Displaying publications 41 - 60 of 70 in total

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  1. Mohd-Sidik S, Arroll B, Goodyear-Smith F, Zain AM
    Int J Psychiatry Med, 2011;41(2):143-54.
    PMID: 21675346 DOI: 10.2190/PM.41.2.d
    OBJECTIVE: To determine the diagnostic accuracy of the two questions with help question (TQWHQ) in the Malay language. The two questions are case-finding questions on depression, and a question on whether help is needed was added to increase the specificity of the two questions.
    METHOD: This cross sectional validation study was conducted in a government funded primary care clinic in Malaysia. The participants included 146 consecutive women patients receiving no psychotropic drugs and who were Malay speakers. The main outcome measures were sensitivity, specificity, and likelihood ratios of the two questions and help question.
    RESULTS: The two questions showed a sensitivity of 99% (95% confidence interval 88% to 99.9%) and a specificity of 70% (62% to 78%), respectively. The likelihood ratio for a positive test was 3.3 (2.5 to 4.5) and the likelihood ratio for a negative test was 0.01 (0.00 to 0.57). The addition of the help question to the two questions increased the specificity to 95% (89% to 98%).
    CONCLUSION: The two qeustions on depression detected most cases of depression in this study. The questions have the advantage of brevity. The addition of the help question increased the specificity of the two questions. Based on these findings, the TQWHQ can be strongly recommended for detection of depression in government primary care clnics in Malaysia. Translation did not apear to affect the validity of the TQWHQ.
  2. Foo CN, Arumugam M, Lekhraj R, Lye MS, Mohd-Sidik S, Jamil Osman Z
    PMID: 32858791 DOI: 10.3390/ijerph17176179
    BACKGROUND: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia.

    METHODS: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat.

    RESULTS: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing.

    CONCLUSION: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.

  3. Jaffar A, Mohd Sidik S, Foo CN, Muhammad NA, Abdul Manaf R, Fadhilah Ismail SI, et al.
    PMID: 33946203 DOI: 10.3390/ijerph18094792
    BACKGROUND: The delivery of pelvic floor muscle training (PFMT) through mHealth apps has been shown to produce promising results in improving pelvic floor muscle strength and urinary incontinence (UI). However, there is limited evidence on mHealth apps designed for pregnant women who are at high risk of developing UI. This pilot study aims to evaluate the feasibility of conducting an effectiveness trial for a newly developed PFMT app among pregnant women in Malaysia.

    METHODS: This is a prospective, single-centre, single-blind, randomised controlled pilot feasibility study: The Kegel Exercise Pregnancy Training app (KEPT-app) Trial. Sixty-four incontinent pregnant women who attended one primary care clinic for the antenatal follow-up will be recruited and randomly assigned to either intervention or waitlist control group. The intervention group will receive the intervention, the KEPT-app developed from the Capability, Opportunity, Motivation-Behaviour (COM-B) theory with Persuasive Technology and Technology Acceptance Model.

    DISCUSSION: This study will provide a fine-tuning for our future randomised control study on the recruitment feasibility methods, acceptability, feasibility, and usability of the KEPT-app, and the methods to reduce the retention rates among pregnant women with UI.

    TRIAL REGISTRATION: This study was registered on ClinicalTrials.gov on 19 February 2021 (NCT04762433) and is not yet recruiting.

  4. Ab Ghaffar SF, Mohd Sidik S, Ibrahim N, Awang H, Gyanchand Rampal LR
    PMID: 31817328 DOI: 10.3390/ijerph16244913
    Anxiety is one of the most common mental health disorders in childhood, and children with anxiety have an increased risk of psychiatric disorders during adulthood. This study aimed to evaluate the effectiveness of a school-based anxiety prevention program for reducing anxiety among primary school students relative to a school-as-usual control group. Secondary to this, the current study aimed to examine the effect of a school-based prevention program on worry coping skills and self-esteem. A two-group parallel cluster randomized controlled trial of a single-blinded study was conducted to evaluate the effectiveness of the program, with schools as the unit of allocation and individual participants as the unit of analysis. The intervention program was conducted between May 2016 and December 2017. The primary outcome was anxiety, whereas the secondary outcomes were worry coping skills and self-esteem measured at three months post-intervention. Data were analyzed by using a generalized linear mixed model, accounting for the clustering effect. Subgroup analyses were performed for children with anxiety. A total of 461 students participated in this study. At baseline, there was no significant difference between groups for anxiety score, worry coping skills score, and self-esteem score (p > 0.05). The intervention was effective in reducing anxiety for the whole sample (p = 0.001) and the anxiety subgroup (p = 0.001). However, it was not effective in improving worry coping skills and self-esteem. These findings suggest that the program could be effective for reducing symptoms of anxiety when delivered in schools and provide some support for delivering this type of program in primary school settings.
  5. Yap SY, Foo CN, Lim YM, Ng FL, Mohd-Sidik S, Tang PY, et al.
    Int J Environ Res Public Health, 2021 May 18;18(10).
    PMID: 34069915 DOI: 10.3390/ijerph18105366
    Depression is commonly observed in university students, who are a high risk group for developing psychiatric disorders during adulthood. This study aimed to determine the prevalence of depression and its traditional Chinese medicine body constitutions and psychological determinants among university students in Malaysia. A cross-sectional pilot study was conducted between 9 and 28 September 2020 among 80 university students in Malaysia. Participants completed online survey questionnaires, including the validated Patient Health Questionnaire (PHQ-9), Constitution in Chinese Medicine Questionnaire (CMCQ), Dysfunctional Attitude Scale (DAS), Depression Anxiety Stress Scale (DASS-21) stress subscale, Perceived Stress Scale (PSS-10), and Rosenberg Self-Esteem Scale (RSES), which assess depression, body constitution, dysfunctional attitude, stress, perceived stress, and self-esteem. Multiple linear regression analyses were performed to determine the associated risk factors for depression. The overall prevalence of depression among university students was 33.8%. The multiple regression analysis showed a significant relationship between depression and qi-stagnation constitution (B = 0.089, p = 0.011), balanced constitution (B = -0.077, p = 0.049), and self-esteem (B = -0.325, p = 0.001). Our findings suggest that some traditional Chinese medicine body constitutions and self-esteem are significant risk factors affecting depression among university students. Identifying risk factors of depression is vital to aid in the early detection of depression among university students.
  6. Mohd-Sidik S, Lekhraj R, Foo CN
    PMID: 33498401 DOI: 10.3390/ijerph18030868
    BACKGROUND: The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity.

    METHODS: A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated.

    RESULTS: The overall prevalence of obesity (BMI ≥ 30 kg/m2) among adults in Selangor, Malaysia, was 18.6%. Factors significantly associated with increased risk of obesity were: being female (OR = 1.61, 95% CI [1.20-2.17]), aged between 30 to 39 years old (OR = 1.40, 95% CI [1.04-1.88]), being Indian (OR = 1.55, 95% CI [1.13-2.12]), married (OR = 1.37, 95% CI [1.03-1.83]), and having only primary school education (OR = 1.80, 95% CI [1.17-2.78] or secondary school education (OR = 1.37, 95% CI [1.04-1.81]). In the multiple linear regression analysis (stepwise method), perceived stress (B = -0.107, p = 0.041), suicidal ideation (B = -2.423, p = 0.003), and quality of life in the physical health domain (B = -0.350, p = 0.003) inversely and significantly contributed to BMI among males. Among females, stressful life events contributed positively to BMI (B = 0.711, p < 0.001, whereas quality of life in the psychological domain had a negative effect (B = -0.478, p < 0.001) in this respect.

    CONCLUSION: There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.

  7. Mohd Sidik S
    ISBN: 978-1-4987-6752-1
    Citation: Sherina Mohd Sidik. Chapter 36: Primary Care Research in Malaysia. In: Goodyear-Smith F, Mash B (editors). International Perspectives on Primary Care Research. Boca Raton, Florida, United States of America: CRC Press (Taylor & Francis Group), World Organization of Family Doctors (WONCA); 2016, p199-201
  8. Tan CE, Lau SCD, Abdul Latiff Z, Lee CC, Teh KH, Mohd Sidik S
    Health Info Libr J, 2023 Jun 18.
    PMID: 37332240 DOI: 10.1111/hir.12491
    BACKGROUND: Timely and relevant information helps parents to cope when a child is diagnosed with cancer. However, obtaining and understanding information is not a straightforward process for parents.

    OBJECTIVES: This article aims to explain paediatric cancer parents' information behaviour related to the care of their child.

    METHODS: Qualitative in-depth interviews were conducted with fourteen Malaysian paediatric cancer parents and eight healthcare professionals who worked with paediatric cancer patients. Reflexivity and inductive approaches were used to interpret the data to identify meaningful themes and subthemes.

    RESULTS: Three themes about how paediatric cancer parents interact with information emerged: Acquiring information, internalising information, and using information. Information may be actively sought or passively acquired. Cognitive and affective aspects influence how information is internalised into meaningful knowledge. Knowledge then leads to further action including further information gathering.

    CONCLUSION: Paediatric cancer parents need health literacy support to meet their information needs. They require guidance in identifying and appraising suitable information resources. Development of suitable supporting materials is needed to facilitate parents' ability to comprehend information related to their child's cancer. Understanding parents' information behaviour could assist healthcare professionals in providing information support in the context of paediatric cancer.

  9. Periasamy U, Mohd Sidik S, Rampal L, Fadhilah SI, Akhtari-Zavare M, Mahmud R
    Health Qual Life Outcomes, 2017 May 15;15(1):104.
    PMID: 28506305 DOI: 10.1186/s12955-017-0680-2
    BACKGROUND: Cancer is now becoming a leading cause of death. Chemotherapy is an important treatment for cancer patients. These patients also need consultation during their treatment to improve quality of life and decrease psychological disorders. The objectives of the study were to develop, implement and evaluate the effectiveness of a chemotherapy counseling module by pharmacists among oncology patients on their quality of life and psychological outcomes in Malaysia.

    METHOD: A single-blind randomized controlled trial was carried out among 162 oncology patients undergoing chemotherapy from July 2013 to February 2014 in a government hospital with oncology facilities in Malaysia. Participants were randomized to either the intervention group or the control group. Chemotherapy counseling using the module on 'Managing Patients on Chemotherapy' by Pharmacists was delivered to the intervention group. The outcome measures were assessed at baseline, first follow-up and second follow-up and third follow-up post-intervention. Chi-square, independent samples t-test and two-way repeated measures ANOVA were conducted in the course of the data analyses.

    RESULTS: In assessing the impact of the chemotherapy counseling module, the study revealed that the module along with repetitive counseling showed significant improvement of quality of life in the intervention group as compared to the control group with a large effect size in physical health (p = 0.001, partial Ƞ2 = 0.66), psychological (p = 0.001, partial Ƞ2 = 0.65), social relationships (p = 0.001, partial Ƞ2 = 0.30), and environment (p = 0.001, partial Ƞ2 = 0.67) and decrease in the anxiety (p = 0.000; partial Ƞ2 = 0.23), depression (p = 0.000; partial Ƞ2 = 0.40).

    CONCLUSION: The module on 'Managing Patients on Chemotherapy' along with repetitive counseling by pharmacists has been shown to be effective in improving quality of life and decreasing anxiety and depression among oncology patients undergoing chemotherapy.

    TRIAL REGISTRATION NUMBER: National Medical Research Register (NMRR) of Malaysia and given a registration number NMRR-12-1057-12,363 on 21 December 2012.

  10. Akhtari-Zavare M, Mohd-Sidik S, Periasamy U, Rampal L, Fadhilah SI, Mahmud R
    Health Qual Life Outcomes, 2018 Aug 13;16(1):163.
    PMID: 30103759 DOI: 10.1186/s12955-018-0989-5
    BACKGROUND: Cancer is a serious public health problem not only in Malaysia, also worldwide. The aim of this study was to determine the determinants of quality of life (QOL) among cancer patients in Peninsular Malaysia.

    METHODS: A cross sectional study was conducted among 2120 cancer patients in Peninsular Malaysia, between April 2016 to January 2017. All cancer patients aged 18 years old and above, Malaysian citizens and undergoing cancer treatment at government hospitals were approached to participate in this study and requested to complete a set of validated questionnaires. Inferential statistical tests such as t-test and one-way ANOVA were used to determine the differences between demographic variables, physical effects, clinical factors, psychological effects and self-esteem with the quality of life of cancer patients. Predictor(s) of quality of life were determined by using Multivariate linear regression models.

    RESULT: A total 1620 out of 2120 cancer patients participated in this study, giving a response rate of 92%. The majority of cancer patients were female 922 (56.9%), Malays 1031 (63.6%), Muslim 1031 (63.6%), received chemotherapy treatment 1483 (91.5%). Overall, 1138 (70.2%) of the patients had depression and 1500 (92.6%) had anxiety. Statistically significant associations were found between QOL and clinical factors, physical side effects of cancer, psychological effects and self-esteem (p 

  11. Chew BH, Mohd-Sidik S, Shariff-Ghazali S
    Health Qual Life Outcomes, 2015 Nov 24;13:187.
    PMID: 26596372 DOI: 10.1186/s12955-015-0384-4
    BACKGROUND: Patients with type 2 diabetes mellitus (T2D) often experienced change in life, altered self-esteem and increased feelings of uncertainty about the future that challenge their present existence and their perception of quality of life (QoL). There was a dearth of data on the association between diabetes-related distress (DRD) and health-related quality of life (HRQoL). This study examined the determinants of HRQoL, in particular the association between DRD and HRQoL by taking into account the socio-demographic-clinical variables, including depressive symptoms (DS) in adult patients with T2D.
    METHODS: This cross-sectional study was conducted in 2012-2013 in three public health clinics in Malaysia. The World Health Organization Quality of Life-Brief (WHOQOL-BREF), 17-items Diabetes Distress Scale (DDS-17), and 9-items Patient Health Questionnaire (PHQ-9) were used to measure HRQoL, DRD and DS, respectively. The aim of this research was to examine the association between the socio-demographic-clinical variables and HRQoL as well as each of the WHOQOL-BREF domain score using multivariable regression analyses.
    RESULTS: The response rate was 93.1% (700/752). The mean (SD) for age was 56.9 (10.18). The majority of the patients were female (52.8%), Malay (53.1%) and married (79.1%). About 60% of the patients had good overall HRQoL. The mean (SD) for Overall QoL, Physical QoL, Psychological QoL, Social Relationship QoL and Environmental QoL were 61.7 (9.86), 56.7 (10.64), 57.9 (11.73), 66.8 (15.01) and 65.3 (13.02), respectively. The mean (SD) for the total DDS-17 score was 37.1 (15.98), with 19.6% (136/694) had moderate distress. DDS-17 had a negative association with HRQoL but religiosity had a positive influence on HRQoL (B ranged between 3.07 and 4.76). Women, especially younger Malays, who had diabetes for a shorter period of time experienced better HRQoL. However, patients who were not married, had dyslipidaemia, higher levels of total cholesterol and higher PHQ-9 scores had lower HRQoL. Macrovascular complications showed the largest negative effect on the overall HRQoL (adjusted B = -4.98, 95% CI -8.56 to -1.40).
    CONCLUSION: The majority of primary care adult with T2D had good overall HRQoL. Furthermore, the independent determinants for HRQoL had also concurred with many past studies. In addition, the researchers found that DRD had negative effects on HRQoL, but religiosity had positive influence on HRQoL. Appropriate support such as primary care is needed for adult patients with T2D to improve their life and their HRQoL.
    TRIAL REGISTRATION: NMRR-12-1167-14158.
  12. Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:16-20.
    PMID: 33370858 DOI: 10.1111/ggi.14031
    AIM: Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD.

    METHODS: A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.

    RESULTS: The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P 

  13. Ahmad NA, Abd Razak MA, Kassim MS, Sahril N, Ahmad FH, Harith AA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:21-25.
    PMID: 33370850 DOI: 10.1111/ggi.14012
    AIM: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia.

    METHODS: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables.

    RESULTS: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income.

    CONCLUSIONS: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.

  14. Visvanathan R, Zaiton A, Mohd Sidik S, Muhamad YA
    Eur J Clin Nutr, 2005 Mar;59(3):318-24.
    PMID: 15523487
    OBJECTIVES: The aim of this study was to determine the: (1) prevalence of undernutrition as determined by the 'DETERMINE Your Nutritional Health Checklist' (NHC) and (2) factors independently associated with undernutrition among the older residents of these publicly funded shelter homes in Peninsular Malaysia.
    DESIGN: A total of 1081 elderly people (59%M) over the age of 60 y were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well-being.
    SETTING: Shelter homes, Peninsular Malaysia.
    RESULTS: In all, 41.4% (n = 447) were nourished (score <3), 32.1% (n = 347) at moderate risk (score between 3 and 5) and 26.6% (n = 287) were at high risk of undernutrition (score>5) according to the NHC. A large proportion of subjects were underweight with 14.3% of subjects recording a low body mass index (BMI) <18.5 kg/m2 and a further 18.2% recording a BMI between 18.5 and 20 kg/m2. The residential geriatric depression score (GDS-12R) (relative risk (RR) = 1.03 (95% confidence interval (CI) 1.01-1.05); P = 0.002) and the number of illnesses (RR = 1.14 (95% CI 1.07-1.21); P < 0.001) were found to be independently associated with nutritional risk (NHC score > or = 3). Using a BMI < 18.5 kg/m2 as an objective marker for nutritional risk, the NHC was shown to have a sensitivity of 66.4% (95% CI 58.0-74.2%), specificity of 42.7% (95% CI 39.3-46.1%), positive predictive value of 16.2% (95% CI 13.3-19.5%) and a negative predictive value of 88.4% (95% CI 84.9-91.4%).
    CONCLUSIONS: Many elderly people residing in publicly funded shelter homes in Malaysia may be at-risk of undernutrition, and were underweight. The NHC is better used as an awareness tool rather than as a screening tool.
  15. Tan CE, Lau SCD, Tan KA, Latiff ZA, Teh KH, Lee CC, et al.
    Cureus, 2022 Oct;14(10):e30903.
    PMID: 36465778 DOI: 10.7759/cureus.30903
    Introduction Validated tools to measure caregiving knowledge among parents of children with hematological cancers are needed to measure the clinical outcome of caregiver interventions. This study reports the development and validation of the Hematological Oncology Parents Education Caregiving Knowledge Questionnaire (HOPE-CKQ) among Malaysian parents of pediatric leukemia and lymphoma patients. Methods Initially, 60 items on caregiving knowledge were developed based on a qualitative needs assessment study. Content validity was evaluated using item content validity index (I-CVI) and scale content validity index (S-CVI/Ave). Parents of pediatric leukemia and lymphoma patients were invited to complete the 60-item version of the HOPE-CKQ. Exploratory factor analysis (EFA) using polychoric correlation resulted in an 18-item version of HOPE-CKQ. Confirmatory factor analysis (CFA) was used to verify the factor structure. Known-group validity was tested by comparing the scores among different levels of parent education. Results The I-CVI ranged from 0.83 to 1.00 whereas the S-CVI/Ave was 0.99, indicating good content validity. A total of 167 complete responses were analyzed for factor analysis. EFA using polychoric correlations resulted in a single-factor structure consisting of 18 items. CFA confirmed that the 18-item single-factor HOPE-CKQ model had a good fit for the data. The internal consistency reliability was good (α=0.80). Parents with tertiary education level had higher caregiving knowledge (M=12.61, SD=3.37) compared to parents with secondary education and below (M=10.33, SD=3.80) (t=3.58, p<0.001). Conclusions The 18-item HOPE-CKQ is valid and reliable for use to measure caregiving knowledge among pediatric leukemia and lymphoma parents. This tool may be considered to measure caregiving knowledge in future preventive and intervention programs.
  16. Osman ZJ, Mukhtar F, Hashim HA, Abdul Latiff L, Mohd Sidik S, Awang H, et al.
    Compr Psychiatry, 2014 Oct;55(7):1720-5.
    PMID: 24952938 DOI: 10.1016/j.comppsych.2014.04.011
    OBJECTIVE: The 21-item Depression, Anxiety and Stress Scale (DASS-21) is frequently used in non-clinical research to measure mental health factors among adults. However, previous studies have concluded that the 21 items are not stable for utilization among the adolescent population. Thus, the aims of this study are to examine the structure of the factors and to report on the reliability of the refined version of the DASS that consists of 12 items.
    METHOD: A total of 2850 students (aged 13 to 17 years old) from three major ethnic in Malaysia completed the DASS-21. The study was conducted at 10 randomly selected secondary schools in the northern state of Peninsular Malaysia. The study population comprised secondary school students (Forms 1, 2 and 4) from the selected schools.
    RESULTS: Based on the results of the EFA stage, 12 items were included in a final CFA to test the fit of the model. Using maximum likelihood procedures to estimate the model, the selected fit indices indicated a close model fit (χ(2)=132.94, df=57, p=.000; CFI=.96; RMR=.02; RMSEA=.04). Moreover, significant loadings of all the unstandardized regression weights implied an acceptable convergent validity. Besides the convergent validity of the item, a discriminant validity of the subscales was also evident from the moderate latent factor inter-correlations, which ranged from .62 to .75. The subscale reliability was further estimated using Cronbach's alpha and the adequate reliability of the subscales was obtained (Total=76; Depression=.68; Anxiety=.53; Stress=.52).
    CONCLUSION: The new version of the 12-item DASS for adolescents in Malaysia (DASS-12) is reliable and has a stable factor structure, and thus it is a useful instrument for distinguishing between depression, anxiety and stress.
  17. Yusof KM, Mohd Sidik S, Mahmud R, Abdullah M, Avery-Kiejda KA, Rosli R
    Breast Cancer, 2023 Sep;30(5):810-819.
    PMID: 37306933 DOI: 10.1007/s12282-023-01475-0
    BACKGROUND: Although higher survival rates of breast cancer are achieved these days, breast cancer survivors are challenged with unwanted side effects from treatment or management that affect physical, functional, and psychological well-being of an individual. This study aimed to assess psychological distress status in Malaysian breast cancer survivors and factors that affected the condition.

    METHODS: A cross-sectional study design was conducted on 162 breast cancer survivors from various breast cancer support groups in Malaysia. Psychological distress status was assessed based on depression and anxiety scores by applying the Malay version of Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7). Both instruments were self-administered along with a set of questionnaires comprising demographic, medical history, quality of life, and upper extremity function assessment. Outcomes from the PHQ-9 and GAD-7 were analyzed for severity level of psychological distress, and its association with relevant variables, arm morbidity symptoms, as well as the duration of cancer survivorship.

    RESULTS: The univariate analysis showed that breast cancer survivors with arm morbidities after breast surgery had a higher score of depression (5.0 vs 4.0, p = 0.011) and anxiety (3.0 vs 1.0, p = 0.026) than those who did not. Besides that, receiving fewer post-rehabilitation treatments (p = 0.049) and having a family history of cancer (p = 0.022) were correlated with higher anxiety level. The level of depression and anxiety was inversely proportionate with quality of life and positively correlated with greater disability of the arm function (p 

  18. Ponka D, Coffman M, Fraser-Barclay KE, Fortier RDW, Howe A, Kidd M, et al.
    BMJ Glob Health, 2020 07;5(7).
    PMID: 32624501 DOI: 10.1136/bmjgh-2020-002470
    The Alma Ata and Astana Declarations reaffirm the importance of high-quality primary healthcare (PHC), yet the capacity to undertake PHC research-a core element of high-quality PHC-in low-income and middle-income countries (LMIC) is limited. Our aim is to explore the current risks or barriers to primary care research capacity building, identify the ongoing tensions that need to be resolved and offer some solutions, focusing on emerging contexts. This paper arose from a workshop held at the 2019 North American Primary Care Research Group Annual Meeting addressing research capacity building in LMICs. Five case studies (three from Africa, one from South-East Asia and one from South America) illustrate tensions and solutions to strengthening PHC research around the world. Research must be conducted in local contexts and be responsive to the needs of patients, populations and practitioners in the community. The case studies exemplify that research capacity can be strengthened at the micro (practice), meso (institutional) and macro (national policy and international collaboration) levels. Clinicians may lack coverage to enable research time; however, practice-based research is precisely the most relevant for PHC. Increasing research capacity requires local skills, training, investment in infrastructure, and support of local academics and PHC service providers to select, host and manage locally needed research, as well as to disseminate findings to impact local practice and policy. Reliance on funding from high-income countries may limit projects of higher priority in LMIC, and 'brain drain' may reduce available research support; however, we provide recommendations on how to deal with these tensions.
  19. Hossain M, Mani KK, Mohd Sidik S, Shahar HK, Islam R
    BMC Public Health, 2014;14:775.
    PMID: 25081860 DOI: 10.1186/1471-2458-14-775
    BACKGROUND:
    Knowledge and awareness concerning sexually transmitted diseases (STDs) has become the burning issue of the day. Although STDs pose serious risks to health security, there is very little literature quantifying the knowledge and awareness of these diseases and their principal socioeconomic determinants. The aim of this study is to determine the effect of different socio-economic and demographic factors on knowledge and awareness about STDs among women in Bangladesh.

    METHODS:
    This is a cross-sectional study using data from the Bangladesh Demographic and Health Survey (BDHS) 2011. It involves 10,996 women in six divisions of Bangladesh - Dhaka, Rajshahi, Chittagong, Barisal, Khulna and Sylhet. In this study, the percentage distribution and logistic regression model are used to identify which factors are associated with knowledge and awareness among women in Bangladesh about STDs.

    RESULTS:
    There is a significant association between geographic division (Dhaka: OR = 1.669, 95% CI = 0.89-2.10, Khulna: OR = 2.234, 95% CI = 1.2-3.2); places of residence (Rural: OR = 0.363, 95% CI = 0.20-1.08), respondent's age (20-29 years: OR = 1.331; 95% CI = 0.98-2.31); education (Primary: OR = 2.366, 95% CI = 1.98-3.1, secondary: OR = 10.089, 95% CI = 8.98-12.77, higher: OR = 20.241, 95% CI = 18.33-22.65); listening to radio (OR = 1.189, 95% CI = 1.29-3.12) and watching TV (OR = 2.498, 95% CI = 2.22-4.09) with knowledge and awareness among women in Bangladesh about STDs.

    CONCLUSION:
    There is a need to improve the education in Bangladesh about STDs particularly among those in the rural areas and older ages of women (30-49 years). Formal, informal and special educational knowledge and awareness programmes may be implemented to educate people concerning STDs in Rajshahi, Sylhet and Chittangong division. Campaigns and mass media can be used to increase the knowledge and awareness among the community, especially among women. Policies concerning the issue of STDs need to be improved and can be emphasized in collaboration with government agencies to ensure the success of these campaigns.
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