MyMedR

Social support and burden among caregivers of patients with dementia in Malaysia

Choo WY, Low WY, Karina R, Poi PJ, Ebenezer E, Prince MJ

Asia Pac J Public Health, 2003;15(1):23-9.

PMID: 14620494 DOI: 10.1177/101053950301500105

This study aims to examine selected factors of dementia patients and their caregivers that were associated with the burden of family caregivers. This cross sectional study involves face-to-face interview with family caregivers of patients with dementia. Participants were recruited through convenient sampling from geriatric and psychiatry outpatient clinics from three government hospitals, one university hospital, one rural health centre and Alzheimer Disease caregivers' support groups. 70 caregivers took part in the study. Measures included patient and caregiver demographic variables and caregiver burden using the Zarit Burden Interview (ZBI). Caregiver burden was found to be significantly associated with both ethnicity and informal support. Chinese caregivers were found to have a higher level of burden compared to Indians and Malays. Informal support, in particular assistance from family members, was significantly associated with a lower burden perceived by the caregivers. However, the study shows that formal support such as assistance from maids and private nurses did not alleviate the burden of caregivers. Results highlighted the importance of improving the coping skills in burdened caregivers particularly among family members with dementia relatives. Interventions should be designed for specific needs of caregivers of different ethnicities.

Matched MeSH terms: Cultural Characteristics

Fulltext Libido, sexuality and the levonorgestrel IUS in Malaysia

Wong CY

J Fam Plann Reprod Health Care, 2001 Jan;27(1):56.

PMID: 12457552 DOI: 10.1783/147118901101194976

Hysterectomy and tubal sterilisation are two commonly performed gynaecological procedures in Malaysia. Little has been published about the psychological impact on sexuality of such operations in the Far East. Many Malaysian patients believe that surgery to the pelvic organs may be detrimental to the sexual health and needs of women. There is a widespread belief that the uterus is essential for the libido and sexual wellbeing of women. It is also believed that tubal sterilisation may result in the loss of libido and thus of sexual desire for her husband. Despite counselling to dispel these misconceptions, patients frequently refuse surgical management for fear of losing their libido and sexuality. Inability to satisfy and consummate marriage is a valid reason for the partner to find another wife (Muslims in Malaysia are legally allowed to have four wives). This fear of ultimately losing the husband to another woman due to lack of libido and loss of sexuality often causes women to refuse appropriate surgery. The recent availability of the levonorgestrel intra-uterine system (IUS) in Malaysia provides a suitable medical alternative to surgery in managing some of these patients. There is good evidence to suggest the effectiveness of the levonorgestrel IUS in the treatment of menorrhagia. The use of the levonorgestrel IUS in women whose cultural beliefs/misconceptions are not amenable to counselling, may help in the psychological preservation of their libido and sexuality.

Matched MeSH terms: Cultural Characteristics

Eating disorders in the Far East

Tsai G

Eat Weight Disord, 2000 Dec;5(4):183-97.

PMID: 11216126

OBJECTIVE: To investigate eating disorders (EDs) prevalence rates among Asian populations and identify characteristics that distinguish them from their Western counterparts.

METHOD: Potential references were identified through an English-language literature search using Medline, Psychinfo, Dissertation Abstracts (1966 to 1999) and through extensive manual searching of textbooks, reviews and reference lists.

RESULTS: The majority of studies related to EDs were conducted in Japan and China and a few were conducted in Singapore, Malaysia, Taiwan, and Korea whereas there was none in the Philippines, Laos, Vietnam, Cambodia, Myanmar, Indonesia and Thailand. Prevalence rates in Japan range from 0.025 to 0.030% for anorexia nervosa (AN) and from 1.9 to 2.9% for bulimia nervosa (BN). Community studies in China have found the AN prevalence to be 0.01% and BN rates ranging from 0.5% to 1.3%. These rates are lower than ED rates in the West (particularly the U.S. and Britain). Body dissatisfaction (BD) and dieting rates, however, were similar to those in the West. BD rates ranged from 68% (Taiwan) to 81% (Korea) and dieting rates ranged from 34% (Taiwan) to 68% (Japan). Sociocultural and developmental risk factors were relevant to this population.

CONCLUSIONS: EDs in Asian populations have received little attention because they have been predominantly viewed as associated with Western culture. Classified by many as a "culture-bound syndrome" of the West, they may really be a culture-change syndrome.

Matched MeSH terms: Cultural Characteristics

Rating the quality of the family environment in different cultures

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

J Am Acad Child Adolesc Psychiatry, 2000 Sep;39(9):1168-74.

PMID: 10986814 DOI: 10.1097/00004583-200009000-00017

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

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

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

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

Matched MeSH terms: Cultural Characteristics*

Levonorgestrel IUS use in Islamic Malaysia

Wong CY

Br J Fam Plann, 2000 Apr;26(2):117.

PMID: 10896464

Matched MeSH terms: Cultural Characteristics*

Autonomy for whom? A perspective from the Orient

Ng LF, Shumacher A, Goh CB

Palliat Med, 2000 Mar;14(2):163-4.

PMID: 10829153 DOI: 10.1191/026921600669696020

Matched MeSH terms: Cultural Characteristics

Religious--sociocultural psychotherapy in patients with anxiety and depression

Razali SM, Hasanah CI, Aminah K, Subramaniam M

Aust N Z J Psychiatry, 1998 Dec;32(6):867-72.

PMID: 10084352

To show the effectiveness of incorporating religious-sociocultural components in the management of patients with generalised anxiety disorders and major depression who have strong religious and cultural backgrounds as compared with a normal psychotherapeutic approach.

Matched MeSH terms: Cultural Characteristics*

Cultural formulation of psychiatric diagnosis. Sakit Gila in an Iban longhouse: chronic schizophrenia

Barrett RJ

Cult Med Psychiatry, 1997 Sep;21(3):365-79.

PMID: 9352169

Matched MeSH terms: Cultural Characteristics

Female genital mutilation. Council on Scientific Affairs, American Medical Association

JAMA, 1995 Dec 6;274(21):1714-6.

PMID: 7474278

Female genital mutilation is the medically unnecessary modification of female genitalia. Female genital mutilation typically occurs at about 7 years of age, but mutilated women suffer severe medical complications throughout their adult lives. Female genital mutilation most frequently occurs in Africa, the Middle East, and Muslim parts of Indonesia and Malaysia, and it is generally part of a ceremonial induction into adult society. Recent political and economic problems in these regions, however, have increased the numbers of students and refugees to the United States. Consequently, US physicians are treating an increasing number of mutilated patients. The Council on Scientific Affairs recommends that US physicians join the World Health Organization, the World Medical Association, and other major health care organizations in opposing all forms of medically unnecessary surgical modification of the female genitalia.

Matched MeSH terms: Cultural Characteristics

Fulltext Phenomenological differences of delusions between schizophrenic patients of two cultures of Malaysia

Azhar MZ, Varma SL, Hakim HR

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

PMID: 8553090

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

Matched MeSH terms: Cultural Characteristics*

Climacteric and menopause in seven South-east Asian countries

Boulet MJ, Oddens BJ, Lehert P, Vemer HM, Visser A

Maturitas, 1994 Oct;19(3):157-76.

PMID: 7799822

The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be 'translated' into psychological complaints, which are more frequently considered to warrant consulting a physician.

Matched MeSH terms: Cultural Characteristics

Sex preference and fertility in Peninsular Malaysia

Pong SL

Stud Fam Plann, 1994 May-Jun;25(3):137-48.

PMID: 7940619 DOI: 10.2307/2137940

This study uses data from the Second Malaysian Family Life Survey, conducted in 1988, to examine parents' preferences for the sex of their children within each of Malaysia's three ethnic groups. While Malay and Indian parents do not show a consistent sex preference, Chinese parents prefer to have all sons, or a combination of sons and daughters, with more sons than daughters, or at least an equal number of them. Son preference among the Chinese does not seem to be a constraint to fertility decline among that population. Since 1970, Chinese fertility has dropped rapidly; at the same time, Chinese son preference has become more pronounced. Evidence indicates that further reductions in Chinese fertility, through the reduction in sex preference, would be small.

Matched MeSH terms: Cultural Characteristics

Quality of Life--Asian perspective--a personal view

Chelvam P

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

PMID: 8171292

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

Matched MeSH terms: Cultural Characteristics

Classification of amok in DSM-IV

Gaw AC, Bernstein RL

Hosp Community Psychiatry, 1992 Aug;43(8):789-93.

PMID: 1427677

Culture-bound syndromes have been described worldwide in many individuals and, for certain syndromes, in epidemic proportion, yet these disorders have been classified as rare and exotic conditions warranting minimal attention. Development of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and the tenth edition of the International Classification of Diseases offers an opportunity for providing a more sophisticated classification of these phenomena. The authors examine amok, a syndrome first described in Malaysia that consists of homicidal frenzy preceded by a state of brooding and ending with somnolence and amnesia. They discuss the concept of and criteria for a culture-specific disorder and propose that amok be classified as a culture-specific explosive behavioral disorder in DSM-IV.

Matched MeSH terms: Cultural Characteristics*

The impact of religion and cultural values on AIDS education programs in Malaysia and the Philippines

Osteria T, Sullivan G

AIDS Educ Prev, 1991;3(2):133-46.

PMID: 1873137

This paper examines the impact of cultural values and government policies on the content of AIDS educational literature prepared by public health agencies in Malaysia and the Philippines. The literature from these countries, which has been distributed to the public and is intended to inform them of the danger of AIDS, how the HIV is and is not transmitted, and how to avoid infection, is analyzed and evaluated for effectiveness and congruence with the dominant religious tenets and cultural practices in each country, and attitudes to sexual behavior. The paper also describes the response of these countries to the AIDS pandemic, and concludes with suggestions about how this form of AIDS education can be improved.

Matched MeSH terms: Cultural Characteristics*

Sporadic koro and marital dysharmony

Adityanjee, Zain AM, Subramaniam M

Psychopathology, 1991;24(1):49-52.

PMID: 2023985 DOI: 10.1159/000284697

A case of Koro is described in a Malaysian Chinese man in the setting of martial dysharmony and sexual rejection. A distinction is suggested between the epidemic form of Koro and the Koro symptom occurring sporadically. Existence of the sporadic Koro syndrome is discussed and a unified classificatory system is proposed.

Matched MeSH terms: Cultural Characteristics*

Primary health care for the children of Sarawak

Benster R, Stanton J

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

PMID: 2611474

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

Matched MeSH terms: Cultural Characteristics

Living arrangements of the elderly in Fiji, Korea, Malaysia, and the Philippines

Martin LG

Demography, 1989 Nov;26(4):627-43.

PMID: 2583321

Using logit techniques and data from surveys of the elderly conducted in 1984 under the auspices of the World Health Organization, this article investigates socioeconomic, cultural, and demographic determinants of living arrangements of the elderly. Having a spouse or children with whom to live has important effects on living arrangements. The results provide only weak support, however, for hypotheses based on modernization theory and point to the need for detailed data on transitions in living arrangements and for information about the younger generation as well as the older generation, both of which are involved in deciding who lives with whom.

Matched MeSH terms: Cultural Characteristics

Fulltext The consultation of traditional healers by Malay patients

Salleh MR

Med J Malaysia, 1989 Mar;44(1):3-13.

PMID: 2626110

Sixty four percent (104 patients) of Malay patients attending the Psychiatric Clinic for the first time were interviewed. A similar number from the general Out-patients Department (O.P.D.) randomly chosen, served as the control group. Seventy six (73.1%) psychiatric patients had consulted a bomoh prior to their visit to the clinic as compared to 26 (25%) O.P.D. patients. The number of bomohs consulted was significantly higher among the psychiatric patients than the O.P.D. patients. The strength of social support, the availability of a bomoh and the belief of the patients, friends and/or relatives in the bomoh have been suggested as the main factors that influenced the Malay patients in seeking bomoh treatment. The belief that mental illness is due to supernatural causes is firmly held by bomohs who reinforce this notion in those who seek their advice. The importance of understanding the patient's cultural background in treating psychiatric patients is highlighted.
Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Cultural Characteristics*

Reasons for seeking dental care in a Malaysian urban adult population: an analysis by sex and ethnic group

Jaafar N, Abdul Razak I

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

PMID: 3162860

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

Matched MeSH terms: Cultural Characteristics

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