehensive and systematic search was performed in five electronic databases, namely the Scopus, Web of Sciences, CINAHL® Complete @EBSCOhost, ScienceDirect and MEDLINE. Reference lists from the screened full-text articles were reviewed.

    RESULTS: From a total of 1252 literature screened, 22 studies published between 2010-2019 were included in the review. From those articles, four key themes were identified: (a) Prevalence of psychological distress; (b) Factors affecting family members; (c) Symptoms of psychological distress; and (d) Impact of psychological distress.

    CONCLUSIONS: Family members with a critically ill patient in ICU show high levels of anxiety, depression and stress. They had moderate to major symptoms of psychological distress that negatively impacted both the patient and family members.

    RELEVANCE TO CLINICAL PRACTICE: The review contributed further insights on psychological distress among ICU patient's family members and proposed psychological interventions that could positively impact the family well-being and improve the patients' recovery.

  11. Huang WX, Chong MC, Tang LY, Liu XX, Fang M, Shen YY, et al.
    BMC Nurs, 2025 Feb 05;24(1):135.
    PMID: 39910581 DOI: 10.1186/s12912-024-02528-1
    BACKGROUND: Nurses play a critical role in the implementation of child-friendly healthcare, ensuring that pediatric patients receive comprehensive and compassionate services. However, there is a global scarcity of research evaluating nurses' practices in delivering child-friendly healthcare. Therefore, this study focuses on exploring the assessment of child-friendly healthcare practices from the perspective of nurses themselves.

    METHOD: This descriptive qualitative study employed purposive and snowball sampling methods to recruit 14 pediatric nurses from six hospitals in Zhejiang province, Southeast China. Individual semi-structured interviews were conducted face-to-face between January and June 2024. Data were analyzed through the qualitative content analysis approach.

    RESULTS: We identified 415 unique meaning units in the interview data, 332 of which were related to child-friendly healthcare practice assessment. These units were classified into 58 codes across 4 categories and 17 subcategories. The four categories were identified: services designed for children's interests, tailoring the environment adapted for children, facilitating social interactions, and promoting childhood development.

    CONCLUSION: The findings from this study were derived from the perspectives of Chinese nurses on child-friendly healthcare practice assessment, offering a comprehensive and multidimensional view of this field. The results reflect the current state and future direction of child-friendly healthcare in China, which will aid in sustaining the development of a child-friendly healthcare evaluation system.

  12. Chui PL, Chong MC, Abdullah KL, Ramoo V, Tang LY, Lee WL, et al.
    Healthcare (Basel), 2021 Sep 24;9(10).
    PMID: 34682939 DOI: 10.3390/healthcare9101259
    The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.
  13. Huang T, Su LJ, Zeng NK, Lee SML, Lee SS, Thi BK, et al.
    Front Microbiol, 2022;13:1087756.
    PMID: 36741898 DOI: 10.3389/fmicb.2022.1087756
    Hainan is the second largest island in China with the most extensive and well-preserved tropical forests and is also the largest island of the Indo Burma Biodiversity Hotspot. It provides in situ conservation for the unique ecosystem of the island. Recent studies have shown that there are diverse fungal species in Hainan. In this study, about 40 collections of the genus Amanita have been studied based on the morphology and molecular systematics, including 35 Chinese specimens (24 from Hainan, and eleven from other regions) and three specimens from other countries (Singapore and Malaysia). In total, five new species belonging to Amanita section Validae are described: A. cacaina, A. parvigrisea, A. pseudofritillaria, A. pseudosculpta, and A. yangii. Amanita parvifritillaria is recorded for the first time in Hainan. It is also the first report of this fungus occurring, outside Yunnan Province, China. Among the five new species, two are unique in this section because of the appendiculate pileus margin and the absence of an annulus. Based on these new findings, the diagnosis of the section Validae should be slightly modified to include a few species with appendiculate margin and the lack of annulus.
  14. Binns CW, Lee MK, Kagawa M, Low WY, Liqian Q, Guldan GS, et al.
    Asia Pac J Public Health, 2017 Mar;29(2):98-101.
    PMID: 28325079 DOI: 10.1177/1010539517694295
    Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.
  15. Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, et al.
    Asia Pac J Public Health, 2020 05;32(4):179-187.
    PMID: 32475150 DOI: 10.1177/1010539520931328
    Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
  16. Goossens ME, Isa F, Brinkman M, Mak D, Reulen R, Wesselius A, et al.
    Arch Public Health, 2016;74:30.
    PMID: 27386115 DOI: 10.1186/s13690-016-0140-1
    In 2012, more than 400,000 urinary bladder cancer cases occurred worldwide, making it the 7(th) most common type of cancer. Although many previous studies focused on the relationship between diet and bladder cancer, the evidence related to specific food items or nutrients that could be involved in the development of bladder cancer remains inconclusive. Dietary components can either be, or be activated into, potential carcinogens through metabolism, or act to prevent carcinogen damage.
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