BACKGROUND: The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia.
OBJECTIVE: To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic.
METHOD: This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation.
RESULTS: A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated significant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain.
CONCLUSION: The MMT program at HTAA is effective in improving the QOL among heroin dependants.
Study site: MMT clinic, Tengku Ampuan Afzan Hospital (HTAA), Kuantan, Pahang, Malaysia
Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients
those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack
occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation
(r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.
Keywords: stroke; physical functioning; disability; physical impairment
AIMS: The purpose of this study was to investigate the association of diabetes-related knowledge and treatment adherence with glycaemic control among patients with type 2 diabetes mellitus (T2DM) in Pakistan.
METHODS: The study was designed as a questionnaire-based, cross-sectional analysis. T2DM patients attending a public outpatient clinic in Sargodha, Pakistan, were targeted for the study. In addition to the demographic information, the Urdu version of Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used for data collection. Patients' medical records were reviewed for glycated haemoglobin levels (HbA1c). Descriptive statistics were used to elaborate sociodemographic characteristics. The Spearman's Rho correlation was used to measure association of disease-related knowledge and treatment adherence with glycaemic control. SPSS V 20.0 was used for data analysis and p<0.05 was taken as significant.
RESULT: In total, 392 T2DM patients were included in the study. The mean age (SD) of these patients was 50.77±9.671 years, 56.6% were males and 90% (n=353) of respondents were married. The mean (SD) duration of disease was 5.58 (4.09) years with median HbA1c of 9.00 (IQR=8.20-10.40). The median knowledge score was 8.0 (IQR=6.0-10.0), while the median adherence score was 4.7 (IQR=3.0-6.0). HbA1c had non-significant and weak negative association with diabetes-related knowledge (r=-0.036, p=0.404) and treatment adherence (r=-0.071, p=0.238).
CONCLUSION: There was negative association reported between HbA1c, treatment adherence and diabetes-related knowledge. Greater efforts are clearly required to investigate other factors affecting glycaemic control among T2DM patients in Pakistan.
KEYWORDS: Adherence; Correlation; Diabetes-related knowledge; Glycaemic control; Type 2 diabetes
OBJECTIVE: This study aims to describe the health-related quality of life (HRQoL) profile of Type 2 diabetes mellitus (T2DM) population attending outpatient clinics in Sargodha City, Pakistan.
METHODS: The study was designed as a cross-sectional descriptive survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The EuroQol EQ-5D was used for the assessment of HRQoL and was scored using values derived from the UK general population survey. Descriptive statistics were used for the elaboration of sociodemographic characteristics. The Chi-square test was used to depict the possible association between study variables and HRQoL. Where significant associations were noted, Phi/Cramer's V was used for data interpretation accordingly. SPSS version 21 (SPSS Inc., Chicago, IL, USA) was used for data analysis and P < 0.05 was taken as significant.
RESULTS: Three hundred and ninety-two patients were approached for the study. The cohort was dominated by males (n = 222, 56.60%) with 5.58 ± 4.09 years of history of T2DM. The study highlighted poor HRQoL among the study participants (0.471 ± 0.336). Gender, marital status, education, monthly income, occupation, location and duration of the disease were reported to be significantly associated with HRQoL (P < 0.001).
CONCLUSION: T2DM imposes a negative effect on HRQoL of the patients. Attention is needed to highlight determinants of HRQoL and to implement policies for better management of T2DM, particularly in early treatment phases where improving HRQoL is still possible.
KEYWORDS: EQ-5D; Pakistan; health-related quality of life; type 2 diabetes mellitus
One hundred consecutive patients attending the UKM (Universiti Kebangsaan Malaysia) Cardiology Clinic completed a questionnaire enquiring about their own assessment of their knowledge about their illness, their awareness of cardiac risk factors and their expectations in their management. Only 11% of our patients had graduated from tertiary education. 59% of our patients were being treated for ischaemic heart disease. Although only 28% of our patients considered having considerable knowledge of their illness, a majority of our patients were aware of cardiac risk factors. This was independent of the formal education achieved. However this awareness did not necessarily result in appropriate behaviour; 32% of patients admitted to smoking despite being aware of the harmful effects of smoking. 74% of our patients expected a cure from their doctors; only 37% of our patients thought they required medication indefinitely. Thus, patients could be made aware of their illness regardless of their formal educational status. However this may not necessarily result in appropriate behaviour. The high expectations which the patients have of their doctors is unrealistic and may be detrimental to appropriate long-term management of their chronic illness.
Study site: Cardiology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
OBJECTIVE: The objective of this study is to determine the quality of life among breast cancer patients in Yemen based on socio-demographic and clinical characteristics.
METHODOLOGY: This study was designed as a cross-sectional study. The data collected from 106 female breast cancer patients who were chosen for recruitment from the outpatient in National Oncology Centre (NOC), Sana'a, Yemen from November 2008 to June 2011. Questionnaires were distributed to the patients during their visit to the outpatient clinics in the center. The instrument of this study consists of two parts: Socio-demographic and the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Regarding data analysis, means and SD of subscales were evaluated for descriptive purpose. Analysis of variance (ANOVA) was performed to compare the three groups regarding QOL subscales. Whereas, independent t-test was performed for comparing two groups regarding QOL subscales. Multiple linear regression using backward analysis was performed to obtain the final model for each domain. The final model was chosen depending on R2 and the p value of the model. A p value less than 0.05 is considered statistically significant.
RESULTS: A total number of 106 breast cancer patients were participated in this study. The majority of them were uneducated, unemployed with normal weight and had middle income (60.4%; 95.3%; 59.4%, 46.2%; respectively). As for clinical characteristics of the study participants; the majority of them had had no family history of breast cancer, have been diagnosed at least 2 years, were diagnosed at grade 3 and size of tumor greater than 2 cm (88.7%, 66.0%, 35.8%, 73.6%; respectively). The majority of them underwent mastectomy, radiotherapy, chemotherapy and tamoxifen therapy (85.8%, 63.2%, 94.3% and 62.3%; respectively). For univariate analysis, the present study has identified several factors includes family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery that influence the QOL of breast cancer patients in Yemen. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients (p=0.01, p=0.023, p=0.039; respectively).
CONCLUSION: Family monthly income, BMI, educational status, years after diagnosis, histological grade radiotherapy and surgery were significantly influence the QOL of breast cancer patients in Yemen, in univariate analysis. For multivariate analysis, years after diagnosis, family monthly income and radiotherapy were significantly associated with total QOL of the breast cancer patients.
Background: The elderly population is the largest consumer of medications as this age group is at high risk for developing chronic diseases. However, medication use among elderly people is complicated by an increased risk of drug-related problems. Therefore, the present study was conducted to investigate the effects of collaborative interventions between pharmacists and physicians on health-related outcomes of elderly patients.
Patients and methods: This was a randomized controlled trial (RCT) conducted on elderly outpatients who sought treatment in the Medical Outpatient Department of a public tertiary hospital in Malaysia and who were taking at least five medications. The participants were randomly allocated to the intervention and control groups. The intervention group received pharmaceutical care from a pharmacist in collaboration with physicians and was followed-up for 6 months, while the control group received usual care in the outpatient pharmacy.
Results: A total of 73 participants in the intervention group and 79 participants in the control group completed the study. Participants in the intervention group had significantly better medication adherence (median =7.0 vs 5.0, U=1224.5, p<0.001, r=0.503) and better Medication Appropriateness Index (MAI) score (median =8.0 vs 20.0, U=749.5, p<0.001, r=0.639).
Conclusion: Collaborative interventions between pharmacists and physicians improved medication adherence and MAI scores of the elderly patients. Therefore, such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
Trial registration: NMRR-12-958-13020.
Study site: Outpatient clinic (MOPD), Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
Nonsedating selective peripheral H1 receptor antagonists are an important advance in antihistaminic therapy in allergic patients. This is a randomised, double-blind parallel group study comparing the use of two such agents viz loratadine 10mg daily and astemizole 10mg daily for two weeks in 39 Malaysian allergic rhinitis patients. At these dosages, both drugs were demonstrated to be efficacious (p < 0.05) for controlling nasal symptoms and safe in terms of short term biochemical and haematological changes and adverse effects noted. Evaluating efficacy criteria utilised in this study loratadine and astemizole were comparable but loratadine was significantly more effective in three areas viz: (i) in diminishing nasal symptoms after 2 weeks of treatment (p = 0.03); (ii) physician's efficacy evaluation after 2 weeks' treatment (p = 0.009); (iii) patient's efficacy evaluation after 2 weeks' treatment (p = 0.019).
Study site: Allergy clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Purpose: To develop and validate the English version of the Satisfaction Questionnaire for Osteoporosis Prevention (SQOP) in Malaysia.
Methods: The SQOP was modified from the Osteoporosis Patient Satisfaction Questionnaire and developed based on literature review and patient interviews. Face and content validity were established via an expert panel. The SQOP consists of two sections: clinical services and types of counseling. There were 23 items in total, each with a five-point Likert-type response. Satisfaction score was calculated by converting the total score to a percentage. A higher score indicates higher satisfaction. English speaking, non-osteoporotic, postmenopausal women aged 50 years were included in the study. Participants were randomized to either the control or intervention group. Intervention participants were provided counseling, whereas control participants received none. Participants answered the SQOP at baseline and 2 weeks later.
Results: A total of 140 participants were recruited (control group: n=70; intervention group: n=70). No significant differences were found in any demographic aspects. Exploratory factor analysis extracted seven domains. Cronbach’s α for the domains ranged from 0.531–0.812. All 23 items were highly correlated using Spearman’s correlation coefficient 0.469–0.996 (P<0.05), with no significant change in the control group’s overall test–retest scores, indicating that the
SQOP achieved stable reliability. The intervention group had a higher score than the control group (87.91±5.99 versus 61.87±8.76; P<0.05), indicating that they were more satisfied than control participants. Flesch reading ease was 62.9.
Conclusion: The SQOP was found to be a valid and reliable instrument for assessing patients’ satisfaction towards an osteoporosis screening and prevention service in Malaysia.
Keywords: patient satisfaction, randomized controlled trial, postmenopausal women, screening
Study site: primary care clinic, tertiary hospital, Malaysia
Background: Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area.
Objective: To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management.
Setting: A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia.
Method: Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists.
Results: All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role.
Conclusion: Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Study site: Primary care clinic, teaching hospital, Kuala Lumpur, Malaysia
The Short Form Health Survey SF-36 is a well-known generic health-related quality of life measure that has widely been used worldwide. However, given the cultural, social and ethnic differences in some countries, it might not follow the intended structure of the instrument. Hence, this study aims to determine the psychometric properties of the Malay version of Short Form Health Survey (SF-12) among postpartum mothers. A cross-sectional study was conducted among 1-month postpartum mothers attending Obstetric and Gynecology clinic, Universiti Sains Malaysia Hospital, Kelantan, Malaysia. Reliability was estimated using internal consistency and the factor structure was extracted by performing confirmatory factor analysis using SPSS v. 20 and AMOS v. 20. A total of 108 women responded. The mean (SD) score for the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score were 43.3 (7.08) and 42.4 (6.87) respectively. The Cronbach alpha for PCS-12 was 0.749 and MCS-12 was 0.701. Spearman correlations of individual items and the SF-12 component summary scores showed PF, RP, BP and GH items correlated higher with the PCS score, whereas the VT, SF, RE, and MH items correlated higher with the MCS score lending support to its good convergent validity. The confirmatory factor solution showed final model with two factors structure and six items each with acceptable factor loadings, satisfactory absolute and parsimonious fitness (RMSEA=0.1, x2/df=2.4). The psychometric tests of the Malay version of SF-12 generally showed acceptable validity and reliability among postpartum women.
Study site: Obstretic and gynecology Hospital Universiti Sains Malaysia (HUSM)
The anterior surface of the eye is covered by several physically contiguous but histologically distinguishable epithelia overlying the cornea, limbus, bulbar conjunctiva, fornix conjunctiva, and palpebral conjunctiva. The self-renewing nature of the conjunctival epithelia makes their long-term survival ultimately dependent on small populations of stem cells. Hence, the objective of this study was to investigate the expression of the stem cell genes Sox2, OCT4, NANOG, Rex1, NES, and ABCG2 in cultured human conjunctival epithelium from different conjunctival zones, namely, the bulbar, palpebral and fornix zones. Three samples were taken from patients with primary pterygium and cataract (age range 56-66 years) who presented to our eye clinic at the UKM Medical Centre. The eye was examined with slit lamp to ensure there was no underlying ocular surface diseases and glaucoma. Conjunctival tissue was taken from patients who underwent a standard cataract or pterygium operation as a primary procedure. Tissues were digested, cultured, and propagated until an adequate number of cells was obtained. Total RNA was extracted and subjected to expression analysis of conjunctival epithelium genes (KRT4, KRT13, KRT19) and stem cell genes (Sox2, OCT4, NANOG, Rex1, NES, ABCG2) by reverse transcriptase-PCR and 2% agarose gel electrophoresis. The expression of Sox2, OCT4, and NANOG genes were detected in the fornical cells, while bulbar cells only expressed Sox2 and palpebral cells only expressed OCT4. Based on these results, the human forniceal region expresses a higher number of stem cell genes than the palpebral and bulbar conjunctiva.
Study site: Eye clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
OBJECTIVES: The primary objective of this study was to evaluate the pattern of use, reasons for use, and perceived effect of complementary and alternative medicine (CAM), accompanied by identification and comparison of the factors that are potentially associated with CAM use.
DESIGN: This cross-sectional study was carried out in 325 randomly sampled patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), at HIV/AIDS referral clinics in the Hospital Sungai Buloh, Malaysia. Simple random sampling was used, where randomization was done using patients' medical record numbers.
SUBJECTS AND METHODS: Semistructured face-to-face interviews were conducted using 38 questions pertaining to type, pattern, perceived efficacy, adverse effects, and influential factors associated with CAM use. In addition, CD4 count and viral load readings were recorded.
RESULTS: Of 325 randomly sampled patients with HIV/AIDS, 254 of them were using some forms of CAM, resulting in a utilization rate of 78.2%. Vitamins and supplements (52.6%), herbal products (33.8%), and massage (16.6%) were the top three most frequently used CAM modalities. Sociodemographic factors including education level (p = 0.021, r(s) = 0.148), monthly income (p = 0.001, r(s) = 0.260), and family history of CAM use (p = 0.001, r(s) = 0.231) were significantly associated and positively correlated with CAM use. However, the majority of these patients (68%) did not disclose CAM use to health care professionals. About half of those who rated their health as good or very good perceived it as a result of CAM use.
CONCLUSIONS: This study confirmed the range of 30%-100% CAM use among individuals infected with HIV/AIDS. Although, on the one hand some types of CAM reduced viral load and enhanced the immune system, on the other hand some forms of CAM produced a detrimental effect on the virological suppression, opening this platform to more research and investigation in order to optimize the use of CAM among patients with HIV/AIDS.
Study site: HIV/AIDS clinic, Hospital Sungai Buloh, Selangor, Malaysia
PURPOSE:This study aimed to determine the relationship between macular thickness and spherical equivalent refraction (SER), axial length (AL) and vitreous chamber depth (VCD) in Malay subjects.
METHODS: Sixty-three subjects (aged 19-24 years) with a mean SER of -1.79 ± 2.24 D, mean axial length of 24.26 ± 1.35 mm and mean vitreous chamber depth of 17.02 ± 1.33 mm were included in this clinical cross-sectional study. Stratus optical coherence tomography (Time Domain optical coherence tomography) was used to determine the thickness of the outer macular (perifovea) and inner macular (parafovea) at four different locations, that is, temporal, superior, nasal and inferior quadrants and also the fovea itself.
RESULTS: Positive correlations were found between the outer macular (perifovea) thickness and SER at the temporal (R = 0.47, p < 0.05), superior (R = 0.36, p < 0.05) and inferior (R = 0.31, p < 0.05) quadrants. Foveal thickness was also positively correlated with AL (R = 0.34, p < 0.05) and VCD (R = 0.32, p < 0.05). Negative correlations were found between outer macular thickness and axial length at the temporal (R = -0.46, p < 0.05), superior (R = -0.27, p < 0.05), nasal (R = -0.25, p < 0.05) and inferior (R = -0.36, p < 0.05) quadrants. Negative correlations were also found between outer macular thickness and VCD at the temporal (R = -0.51, p < 0.05), superior (R = -0.32, p < 0.05), nasal (R = -0.31, p < 0.05) and inferior (R = -0.40, p < 0.05) quadrants.
CONCLUSIONS: This study shows that the degree of myopia and elongation of the globe are associated with thinning of most areas of the perifovea. A trend for foveal thickening in the high myopia group is also inferred, although this does not apply to the low and moderate myopia groups.
Study site: Optometry and ophthalmology clinics, National Institute of Ophthalmic Sciences, Tun Hussein Onn National Eye Hospital (THONEH), Petaling Jaya
Eighty consecutive patients who came to collect their prescriptions for pressurised aerosol inhalers at the Pharmacy of the University Hospital, Kuala Lumpur, were interviewed regarding their use of the pressurised inhaler. Their inhaler technique was also assessed. A significant proportion inhaled the steroid aerosol before the bronchodilator and 23.5% used the steroid inhaler for relief of acute dyspnoea. Only 28.8% of the 80 patients performed correctly all 6 steps necessary for the proper use of inhalers. The most common mistake was the failure to inhale slowly and deeply. Patients who had used the device for more than 5 years performed better, while correct inhaler technique was not dependent on the patient's sex, age or level of education.
Study site: Chest clinic, University Malaya Medical Centre (UMMC)
Objectives: To examine the descriptive epidemiology of the patient population referred to paediatric rheumatology centres (PRCs) in Southeast Asia (SEA) and to compare the frequency of conditions encountered with other PRC populations.
Methods: A web-based Registry for Childhood Onset Paediatric Rheumatic Diseases was established in 2009 and seven PRCs in four SEA countries, where paediatric rheumatologists are available, participated in a prospective 24 month data collection (43 months for Singapore).
Results: The number of patients analysed was 4038 (788 from Malaysia, 711 from the Philippines, 1943 from Singapore and 596 from Thailand). Over 70% of patients evaluated in PRCs in Malaysia, the Philippines and Thailand had rheumatic diseases (RDs), as compared with one-half of the proportion seen in Singaporean PRCs, which was similar to the Western PRC experience. Among RDs diagnosed (n = 2602), JIA was the most common disease encountered in Malaysia (41%) and Thailand (61%) as compared with systemic vasculitides in the Philippines (37%) and Singapore (35%) among which Henoch-Schönlein purpura was the most prevalent. SLE and related diseases were more common, but idiopathic pain syndrome and abnormal immunological laboratory tests were rarer than those seen in the West. JIA subtype distributions were different among countries. Among non-RDs (n = 1436), orthopaedic and related conditions predominated (21.7-59.4%).
Conclusion: The frequencies of RDs seen by SEA PRCs were different from those in the West. Systemic vasculitides and SLE were common in addition to JIA. Paediatric rheumatologist availability and healthcare accessibility partially explain these observed discrepancies.
Study site: multination + Selayang Hospital, Malaysia
Death among tuberculosis patients is one of the major reasons for non-attainment of 85% treatment success target set by World Health Organization. In this short paper, we evaluated whether the overall mortality rate in pulmonary tuberculosis is being affected by other comorbid conditions. All new smear positive pulmonary tuberculosis patients (N =336), who started their treatment at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were followed-up until December 2011. Tuberculosis treatment outcomes were reported according to six treatment outcome categories recommended by World Health Organization. The outcome category 'died' was defined as 'a patient who died due to tuberculosis or other cause during tuberculosis treatment'. Our findings showed that out of 336 smear positive pulmonary tuberculosis patients, 59 (17.6%) died during treatment (mortality rate = 1.003 cases per 1000 person-days of follow-up). Among the deceased patients, the mean age was 55.8 years (SD =16.17) and 49 were male. According to the mortality review forms, 29 deaths were tuberculosis-related, while the remaining 30 patients died due to reasons other than tuberculosis. Cerebrovascular accident (n =7), septicaemia shock (n =4) and acute coronary syndrome (n =4) were the most common non-tuberculosis related reasons for mortality in the patients. If the 30 patients, for whom tuberculosis was incidental to death, are excluded from the final cohort, the proportion of patients in the 'died' outcome category could be reduced to 9.5%. The treatment outcome criterion (i.e., died) set by World Health Organization has limitations. Therefore, it requires improvement for more objective evaluation of the performance of the National Tuberculosis Program.
Study site: Chest clinic, Hospital Pulau Pinang, Malaysia
Objective: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life.
Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used.
Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients.
Keyword: Dementia Caregivers, Support Group, Malay, Burden, Quality of Life
Study site: Memory clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
A study was done on 638 infants with BCG related lymphadenitis seen between August 1990 and December 1993. Most infants (86.5%) had developed symptoms by six months after vaccination and the nodes became suppurative in 317. Surgical procedures were carried out in 82 cases and the rest were managed conservatively. The mean duration to resolution was 6.6 months (range 1 to 29 months). This outbreak was related to a change from the Japan to the Pasteur strain of BCG. The incidence remained high ( > 15 per 1000 live births) despite a dose reduction from 0.1 ml to 0.05 ml, but declined when the Japan strain was reintroduced in April 1992.
Study site: Chest Clinic, Hospital Pulau Pinang, Malaysia