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Mandarin version of the Leeds Dyspepsia Questionnaire: A valid instrument for assessing symptoms in Asians

Leow HR, Ching SM, Sujarita R, Yap CF, Chia YC, Ho SH, et al.

J Dig Dis, 2014 Nov;15(11):591-6.
PMID: 25139629 DOI: 10.1111/1751-2980.12183

OBJECTIVE:
To develop and validate a Mandarin version of the Leeds Dyspepsia Questionnaire (M-LDQ) in Asian patients with dyspepsia.

METHODS:
The M-LDQ was developed according to standardized methods. The validity, internal consistency, test-retest reliability and responsiveness of the instrument were evaluated in both primary and secondary care patients.

RESULTS:
A total of 184 patients (mean age 54.0 ± 15.8 years, of whom 59% were women and 72.3% of whom had at least secondary level education) were recruited between August 2012 and March 2013, from both primary (n = 100) and secondary care clinics (n = 84). Both the internal consistency of all components of the M-LDQ (Cronbach's α 0.79) and test-retest reliability (Spearman's correlation coefficient 0.78) were good. The M-LDQ was valid in diagnosing dyspepsia in primary care (area under the receiver operating characteristics curve 0.84) and was able to discriminate between secondary and primary care patients (median cumulative LDQ score 13.0 vs 3.0, P < 0.0001). Among eight patients with organic dyspepsia, the median M-LDQ score reduced significantly from 21.0 (pretreatment) to 9.5 (4 weeks post-treatment) (P < 0.0001).

CONCLUSION:
The M-LDQ is a valid and responsive instrument for assessing ethnic Chinese adults with dyspepsia.

KEYWORDS:
Mandarin; ethnic Chinese; functional dyspepsia; outcome measure; questionnaire; validation

Matched MeSH terms: Cultural Characteristics
Men's health issues in Asia

Ho CC, Tan HM

Aging Male, 2013 Sep;16(3):81-4.
PMID: 23822757 DOI: 10.3109/13685538.2013.809414

Men's health has gained prominence over the past few years but it is still not on par with the attention or funding that women and child health is getting. In Asia, this issue is even more conspicuous. With westernization of lifestyle, Asian men's problems emulate their Western counterparts but there are certain issues unique to Asian men due to cultural differences. This review will discuss the health issues affecting Asian men and suggest measures that can be taken to overcome them.

Matched MeSH terms: Cultural Characteristics*
Midlife crisis perceptions, experiences, help-seeking, and needs among multi-ethnic malaysian women

Wong LP, Awang H, Jani R

Women Health, 2012;52(8):804-19.
PMID: 23127220 DOI: 10.1080/03630242.2012.729557

In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.

Matched MeSH terms: Cultural Characteristics
Fulltext Navigating HIV prevention policy and Islam in Malaysia: contention, compatibility or reconciliation? Findings from in-depth interviews among key stakeholders

Barmania S, Aljunid SM

BMC Public Health, 2016 07 07;16:524.
PMID: 27387326 DOI: 10.1186/s12889-016-3247-y

BACKGROUND: Malaysia is a multicultural society, predominantly composed of a Muslim majority population, where Islam is influential. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as, Intravenous Drug Users (IVDU), sex workers, transgender women and Men who have sex with Men (MSM). The objective of this study is to understand how Islam shapes HIV prevention strategies in Malaysia by interviewing the three key stakeholder groups identified as being influential, namely the Ministry of Health, Religious leaders and People living with HIV.
METHODS: Thirty-Five in depth semi structured interviews were undertaken with religious leaders, Ministry of Health and People living with HIV in the last half of 2013 using purposive sampling. Interviews adhered to a topic guide, were audiotaped, and transcribed verbatim and analyzed using a framework analysis.
RESULTS: Themes including the importance of Islam to health, stakeholder relationships and opinions on HIV prevention emerged. Islam was seen to play a pivotal role in shaping strategies relating to HIV prevention in Malaysia both directly and indirectly. Stakeholders often held different approaches to HIV prevention, which had to be sensitively considered, with some favouring promotion of Islamic principles, whilst others steering towards a more public health centred approach.
CONCLUSIONS: The study suggests that Islam indeed plays an important role in shaping health policies and strategies related to HIV prevention in Malaysia. Certainly, stakeholders do hold differing viewpoints, such as stances of what constitutes the right approach to HIV prevention. However there are also areas of broad consensus, such as the importance in Islamic tradition to prevent harm and disease, which can be crafted into existing and future HIV prevention strategies in Malaysia, as well as the wider Muslim world.

Matched MeSH terms: Cultural Characteristics*
One world is not enough: the structured phenomenology of lifestyle migrants in East Asia

Stones R, Botterill K, Lee M, O'Reilly K

Br J Sociol, 2019 Jan;70(1):44-69.
PMID: 29479667 DOI: 10.1111/1468-4446.12357

The paper is based on original empirical research into the lifestyle migration of European migrants, primarily British, to Thailand and Malaysia, and of Hong Kong Chinese migrants to Mainland China. We combine strong structuration theory (SST) with Heideggerian phenomenology to develop a distinctive approach to the interplay between social structures and the lived experience of migrants. The approach enables a rich engagement with the subjectivities of migrants, an engagement that is powerfully enhanced by close attention to how these inner lives are deeply interwoven with relevant structural contexts. The approach is presented as one that could be fruitfully adopted to explore parallel issues within all types of migration. As is intrinsic to lifestyle migration, commitment to a better quality of life is central to the East Asian migrants, but they seek an uncomplicated, physically enhanced texture of life, framed more by a phenomenology of prosaic well-being than of self-realization or transcendence. In spite of possessing economic and status privileges due to their relatively elite position within global structures the reality for a good number of the lifestyle migrants falls short of their prior expectations. They are subject to particular kinds of socio-structural marginaliszation as a consequence of the character of their migration, and they find themselves relatively isolated and facing a distinct range of challenges. A comparison with research into various groups of migrants to the USA brings into relief the specificities of the socio-structural positioning of the lifestyle migrants of the study. Those East Asian migrants who express the greatest sense of ease and contentment seem to be those who have responded creatively to the specific challenges of their socio-structural situation. Often, this appears to have been achieved through understated but active involvements with their new settings and through sustaining focused transnational connections and relationships.

Matched MeSH terms: Cultural Characteristics
Paradoxical sleep characteristics and cultural environment. Preliminary results

Petre-Quadens O, Hussain H, Balaratnan C

Acta Neurol Belg, 1975 Mar;75(2):85-92.
PMID: 168717

The Temiars are a tribe of negroid pygmies of basically Proto-Malaysian affinities. Field-work in the Malaysian jungle provided some observations on the sleep-wakefulness cycle of two young Temiar adults. This cycle was monophasic circumstances permitting. Their rest-activity cycle at night was similar in the jungle and in the laboratory. Polygraphic total night-sleep recordings were made with both of them in the EEG laboratory in the Hospital Besar in Kuala Lumpur. The eye-movement frequencies of PS were compared with those from young adults of the West. Although the differences were not statistically significant, the Rem-densities of the Temiars were constantly at the low side. The significance of the results are being discussed.

Matched MeSH terms: Cultural Characteristics*
Parents' evaluation of aural/oral performance of children (PEACH) scale in the Malay language: data for normal-hearing children

Quar TK, Ching TY, Mukari SZ, Newall P

Int J Audiol, 2012 Apr;51(4):326-33.
PMID: 22176307 DOI: 10.3109/14992027.2011.637079

The parents' evaluation of aural/oral performance of children (PEACH) scale was developed to assess the effectiveness of amplification for children, based on a systematic use of parents' observations of children's performance in real-world environments.

Matched MeSH terms: Cultural Characteristics
Fulltext Phenomenological differences of delusions between schizophrenic patients of two cultures of Malaysia

Azhar MZ, Varma SL, Hakim HR

Singapore Med J, 1995 Jun;36(3):273-5.
PMID: 8553090

Two hundred and seventy schizophrenia patients were interviewed using the Present State Examination to elicit the phenomenological symptoms of the illness. Cultural factors and ethnicity were found to be significant variables associated with the symptoms. Higher prevalence of religious and other subculturally related delusions were common in Kelantan patients. Our general belief that Malaysian culture influences symptomatology of mental illness seems to be proven.

Matched MeSH terms: Cultural Characteristics*
Physicians' experiences with HPV vaccine delivery: evidence from developing country with multiethnic populations

Wong LP

Vaccine, 2009 Mar 4;27(10):1622-7.
PMID: 19100803 DOI: 10.1016/j.vaccine.2008.11.107

Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use.

Matched MeSH terms: Cultural Characteristics
Postpartum depression in Asian cultures: a literature review

Klainin P, Arthur DG

Int J Nurs Stud, 2009 Oct;46(10):1355-73.
PMID: 19327773 DOI: 10.1016/j.ijnurstu.2009.02.012

OBJECTIVES:
Postpartum depression (PPD), a major health concern, produces insidious effects on new mothers, their infant, and family. This literature review aims to explore risk factors for postpartum depression among women in Asian cultures, which has not been fully elaborated.

DATA SOURCES:
A literature search was undertaken by using various electronic research databases. Studies were eligible for this review if they (a) examined risk factors for PPD, (b) were conducted in Asian countries using quantitative or qualitative methodologies, and (c) were published in English in peer-reviewed journals between 1998 and 2008. A total of 64 studies from 17 countries were reviewed, summarised, and synthesised.

RESULTS:
The prevalence of postpartum depression in Asian countries ranged from 3.5% to 63.3% where Malaysia and Pakistan had the lowest and highest, respectively. Risk factors for postpartum depression were clustered into five major groups: biological/physical (e.g., riboflavin consumption), psychological (e.g., antenatal depression), obstetric/paediatric (e.g., unwanted pregnancy), socio-demographic (e.g., poverty), and cultural factors (e.g., preference of infants' gender). Traditional postpartum rituals were not found to provide substantial psychological benefits for the new mothers.

CONCLUSIONS:
This review informs a current state of knowledge regarding risk factors for postpartum depression and has implications for clinical practice. Health care professionals should be aware that the phenomenon is as prevalent in Asian cultures as in European cultures. Women should be screened for potential risk factors and depressive symptoms during pregnancy and postpartum periods so that appropriate interventions, if needed, can be initiated in a timely fashion.

Matched MeSH terms: Cultural Characteristics*
Prevalence and correlates of erectile dysfunction (ED) and treatment seeking for ED in Asian Men: the Asian Men's Attitudes to Life Events and Sexuality (MALES) study

Tan HM, Low WY, Ng CJ, Chen KK, Sugita M, Ishii N, et al.

J Sex Med, 2007 Nov;4(6):1582-92.
PMID: 17908233 DOI: 10.1111/j.1743-6109.2007.00602.x

INTRODUCTION: There have been limited multiregional studies in Asia examining the parameters of men's general and sexual health and quality of life in the general population vs. those in clinical cohorts of patients with erectile dysfunction (ED).
AIMS: The aims of the Asian Men's Attitudes to Life Events and Sexuality (Asian MALES) study were to investigate the prevalence of ED, associated health conditions, and ED treatment-seeking patterns in the general male population in five regions of Asia (China, Japan, Korea, Malaysia, and Taiwan).
MAIN OUTCOME MEASURE: Standardized questionnaire previously used in a similar multiregional study and modified to ensure culturally appropriate content for Asia.
METHODS: Phase I of the study involved 10,934 adult men, aged 20-75 years, who were interviewed using the standardized questionnaire. Phase II of the study involved men with self-reported ED recruited from Phase I and via physician referral, invitations in general practitioner offices, and street interception (total Phase II sample, N = 1,209).
RESULTS: The overall prevalence of self-reported ED in the Phase I study population was 6.4%. ED prevalence varied by region and significantly increased with age (P < 0.01). Men with ED reported significantly greater rates of comorbid illness (P < 0.0001) and a reduced quality of life (P = 0.0001), compared with men without ED. Phase II of the study revealed that fewer than half of men with self-reported ED had sought treatment for their problem. Men were more likely to seek help for erection difficulties from Western doctors than from traditional medicine practitioners (P = 0.0001). A man's partner/spouse was the most common influencer of treatment seeking in all regions except Malaysia.
CONCLUSION: The findings confirm those of existing research on ED in both Asian and non-Asian males: ED is a prevalent condition; the prevalence of ED increases with age and is strongly associated with comorbid conditions; and the majority of men have never sought treatment for their condition. This study highlights a substantial need for the evaluation and treatment of ED in Asian men.

Matched MeSH terms: Cultural Characteristics
Primary health care for the children of Sarawak

Benster R, Stanton J

Br J Hosp Med, 1989 Dec;42(6):488-90.
PMID: 2611474

Rosalind Benster and Judith Stanton went to Sarawak to study child health care. Their aim was to highlight areas of most need so that the tiny health budget could be channelled in the relevant directions. They found cultural and environmental differences to account for significant differences in the nutritional status of children from different tribes. They suggest remedies to this situation.

Matched MeSH terms: Cultural Characteristics
Providing primary health care with non-physicians

Chen PC

Ann Acad Med Singap, 1984 Apr;13(2):264-71.
PMID: 6497324

The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

Matched MeSH terms: Cultural Characteristics
Psychiatric sequelae of Amok

Tan EK, Carr JE

Cult Med Psychiatry, 1977 Apr;1(1):59-67.
PMID: 756354

The authors present evidence of an indigenous diagnostic system by which Malay culture defines Amok, and of the disparate relations between individual conceptualization, behavior, and tradition which contributes to the labeling process. Amok is viewed as a cultural prescription for violent behavior in response to a given set of conditions. It is not a disease but rather a behavioral sequence, perceived as illness, that may be precipitated by various etiological factors. Finally, evidence is presented to support the hypothesis that traditional forms of Amok are being replaced by new variants in which psychopathology is increasingly evident.

Matched MeSH terms: Cultural Characteristics
Psychometric properties of the Malay version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetic patients

Abdulameer SA, Syed Sulaiman SA, Hassali MA, Sahib MN, Subramaniam K

Int J Rheum Dis, 2014 Jan;17(1):93-105.
PMID: 24472272 DOI: 10.1111/1756-185X.12104

The aims of this study were to translate and examine the psychometric properties of the Malaysian version of the Osteoporosis Health Belief Scale (OHBS-M) among type 2 diabetes patients (T2DM) and to assess the correlation between osteoporosis knowledge, health belief and self-efficacy scales, as well as assess the osteoporosis risk in the sample population using quantitative ultrasound measurement (QUS).

Matched MeSH terms: Cultural Characteristics
Quality of Life--Asian perspective--a personal view

Chelvam P

Scand. J. Gastroenterol. Suppl., 1993;199:16-7.
PMID: 8171292

There is a need to define Quality of Life and to develop a practical method to measure objectively this aspect in gastrointestinal diseases. This has not been performed in any Asian population. It is proposed that this evaluation be part of future trials in Asia on the basis that Asian patients are culturally, socially and politically different from Westerners.

Matched MeSH terms: Cultural Characteristics
Fulltext Quality of life in South East Asian patients who consult for dyspepsia: validation of the short form Nepean Dyspepsia Index

Mahadeva S, Wee HL, Goh KL, Thumboo J

Health Qual Life Outcomes, 2009;7:45.
PMID: 19463190 DOI: 10.1186/1477-7525-7-45

BACKGROUND:
Treatment objectives for dyspepsia include improvements in both symptoms and health-related quality of life (HRQoL). There is a lack of disease-specific instruments measuring HRQoL in South East Asian dyspeptics.

OBJECTIVES:
To validate English and locally translated version of the Short-Form Nepean Dyspepsia Index (SF-NDI) in Malaysian patients who consult for dyspepsia.

METHODS:
The English version of the SF-NDI was culturally adapted locally and a Malay translation was developed using standard procedures. English and Malay versions of the SF-NDI were assessed against the SF-36 and the Leeds Dyspepsia Questionnaire (LDQ), examining internal consistency, test-retest reliability and construct validity.

RESULTS:
Pilot testing of the translated Malay and original English versions of the SF-NDI in twenty subjects did not identify any cross-cultural adaptation problems. 143 patients (86 English-speaking and 57 Malay speaking) with dyspepsia were interviewed and the overall response rate was 100% with nil missing data. The median total SF-NDI score for both languages were 72.5 and 60.0 respectively. Test-retest reliability was good with intraclass correlation coefficients of 0.90 (English) and 0.83 (Malay), while internal consistency of SF-NDI subscales revealed alpha values ranging from 0.83 - 0.88 (English) and 0.83 - 0.90 (Malay). In both languages, SF-NDI sub-scales and total score demonstrated lower values in patients with more severe symptoms and in patients with functional vs organic dyspepsia (known groups validity), although these were less marked in the Malay language version. There was moderate to good correlation (r = 0.3 - 0.6) between all SF-NDI sub-scales and various domains of the SF-36 (convergent validity).

CONCLUSION:
This study demonstrates that both English and Malay versions of the SF-NDI are reliable and probably valid instruments for measuring HRQoL in Malaysian patients with dyspepsia.

Matched MeSH terms: Cultural Characteristics
Rates of treated schizophrenia and its clinical and cultural features in the population isolate of the Iban of Sarawak: a tri-diagnostic approach

Barrett R, Loa P, Jerah E, Nancarrow D, Chant D, Mowry B

Psychol Med, 2005 Feb;35(2):281-93.
PMID: 15841685

We present results of a study of treated rates of schizophrenia among the Iban of Sarawak, Malaysia. Most Iban live in longhouses, each comprising a kindred group of up to 300 individuals. Cultural practices such as minimal intermarriage with members of adjacent ethnic groups and in-depth genealogical knowledge make them a population suitable for genetic investigation. Iban culture is conducive to a focus on symptoms and illness, and to patterns of treatment-seeking behaviour that are enthusiastic and persistent.

Matched MeSH terms: Cultural Characteristics*
Rating the quality of the family environment in different cultures

Rey JM, Peng R, Morales-Blanquez C, Widyawati I, Peralta V, Walter G

J Am Acad Child Adolesc Psychiatry, 2000 Sep;39(9):1168-74.
PMID: 10986814 DOI: 10.1097/00004583-200009000-00017

OBJECTIVE:
To examine the extent to which clinicians from different cultures agree when rating the quality of a child's family environment and the effect of country, language, and training factors on these ratings.

METHOD:
Eighty-seven health professionals from Malaysia, Spain, Australia, Indonesia, the United States, Denmark, and Singapore rated 7 case vignettes using the Global Family Environment Scale. Half (54%) were psychiatrists. One quarter (26%) performed the ratings after attending a training session, the rest (n = 64, 74%) after reading a training manual.

RESULTS:
Overall, interrater agreement (intraclass r) was 0.84 (95% confidence interval: 0.68-0.96). There were no significant differences in agreement according to country, language, training, or professional group, although there were country differences in the ratings given to 2 vignettes. The majority of raters found the description of the anchor points (86%), training manual (95%), and case vignettes (97%) clear.

CONCLUSIONS:
Clinicians from different cultures seem to be able to make global ratings of the quality of the family environment that are reliable and consistent when using case vignettes. This can be achieved with little training. Global ratings of the quality of the family environment may be a useful tool in mental health research and clinical work.

Matched MeSH terms: Cultural Characteristics*
Reasons for seeking dental care in a Malaysian urban adult population: an analysis by sex and ethnic group

Jaafar N, Abdul Razak I

Community Dent Oral Epidemiol, 1988 Apr;16(2):75-8.
PMID: 3162860

Different groups of people will view and use modern dental services differently. This is determined by their traditional beliefs and cultural background. The aim of this study is to identify variations in utilization among adults in the three major ethnic groups in Malaysia. Dental records of 500 adults attending the University dental center were randomly selected and analyzed by sex and ethnic group. Results from this pilot study clearly indicate that different ethnic groups tend to use certain types of services more than others. Similarly, there is evidence of variation in the type of dental service preferred between males and females. The implications of these findings for dental health educators, program planners and further research is emphasized in order to promote a more positive pattern of utilization among the various ethnic groups.

Matched MeSH terms: Cultural Characteristics

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