METHODS AND ANALYSIS: The pre-HO intervention is the 'Medicorp' module that includes clerkship, experience sharing, hands-on skills training, common clinical cases and introduction of the local healthcare system. This is a pre-post quasi-experimental study lasting 1 year, with three assessment time points-at pretraining, immediately after training and 1 month into the participants' HO-ship. The study is currently ongoing and involves 208 participants who attended the course in Malaysia. Participants with known psychiatric illness, working HOs and medical students are excluded. A pretested, self-administered questionnaire that includes baseline sociodemography, adaptation of the International Medical University (IMU) Student Competency Survey and the Depression Anxiety Stress Scale has been adopted, and 1 month follow-up will be conducted by telephone. Data will be analysed using SPSS V.24. The primary outcome is change in confidence level, while the secondary outcomes are changes in the readiness and psychological well-being of the participants.
ETHICS AND DISSEMINATION: This study protocol has received ethics approval from Ethics Committee for Research Involving Human Subjects Universiti Putra Malaysia and the National Medical Research Registry Malaysia. Written informed consent has been obtained from each participant. Results will be disseminated through journals and conferences, especially those involved in medical education specifically looking into the training of medical doctors.
TRIAL REGISTRATION NUMBER: NCT03510195.
DESIGN AND METHODS: Participants were randomly selected using multi-stage sampling methods from three public universities in the study location. Participants completed measures of internet and smartphone addictions, depression, anxiety, stress, and suicidality, along with sociodemographic items.
FINDINGS: At bivariate level, both internet and smartphone addictions were found to have significant positive correlations with depression, anxiety, stress, and suicidality. At multivariate level, only internet addiction emerged as a consistent significant predictor for depression, anxiety, stress, and suicidality.
PRACTICE IMPLICATIONS: The present findings have implications for mental health professionals to routinely screen for psychological disturbance in young adults who have potential risks for internet addiction.
METHODS: Through the Association of Southeast Asian Nations Costs in Oncology study, 1490 newly diagnosed cancer patients were followed-up in Malaysia for 1 year. Health-related quality of life was assessed by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EuroQol-5 (EQ-5D) dimension questionnaires at baseline, 3 and 12 months. Psychological distress was assessed by using Hospital Anxiety and Depression Scale. Data were modeled by using general linear and logistic regressions analyses.
RESULTS: One year after diagnosis, the mean EORTC QLQ-C30 Global Health score of the cancer survivors remained low at 53.0 over 100 (SD 21.4). Fifty-four percent of survivors reported at least moderate levels of anxiety, while 27% had at least moderate levels of depression. Late stage at diagnosis was the strongest predictor of low HRQoL. Increasing age, being married, high-income status, hospital type, presence of comorbidities, and chemotherapy administration were also associated with worse HRQoL. The significant predictors of psychological distress were cancer stage and hospital type.
CONCLUSION: Cancer survivors in this middle-income setting have persistently impaired HRQoL and high levels of psychological distress. Development of a holistic cancer survivorship program addressing wider aspects of well-being is urgently needed in our settings.
METHODS: This was a cross-sectional survey using convenient sampling of 192 RA patients who attended the Rheumatology Clinic outpatient appointment, Hospital Melaka from June 2013 to December 2013. Depression, Anxiety and Stress Scale (DASS21) questionnaire was used to evaluate symptoms of depression, anxiety and stress. RA disease activity was assessed using the DAS28-ESR formula. Functional status was assessed via the Health Assessment Questionnaire Disability Index (HAQ-DI).
RESULTS: Out of 189 completed questionnaires, 46%(n=86) patients reported psychological distress symptoms, and 25%(n=48) experienced more than one negative emotional states. The prevalence of depression, anxiety and stress among our patients were 23.3%(n=44), 42.3%(n=80) and 20.1%(n=38) respectively. There were significant positive correlations (p<0.05) between these psychological symptoms with disease activity, number of tender joints, general health, pain and HAQ score. Age was inversely correlated with depression, anxiety and stress. Higher number of swollen joints correlated positively with depression but not with anxiety and stress. HAQ was the only independent predictor for depression (Odds Ratio [OR]=2.07; 95%CI: 1.19 to 3.61) and anxiety (OR=1.81; 95%CI: 1.1 to 3.0) whilst pain was found to be independent predictor for stress (OR=1.04; 95%CI: 1.0 to 1.1).
CONCLUSION: The incidence of depression and anxiety in our Malaysian sample of RA patient was comparable to that observed in Caucasian populations. Functional status was an independent predictor of depression and anxiety, whereas pain was an independent predictor of stress.
METHODS: This was a descriptive, cross-sectional study of 526 women with GDM. Depressive, anxiety and stress symptoms are defined as the final score in mild to extremely severe risk in the severity rating scale. Data analysis was performed using SPSS v.21, while multiple logistic regression was used to identify predictors of depressive, anxiety and stress symptoms.
RESULTS: Prevalence of anxiety symptoms was highest (39.9%), followed by depressive symptoms (12.5%) and stress symptoms (10.6%) among women with GDM. According to multiple logistic regression analyses, younger age (OR = 0.955, 95% CI = 0.919-0.993), comorbidity with asthma (OR = 2.436, 95% CI = 1.219-4.870) and a family history of depression and anxiety (OR = 4.782, 95% CI = 1.281-17.853) had significant associations with antenatal anxiety symptoms. Being non-Muslim (OR = 2.937, 95% CI = 1.434-6.018) and having a family history of depression and anxiety (OR = 4.706, 95% CI = 1.362-16.254) had significant associations with antenatal depressive symptoms. Furthermore, being non-Muslim (OR = 2.451, 95% CI = 1.273-4.718) had a significant association with antenatal stress symptoms.
CONCLUSIONS: Within a population of women with GDM in Malaysia, those at higher risk of having depressive, anxiety and stress symptoms can be identified from several baseline clinical characteristics. Clinicians should be more alert so that the high-risk patients can be referred earlier for further intervention.
METHODS: A qualitative study was conducted with semi-structured interviews to explore the experiences of suffering of ESRF patients on maintenance dialysis in Malaysia. The results were thematically analyzed.
RESULTS: Nineteen ESRF patients were interviewed. The themes and subthemes were: (I) physical suffering-physical symptoms and functional limitations, (II) psychological suffering-the emotions and thoughts of suffering, (III) social suffering-healthcare-related suffering and burdening of others and (IV) spiritual suffering-the queries of suffering.
CONCLUSIONS: These findings may help healthcare professionals to fill in the gaps in the delivery of best renal palliative care.
METHODS: This study employed cross-sectional, self-reported survey methodology. We used the 6-item Kessler screening scale (K6) to assess psychological distress (cutoff score ≥ 13, range 0-24, with higher scores indicating greater psychological distress). Participants self-reported their perceptions of whether they had been bullied at work and how frequently this occurred. A multivariate logistic regression was conducted with ever bullying and never bullying as dichotomous categories.
RESULTS: There were a total of 5235 participants (62.3% female). Participant ages ranged from 18 to 85, mean ± standard deviation (M ± SD): 33.88 ± 8.83. A total of 2045 (39.1%) participants reported ever being bullied. Of these, 731 (14.0%) reported being subject to at least occasional bullying, while another 194 (3.7%) reported it as a common occurrence. Across all income strata, mean scores for psychological distress were significantly higher for ever bullied employees (M ± SD: 8.69 ± 4.83) compared to those never bullied (M ± SD: 5.75 ± 4.49). Regression analysis indicated significant associations (p
METHODS: In this research work, the systematic review, meta-analysis and meta-regression approaches are used to approximate the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients. The keywords of prevalence, anxiety, stress, depression, psychopathy, mental illness, mental disorder, doctor, physician, nurse, hospital staff, 2019-nCoV, COVID-19, SARS-CoV-2 and Coronaviruses were used for searching the SID, MagIran, IranMedex, IranDoc, ScienceDirect, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases. The search process was conducted in December 2019 to June 2020. In order to amalgamate and analyze the reported results within the collected studies, the random effects model is used. The heterogeneity of the studies is assessed using the I2 index. Lastly, the data analysis is performed within the Comprehensive Meta-Analysis software.
RESULTS: Of the 29 studies with a total sample size of 22,380, 21 papers have reported the prevalence of depression, 23 have reported the prevalence of anxiety, and 9 studies have reported the prevalence of stress. The prevalence of depression is 24.3% (18% CI 18.2-31.6%), the prevalence of anxiety is 25.8% (95% CI 20.5-31.9%), and the prevalence of stress is 45% (95% CI 24.3-67.5%) among the hospitals' Hospital staff caring for the COVID-19 patients. According to the results of meta-regression analysis, with increasing the sample size, the prevalence of depression and anxiety decreased, and this was statistically significant (P stress increased with increasing the sample size, yet this was not statistically significant (P = 0.829).
CONCLUSION: The results of this study clearly demonstrate that the prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients is high. Therefore, the health policy-makers should take measures to control and prevent mental disorders in the Hospital staff.