As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.
Occupational cancers, including mesothelioma and lung cancer are linked to the use of asbestos. Annually, at least 100,000 global deaths are attributed to asbestos exposure putting a heavy burden on national budgets. Expenses incurred on treatment of asbestos related diseases (ARDs) reduce households and national resource savings, while ARDs culminate in terminal burdens. The objective of this study is to measure the economic burden of ARDs and to assess the economic impact of asbestos consumption. The health and economic burden of asbestos was estimated in macro-global consumption-production model using production function frontier-based and generalized least squared approach for asbestos products and cost tabulation. Production, in metric tons (Mt) was adopted as a dependent variable among explanatory variables, including consumption. Information on treatment cost of asbestos related diseases (mesothelioma, asbestosis and lung cancer) was obtained from costing information and published literatures. Annual total economic burden of asbestos is at USD 11.92 billion. Out of this cost, USD 4.34 billion per annum is the economic burden of managing three common ARDs. The cost of compensation for patients suffering ARDs is USD 4.28 billion. From the remaining USD 3.3 billion, USD 2.93 billion is the value of asbestos consumed in 2003 and USD372.15 million is the loss of earning due to hospital visits and admissions. For every USD 1 spent on consumption of asbestos, global economy has to absorb almost USD 4 due to health consequences of ARDs. Banning of asbestos production and usage in production of goods has far-reaching impacts on household welfare, health and economic development. The insights revealed are expected to inform decision makers the need to ban all forms of asbestos, especially in developing countries where usage is increasing.
The type of specific learning needs of women with breast cancer using the Information Needs Questionnaire (INQ) had been identified prior to developing a breast cancer education package. It is also important to determine the types of patient factors such as demographic and clinical factors that influence women’s specific learning needs on breast cancer. This study thus reports the findings on what type of patient factors influence women’s specific learning needs related to the types of INQ. A total of 140 women with breast cancer who sought treatment at Universiti Kebangsaan Malaysia Medical Centre participated in this cross sectional study. Age showed a significant relationship with specific learning needs on sexual attractiveness (p=0.001) and self-care (p=0.048). Duration of illness was related to information on spread of breast cancer (p=0.040) and self-care (p=0.047). Education level showed a significant relationship with cure (p=0.001), sexual attractiveness (p=0.007) and spread of breast cancer (p=0.003). Occupation showed a significant relationship with specific learning needs on sexual attractiveness (p=0.005), chemotherapy (p=0.043), radiotherapy (p=0.039) and hormonal therapy (p=0.043). On treatment received, a significant relationship was noted with sexual attractiveness (p=0.009), radiotherapy (p=0.029), hormonal therapy (p=0.038) and targeted therapy (p=0.047). Ethnicity and Marital status showed no significant relationship with all the specific learning needs. Findings of this study concluded that certain patient factors had significant relationship with certain specific learning needs. All the patient factors studied and their influence on the specific learning needs were taken into consideration prior to developing the breast cancer education package.
The increased use of health care services by elderly has placed greater pressure to an already strained health care resources. Thus, an accurate economic cost estimation for specific age-related diseases like dementia is essential. The objectives of this project are to estimate costs of treating patient dementia among Malaysian elderly in the hospital settings. Two types of data were collected: Hospital costing data (using costing template) and patient clinical data (using questionaire). The cost analysis for hospital setting was carried out using a step-down costing methodology. The costing template was used to organize costing data into three levels of cost centers in hospitals: overhead cost centers (e.g. administration, consumables, maintenance), intermediate cost centers (e.g. pharmacy, radiology), and final cost centers (all wards and clinics). In estimating the cost for each cost center, both capital cost (building, equipment and furniture cost) and recurrent cost (staff salary and recurrent cost except salary) were combined. Information on activities which reflects the workload such as discharges, inpatient days, number of visit, floor space etc., are gathered to determine an appropriate allocation factor. In addition, for each final cost center, the fully allocated costs are then divided by the total unit of in-patient days to obtain the cost of providing services on a per-patient per-day of stay basis, referred as unit cost. The unit cost is finally multiplied with the individual patient’s length of stay to obtain the cost of care per patient per admission. All these steps were simplified by using the Clinical Cost Modeling Software Version 3.0 (CCM Ver. 3.0). The mean cost of dementia cases per episode of care was RM 12,806 (SD=10,389) with the length of stay of 14.3 (SD=9.9) days per admission. The top three components of cost for the treatment of dementia were the ward services 8,040 (SD=7,512), 62.78% of the total cost, followed by the pharmacy 1,312(SD=1,098), 10.25% of the total cost and Intensive Care Unit 979 (SD=961), 7.64% of the total cost. A multivariable analysis using multiple linear regressions showed that factors which significantly influence (p<0.05) the treatment costs of dementia cases were the length of stay (p<0.001), followed by age (p=0.001), case type severe (p=0.005) and study location (p=0.032). However, the factor length of stay is the tremendous parameter. In conclusion, data collection from selected hospitals as well as patient level data from medical record unit were successfully used to estimate the provider costs of hospital for the elderly with dementia disease. Results from the project will enable an assessment on the economic impact and consequences of cognitive impairment in an aged population. A cost quantification and distributive mapping of the burden of care can assist in policy implementation through targeted intervention for at-risk groups, which will translate into savings by means of delayed onset or progression of dementia.
The Malaysia Diagnosis Related Group (MY-DRG®), established since 2002, is a patient classification system that stratifies disease severity and categories patients into iso-resource groups. Casemix can be used to estimate costs per episode of care and as a provider payment tool in health services. Casemix has also been used to enhance quality and improve the efficiency of health services. Hence, estimation cost per DRG is important especially in developing countries where costing data are still scarce. We embarked on a study to determine the costs of the diagnostics laboratory services for each MY-DRG® based on the severity of illnesses. Most costing studies for diagnostic laboratory services usually focus on the cost of consumables and equipment alone and employed the step-down costing method. Very few studies applied Activity-Based Costing (ABC) method to estimate the costs for diagnostic laboratory services. This study was done with the purpose of developing the diagnostics laboratory cost using the ABC method. All medical cases discharged from UKM Medical Centre (UKMMC) in 2011 grouped into MY-DRG® were included in this study. In 2011, a total of 2.7 million diagnostic laboratory investigations were carried out in the Department of Diagnostic Laboratory Services in UKMMC. ABC was conducted from January to December 2013 in all units of the department. Cost of 242 types of diagnostic laboratory services were collected using a costing format. Out of 25,754 cases, 16,173 (62.8%) cases were from the medical discipline. After trimming using L3H3 method, 15,387 cases were included in the study. Most of the cases were on severity level one (44.6%), followed by severity level two (32.3%) and severity level three (23.1%). The highest diagnostic laboratory service weight was for Lymphoma & Chronic Leukemia, severity level III (C-4-11-III) with the value of 5.9609. Information on seven cost components was collected form each procedure: human resources, consumables, equipment, reagents, administration, maintenance and utilities. The results revealed that, the biggest cost component for human resources was in Molecular Genetic Unit (89.6%), consumables (34.8%) from Tissue Culture Unit, equipment (11.2%) and reagents (68.1%) from Specialized Haemostasis Unit. In conclusion, the accurate and reliable cost of the diagnostic laboratory services can be determined using ABC. Top management of the department should be able to use the output of the study to take appropriate steps to reduce unnecessary wastages of resources in the various units of the services.
Antenatal care is a vital part of primary healthcare that is known to improve maternal and newborn outcomes. The aim of this study was to identify the factors affecting utilization of antenatal care services for women in reproductive age in Yemen. This cross-sectional community-based study was conducted in six districts of Sana’a City, Yemen. Data were collected from 460 mothers who gave birth in the past six months via face-to-face interviews at home between September to December 2010. Only 54% of mothers were found to have made four or more antenatal care visits. Almost two third of participants made their first visit during their first trimester due to presence of health problems and did not follow up when they became healthy during pregnancy. Reasons for not receiving antenatal care services due to absence of health problems, high cost of antenatal care services, long waiting time, and poor staff attitude. Sixty percent of participants were unaware of the danger symptoms of common health problems in pregnancy. The significant factors affecting utilization of antenatal services were mother education, residence place, age at first pregnancy, gravida, parity, occurrence of pregnancy without planning, and number of live children (P<0.05). The factors affecting the number of visits were mother education, place of residence, and husband work were (P<0.05). Future healthcare activities should focus on improving women’s awareness of the importance of antenatal care even in the absence of noticeable health problems and lack of education about the common danger signs and symptoms of pregnancy.
Paddy cultivation is one of the widely planted crop in Malaysia. The growth of agricultural activity leads to the use of Organophosphate pesticide to protect the crop. This study is to determine the relationship between the levels of blood cholinesterase with the performance of motor coordination of children living in paddy farming area in Tanjung Karang, Selangor. This cross sectional study was conducted among 683 children from four schools in an agricultural area. Majority of the children have at a family member worked as farmer and was involved with pesticides. A set of questionnaire on the was given to the children to be filled by their parents. To measure their exposure to pesticide, blood cholinesterase levels were measured. Blood samples were taken through finger prick technique and were then analysed using LOVIBOND 412870 AF287. The children were administered with motor-coordination performance test using WHO Neurobehavioral Core Test Battery and McCarthy Learning Ability Scale. Young group children (6-85 years) showed a mean score of 56.66 in motor-coordination test while older group children (10-11)= years) scored a mean of 45.37. There was a significant relationship between blood cholinesterase level and motor coordination performance among the young-group children (r=0.215, p<0.001) and the older-group children (r=0.106, p=0.049). Based on the Linear Regression test results, total household income of family, and mode of transport used were found to have significant relationship with blood cholinesterase level of children in both groups. In addition, blood cholinesterase level and mothers’ occupation were found to have significant relationship with the motor-coordination performance of all children.
Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzymelinked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.
Staphylococcus aureus aregram positive cocci which colonizethe skin and mucous membranes particularly the anterior nares. Prevalence of nosocomial infections associated with methicillin resistant S. aureus have been reported in hospitals (HA-MRSA) for over five decades. Recently,community-acquired MRSA (CA-MRSA) has emerged as a cause of skin and soft tissue infections in healthy individuals. These strains are sensitive to antimicrobials, carry genes for Panton-Valentine leukocidin (PVL) toxin and belong to the staphylococcal cassette chromosome (SCC) mec type IV or V. The suspected mode of transmission involves close contact with carriers leading to skin or nasal colonization that resultin subsequent active infection. Molecular typing is used to determine the mode of transmission of CA-MRSA in the community.General typing methods such as pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) and specific methods for Staphylococci such as SCCmec typing and spa typing have the capability to characterize bacterial chromosomes and mobile genetic elements. Combination of these molecular typing methods is necessary as each method has its own advantages with respect to discriminatory power, rapidity, cost effectiveness, reproducibility, and ease of performance.
Safety is vital in any industry, including the offshore sector, which is classified as a major hazard industry. Health, Safety and the Environment (HSE) identified that the probability of accidents is high while working on the offshore sectors where it will exposed workers to many hazardous work activities. The appropriate measures to prevent accident in this sectors must be laid out clearly. This paper is to identify the effectiveness of safety awareness campaign and the continuity of the awareness among the workers to prevent injuries at offshore. To achieve this, we have identified the level of awareness and propose a guideline on areas of improvement. Prior of embarking to offshore, staff were exposed to safety awareness program for four weeks. After the program, we started with the pretest to all staff. They were posted offshore for 6 weeks. Within the period, the performance awareness of each staff is monitored through observation and interview. During the final week, the posttest questionnaire were administered to all staff. Two instruments were used for the quantitative data collection, which are Unsafe Act Unsafe Condition (UAUC) card; and Behavior Observation Tool (BOT) card. Questionnaire data were analyzed quantitatively. Paired-sample t-test was used for analyzing pre and post result. The results show that the mean was increased. Recent studies on the safety briefing highlighted several significant changes in terms of employee understanding toward safety. Safety awareness training has been introduced in the new safety briefing prior to offshore mobilization.
Agriculture sector accounts significant numbers of injuries and fatalities in the workplace particularly related to pesticide management. Among three main pathways of pesticide exposure, dermal contact is the most common route, which exposure usually occurs during pesticide mixing/loading, application, harvesting and other farming activities. This review aims to present and discuss several vital components of pesticide dermal exposure among agriculture workers, as well as pesticide application in agriculture sector in Malaysia involving different commodity agriculture sub-sectors. Pesticide exposure was discussed from perspective of three pesticide management activities (i.e. preparation, application and cleaning) that contribute to the risk of exposure through three routes (i.e. emission, deposition, transfer). Moreover, this paper also discussed pesticide dermal exposure risk assessment methods which can be defined into exposure assessment and effect assessment. The exposure rate was affected by various factors such as application equipment, application rate and duration, type of pesticide formulation, pesticide management stage, usage of personal protective equipment, training and aptitude of the applicator as well as environmental factors (i.e. temperature, humidity, wind speed and direction). The factors mention earlier have been used to explain the exposure distribution over different parts of the body and support the fact that pesticide type was not a major factor in total exposure.
Relaxation technique is a method, process, procedure or activity that helps a person to relax. There are several methods of relaxation techniques that can be used proven beneficial to improve the individual state of relaxation. Relaxation can be performed individually or in a group. With suitable technique of relaxation, it will improve quality of life as well as emotional and physical. This study aims to investigate the impact of three different relaxation techniques, namely Autogenic (AGR), Progressive Muscle (PMR) and Music Relaxation (MR) on mood states among Universiti Sultan Zainal Abidin (UniSZA) athletes. Eighty UniSZA athletes aged between 18 to 25 years old were randomly assigned into four groups which were AGR, PMR, MR and control group. Each groups consisted of 20 subjects which were male and female athletes with multidiscipline of the sports involvement. The mood states were determined by Brunel Mood Scale (BRUMS) during pre and post-intervention. The subjects in the three intervention groups received relaxation training twice a week for four weeks, 30 minutes per sessions. While, a control group not received any relaxation training during the intervention time. Repeated measure ANOVA conducted showed that the two parameters in BRUMS significantly changes in post-intervention such vigour (F=16.083, p<0.0001) and confusion (F=3.412, p=0.022). Other negative mood scores showed no significant changes such; (anger; F=2.235, p=0.091, depression; F=0.960, p=0.416, fatigue; F=0.724, p=0.540, tension; F=16.083, p=0.913).The results of Pairwise Comparison revealed that the three types of relaxation techniques (AGR, PMR and MR) effective to enhance vigour (positive mood) score among the adult subjects. In this study, PMR was the most effective relaxation technique followed by AGR and MR to regulate the mood state among adults.
The purpose of the study was to determine the level of knowledge and beliefs about female breast cancer among male students. A cross-sectional study involving 460 male students of a private university selected by convenient sampling was conducted using self-administered questionnaires that consists of socio-demographic details as well as knowledge and beliefs about female breast cancer. The prevalence of good knowledge was only 45.2%, there was a significant association between level of knowledge and age, course of study (p=0.02 and < 0.001, respectively). The prevalence of poor belief was 72.6% and the main source of information was the media (84.1 %). There was no significant association between beliefs about female breast cancer and family income, mother’s education and race. However, there was a significant association between beliefs about female breast cancer and age, course of study and father’s education. As a conclusion, the knowledge and beliefs about female breast cancer among the male students was very poor. More education and awareness need to be emphasized; especially the media was the most common source of information in our study.
A validated screening tool for patient triage based on the pain symptoms, could potentially optimize the resources and expertise available in dental pain management. The aim of this study was to translate and validate the Modified Dental Pain Questionnaire (M-DePaQ) for use in categorizing patients with pain into three groups of common dental conditions. Forward Malay and Chinese translation was performed, followed by backward English translation. The translation was reviewed by an expert panel and pre-tested on patients who are native speakers.Consecutive patients aged 18 years and older experiencing pain and attending the primary dental care clinic completed the questionnaires. Four calibrated dentists made clinical diagnoses independent of the questionnaire responses. For data analysis, the cases were split randomly into Random Sample 1 (RS1) and Random Sample 2 (RS2). Discriminant analysis was performed on RS1 to develop a model for classifying dental pain cases into three groups. The model was applied to cases in RS2, and a cross-validated accuracy rate was obtained. Criterion validity was assessed using measures such as sensitivity, specificity, positive predictive value, and kappa. Of the 234 questionnaires distributed, 216 (92.3%) were returned. Classification rates were recorded at 73.8% for RS1, 75.0% for RS2, and 71.1% for all cases. The sensitivity values were 0.72, 0.39, and 0.43 for Groups 1, 2, and 3, respectively. The corresponding specificity values were 0.42, 0.87, and 0.94. The discriminant validity of the adapted questionnaire was satisfactory, but the criterion validity could not be established because of biases incorporated in the study.
Obese children had impaired psychosocial status as they generally tend to be socially isolated, have poor self-esteem, anxiety, mood disorder (depression and bipolar disorder) and eating disorder. The aim of this study was to investigate the child-report and parent-report of HRQoL among 9-11 years old obese school children in Malaysia and to determine the associated factors of HRQoL among obese children in Malaysia. This study was a cross-sectional study involving 101 obese Malay primary school children aged 9-11 years old from eleven primary schools in Kuala Terengganu which were selected via convenience sampling. Height and weight of the respondents were measured and their BMI was calculated. Health-related quality of life (HRQoL) was measured using PedsQL version 4.0. The mean age of the respondents was 10.02 ± 0.82 years old with mean BMI z-score was 3.01 ± 0.60. There were significance differences between boys and girls in; 1) emotional domain score for child-report QoL (p=0.019) using paired t-test and 2) psychosocial domain score for parent-report QoL (p=0.025). Regression analysis found that age and gender were the associated factors for Psychological Health for obese children (p<0.005). Being obese had negative effects on children’s quality of life. Various strategies interventions should be done to improve the HRQoL of these obese children. A multidisciplinary approach in schools must be organized to encourage a healthy lifestyle as part of routine among the school children.
Cultural attitudes of the societies have long been identified as one of the important determinants of Quality of Life (QoL). Yet there is a dearth of socio-culturally validated instruments for local population to assess the impact of socio-cultural practice on health. The aim of this validation study is to develop and test the validity and reliabilityof a questionnaire on culture dimensions.Respondents were asked about their engagement in socio-cultural aspects including beliefs and practice oftraditional customs and culture using a set of newly developed questionnaire.A total of 275eligible respondentsparticipatedwith150(54.5%)from the general population and 125 (45.5%)from the Orang Asli population. Kaiser-Meyer Olkin measure of Sampling Adequacy (KMO) was 0.791 and 0.677 for the general and Orang Asli population respectively. Bartlett’s test for both population was significant (p<0.001). By Principal Common Analysis, four factorswere extracted (Eigen values >1.0) that jointly accounted for 54.7% and 52.0% of the total variance among the general population and Orang Asli respectively.The Cronbach alpha value score was 0.785and 0.730 for the general population and Orang Asli population respectively. The Cronbach alpha values foreach of the four domains ranged from 0.477-0.865 and 0.543-0.758 for the general population and Orang Asli population respectively.These results suggest that the newly developed questionnaire appeared to have adequate validity and reliability in measuringsocio-cultural factors in the population.
We compared the determinant factors of depression; among faculties in university, among junior and senior students, and gender differences among representative samples of faculties in university. Centre for Epidemiological Studies Depression (CES-D) consisting for 20 questions was used to assess the status of well-being of students. A total of 240 students participated and completed the assessment forms. The results were then compared and analyzed using the IBM SPSS Statistics version 21. There was no effect of faculty on depression (p=0.854). The association between year of study and depression was not statistically significant (p≥0.05). Likewise, the association between gender and depression was statistically not significant (p≥0.05). The study revealed absence of statistically significant effect of faculty on depression. It was also found that gender and depression as well as year of study and depression were not statistically significant.
Noncommunicable diseases are the number one killer globally and it could develop due to various risk factors. This cross-sectional study was aimed to identify these risk factors by assessing body mass index, waist circumference, waist to hip ratio and blood pressure and to find out the correlation between these risk factors, and cardiorespiratory fitness and physical activity level. The study samples were 103 students from two universities in Negeri Sembilan state selected by the convenience sampling method. After ethical clearance, International Physical Activity Questionnaire-short form in English was used to assess the physical activity level. The cardiorespiratory fitness was assessed by the Rockport one mile walk test and the other parameters were assessed following the standard protocols. The percentage of overweight (32.04%) and pre-hypertension (25.24%) were higher among students. 35.92% of students reported a low physical activity level and 46.6% having a lower fitness level (fair and poor). The physical activity level correlated with the cardiorespiratory fitness level (P<0.01). The body mass index (P<0.01) and systolic blood pressure (male P 0.05, female P<0.01) negatively correlated with the cardiorespiratory fitness level. Therefore, measures have to be taken to improve the physical activity level and cardiorespiratory fitness to lower the risk of overweight and high blood pressure among university students.
The practice of diabetes self-care plays an important role in achieving and maintaining good glycaemic control. However, not all patients with insulin-treated diabetes engage in their self-care activities. There is some evidence that self-care practices in patients with insulin-treated diabetes can be understood and predicted by their health beliefs, although studies are often hampered by methodological weaknesses, and the fact that less is known about adults with insulin-treated diabetes in Malaysia. This study was conducted to examine whether health beliefs (as specified in the Health Belief Model: HBM) can predict self-care practices and glycaemic control in patients with insulin-treated diabetes in Malaysia. Longitudinal design with self-reported questionnaire measures was administered at baseline (Time 1:T1) and six months later (Time 2: T2). Participants were recruited from three endocrinology clinics in Malaysia. The measures included self-care practices (diet, insulin intake, exercise and self-blood glucose monitoring: SMBG), health beliefs and diabetes knowledge. Participants’ glycaemic control was examined based on their glycated hemoglobin (HbA1c) results. Data analysis was performed at different points of the study times; T1, T1-T2 and T2. Diabetes knowledge and demographic data were controlled for in predictive statistical analyses. A total of 159 patients with insulin-treated diabetes (aged 18-40 years) completed the measures at T1. Of these, only 108 (67.9%) completed follow-up measures at T2. However, demographic characteristics were not significantly different between those who completed and dropped out of the study (p>0.05). The HBM was significantly predictive of diet self-care at T2, insulin intake practice at T1 and HbA1c at T1-T2 andT2. Of the HBM constructs, perceived benefits significantly predicted good dietary habits at T1 (OR 1.92) and T2 (OR .23) and adherence to insulin injection at T1 (OR 3.17) and T1-T2 (OR 2.68). With the exception of perceived severity, all other HBM constructs significantly predicted HbA1c [perceived susceptibility (β .169) at T1, perceived barriers (β -.206) and perceived benefits (β -.397) at T2 and cues to action (β -.233) at T1-T2]. Health beliefs predict self-care practices and glycaemic control in young to middle-aged adults with insulin-treated diabetes in Malaysia. Diabetes educators could use this knowledge in their efforts to improve diabetes self-care in this patient groupby modifying those beliefs through their diabetes education.
Study site: Endocrinology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Hospital Putrajaya, and Hospital Melaka, Malaysia