Displaying publications 41 - 60 of 121 in total

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  1. Nicholas Pang, Jiann Lin Loo
    MyJurnal
    Introduction: Global health awareness is sorely lacking in medical curricula and the general public, leading to increasing apathy and decreased levels of volunteerism. Much knowledge about pertinent global health issues is sequestered with academicians and researchers, with little public trickle down. The aim of the study was to increase awareness among Sabahan public about global health issues and promote discussion. Methods: A global health film club was established at community level and discussions about issues and potential individual action points was conducted. Films were screened every month in both UMS and Palliative Care Center Sabah. Global health issues ranging from First World manipulation of HIV/AIDS medication prices, deregulation of medical devices industries, heroin addiction, ADHD drug abuse, and stigma in psychiatry were covered. Public participants’ responses were collected qualitatively. Results: The films largely were well received by participants, with most participants prefer-ring the expose-type films over the more narrative approaches. Films spurred discussion about how foreign or global issues were related to local level, for example unscrupulous sale of medical devices in Malaysian populations and abuse of sleeping medications from local health providers. Also each film screening vastly increased participants’ awareness of pertinent issues, and spurred them to evangelise about said issues to others and take small actions. Conclusion: Global health is a somewhat neglected part of medical and community curricula. Lack of awareness about global health issues reduces the public’s capacity for collective action in exerting pressure on stakeholders, governments, and civil society in taking action. It is hoped such regular global health film screenings at local level brings literacy on urgent public health issues to the people for whom it matters most – the communities where ad-verse global health consequences eventually arise.
    Matched MeSH terms: Palliative Care
  2. Jeremic B, Fidarova E, Sharma V, Faheem M, Ameira AA, Nasr Ben Ammar C, et al.
    Radiother Oncol, 2015 Jul;116(1):21-6.
    PMID: 26163093 DOI: 10.1016/j.radonc.2015.06.017
    To optimize palliation in incurable locally advanced non-small cell lung cancer (NSCLC), the International Atomic Energy Agency conducted a prospective randomized study (NCT00864331) comparing protracted palliative radiotherapy (RT) course with chemotherapy (CHT) followed by short-course palliative RT.
    Matched MeSH terms: Palliative Care*
  3. Abd Aziz NAS, Mohd Fahmi Teng NI, Kamarul Zaman M
    Clin Nutr ESPEN, 2019 02;29:77-85.
    PMID: 30661705 DOI: 10.1016/j.clnesp.2018.12.002
    BACKGROUND & AIMS: Malnutrition is common among hospitalized elderly patients, and the prevalence is increasing not only in Malaysia but also in the rest of the world. The Geriatric Nutrition Risk Index (GNRI) and the Mini Nutritional Assessment (MNA) were developed to identify malnourished individuals among this group. The MNA was validated as a nutritional assessment tool for the elderly. The GNRI is simpler and more efficient than the MNA, but studies on the use of the GNRI and its validity among the Malaysian population are absent. This study aimed to determine the prevalence of malnourished hospitalized elderly patients and assess the criterion validity of the GNRI and MNA among the geriatric Malaysian population against the reference standard for malnutrition, the Subjective Global Assessment (SGA), and determine whether the optimal cutoff value of the GNRI is suitable for the Malaysian population and determine the optimal tool for use in this population.

    METHODS: A cross-sectional study was conducted among 134 geriatric patients with a mean age of 68.9 ± 8.4 who stayed at acute care wards in Hospital Tuanku Ampuan Rahimah, Klang from July 2017 to August 2017. The SGA, MNA, and GNRI were administered through face-to-face interviews with all the participants who gave their consent. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the GNRI and MNA were analyzed against the SGA. Receiver-operating characteristic (ROC) curve analysis was used to obtain the area under the curve (AUC) and suitable optimal cutoff values for both the GNRI and MNA.

    RESULTS: According to the SGA, MNA, and GNRI, 26.9%, 42.5%, and 44.0% of the participants were malnourished, respectively. The sensitivity, specificity, PPV, and NPV for the GNRI were 0.622, 0.977, 0.982, and 0.558, respectively, while those for the MNA were 0.611, 0.909, 0.932, and 0.533, respectively. The AUC of the GNRI was comparable to that of the MNA (0.831 and 0.898, respectively). Moreover, the optimal malnutrition cutoff value for the GNRI was 94.95.

    CONCLUSIONS: The prevalence of malnutrition remains high among hospitalized elderly patients. Validity of the GNRI is comparable to that of the MNA, and use of the GNRI to assess the nutritional status of this group is proposed with the new suggested cutoff value (GNRI ≤ 94.95), as it is simpler and more efficient. Underdiagnosis of malnutrition can be prevented, possibly reducing the prevalence of malnourished hospitalized elderly patients and improving the quality of the nutritional care process practiced in Malaysia.

    Matched MeSH terms: Palliative Care
  4. Guan NC, Beng TS, Sue-Yin L, Kanagasundram S
    Indian J Palliat Care, 2021 02 17;27(1):83-88.
    PMID: 34035622 DOI: 10.4103/IJPC.IJPC_122_20
    Context: While pain is a common complaint among palliative cancer patients, there is little research looking into nonpharmacological methods for the reduction of pain in the palliative setting.

    Aim: This study aims to study the efficacy of 5-min mindful breathing for rapid reduction of pain in a palliative care setting.

    Methods: This is a sub-analysis of the previous randomized controlled study on distress reduction. Sixty patients were recruited and randomly assigned to either the intervention (5-min mindful breathing) or the control (5-min normal listening) group. Participants reported their pain on a 10-item analog scale at baseline, immediately after intervention and 10 min postintervention. Changes in pain scores were further analyzed.

    Results: Pain scores decreased for both the intervention and control groups. However, the reduction of pain did not reach statistical difference in both groups (P > 0.05).

    Conclusion: Five-minute mindful breathing is a quick and easy to administer therapy but does not have significant effects in terms of pain reduction in palliative settings. Future research and directions are nonetheless suggested and encouraged to look for short-term mindfulness-based therapies on pain reduction for this population.

    Matched MeSH terms: Palliative Care; Hospice and Palliative Care Nursing
  5. Ahmad Zubaidi ZS, Ariffin F, Oun CTC, Katiman D
    BMC Palliat Care, 2020 Dec 08;19(1):186.
    PMID: 33292214 DOI: 10.1186/s12904-020-00691-1
    BACKGROUND: Informal caregivers (IC) are often overshadowed by the attention required by the terminally ill. This study aims to reveal the estimated proportion of caregiver burden, psychological manifestations and factors associated with caregiver burden among IC in the largest specialized Palliative Care Unit (PCU) in Malaysia.

    METHODS: This was a cross-sectional study involving IC attending a PCU. Caregiver burden and psychological manifestations were measured using previously translated and validated Zarit Burden Interview and DASS-21 questionnaires respectively. Two hundred forty-nine samples were selected for analysis.

    RESULT: The mean ZBI score was 23.33 ± 13.7. About half of the population 118(47.4%) was found to experienced caregiver burden whereby majority have mild to moderate burden 90(36.1%). The most common psychological manifestation among IC is anxiety 74(29.7%) followed by depression 51(20.4%) and stress 46(18.5%). Multiple logistic regression demonstrated that women who are IC to patients with non-malignancy were less likely to experience caregiver burden. IC who were highly educated and spent more than 14 h per day caregiving were at least twice likely to experience caregiver burden. Finally, those with symptoms of depression and anxiety were three times more likely to suffer from caregiver burden.

    CONCLUSION: Caregiver burden among IC to palliative patients is prevalent in this population. IC who are men, educated, caregiving for patients with malignancy, long hours of caregiving and have symptoms of depression and anxiety are at risk of developing caregiver burden. Targeted screening should be implemented and IC well-being should be given more emphasis in local policies.

    Matched MeSH terms: Palliative Care/methods*; Palliative Care/psychology; Palliative Care/standards
  6. Chong LA, Khalid F
    Singapore Med J, 2016 Feb;57(2):77-80.
    PMID: 26893078 DOI: 10.11622/smedj.2016032
    There is increased awareness of paediatric palliative care in Malaysia, but no local published data on home care services. We aimed to describe the paediatric experience at Hospis Malaysia, a community-based palliative care provider in Malaysia.
    Matched MeSH terms: Palliative Care/organization & administration*
  7. Rai NP, Divakar DD, Al Kheraif AA, Ramakrishnaiah R, Mustafa SM, Durgesh BH, et al.
    Asian Pac J Cancer Prev, 2015;16(16):6919-22.
    PMID: 26514468
    BACKGROUND: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality.

    MATERIALS AND METHODS: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time.

    RESULTS: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of 352 ± 281.7 days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of 112 ± 144.0 days.

    CONCLUSIONS: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

    Matched MeSH terms: Palliative Care*
  8. Khoo EJ
    PMID: 37945387 DOI: 10.1016/j.cppeds.2023.101452
    The evolution of paediatric palliative care in Malaysia has followed a distinct trajectory compared to adult palliative care. While adult palliative care was well-established by the mid-1990s, paediatric palliative care was still then largely ad hoc, with individual paediatricians and NGOs taking on the responsibility. Despite progress over the last decade, challenges persist. There is a shortage of trained paediatricians in this subspecialty, and financial constraints hinder progress. Decision-making in paediatric palliative care is also influenced by cultural values, religious beliefs, and societal norms. Parents are steered by cultural practices and the guidance of elder family members in a setting of communitarian traditions that are prevalent in Asian cultures. Discussions about end-of-life matters are hampered by cultural taboos. Additionally, the hierarchical medical culture, where doctors are seen as authoritative, hinder patients, including parents, from taking an active role in decision-making. The paper exemplifies these complexities through a case study, where the family's hopes and concerns were overlooked in a hectic and hurried hospital environment. The narrative calls for a compassionate, collaborative ecosystem that bridges cultural gaps and embraces shared decision-making in paediatric palliative care. It emphasizes the need to harmonize palliative care with societal values, involving healthcare providers, families, and the community. However, recognizing individual preferences and avoiding cultural assumptions are crucial. Healthcare professionals must develop skills in cultural diversity, delivering distressing news with compassion, and effectively communicate to involve families in decision-making, all while respecting their beliefs and values.
    Matched MeSH terms: Palliative Care*
  9. Khoo SB
    Med J Malaysia, 2002 Dec;57(4):408-17.
    PMID: 12733165
    The concept of Palliative Care is still quite new in Malaysia and there is a need to promote the awareness of its importance for patients with incurable and advanced illnesses, not only to the public but also to the nursing and medical professionals. These patients especially the poor ones very often have no one to turn to; they cannot afford to seek treatment from the private hospitals, they are turned away from acute General Hospitals and are told that there is nothing more to be done because their illnesses are no longer curable, they cannot pay for GPs to come to their homes, and there is difficulty in purchasing opiate drugs for pain relief. This is a retrospective observational study of the palliative care services we try to provide to those few patients referred to us. This study showed that out of the total of 156 patients, majority were Chinese, peak age between 50-59 years, referrals were mainly from the community and the Obstetrics + Gynaecology department, patients were referred rather late, 60% of patients died at home, most common malignancies being those of the breast, colorectal and cervix, common sites of metastases being the lungs, liver, bones, peritoneum and local infiltration, 87% of patients experienced pain, about 40% of patients were not fully aware of both diagnosis and prognosis, common drugs used being opiate analgesics followed by dexamethasone, H2 antagonist, antiemetics and NSAID.
    Matched MeSH terms: Palliative Care/statistics & numerical data*
  10. Khoo SB
    Asia Pac Fam Med, 2003;2(3):143-147.
    The concept of palliative care is still quite new in Malaysia. Through the experience of delivering palliative care in both the hospital and community settings, the author has realized that there are many false beliefs among the medical and nursing professionals, as well as patients and their caregivers. By exploring and providing factual explanations to these beliefs, the present article highlights the differences in approach between acute and palliative management and the importance of good communication skills, as well as correcting the myths of patients and their caregivers, with the aim of improving the understanding of palliative care., (C) 2003 Blackwell Science Ltd
    Matched MeSH terms: Palliative Care
  11. Khoo SB
    Asia Pac Fam Med, 2004;4(1):1-3.
    Patients who are entering the last phase of their illness and for whom life expectancy is short, have health needs that require particular expertise and multidisciplinary care. A combination of a rapidly changing clinical situation and considerable psychosocial and spiritual demands pose challenges that can only be met with competence, commitment and human compassion. This article is concerned with the definition of suffering, recognition of the terminal phase and application of the biopsychosocial-spiritual model of care where family physicians play an important role in the community. Key words: biopsychosocial-spiritual care, dying, family medicine, good death, palliative care, suffering.
    Matched MeSH terms: Palliative Care
  12. Khoo SY
    J Palliat Med, 2013 Jun;16(6):703.
    PMID: 23614714 DOI: 10.1089/jpm.2012.0428
    Matched MeSH terms: Palliative Care*
  13. Khoo, S.P.
    Ann Dent, 1999;6(1):-.
    MyJurnal
    Oral recurrent aphthous stomatitis is the most common oral mucosal disease. Despite much clinical and research attention, the causes remain incompletely understood. Treatment options include no treatment, treatment of associated systemic diseases, topical medications, systemic treatment and palliative treatments. The most effective treatments involve agents that suppress or modulate the immune function. Topical agents are preferred due to its limited side-effects. Adjunct pain control and prevention of secondary infections is sometimes necessary.
    Matched MeSH terms: Palliative Care
  14. Vollstedt EJ, Madoev H, Aasly A, Ahmad-Annuar A, Al-Mubarak B, Alcalay RN, et al.
    PLoS One, 2023;18(10):e0292180.
    PMID: 37788254 DOI: 10.1371/journal.pone.0292180
    Parkinson's disease (PD) is the fastest-growing neurodegenerative disorder, currently affecting ~7 million people worldwide. PD is clinically and genetically heterogeneous, with at least 10% of all cases explained by a monogenic cause or strong genetic risk factor. However, the vast majority of our present data on monogenic PD is based on the investigation of patients of European White ancestry, leaving a large knowledge gap on monogenic PD in underrepresented populations. Gene-targeted therapies are being developed at a fast pace and have started entering clinical trials. In light of these developments, building a global network of centers working on monogenic PD, fostering collaborative research, and establishing a clinical trial-ready cohort is imperative. Based on a systematic review of the English literature on monogenic PD and a successful team science approach, we have built up a network of 59 sites worldwide and have collected information on the availability of data, biomaterials, and facilities. To enable access to this resource and to foster collaboration across centers, as well as between academia and industry, we have developed an interactive map and online tool allowing for a quick overview of available resources, along with an option to filter for specific items of interest. This initiative is currently being merged with the Global Parkinson's Genetics Program (GP2), which will attract additional centers with a focus on underrepresented sites. This growing resource and tool will facilitate collaborative research and impact the development and testing of new therapies for monogenic and potentially for idiopathic PD patients.
    Matched MeSH terms: Palliative Care
  15. Huey NS, Guan NC, Gill JS, Hui KO, Sulaiman AH, Kunagasundram S
    PMID: 30115817 DOI: 10.3390/ijerph15081758
    A valid method to diagnose depression in palliative care has not been established. In this study, we aim to determine the prevalence of depression and the discriminant validity of the items of four sets of diagnostic criteria in palliative care. This is a cross-sectional study on 240 palliative care patients where the presence of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, DSM⁻IV Criteria, Modified DSM⁻IV Criteria, Cavanaugh Criteria, and Endicott's Criteria's. Anxiety, depression, and distress were measured with Hospital Anxiety and Depression Scale and Distress Thermometer. The prevalence of depression among the palliative care patients was highest based on the Modified DSM⁻IV Criteria (23.3%), followed by the Endicott's Criteria (13.8%), DSM⁻IV Criteria (9.2%), and Cavanaugh Criteria (5%). There were significant differences (p < 0.05) in the depressive symptoms showed by DSM⁻IV item 1 (dysphoric mood), item 2 (loss of interest or pleasure), and Endicott's criteria item 8 (brooding, self-pity, or pessimism) among the palliative patients, even after adjustment for the anxiety symptoms and distress level. We found that dysphoric mood, loss of interest, and pessimism are the main features of depression in palliative patients. These symptoms should be given more attention in identifying depression in palliative care patients.
    Matched MeSH terms: Palliative Care
  16. Tan SB, Ching HC, Chia YL, Yee A, Ng CG, Hasan MSB, et al.
    Am J Hosp Palliat Care, 2020 Aug;37(8):606-612.
    PMID: 31854193 DOI: 10.1177/1049909119894507
    Informal caregivers are at risk of being overwhelmed by various sources of suffering while caring for their significant others. It is, therefore, important for caregivers to take care of themselves. In the self-care context, mindfulness has the potential to reduce caregiver suffering. We studied the effect of a single session of 20-minute mindful breathing on the perceived level of suffering, together with the changes in bispectral index score (BIS) among palliative care informal caregivers. This was a randomized controlled study conducted at the University of Malaya Medical Centre, Malaysia. Forty adult palliative care informal caregivers were recruited and randomly assigned to either 20-minute mindful breathing or 20-minute supportive listening. The changes in perceived suffering and BIS were measured preintervention and postintervention. The reduction in suffering score in the intervention group was significantly more than the control group at minute 20 (U = 124.0, n1 = n2 = 20, mean rank1 = 24.30, mean rank2 = 16.70, z = -2.095, P = .036). The reduction in BIS in the intervention group was also significantly greater than the control group at minute 20 (U = 19.5, n1 = n2 = 20, mean rank1 = 29.52, mean rank2 = 11.48, z = -4.900, P < .0001). Twenty minutes of mindful breathing was more efficacious than 20 minutes of supportive listening in the reduction in suffering among palliative care informal caregivers.
    Matched MeSH terms: Palliative Care/psychology*
  17. Tan SB, Lee YL, Tan SN, Ng TY, Teo YT, Lim PK, et al.
    J Hosp Palliat Nurs, 2020 10;22(5):407-414.
    PMID: 32898385 DOI: 10.1097/NJH.0000000000000678
    Palliative care providers find meaning in their work, even though stress, burnout, and compassion fatigue can be a concern. In this study, we aimed to explore the experiences of well-being of palliative care providers in Malaysia. Data collected using semistructured interviews were thematically analyzed. Eighteen palliative care providers participated: 9 doctors and 9 nurses. Five subthemes were generated: (1) values and strengths, (2) coping and work-life balance, (3) social support and spirituality, (4) passion and satisfaction, and (5) learning, growth, and transformation. These subthemes were further categorized into 2 themes: resilience and reward. The results may inform the development of interventions in the promotion and sustenance of well-being of palliative care providers.
    Matched MeSH terms: Palliative Care
  18. Look ML, Tan SB, Hong LL, Ng CG, Yee HA, Lim LY, et al.
    BMJ Support Palliat Care, 2021 Dec;11(4):433-439.
    PMID: 32788274 DOI: 10.1136/bmjspcare-2020-002382
    CONTEXT: There has been increasing evidence of the role of mindfulness-based interventions in improving various health conditions. However, the evidence for the use of mindfulness in the palliative care setting is still lacking.

    OBJECTIVES: The objective of our study was to determine the efficacy of a single session of 20 min mindful breathing in alleviating multiple symptoms in palliative care.

    METHODS: Adult palliative care in patients with at least one symptom scoring ≥5/10 based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from September 2018 to December 2018. Recruited patients were randomly assigned to either 20 min mindful breathing and standard care or standard care alone.

    RESULTS: Forty patients were randomly assigned to standard care plus a 20 min mindful breathing session (n=20) or standard care alone (n=20). There was statistically significant reduction of total ESAS score in the mindful breathing group compared with the control group at minute 20 (U=98, n 1 = n 2 = 20, mean rank 1 = 15.4, mean rank 2 = 25.6, median reduction 1 = 6.5, median reduction 2 = 1.5, z=-2.763, r=0.3, p=0.005).

    CONCLUSION: Our results provided evidence that a single session of 20 min mindful breathing was effective in reducing multiple symptoms rapidly for palliative care patients.

    Matched MeSH terms: Palliative Care; Hospice and Palliative Care Nursing*
  19. Fahisham Taib, Lee, Chee Chan
    MyJurnal
    Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
    discussion and goal of care should focus towards improving the baby quality of life. It does not mean
    palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
    who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
    leukaemia. There were various ethical issues related to the approach of death and dying infant and
    psychosocial challenges surrounding the case.
    Matched MeSH terms: Palliative Care
  20. Tye SK, Razali NS, Ahmad Shauqi SA, Azeman NA, Basran NF, Liew JHJ, et al.
    Cardiol Young, 2024 Apr;34(4):900-905.
    PMID: 37965721 DOI: 10.1017/S1047951123003773
    OBJECTIVES: This study aimed to describe the perception of Malaysian patients with pulmonary hypertension towards palliative care and their receptivity towards palliative care.

    METHODS: This was a cross-sectional, single-centre study conducted via questionnaire. Patients aged 18 years old and above, who were diagnosed with non-curable pulmonary hypertension were recruited and given the assessment tool - perceptions of palliative care instrument electronically. The severity of pulmonary hypertension was measured using WHO class, N-terminal pro B-type natriuretic peptide and the 6-minute walking test distance.

    RESULTS: A total of 84 patients [mean age: 35 ±11 years, female: 83.3%, median N-terminal pro B-type natriuretic peptide: 491 pg/ml (interquartile range: 155,1317.8), median 6-minute walking test distance: 420m (interquartile range: 368.5, 480m)] completed the questionnaires. Patients with a higher WHO functional class and negative feelings (r = 0.333, p = 0.004), and cognitive reaction to palliative care: hopeless (r = 0.340, p = 0.003), supported (r = 0.258, p = 0.028), disrupted (r = 0.262, p = 0.025), and perception of burden (r = 0.239, p = 0.041) are more receptive to palliative care. WHO class, N-terminal pro B-type natriuretic peptide, and 6-minute walking test distance were not associated with higher readiness for palliative care. In logistic regression analyses, patients with positive feelings (β = 2.240, p = < 0.05), and practical needs (β = 1.346, p = < 0.05), were more receptive to palliative care.

    CONCLUSIONS: Disease severity did not directly influence patients' readiness for palliative care. Patients with a positive outlook were more receptive to palliative care.

    Matched MeSH terms: Palliative Care
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