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Fulltext Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patients: a Malaysian study

Quek KF, Low WY, Razack AH, Loh CS

Psychiatry Clin Neurosci, 2001 Oct;55(5):509-13.
PMID: 11555347 DOI: 10.1046/j.1440-1819.2001.00897.x

This present study was undertaken to validate the English version of the General Health Questionnaire (GHQ-12) in urological patients. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items with Cronbach's alpha value of 0.37-0.79, while total scores was 0.79 in the population study. Test-retest correlation coefficient for the 12 items score were highly significant. Intraclass correlation coefficient was high (0.35-0.79). It showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across all 12 items in the treatment cohort but not in the control group. The GHQ-12 is suitable, reliable, valid and sensitive to clinical change in urological disorders.
Fulltext Emotional Distress as a Predictor of Work-Related Musculoskeletal Disorders in Malaysian Nursing Professionals

Amin NA, Quek KF, Oxley JA, Noah R, Nordin R

Int J Occup Environ Med, 2018 04;9(2):69-78.
PMID: 29667644 DOI: 10.15171/ijoem.2018.1158

BACKGROUND: Emotional distress is becoming a great concern and is more common in both developed and developing countries. It is associated with several disease conditions.
OBJECTIVE: To determine the prevalence of self-perceived emotional distress and its relation to work-related musculoskeletal disorders (WRMSDs) in nurses.
METHODS: A self-administered questionnaire survey was carried out on 660 female nurses working in public hospitals in the Klang Valley, Malaysia. The validated Malay version of the standardized Nordic musculoskeletal questionnaire (M-SNMQ) was used to identify the annual prevalence of WRMSDs; perceived emotional distress was assessed using the validated Malay short version, depression, anxiety, and stress (M-DASS) instrument. In addition, socio-demographic and occupational profiles of the participants were considered. Factors associated with WRMSDs were identified using logistic regression analysis.
RESULTS: A total of 376 nurses completed the survey (response rate 83.3%). 73.1% of the nursing staffs experienced WRMSDs in at least one anatomical site 12 months prior to the study. 75% of nurses expressed emotional distress. Of these, over half also reported anxiety and stress. Multiple logistic regression analysis showed that stress and anxiety significantly increased the risk of WRMSDs by approximately twofold.
CONCLUSION: There were significant associations between emotional distress and WRMSDs. Future longitudinal studies are therefore needed to investigate and identify the sources of emotional distress (non-occupational and occupational) to be used to establish preventive strategies to reduce the risk of WRMSDs.
Ethnicity and H. pylori as risk factors for gastric cancer in Malaysia: A prospective case control study

Goh KL, Cheah PL, Md N, Quek KF, Parasakthi N

Am J Gastroenterol, 2007 Jan;102(1):40-5.
PMID: 17100981

To determine the risk factors for gastric cancer (GCA), with particular emphasis on ethnicity in our multiracial population.
Fulltext Validation of the hospital anxiety and depression scale and the psychological disorder among premature ejaculation subjects

Quek KF, Atiya AS, Heng NGC, Beng CC

Int J Impot Res, 2007 May-Jun;19(3):321-5.
PMID: 17136103 DOI: 10.1038/sj.ijir.3901528

Premature ejaculation (PE) is a common sexual dysfunction among the general population. PE has often been associated with a psychological state of mind. Hospital Anxiety and Depression Scale (HADS) can be used as an instrument to assess the emotional and psychological state. The present study was designed to assess the reliability and validity of the HADS in a Malaysian population. The validity and reliability were studied in subjects with and without PE. Test-retest methodology was used to assess the reliability whereas Cronbach's alpha was used to assess the internal consistency. In the control and the PE groups, the internal consistency was good and a high degree of internal consistency was observed for all 14 items. In the control group, the Cronbach's alpha values at baseline were from 0.811 to 0.834, whereas for retest, the Cronbach's alpha values were from 0.821-0.838 items. Intraclass correlation coefficient (ICC) was high for the control (0.797-0.868: baseline and 0.805-0.872: retest) and PE group (0.822-0.906: baseline and 0.785-0.887: retest). The high value of ICC and the internal consistency was due to high reliability and consistency of the items at 2-week interval. A degree of significance between the baseline and week-2 scores was observed across all items in the PE group but not in the control group. The HADS is a suitable, reliable, valid and sensitive instrument to measure the clinical change for anxiety and depression in the Malaysian population.
Fulltext Communication, the Heart of a Relationship: Examining Capitalization, Accommodation, and Self-Construal on Relationship Satisfaction

De Netto PM, Quek KF, Golden KJ

Front Psychol, 2021;12:767908.
PMID: 34966329 DOI: 10.3389/fpsyg.2021.767908

The study of processes that enrich positive relationships has been an under-researched area within positive psychology practice. The way an individual responds during couple conflicts (accommodation response) and toward the disclosure of good news of a partner (capitalization response) has been linked to relationship quality. Although the accommodation and capitalization communication processes are part and parcel of our everyday lives, the two processes have been examined separately and dominated by the Western perspectives in past research. Prior work has suggested that Western and Asian cultures differ in expressing and perceiving beneficial communication behaviors. Yet, it is still unclear which accommodation and capitalization responses matter the most from an Asian lens. To date, there is no research examining these interconnected variables simultaneously in Asia, specifically in Malaysia. In this study, two forms of communication processes, namely, (1) accommodation and (2) capitalization, were explored concurrently to disentangle the unique associations and influence on relationship satisfaction. This study also sought to understand the moderating effects of culture in terms of interdependent self-construal on the link between these two communication processes and relationship satisfaction. Responses of 139 Malaysians in dating relationships between the age of 18 and 30 years (M age = 23.15) were collected through online surveys. An active and constructive reaction was captured as the most favorable response through both the capitalization and accommodation processes. Prominently, an active-constructive capitalization response bore the strongest influence on relationship satisfaction above and beyond other responses. A passive and constructive response was revealed only fruitful for disclosures of positive news and not during conflicts. Conversely, in the destructive paradigm, passive-destructive responses were the most detrimental factor in relationships compared to other destructive responses. The results also uncovered that interdependent self-construal did not moderate the two forms of communication processes. However, the findings discovered unexpected individual and cultural variations. This pioneering study is a noteworthy addition to the positive psychology literature from an Asian standpoint. It highlights the significance of not only protecting relationships through better conflict management but also enriching relationships by capitalizing on the positive aspects across the lives of the couple, ultimately providing a greater holistic insight into cultivating flourishing lives.
Tuberculosis: clinical manifestations and outcomes

Nissapatorn V, Kuppusamy I, Anuar AK, Quek KF, Latt HM

Southeast Asian J Trop Med Public Health, 2003;34 Suppl 2:147-52.
PMID: 19238668

A total of 290 HIV/AIDS patients were recruited into this retrospective study, which was carried out at the National Tuberculosis Center (NTBC), Kuala Lumpur. The age range was 18 to 75 years with a mean age of 36.10 (SD +/- 7.44) years. Males outnumbered females by a ratio of 31:1. In this study, the majority of patients were male (96.9%), Malay (47.2%), single (66.9%), unemployed (81%), and smoked (61.4%). The main risk marker identified was injecting drug use (74.5%). The most common clinical manifestations were cough, fever, sputum, lymphadenopathy, and chest infiltrations. More than half of the patients (85.9%) were diagnosed with localized tuberculosis (pulmonary) and the others (14.1%) had extra-pulmonary or disseminated tuberculosis. At the time of this study, the majority of the patients (16.9%) had CD4 cell counts of less than 200 cell/mm3, with a median of 221 cell/mm3. Clinical outcomes demonstrated that among those who survived, 11.0% and 20.7% of the patients had completed treatment either > or = 6 or > or = 9 months, respectively, whereas 54.8% of patients were lost to follow-up, including 0.7% for MDR-TB. Diagnostic criteria for tuberculosis in this study were mainly clinical symptoms/signs and chest x-ray findings (31.0%).
Tuberculosis in HIV/AIDS patients: a Malaysian experience

Nissapatorn V, Kuppusamy I, Sim BL, Quek KF, Khairul Anuar A

Southeast Asian J Trop Med Public Health, 2005 Jul;36(4):946-53.
PMID: 16295550

This retrospective study was conducted at the National Tuberculosis Center (NTBC) where 252 HIV-positive patients coexisting with tuberculosis (TB/HIV) were examined. We found that patients with pulmonary (PTB) and extrapulmonary tuberculosis (EPT) had similar mean age. A higher sex ratio between male to female (10.7:1) was observed in patients with PTB. The other characteristics of patients with pulmonary and extrapulmonary tuberculosis were not statistically different from each other. Cough (88%) and hemoptysis were the most common presenting symptoms, significantly related to patients with PTB. Lymphadenopathy (33.5%) was the most common sign in patients with EPT. The majority of patients with pulmonary and extrapulmonary tuberculosis had CD4 cell counts of less than 200 cells/mm3 (range 0-1,179 with a median of 57 cells/mm3). Lung (89%) and miliary (55.6%) forms were the most frequent disease locations in patients with PTB and EPT, respectively. A higher percentage of patients with PTB (42%) were treated successfully with short-course (6 months) therapy, whereas in patients with EPT (43%) needed a longer period (9 months) for successful treatment. Of the patients who defaulted treatment, a higher proportion (87%) had PTB. No MDR-TB or relapse cases were found in this study.
Fulltext A web-based dietary intervention for people with type 2 diabetes: development, implementation, and evaluation

Ramadas A, Chan CK, Oldenburg B, Hussien Z, Quek KF

Int J Behav Med, 2015 Jun;22(3):365-73.
PMID: 25274015 DOI: 10.1007/s12529-014-9445-z

BACKGROUND: Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported.
PURPOSE: We describe the development, implementation, and process evaluation of an Internet-delivered dietary intervention program (myDIDeA) for diabetic patients in a developing country.
METHOD: Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of Change and user-centered design approach. Finally, the effectiveness of the website was tested through a randomized-controlled trial to promote dietary change in patients with type 2 diabetes. The participants in the intervention group (n = 66) were given access to myDIDeA for 6 months. Process evaluation in form of intervention adherence and program reception were conducted at post intervention.
RESULTS: The response rate for the process evaluation was 89%. On average, each participant logged in at least once for each lesson plan and spent almost 12 min on the site. The participants' content satisfaction, acceptability, and usability scores were satisfactory. The primary outcome of the trial, Dietary Knowledge, Attitude, and Behavior score was strongly correlated with content satisfaction (r = 0.826, p
Pediatric appendicitis in a developing country: what are the clinical predictors and outcome of perforation?

Ngim CF, Quek KF, Dhanoa A, Khoo JJ, Vellusamy M, Ng CS

J Trop Pediatr, 2014 Dec;60(6):409-14.
PMID: 25063462 DOI: 10.1093/tropej/fmu037

This study explored the risk factors and outcomes associated with perforation in children who underwent emergency appendicectomies.
Fulltext Knowledge of diabetes and lifestyle behaviour amongst indigenous population in Peninsular Malaysia

Ahmad B, Khalid BA, Quek KF, Anuar Z, Phipps ME

Med J Malaysia, 2013 Aug;68(4):309-14.
PMID: 24145258 MyJurnal

A cross-sectional study involving seven Orang Asli
settlements located in three different states in Peninsular
Malaysia; Johor, Selangor and Perak.
Fulltext Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years

Khor CS, Sam IC, Hooi PS, Quek KF, Chan YF

BMC Pediatr, 2012;12:32.
PMID: 22429933 DOI: 10.1186/1471-2431-12-32

Viral respiratory tract infections (RTI) are relatively understudied in Southeast Asian tropical countries. In temperate countries, seasonal activity of respiratory viruses has been reported, particularly in association with temperature, while inconsistent correlation of respiratory viral activity with humidity and rain is found in tropical countries. A retrospective study was performed from 1982-2008 to investigate the viral etiology of children (≤ 5 years old) admitted with RTI in a tertiary hospital in Kuala Lumpur, Malaysia.
Fulltext Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes mellitus: study protocol of myDIDeA

Ramadas A, Quek KF, Chan CK, Oldenburg B, Hussein Z

BMC Public Health, 2011;11:359.
PMID: 21599990 DOI: 10.1186/1471-2458-11-359

The potential of web-based interventions in dietary behaviour modification of the diabetics has not been fully explored. We describe the protocol of a 12-month match-design randomised controlled trial of a web-based dietary intervention for type 2 diabetic patients with primary aim to evaluate the effect of the intervention on their dietary knowledge, attitude and behaviour (KAB). The secondary objective of this study is to improve the participants' dietary practices, physical measurements and biomarkers.
Evaluation of the routine use of the anaerobic bottle when using the BACTEC blood culture system

Karunakaran R, Raja NS, Quek KF, Hoe VC, Navaratnam P

J Microbiol Immunol Infect, 2007 Oct;40(5):445-9.
PMID: 17932606

The established practice of sending blood cultures in an aerobic-anaerobic pair of bottles has been questioned in recent years, and this study was conducted to evaluate the routine use of an anaerobic bottle in the BACTEC blood culture set at the University of Malaya Medical Centre, Kuala Lumpur, from January to December 2004. A total of 11,663 paired blood culture sets were received, of which 3326 were from pediatric patients and 8337 were from adult patients. The overall positive isolation rate was 15%; the positive isolation rate on excluding the anaerobic bottles was 13%. Overall, there were significantly more organisms isolated from the aerobic bottle (p<0.05); however, the best yield was obtained on using the paired aerobic-anaerobic bottles. Among the positive blood culture sets, organisms were isolated from the anaerobic bottle alone in 15.2% of the pediatric sets and in 18.1% of the adult sets. Organisms that grew more frequently in the anaerobic bottle were anaerobes and some facultative anaerobes; however, the difference was not statistically significant except for anaerobes in the adult sets. We recommend that when culturing blood, an aerobic-anaerobic pair of bottles be used rather than an aerobic-aerobic pair, to optimize the recovery of a wider spectrum of organisms, including obligatory anaerobes.
Fulltext Reliability and validity of the Spielberger State-Trait Anxiety Inventory (STAI) among urological patients: a Malaysian study

Quek KF, Low WY, Razack AH, Loh CS, Chua CB

Med J Malaysia, 2004 Jun;59(2):258-67.
PMID: 15559178 MyJurnal

To validate the English version of the Spielberger State-Trait Anxiety Inventory (STAI) in a sample of Malaysia patients with and without urinary symptoms. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with LUTS who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 40 items with Cronbach's alpha value = 0.38 to 0.89 while the Cronbach's alpha for the total scores was 0.86. Test-retest correlation coefficients for the 40 items score were highly significant. Intraclass correlation coefficient was high (ICC=0.39 to 0.89). A high degree of sensitivity and specificity to the effects of treatment was observed. A high degree of significant level between baseline and post-treatment scores was observed across nearly half of the items in surgical group but not in the non-LUTS group (control subjects). The STAI is reliable, valid and sensitive to clinical change in a sample of Malaysian patients with and without urinary symptoms.
Effect of treating lower urinary tract symptoms on anxiety, depression and psychiatric morbidity: a one-year study

Quek KF, Razack AH, Chua CB, Low WY, Loh CS

Int J Urol, 2004 Oct;11(10):848-55.
PMID: 15479289

The present study aimed to evaluate the effects of treating lower urinary tract symptoms (LUTS) on anxiety, depression and psychiatric morbidity following one year of follow-up.
Fulltext Reliability and validity of the Malay version of the General Health Questionnaire (GHQ - 12) among urological patients

Quek KF, Low WY, Razack AH, Chua CB, Loh CS

Med J Malaysia, 2002 Jun;57(2):169-77.
PMID: 24326647

The aim of the study was to validate the Malay version of the General Quentionnaire (GHQ-12) in patients with psychiatric morbidity secondary to urological disorder. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items and total scores (Cronbach's alpha value = 0.50 and higher and 0.65 respectively. Test-retest correlation coefficient for the 12 items scores was highly significant. Intraclass correlation coefficient was high (ICC=0.47 and above). A significant level between baseline and post-treatment scores were observed across 3 items in the surgical group. The Mal-GHQ-12 is a suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
Reliability and validity of the Malay version of the International Prostate Symptom Score in the Malaysian population

Quek KF, Low WY, Razack AH, Sin Loh C, Chua CB

J Urol, 2002 Mar;167(3):1359-62.
PMID: 11832732

PURPOSE: We validated the Malay version of the International Prostate Symptom Score in patients with and without urinary symptoms in the Malaysian population.
MATERIALS AND METHODS: Validity and reliability were studied in patients with and without lower urinary tract symptoms. Reliability was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus post-intervention score in additional patients with lower urinary tract symptoms who underwent transurethral prostate resection.
RESULTS: Internal consistency was excellent. A high degree of internal consistency was observed for each of the 7 items and for the total score (Cronbach's alpha 0.53 and greater, and 0.68, respectively). The test-retest correlation coefficients of the 7 items were highly significant. The intraclass correlation coefficient was high at 0.51 and greater. There was a high degree of sensitivity and specificity to the effects of treatment. Significant change from baseline to posttreatment scores was observed in all 8 items in the treated but not in the control group.
CONCLUSIONS: The Malay International Prostate Symptom Score is a suitable, reliable, valid instrument that is sensitive to clinical change in the Malaysian population.
The feasibility of the Golombok-Rust Inventory of Marital State (GRIMS) in assessing marital satisfaction in a Malaysian population

Quek KF, Low WY, Razack AH, Chua CB, Loh CS

J Sex Marital Ther, 2002 Oct-Dec;28(5):423-6.
PMID: 12378843

The purpose of this study is to validate the English version of the Golombok-Rust Inventory of Marital State (GRIMS) in a Malaysian population. Using the test-retest method and Cronbach's alpha, we assessed reliability and internal consistency. Sensitivity to change was expressed as the effect size. Internal consistency was excellent (Cronbach's alpha value = 0.59 to 0.91) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant in majority items (ICC = 0.62 and above), and there was a high degree of sensitivity and specificity. The GRIMS is suitable, reliable, valid, and sensitive to clinical change in a Malaysian population.
Reliability and validity of the Malay version of the Health-Related Quality of Life instrument in a Malaysian population

Quek KF, Chua CB, Low WY, Razack AH, Loh CS

BJU Int, 2002 Jul;90(1):37-40.
PMID: 12081766

OBJECTIVE: To validate the Malay version of the Health-Related Quality of Life (Mal-HRQOL-20) questionnaire in patients with and without urinary symptoms in a Malaysian population.
PATIENTS AND METHODS: The validity and reliability of the Mal-HRQOL-20 were assessed in patients with and without lower urinary tract symptoms (LUTS). The reliability was evaluated using the test-retest method and the internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate.
RESULTS: The internal consistency was excellent; there was a high degree of internal consistency for each of the 20 items and for the overall score (Cronbach's alpha > or = 0.57 and 0.79, respectively) in the population study. The test-retest correlation coefficient for the 20 item scores was highly significant. The intra-class correlation coefficient was high (> or = 0.55). The sensitivity and specificity were high for the effects of treatment. There was a very significant agreement between scores before and after treatment across all domains in the treatment cohort, but not in the control group.
CONCLUSION: The Mal-HRQOL-20 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.
Fulltext The performance properties of the International Index of Erectile Function (IIEF-15) in assessing erectile dysfunction in patients with lower urinary tract symptoms

Quek KF, Low WY, Razack AH, Chua CB, Loh CS, Dublin N

Med J Malaysia, 2002 Dec;57(4):445-53.
PMID: 12733169

To validate the International Index of Erectile Function (IIEF-15) in Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Sensitivity to change was expressed as the effect size index. Internal consistency was excellent (Cronbach's alpha value = 0.75 to 0.90) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant (ICC = 0.75 and above) and a high degree of sensitivity and specificity was observed. The IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

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