Displaying publications 41 - 60 of 71 in total

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  1. Sabo A, Kueh YC, Arifin WN, Kim Y, Kuan G
    PLoS One, 2020;15(9):e0239725.
    PMID: 32986724 DOI: 10.1371/journal.pone.0239725
    BACKGROUND: This study aimed to determine the validity of the Malay-translated version scales for assessing the social support and physical environment for exercise activities.

    METHOD: The study was a cross-sectional design in nature, using self-reported questionnaires among the university students in Malaysia. Participants were selected using a convenience sampling approach. Perceptions regarding social support and physical environment were assessed using the Malay-translated version scales. The standard forward-backwards translation was conducted to translate the English version of the scales to the Malay version. Confirmatory factor analysis (CFA) was used to validate the translated version scales; composite reliability (CR) and average variance extracted (AVE) were computed.

    RESULTS: A total of 857 students participated in this study (female: 49.1%, male: 50.9%). The mean age of the participants was 20.2 (SD = 1.6). The fit indices of the initial hypothesized measurement models (social support and physical environment) were not satisfactory. Further improvements were made by adding covariances between residuals' items within the same factor for each hypothesized model. The final re-specified measurement models demonstrated adequate factor structure for the social support scale with 24 items (CFI = .932, TLI = .920, SRMR = .054, RMSEA = .061), and the physical environment scale with five items (CFI = .994, TLI = .981, SRMR = .013, RMSEA = .054). The CR was .918 for family support, .919 for friend support, .813 for perceived availability, and .771 for perceived quality. The AVEs were .560 for family support, .547 for friend support, .554 for perceived availability, and .628 for perceived quality. The intra-class correlation (ICC) based on test-retest was .920 for family support, .984 for friend support, .895 for availability of facilities, and .774 for quality of facilities.

    CONCLUSION: The Malay version of the social support scale for exercise and the physical environment scale for physical activity were shown to have adequate psychometric properties for assessing perceived social support and physical environment among the university students in Malaysia.

    PERSPECTIVE: This study presented the psychometric properties of the social support and physical environment scales based on CFA and was the first to translate these scales from the original English version to the Malay version.

  2. Abdul Wahab P, Mohd Yusoff D, Abdul Kadir A, Ali SH, Lee YY, Kueh YC
    PeerJ, 2020;8:e8581.
    PMID: 32175185 DOI: 10.7717/peerj.8581
    Background: Chronic constipation is a common symptom among the elderly, and it may affect their quality of life (QoL). A lack of available research focused on the elderly means that this effect is not well understood. This study aimed to develop and validate a new scale (Elderly-Constipation Impact Scale (E-CIS)) to measure the impact of chronic constipation on QoL among the elderly.

    Methods: A pool of items was generated from a qualitative study, literature reviews, and expert reviews. Exploratory factor analysis (EFA) was performed on the original 40 items of the E-CIS and followed by 27 items for confirmatory factor analysis (CFA). A total of 470 elderly people with chronic constipation were involved.

    Results: The mean age of the participants was 68.64 ± 6.57. Finally, only 22 items were indicated as appropriately representing the E-CIS, which were grouped into seven subscales: 'daily activities', 'treatment satisfaction', 'lack of control of bodily function', 'diet restriction', 'symptom intensity', 'anxiety' and 'preventive actions'. The scale was confirmed as valid (root mean square error of approximation (RMSEA) = 0.04, comparative fit index (CFI) = 0.961, Tucker-Lewis index (TLI) = 0.952 and chi-square/degree of freedom (chiSq/df) = 1.44) and reliable (Cronbach's alpha: 0.66-0.85, composite reliability (CR) = 0.699-0.851) to assess the impact of chronic constipation on the elderly's QoL.

    Conclusions: The E-CIS is useful to measure the impact of chronic constipation on the elderly's QoL. A further test is needed to determine the validity and reliability of this scale in other elderly population.

  3. Kuan G, Sabo A, Sawang S, Kueh YC
    PLoS One, 2020;15(3):e0230644.
    PMID: 32187222 DOI: 10.1371/journal.pone.0230644
    BACKGROUND: This study examined the psychometric properties of the Malay version of the decisional balance (DB-M) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB-M across gender.

    METHODS: The study sample consisted of 750 students (female: 51.7%, male: 48.3%), with a mean age of 20.2 years (SD = 1.2). Decision balance (DB) scale was assessed with the 10-item DB-M. Standard forward-backward translation was performed to translate the English version of the DB into Malay version (DB-M).

    RESULTS: The confirmatory factor analysis (CFA) results based on the hypothesised measurement model of two factors and ten items demonstrated adequate factor structure after the addition of some correlated item residuals (comparative fit index (CFI) = .979, Tucker and Lewis index (TLI) = .969, standardised root mean square residual (SRMR) = .037, root mean square error of approximation (RMSEA) = .047). The construct reliability and average variance extracted values were .850 and .839, and .542 and .538, for perceived benefits and perceived barriers, respectively. Meanwhile, the Cronbach's alpha was .857 and .859, and the intraclass correlation coefficient for test-retest reliability was .979 and .960 for perceived benefits and perceived barriers respectively. The findings provided evidence for measurement invariance of DB-M for the male and female samples. The final CFA model fit the data well for both male sample (CFI = .975, TLI = .964, SRMR = .040, RMSEA = .052) and female sample (CFI = .965, TLI = .949, SRMR = .044, RMSEA = .058).

    CONCLUSIONS: The translated version of the DB-M was valid and reliable for assessing the level of perceived benefits and perceived barriers in exercise among university students in Malaysia.

  4. Ibrahim MF, Kuan G, Hashim HA, Hamzah NA, Kueh YC
    PMID: 33450935 DOI: 10.3390/ijerph18020622
    The objective of this study was to validate the translated Malay version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-M) scale among Malaysian primary school children using the confirmatory factor analysis (CFA). The Q-LES-Q-M measures the level of enjoyment and satisfaction experienced with relation to physical health, feelings, homework, and leisure. The participants were 607 Malay students, 240 (39.5%) boys and 367 (60.5%) girls, with an age range from 10 to 11 years old. The original version of the Q-LES-Q was translated into the Malay language by forward to backward translation procedures with consideration for the local culture and suitable vocabulary for primary school students. The participants then completed the Q-LES-Q-M. CFA was performed using Mplus 8 software. Using CFA, the initial model did not result in a good data fit. Further analysis of the CFA suggested some changes to the model to improve the fit indices. Model modification included the deletion of three problematic items and co-varying some error items. This resulted in improved fit indices and 40 items remained in the final model. The final model showed good reliability based on two indicators of composite reliability (CR) and Cronbach's alpha (CA). The factors with their CR and CA were physical activity (CR = 0.857, CA = 0.854), feelings (CR = 0.808, CA = 0.813), homework (CR = 0.837, CA = 0.837) and leisure (CR = 0.742, CA = 0.737). The final measurement consists of 40 items. The retained items were deemed suitable for Malay primary school children. The revised Q-LES-Q-M with 40 items is suitable for measuring the levels of children's involvement in determining the enjoyment and satisfaction of learning and physical activity.
  5. Njaka S, Mohd Yusoff D, Anua SM, Kueh YC, Edeogu CO
    Heliyon, 2021 Feb;7(2):e06130.
    PMID: 33644447 DOI: 10.1016/j.heliyon.2021.e06130
    Quarry workers are commonly afflicted with musculoskeletal disorders (MSDs). This health problem has been recognized as a significant threat to the quarry workers' safety but is rarely reported, particularly in Nigeria. Therefore, this study aimed to assess the prevalence of MSDs and their associated factors among quarry workers.

    METHOD: A cross-sectional study was conducted, and data were collected using a self-administered Standard Nordic Musculoskeletal Questionnaire. A total of 266 participants were selected through systematic random sampling method among male and female quarry workers in Ebonyi State, Nigeria. The data were analysed using SPSS version 26, and descriptive statistics were used to determine the prevalence and types of MSDs. Simple and multiple logistic regressions were used to identify the factors associated with MSDs.

    RESULTS: The results revealed that majority of the respondents (89.8%) had MSDs, with the most common types being lower back pain (83.1%) and elbow pain (45.9%). Based on multiple logistic regression modelling, BMI (Adjusted OR 0.17, 95% CI 0.06,0.55, p = 0.003), age (Adjusted OR 1.14, 95% CI 1.07, 1.23, p < 0.001), work experience (Adjusted OR 2.08, CI 1.00, 4.30, p = 0.049), Vibration exposure (Adjusted OR 0.45, CI 0.27, 0.74, P = 0.002), working hour (Adjusted OR 6.84, CI 0.84, 53.4, p = 0.007) and break time (Adjusted OR 0.95, 95% CI 0.91,0.98, p = 0.006) were significantly associated with MSDs.

    CONCLUSION: MSDs are prevalent among the quarry workers in Ebonyi State, Nigeria. Thus, there is an urgent need to increase the workers' and employers' awareness of appropriate ergonomic and personal measures needed to improve the workers' safety and well-being.

  6. Mahd-Ab Lah N, Kueh YC, Kuan G, Yahaya FH, Wong MS, Abd Samat NA, et al.
    PMID: 33802426 DOI: 10.3390/ijerph18052487
    Abdominal bloating (AB) is a prevalent and bothersome symptom, but there are no specific measures for severity and quality of life (QoL) other than the Bloating Severity Questionnaire (BSQ) and Bloating Quality of Life (BLQoL). We aimed to translate the BSQ and BLQoL into the Malay language and to validate them using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. The 12-item BSQ has two components, seven-item severity in general (SevGen) and five-item severity in the past 24 h (Sev24), and BLQOL has five items. Translation to the Malay language (BSQ-M and BLQoL-M) was performed using standard forward and backward processes. EFA followed by CFA were performed in participants with AB due to functional bowel disorders, with the purpose of examining the validity and reliability of the questionnaires translated into Malay. After EFA with 152 participants, all the items of BSQ-M remained in the model. Total variance extracted was 53.26% for BSQ-M and 58.79% for BLQoL-M. The internal consistency based on Cronbach's alpha values was 0.52 for SevGen, 0.86 for Sev24, and 0.81 for BLQoL-M. After performing CFA with another 323 participants, the final measurement model for BSQ-M and BLQoL-M fit the data well in terms of several fit indices (BSQ-M: root mean square error of approximation (RMSEA) = 0.050, Comparative Fit Index (CFI) = 0.966, Tucker-Lewis Fit Index (TLI) = 0.956, and standardized root mean squared residual (SRMR) = 0.051; BLQoL-M: RMSEA = 0.071, CFI = 0.985, TLI = 0.962, SRMR = 0.021). The composite reliability for BSQ-M and BLQoL-M were satisfactory (SevGen = 0.83, Sev24 = 0.89, BLQoL = 0.80). The intraclass correlation (ICC) results showed excellent stability for BSQ-M and BLQoL-M, ranging from 0.74 to 0.93. The Malay language versions of BSQ-M and BLQoL-M are valid and reliable instruments for measuring the severity and QoL of AB for the Asian population with functional bowel disorders.
  7. Hidrus A, Kueh YC, Norsa'adah B, Chang YK, Kuan G
    PMID: 34501562 DOI: 10.3390/ijerph18178972
    Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.
  8. Zhou Y, He S, Zhou K, Kuan G, Chin MK, Kueh YC, et al.
    PMID: 34501842 DOI: 10.3390/ijerph18179253
    Background: This study examined the psychometric properties of the Chinese version of the Attitude toward Physical Activity Scale (APAS) using a cross-sectional design. Methods: The sample consisted of 692 primary students in China (boy 52.6%, girl 47.4%). The mean age of the participants was 9.4 years (SD = 0.92). Psychometric properties of the 57-item APAS was examined using confirmatory factor analysis (CFA). Results: The hypothesized seven factors model was supported by CFA (CFI = 0.912, TLI = 0.901, SRMR = 0.041, RMSEA = 0.029) after 22 items were removed and the inclusion of seven residual covariance for items loaded on the same factor. Cronbach's alphas of the scales ranged between 0.50 and 0.76. The composite reliability (CR) was between 0.50 and 0.75. All inter-factor correlation coefficient was less than 0.85. Conclusions: Findings provided empirical evidence that the Chinese version of the APAS has adequate psychometric properties for assessing attitudes of primary school children in China toward physical activity.
  9. Ibrahim MF, Kuan G, Hashim HA, Hamzah NA, Kueh YC
    BMC Public Health, 2021 10 07;21(1):1798.
    PMID: 34620133 DOI: 10.1186/s12889-021-11869-4
    BACKGROUND: This study aimed to verify a translated Malay version of the Achievement Emotions Questionnaire for Physical Education (AEQ-PE) by assessing the level of achievement emotions in six constructs among the Malaysian primary school pupils using the Confirmatory Factor Analysis (CFA).

    METHODS: A total of 607 Malay pupils, comprising 240 (39.5%) boys and 367 (60.5%) girls aged between 10 and 11, were recruited from 10 schools to answer the questionnaire, which measured their views on 24 items through a five-point Likert scale. The AEQ-PE was translated into Malay language (AEQ-PE-M) using forwarding to backward translation techniques. Certain phrases were adopted in accordance with the local culture and vocabulary appropriate for primary school pupils. CFA was performed using the Mplus 8.0 software, and the final model demonstrated high reliability in terms of the composite reliability and Cronbach's alpha.

    RESULTS: Analysis of the CFA showed an acceptable fit indices in CFI (0.936), TLI (0.926), RMSEA = 0.039 (90% CI, 0.034, 0.045) and SRMR (0.049) of the AEQ-PE measurement model. All of the items in the original AEQ-PE version were retained and deemed suitable for Malay primary school pupils.

    CONCLUSION: The AEQ-PE-M with 24 items was a suitable tool for measuring the level of school children's involvement in determining achievement emotions and their motivation towards physical education.

  10. Saman ZM, Siti-Azrin AH, Othman A, Kueh YC
    PMID: 34770183 DOI: 10.3390/ijerph182111669
    The effect of cyberbullying among adolescents in Malaysia is not much studied. The Cyberbullying Scale (CBS) has been validated to be used among English speaking adolescents to measure cyberbullying but not in Malay language. Therefore, its validity should be established before use in the Malaysian context. Thus, the study aimed to evaluate the validity and reliability of the Malay version of the CBS (CBS-M) among secondary school students. The study was cross-sectional and involved a self-administered questionnaire with 16 items from CBS-M, and 21 items from the Depression, Anxiety, and Stress Scale (DASS-21). Participants were recruited using a multi-stage sampling method. The validity of the CBS-M was tested in two phases, namely, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation was used to examine the strength of the relationship between the CBS and subscales from DASS-21 to further support the validity of CBS-M. A total of 401 respondents from Muar, Johor, participated. The mean age was 14.6 years (SD = 1.25). EFA results indicated a one-factor model of CBS-M with a total variance extracted of 33.9%. Internal consistency measured by Cronbach's alpha reached 0.87. The model was then tested using CFA. The initial model did not fit the data well. Thus, several model re-specifications were conducted on the initial model. The final measurement model of CBS-M fit the data well with acceptable fit indices (CFI = 0.946, TLI = 0.932, SRMR = 0.055, RMSEA = 0.049). The composite reliability for CBS-M was satisfactory with a value of 0.832. The CBS-M questionnaire is a valid and reliable tool for measuring cyberbullying among young adolescents in Malaysia.
  11. Chin NS, Liew GC, Kueh YC, Hashim HA, Tee V, Kuan G
    PMID: 34770207 DOI: 10.3390/ijerph182111694
    The 18-item Sport Motivation Scale (SMS-II) is one of the most-utilised scales measuring athletes' motivation and its psychometric properties. However, we found no Malay version used to examine the Malaysian multi-ethnic population. Thus, the study aimed to translate and validate the SMS-II into the Malay version using confirmatory factor analysis. A total of 436 (16.44 ± 1.22) state athletes were asked to complete the SMS-II Malay version, which utilised the forward-backwards translation method. The results showed an acceptable fit with the data (CFI = 0.906, SRMR = 0.064; RMSEA = 0.056) and internal consistency, with a Cronbach's alpha value that exceeded 0.50, which supported its usage for the assessment of motivation among the multi-ethnic Malaysian athletes. The Cronbach's alpha values of all the factors were satisfactory, except for introjected regulation. Thus, further studies are needed to improve the reliability of such factors. Nonetheless, the Malay version of SMS-II was found to be valid and reliable for assessing the level of motivation of the multi-ethnic Malaysian athletes.
  12. Fadzil NA, Heong WO, Kueh YC, Phang CK
    Malays J Med Sci, 2021 Dec;28(6):121-128.
    PMID: 35002496 DOI: 10.21315/mjms2021.28.6.12
    Background: Among healthcare workers, nurses have a particularly high risk of stress. Stressful conditions in the workplace increase the possibility of burnout and psychological distress. Short mindfulness-based interventions can help to decrease stress, anxiety and depression. This study aimed to explore the effectiveness of a mindfulness-based intervention in reducing perceived stress, anxiety and depression among public teaching hospital staff nurses.

    Methods: Thirty-five nurses from various specialities were recruited from Hospital Universiti Sains Malaysia (HUSM). The intervention comprised a 1-day brief mindfulness-based intervention workshop and 1 h group practice session each month for 3 months together with daily follow-up via WhatsApp group. All the participants completed a self-administered sociodemographic questionnaire validated for use in a Malay population. The Depression, Anxiety and Stress Scale 21 (DASS 21) and Perceived Stress Scale 10 (PSS 10) were used to measure perceived stress, anxiety and depression before the intervention, and 3 months later upon completion of the intervention.

    Results: There was a statistically significant reduction in the scores for stress perception (95% confidence interval [CI]: 0.06, 2.92; P = 0.04) and anxiety (95% CI: 0.06, 2.34; P = 0.04) post-intervention.

    Conclusion: A brief mindfulness-based intervention was effective in reducing perceived stress and anxiety among nurses.

  13. Lim BC, Kueh YC, Arifin WN, Ng KH
    PLoS One, 2021;16(4):e0250627.
    PMID: 33909664 DOI: 10.1371/journal.pone.0250627
    BACKGROUND: Healthy lifestyle habits formed during young adulthood may have a sustaining impact on health across later life. The current study aimed to test the theoretical model of factors (selected demographic variables, knowledge of heart disease, health belief related to cardiovascular disease (CVD), self-efficacy, cues to action, and screening intention) influencing health-promoting behaviours among Malaysian university students.

    METHODS: In a cross-sectional survey, the undergraduate students in Universiti Sains Malaysia were invited to complete the self-administered questionnaires. Participants were selected using a purposive sampling method. The proposed hypothesised model was analysed using a structural equation modelling with Mplus 7.3 program. A total of 788 (70.7% female) undergraduate students with a mean age of 20.2 (SD = 1.02) participated in the study. The primary outcome of knowledge, health beliefs, and health-promoting behaviours related to CVD were measured by questionnaires namely: Knowledge of Heart Disease, Health Beliefs Related to CVD, and Health Promoting Lifestyle Profiles-II.

    RESULTS: The final hypothetical structural model showed a good fit to the data based on several fit indices: with comparative fit index (CFI) at .921, standardised root mean square residual (SRMR) at .037, and root mean square error of approximation (RMSEA) at .044 (90% CI: .032, .054). The final structural model supported 13 significant path estimates. These variables explained 12% of the total variance in health-promoting behaviours. Through perceived benefits, total knowledge had an indirect effect on health-promoting behaviours.

    CONCLUSION: The results suggest that perceived barriers, perceived benefits, family history of CVD, and screening intention enable young adults to engage in health-promoting behaviours.

  14. Kueh YC, Sabo A, Kim Y, Kuan G
    PLoS One, 2021;16(9):e0257511.
    PMID: 34591879 DOI: 10.1371/journal.pone.0257511
    BACKGROUND: This study examined the psychometric properties of the Korean and Malay version of the decisional balance (DB) for exercise (i.e. perceived benefits and perceived barriers) using a cross-sectional design. Also, this study assessed the measurement and structural invariance of the DB scale across countries.

    METHODS: A cross sectional study was conducted in Malaysia and Korea. The study sample consisted of 574 Korean participants and 562 Malaysian participants. The mean age of the participants was 19.8 (SD = 1.29) for the Korean sample and 19.8 (SD = 1.22) for the Malaysian sample. Participants were invited to complete the DB scale with the 10-item and two factors (i.e., perceived benefit and perceived barriers). Confirmatory factor analysis (CFA) and invariance test were conducted on the data by using Mplus 8.3.

    RESULTS: The CFA results based on the hypothesised measurement model of two factors and ten items showed sufficient construct validity after adding residual covariance between items within the same factor: CFI = 0.979, TLI = 0.970, SRMR = 0.036, RMSEA = 0.036 for the Korea sample, and CFI = 0.964, TLI = 0.949, SRMR = 0.055, RMSEA = 0.066 for the Malay sample. For the Korea sample, the construct reliability was 0.62 and 0.74 for perceived benefits and perceived barriers respectively. For the Malay sample, the construct reliability was 0.75 and 0.77 for perceived benefits and perceived barriers respectively. The findings presented evidence for measurement and structural invariance of the DB scale for the Korea and Malaysia samples.

    CONCLUSION: The DB scale was a valid and reliable measure for assessing exercise behaviour and for making comparisons between Korean and Malaysian samples.

  15. Konter E, Gledhill A, Kueh YC, Kuan G
    PMID: 35457519 DOI: 10.3390/ijerph19084654
    The purpose of this study was to examine the relationships between female soccer players’ courage and key performance variables (level of participation, injury past, being selected or non-selected by a national team, being starter or substitute). Methods: The Sport Courage Scale-31, by Konter and Ng (2012) and key performance variables were collected from 210 female soccer players aged 12 to 27 (M = 17.97 ± 3.34 years old). Spearman correlations and Mann−Whitney U tests were used to analyse the collected data. Results: The correlations between mastery (r = 0.196), determination (p = 0.239), assertiveness (r = 0.325), sacrifice behaviour (r = 0.182), total sport courage (r = 0.265) and age of female soccer players were found to be significant (p < 0.05). Female soccer players who have sustained an injury in the past scored significantly higher on the venturesome scale (p = 0.006) than those who have not sustained an injury in the past. In comparison, female soccer players who have not sustained an injury in the past or who have not been substituted had significantly more mastery than female soccer players who have sustained an injury in the past or who have been substituted (p = 0.017, p = 0.002, respectively). Conclusions: This study indicates that sport courage is related to key performance variables among female soccer players. Mastery and age seem to be related to courageous behaviour, whereas increasing venturesomeness might cause injuries in female soccer. Some relevant implications for practitioners can be drawn from the present findings.
  16. Joo CL, Husain M, Fadzil NA, Kueh YC
    Malays J Med Sci, 2022 Oct;29(5):105-116.
    PMID: 36474540 DOI: 10.21315/mjms2022.29.5.11
    BACKGROUND: Medical officers (MOs) face multiple sources of work-related stress, including work system transition, job insecurity, dissatisfaction with income and intense working environments. This study aimed to examine the quality of life (QOL), effort-reward imbalance (ERI) and their association among MOs working in government hospitals in Kuching, Sarawak, Malaysia.

    METHODS: This cross-sectional study was conducted among MOs from Sarawak General Hospital and Hospital Sentosa from May 2018 to March 2020. A total of 614 participants were selected through convenient sampling. An email with a link to three sets of questionnaires via Google forms including a questionnaire on sociodemographic data and job characteristics, the World Health Organization Quality of Life-Brief version (WHOQOL-BREF) (Malay version) and the effort-reward imbalance (ERI-Q) (long version) was sent to potential participants. A total of 276 MOs completed and returned the questionnaires. Data were analysed using descriptive, simple and multiple logistic regression analysis. A P-value of less than 0.05 was taken as a statistically significant result.

    RESULTS: Most MOs reported no adversity in the workplace (i.e. 29% low effort/high reward, 5.1% high effort/high reward, 6.2% low effort/low reward and 23.6% high effort/low reward). More than half of MOs (54%) reported poor general QOL and were associated with a combination of active and passive on-calls (adjusted odds ratio [AOR] = 5.36, 95% confidence interval [CI]: 1.21, 23.79). Poor QOL in the physical domain was associated with the presence of chronic illness (AOR = 23.35; 95% CI: 4.25, 128.45), active on-calls (AOR = 14.75; 95% CI: 1.16, 188.35) and a combination of active and passive on-calls (AOR = 18.25; 95% CI: 1.39, 238.98). Men had a higher risk of poor QOL in the environmental domain (AOR = 2.03; 95% CI: 1.04, 3.98). Only 23.6% of MOs reported psychosocial adversity at work (high effort/low reward). High effort/low reward was associated with poor QOL in general (AOR = 4.71; 95% CI: 1.71, 13.01), physical (AOR = 4.53; 95% CI: 2.02, 10.17), psychological (AOR = 5.95; 95% CI: 2.82, 12.58) and environmental domains (AOR = 4.21; 95% CI: 1.95, 9.08). Low effort/high reward was found to have a lower likelihood of poor QOL in the social domain (AOR = 0.13; 95% CI: 0.04, 0.44).

    CONCLUSION: Higher ERI was found to be associated with poor QOL among MOs in government hospitals. Future research should focus on interventions to improve working conditions.

  17. Nagarajah D, Kueh YC, Lazim NM, Abdullah B
    Syst Rev, 2022 Nov 18;11(1):246.
    PMID: 36401259 DOI: 10.1186/s13643-022-02113-0
    BACKGROUND: A good control of intraoperative bleeding is key for adequate anatomical visualization during endoscopic sinus surgery (ESS). The objective of this review was to assess the practice of hot intranasal saline irrigation (HSI) in achieving intraoperative hemostasis and good surgical field quality during ESS.

    METHODS: An electronic search was performed via PubMed, SCOPUS, Google Scholar, and Cochrane from inception to June 2022. The included trials were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. The primary outcome assessed was the intraoperative bleeding score of the surgical field. The mean arterial pressure, duration of the surgery, amount of blood loss and surgeon's satisfaction score were assessed as the secondary outcomes. The risk of bias for each study was evaluated using the Cochrane risk of bias tool.

    RESULTS: A total of 254 records were identified after removal of duplicates. Based on the title and abstract 246 records were excluded, leaving seven full texts for further consideration. Five records were excluded following full text assessment. Three trials with a total of 212 patients were selected. Hot saline irrigation was superior to control in the intraoperative bleeding score (MD - 0.51, 95% CI - 0.84 to - 0.18; P < 0.001; I2 = 72%; very low quality of evidence) and surgeon's satisfaction score (RR 0.18, 95% CI 0.09 to 0.33; P < 0.001; I2 = 0%; low quality of evidence). The duration of surgery was lengthier in control when compared to HSI (MD - 9.02, 95% CI - 11.76 to - 6.28; P < 0.001; I2 = 0; very low quality of evidence). The volume of blood loss was greater in control than HSI (MD - 56.4, 95% CI - 57.30 to - 55.51; P < 0.001; I2 = 0%; low quality of evidence). No significant difference between the two groups for the mean arterial pressure was noted (MD - 0.60, 95% CI - 2.17 to 0.97; P = 0.45; I2 = 0%; low quality of evidence).

    CONCLUSIONS: The practice of intranasal HSI during ESS is favorable in controlling intraoperative bleeding and improving the surgical field quality. It increases the surgeon's satisfaction, reduces blood loss, shortens operative time and has no effect on intraoperative hemodynamic instability.

    TRIAL REGISTRATION: PROSPERO registration number: CRD42019117083.

  18. Ai JY, Kuan G, Juang LY, Lee CH, Kueh YC, Chu IH, et al.
    Int J Environ Res Public Health, 2022 Nov 22;19(23).
    PMID: 36497548 DOI: 10.3390/ijerph192315472
    Sleep is a crucial factor in healthy aging. However, most middle-aged adults experience high levels of sleep disorders. While previous findings have suggested exercise training could benefit the quality of sleep, the effects of multi-component exercise on sleep quality are less examined. Accordingly, the current study aimed to assess the effectiveness of a multi-component exercise program on the quality of sleep among middle-aged adults. Twenty-four middle-aged adults were randomly assigned either to a multi-component exercise (MCE) group or a control group. The participants in the MCE group attended a 90-min session per week for 12 weeks. The control group was instructed to maintain their daily routine for 12 weeks. The primary outcome was the sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was physical fitness, including muscular strength and endurance, balance, and flexibility. Regarding sleep quality, the global mean score (p = 028), sleep disturbances (p = 011), and sleep efficiency (p = 035) of the PSQI scores were significantly reduced in the MCE group after the 12-week intervention. Regarding physical fitness, the flexibility of the MCE group improved significantly after the intervention (p = 028), yet, no significant change was observed in the control group. Additionally, the muscular strength of the control group declined significantly after the 12-week period (p = 034). Our results revealed the effectiveness of the MCE intervention in improving sleep quality and physical fitness in middle-aged adults. Further studies using larger sample sizes, objective measures of sleep quality, different types of exercise training, as well as different populations, are warranted to extend our current findings.
  19. Abdullah N, Kueh YC, Kuan G, Yahaya FH, Lee YY
    Malays J Med Sci, 2022 Dec;29(6):77-88.
    PMID: 36818903 DOI: 10.21315/mjms2022.29.6.8
    BACKGROUND: Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia.

    METHODS: The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews.

    RESULTS: The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related.

    CONCLUSION: The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.

  20. Hidrus A, Kueh YC, Norsa'adah B, Kim Y, Chang YK, Kuan G
    PLoS One, 2022;17(3):e0266104.
    PMID: 35358248 DOI: 10.1371/journal.pone.0266104
    BACKGROUND: This study aimed determine the structural relationship between psychological constructs of the transtheoretical model (TTM; processes of change, decisional balance, and exercise self-efficacy), motives for physical activity (PA), and amount of PA among Malaysians with type 2 diabetes mellitus (T2DM).

    METHOD: All participants were recruited from the Hospital Universiti Sains Malaysia using a cross-sectional study design with purposive) sampling method. A total of 331 participants were recruited for the present study. Before participation in the study, they were informed that participation in the study was totally voluntary. Those who agreed to participate voluntarily were required to complete the self-administered questionnaire set, which included the processes of change, decisional balance, exercise self-efficacy, physical activity and leisure motivation, and international physical activity questionnaires. Data analysis of structural equation modeling was performed using Mplus 8.

    RESULTS: From the 331 participants, most of whom were male (52%) and Malay (89.4%), with a mean age of 62.6 years (standard deviation = 10.29). The final structural equation model fit the data well based on several fit indices [Root Mean Square Error of Approximation (RMSEA) = 0.059, Comparative Fit Index (CFI) = 0.953, Tucker-Lewis Index (TLI) = 0.925, Standardized Root Mean Square Residual (SRMR) = 0.031]. A total of 16 significant path relationships linked between the TTM, motives for PA, and amount of PA.

    CONCLUSION: The pros of decisional balance, others' expectations, and psychological condition were constructs that directly affected PA, whereas the other constructs had a significant indirect relationship with the amount of PA. A positive mindset is crucial in deciding a behavioral change toward an active lifestyle in people with T2DM.

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