AIM: To determine the influence of psychosocial factors and health-seeking behaviour on the risk of falling among individuals with type 2 diabetes.
METHODS: This prospective study included community-dwelling adults aged ≥55 years selected through stratified random sampling from three neighbouring parliamentary constituencies. Data was collected at baseline in 2013-2015 with computer-assisted home-based interviews and follow-up in 2019 via telephone interviews.
RESULTS: Data on diabetes status and falls were available for 908 participants at baseline and follow-up. Diabetes was present in 42.2% of included participants at follow-up, of whom 22.8% at baseline and 25.3% at 5-year follow-up had at least one fall within the last 12 months. Diabetics had a higher risk of falls at baseline (OR: 1.484; 95% CI: 1.060-2.077) and follow-up (OR: 1.424; 95% Cl: 1.038-1.954) than non-diabetics. It was found that female gender, arthritis, alcohol and presence of depression anxiety or stress were associated with increased risk of falls in diabetics. The presence of any depression, anxiety or stress remained significantly associated with falls in diabetics (OR: 1.947; 95% Cl: 1.115-3.402) after adjustments for age, gender, ethnicity, and education but this relationship was attenuated after additional adjustment for arthritis (OR: 1.763; 95% CI: 0.996-3.122).
CONCLUSION: Our findings suggest that psychological issues are significantly associated with increased risk of falls at five-year follow-up in individuals aged 55 years and over with diabetes. These findings highlight the potential importance of psychosocial support among diabetics to reduce the risk of falls, improve patient outcomes and quality of life.
OBJECTIVE: We aimed to explore factors influencing the adoption of telehealth services among older adults in Malaysia, going beyond the conventional framework by incorporating transition cost and subjective well-being as additional constructs.
METHODS: A cross-sectional survey was conducted among 119 adults aged ≥60 years in Malaysia, using 39 survey items adapted from existing studies. Data analysis was performed using partial least squares structural equation modeling, with both the measurement model and structural model being evaluated. To determine the predictive relevance of the model, PLSpredict was applied. In addition, importance-performance map analysis was conducted to further expand on the structural model results by assessing the performance of each variable.
RESULTS: Of the 119 participants, 52 (43.7%) were women and 67 (56.3%) were men. The study found that subjective well-being (β=0.448; Phealth care accessibility and quality for this vulnerable demographic.
OBJECTIVE: This study aimed to explore cultural beliefs, barriers, and healthcare access challenges influencing breast cancer awareness and screening among Sarawak's indigenous and rural communities.
METHODS: This qualitative study explores how rural Sarawakian women perceive breast cancer and their access to healthcare. Twenty women from three main geographical terrains in Borneo-coastal, riverine, and highland areas participated in the study. After informed consent was obtained, semi-structured interviews were conducted. Data was coded and thematically analyzed to identify cultural nuances affecting their knowledge.
RESULTS: The study found a strong link between cancer and negative beliefs rooted in sociocultural backgrounds. Myths varied, but most associated cancer with death, a fatalistic culture relying on spiritual faith for healing. Participants delayed seeking medical help until "the pain is unbearable," often using oils and herbs first. Lack of knowledge and lack of access to information about cancer are two main findings from the study. Although the majority of the respondents were not equipped with adequate information, they expressed interest in learning about breast screening programs and attending breast cancer awareness campaigns.
CONCLUSION: The findings will be used to design behavioral intervention modules to educate rural Sarawak populations about the importance of breast self-examination (BSE) practices, early detection, and screening.
METHODS: A convenience sample of 96 HIV-positive and 104 HIV-negative incarcerated men who met pre-incarceration criteria for opioid dependence was interviewed using a structured questionnaire to examine participant characteristics and attitudes toward MMT. Factors associated with interest in prison-based MMT initiation were identified using logistic regression analysis.
RESULTS: Among all participants, 85 (42.5%) were interested in receiving MMT within prison. Independent correlates of interest in prison-based MMT were being previously married (AOR=4.15, 95% CI: 1.15, 15.02), previously incarcerated (AOR=5.68, 95% CI: 1.54, 21.02), depression (AOR=3.66, 95% CI: 1.68, 7.98), daily heroin use in the 30days prior to incarceration (AOR=5.53, 95% CI: 1.65, 18.58), and more favorable attitudes toward MMT (AOR=19.82, 95% CI: 6.07, 64.74).
CONCLUSIONS: Overall, interest in receiving prison-based MMT was low, and was associated with adverse social, mental health, and drug use consequences. Incarceration provides a unique opportunity to initiate MMT for those who need it, however, optimal scale-up efforts must be systemic and address modifiable factors like improving attitudes toward and motivation for MMT. Informed or shared decision-making tools may be useful in improving expectations and acceptability of MMT.
METHODS: A nationwide cross-sectional, self-administered online survey was conducted on 1-19 May 2020. The health belief model (HBM) was used as a theoretical framework for understanding COVID-19 vaccination intent and WTP.
RESULTS: A total of 3,541 complete responses were received. The majority reported a probably yes intent (54.6%), followed by a definite yes intent (28.7%). The perception that vaccination decreases the chances of getting COVID-19 under the perceived benefit construct (OR = 3.14, 95% CI 2.05-4.83) and not being concerned about the efficacy of new COVID-19 vaccines under the perceived barriers construct (OR = 1.65, 95% CI 1.31-2.09) were found to have the highest significant odds of a definite intention to take the COVID-19 vaccine. The median (interquartile range [IQR]) of WTP for COVID-19 vaccine was CNY¥200/US$28 (IQR CNY¥100-500/USD$14-72). The highest marginal WTP for the vaccine was influenced by socio-economic factors. The majority were confident (48.7%) and completely confident (46.1%) in domestically-made COVID-19 vaccine. 64.2% reported a preference for a domestically-made over foreign-made COVID-19 vaccine.
CONCLUSIONS: The findings demonstrate the utility of HBM constructs in understanding COVID-19 vaccination intent and WTP. It is important to improve health promotion and reduce the barriers to COVID-19 vaccination.
METHODS: A total of 2,360 adults (18 years and above) from randomly selected households in metropolitan Kuala Lumpur completed face-to-face interviews with trained research assistants that incorporated the validated Malay version of the Cancer Awareness Measure (CAM). Logistic regression was the main statistical technique that was used to investigate the study objectives and relationships (noted above).
RESULTS: The most commonly reported barriers to help-seeking were emotional barriers. The probability of delaying seeking help was 49% higher in participants who reported emotional barriers (OR = 1.49; CI: 1.32-1.68; p health education campaigns or programme should address emotional barriers and encourage early seeking help.
METHODS: University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI).
RESULTS: Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p
METHODS: An ethnographic investigation using purposive sampling to increase subject diversity was used to explore the range of beliefs about kinship and inheritance using Chinese-Australians as a case. Participants comprised a sample of 15 Chinese-Australians who had been recruited through several community-based organizations.
RESULTS: The level of acculturation does not correlate with holding beliefs about inheritance, kinship, and causes of hereditary cancer that are based on "Western" biomedical or traditional concepts. Mismatch between beliefs may exist within families that can impact participation in cancer genetic testing. Family history taking that underpins the surveillance, management, and referral to genetic counseling where there is a strong family history of breast, ovarian, or colorectal cancer can also be impacted unless recognition is made of the patrilineal concept of kinship prevalent in this Chinese-Australian community.
CONCLUSION: This community-based study confirmed and validated views and beliefs on inheritance and kinship and inherited cancer attributed to senior family members by Chinese-Australians who attended cancer genetic counseling. Barriers to communication can occur where there may be incompatibility within the family between "Western" and traditional beliefs. The findings were used to develop strategies for culturally competent cancer genetic counseling with Australian-Chinese patients. These include nonjudgmental incorporation of their belief systems into the genetic counseling process and avoidance of stereotyping. They have also influenced the development of genetics education materials to optimize family history taking.
METHODS: An analytical cross-sectional study was conducted in a government health clinic of Penang from March to August 2019. Asymptomatic clinic attendees aged 50-75 years who had no prior awareness of CRC screening were recruited by systematic random sampling technique. Participants first received a standardised one to one health education, followed by an interview using a standardised questionnaire to assess their CRC screening intention and the relevant motivators and barriers. A submission of a sample for immunochemical faecal occult blood test (iFOBT) was considered as an uptake of the CRC screening.
RESULTS: A total of 546 participants participated in this study. The mean age of the participants was 62.8 (SD=6.36). Majority of them were females (57.3%), Chinese (78.6%), who had attained primary or higher education (92.0%) and had comorbidities (87.0%). After a brief health education, 231 participants (42.3%) agreed to undergo iFOBT. The actual screening uptake rate in this study was 28%. Perceived benefit of the test (84.4%) was the most common motivators, while self-perceived non-vulnerability was the biggest impediment to CRC screening intention. Physicians' recommendation was the perceived most effective way in raising CRC awareness.
CONCLUSION: Participants prefer physicians to provide health education. Standardised brief health education is inadequate to stimulate CRC screening adherence. Future interventions will require in-depth understanding of patients' beliefs, risk perception, and affective responses.
METHODS: Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research.
RESULTS: None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.'
CONCLUSION: The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.
OBJECTIVE: This study aimed to assess the general population's knowledge, symptom experiences, and willingness to vaccinate against IPIs across six countries: Malaysia, Vietnam, India, Pakistan, and China.
MATERIALS AND METHODS: A cross-sectional online survey was conducted between June and December 2023 across six countries in Asia region. Participants completed a self-administered online questionnaire that assessed demographic information, knowledge of IPIs, symptom experiences, and willingness to receive a vaccine against IPIs for themselves and their children. Univariate and multivariable logistic analyses were performed to determine the factors related to vaccination the willingness.
RESULTS: A total of 5470 complete responses were received. The highest proportion of individuals willing to receive the vaccine was in India (86.1 %), followed by China (80.8 %) and Pakistan (75 %), with Vietnam having the lowest proportion at 50.1 %. For child vaccination, China had the highest willingness (83.3 %). A higher knowledge score was significantly associated with increased willingness to be vaccinated [adjusted odds ratio (aOR)= 1.91, 95 % CI: 1.70-2.15]. Additionally, a higher symptom experience score was significantly associated with greater vaccination willingness (aOR=1.71, 95 % CI: 1.50-1.94). Females residing in urban-suburban areas showed significantly higher vaccination intentions. The willingness to vaccinate children against IPIs closely mirrored the trends observed in self-vaccination willingness, with knowledge being the only factor significantly associated with the willingness to vaccinate children.
CONCLUSION: The study underscores the importance of enhancing educational efforts regarding neglected IPIs and vaccination, particularly when vaccines are available and recommended.