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Factors limiting deceased organ donation: focus groups' perspective from culturally diverse community

Wong LP

Transplant Proc, 2010 Jun;42(5):1439-44.
PMID: 20620450 DOI: 10.1016/j.transproceed.2009.11.053

BACKGROUND: In-depth understanding of cultural and religious factors limiting organ donation of three ethnic populations (Malay, Chinese, and Indian) in Southeast Asia is lacking. Identification of factors limiting organ donation among these three ethnic groups will provide insights into culturally appropriate strategies to promote acceptance of organ donation in a multiethnic Asian community.
METHODS: A total of 17 focus group discussions (105 participants) were conducted between September and December 2008. Participants were members of the general public aged 18 to 60 years, recruited through convenient sampling around the Klang Valley area of Malaysia.
RESULTS: Although the majority had favorable attitudes toward deceased organ donation and transplantation, a diversity of myths and misinformation were unearthed from the discussions across the ethnic groups. These include perceived religious prohibition, cultural myths and misperceptions, fear of disfigurement, fear of surgery, distrust of the medical system, and family disapproval. Culture and religious beliefs played important prohibitive roles among those opposed to organ donations. There were distinctive ethnic differences in cultural and religious concerns regarding organ donation. Less-educated and rural groups appeared to have more misconceptions than the well-educated and the urban groups.
CONCLUSION: Our findings may assist organ donation and transplantation organizations to reach diverse sociodemographic and ethnic communities with culture-specific information about organ donation. The involvement of community and religious leaders is critical in organ donation requests.

Matched MeSH terms: Ethnic Groups
HPV information needs, educational messages and channel of delivery preferences: views from developing country with multiethnic populations

Wong LP

Vaccine, 2009 Feb 25;27(9):1410-5.
PMID: 19150379 DOI: 10.1016/j.vaccine.2008.12.045

This qualitative study used focus group discussions (FGDs) to evaluate information needed in order to make informed human papillomavirus (HPV) vaccination decision, opinion on the most acceptable public education messages, and channel of delivery in a multiethnic, multicultural and multireligion country. A total of 19 FGDs were conducted among mothers of eligible vaccinees, young women eligible for the vaccine, and men. Messages that carry accurate information about HPV-cervical cancer link, the HPV preventive vaccines and at the same time minimize the stigma of a sexually transmitted infection (STI) vaccine were preferred. Educational messages for future HPV educational intervention were developed and methods to effectively convey to the public the need for HPV vaccination were identified. The findings serve as a basis for future intervention to develop research-based communication materials and strategies.

Matched MeSH terms: Ethnic Groups
Physicians' experiences with HPV vaccine delivery: evidence from developing country with multiethnic populations

Wong LP

Vaccine, 2009 Mar 4;27(10):1622-7.
PMID: 19100803 DOI: 10.1016/j.vaccine.2008.11.107

Physicians' experiences in providing human papillomavirus (HPV) immunization were assessed by mailed questionnaire. Response rate of 41.4% was achieved. Malay Muslim physicians were more likely to agree that cultural sensitivity is an issue when recommending HPV vaccines. Pediatricians and family physicians were more likely to agree that acceptance is better if vaccines were recommended to prevent cervical cancer than to prevent a sexually transmitted disease. Near 70% rated success of HPV vaccines recommendation in their practice as very poor with the majority patients preferred to postpone immunization. Physicians reported cultural disparities in vaccine uptake and perceived high vaccination cost limits its use.

Matched MeSH terms: Ethnic Groups
Young multiethnic women's attitudes toward the HPV vaccine and HPV vaccination

Wong LP

Int J Gynaecol Obstet, 2008 Nov;103(2):131-5.
PMID: 18768178 DOI: 10.1016/j.ijgo.2008.07.005

To investigate the acceptability of the HPV vaccine among a multiethnic sample of young women in Malaysia.

Matched MeSH terms: Ethnic Groups*
Knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in Malaysia's multi-ethnic society: a baseline study

Wong LP

Clin Transplant, 2011 Jan-Feb;25(1):E22-31.
PMID: 20718827 DOI: 10.1111/j.1399-0012.2010.01312.x

Malaysia's organ and tissue donation rates are among the lowest in the world. The study aims to explore the knowledge, attitudes, practices and behaviors regarding deceased organ donation and transplantation in the diverse ethnic communities in the state of Selangor, Malaysia.

Matched MeSH terms: Ethnic Groups/psychology*
Fulltext Information needs, preferred educational messages and channel of delivery, and opinion on strategies to promote organ donation: a multicultural perspective

Wong LP

Singapore Med J, 2010 Oct;51(10):790-5.
PMID: 21103814

INTRODUCTION:
This study assessed the information needs, preferred educational messages and channels of delivery, as well as opinions on strategies to promote organ donation. It aimed to provide insight into a culturally sensitive public education campaign to encourage organ donation in diverse ethnic communities in Asia, namely the Malays, Chinese and Indians.

METHODS:
A total of 17 focus group discussions with 105 participants were conducted between September and December 2008. The participants were members of the general public aged 18 to 60 years, who were recruited through convenient sampling in the Klang Valley area of Malaysia.

RESULTS:
Across ethnic groups, there was a general concern about the mistreatment of the deceased's body in the organ procurement process. The Chinese and Indian participants wanted assurance that the body would be treated with respect and care. The Muslims wanted assurance that the handling of a Muslim's body would follow the rules and regulations of the Islamic faith. The most important information requested by the Muslim participants was whether cadaveric donation is permissible in Islam. A lack of national public education and promotion of organ donation was noted. All the three ethnic groups, especially the Malays, required community and religious leaders for support, encouragement and involvement, as sociocultural influences play a significant role in the willingness to donate organs.

CONCLUSION:
The pronounced ethnic differences in information needs suggest that culturally sensitive public educational messages are required. Organ donation and transplantation organisations should work closely with community and religious organisations to address the sociocultural barriers identified.

Matched MeSH terms: Ethnic Groups
Fulltext A 3-year cross-sectional study on breast cancer among sandakan indigenous women: do they present earlier?

Wong K. H.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):35-35.
MyJurnal

Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.

Matched MeSH terms: Ethnic Groups
Diode laser contact transscleral cyclophotocoagulation for refractory glaucoma in Asian patients

Wong EY, Chew PT, Chee CK, Wong JS

Am J Ophthalmol, 1997 Dec;124(6):797-804.
PMID: 9402826

PURPOSE: To evaluate the effectiveness and safety of diode laser contact transscleral cyclophotocoagulation in Asian patients with refractory glaucoma by lower energy settings with an innovative probe featuring a glass ball tip that focused the laser beam onto the ciliary body.
METHODS: This prospective clinical study included consecutive Asian patients with dark irides and confirmed for glaucoma. Only one eye of each patient was treated. Diode laser contact transscleral cyclophotocoagulation treatment was performed with the center of the probe placed 1.5 mm behind the limbus. About 30 pulses of 810-mm laser radiation (power, 1.8 to 2.0 W; duration, 0.3 to 0.5 second) were applied around the eye. Patients were examined at fixed postoperative intervals. Intraocular pressure levels and postoperative complications were recorded. The relation between patient and disease characteristics, total laser energy delivered, and intraocular pressure effects were analyzed.
RESULTS: Thirty-three patients were studied, with a mean follow-up period of 9.4 months. An average 56% of patients showed a 30% or greater drop in intraocular pressure. About 38% of patients achieved sustained intraocular pressure lowering to below 22 mm Hg at 18 months. Complications were few and included transient hypotony and iritis.
CONCLUSIONS: In Asian patients with refractory glaucoma or painful glaucomatous eyes with poor visual acuity (defined for this study as worse than 20/200), low-energy-setting diode laser contact transscleral cyclophotocoagulation by means of the glass ball probe is relatively effective and safe.

Matched MeSH terms: Ethnic Groups*
An Asian community's perspective on facial profile attractiveness

Soh J, Chew MT, Wong HB

Community Dent Oral Epidemiol, 2007 Feb;35(1):18-24.
PMID: 17244134

To assess the facial profile preferences of laypersons in an Asian community and the influence of age, ethnic and gender on profile selection.

Matched MeSH terms: Ethnic Groups/psychology*
Serum HDL cholesterol and apolipoprotein AI, AII and B levels in Singapore newborns

Saha N, Wong HB

Biol. Neonate, 1987;52(2):93-6.
PMID: 3115319

The mortality from coronary artery disease (CAD) in Indians is more than three times that in the Chinese and Malays of Singapore. Serum total and HDL cholesterol as well as apolipoprotein (Apo) AI, AII and B levels were determined in a group of 349 newborns (cord blood) from both sexes in these three ethnic groups in order to examine if a trend is reflected at birth. Both serum LDL cholesterol and Apo B levels were low in the newborn, while HDL cholesterol and Apo AII levels were almost the same as in adults. Serum Apo AI levels were also low in newborns. No consistent difference as to ethnic group or sex was observed in any of the parameters investigated, except that the females had significantly higher levels of serum Apo AI in all the ethnic groups. Serum total and HDL cholesterol levels in Singapore newborns were comparable to those reported in Caucasians and Asians. The trends of incidence of CAD were not reflected in the lipid profiles studied at birth.

Matched MeSH terms: Ethnic Groups
Heights and weights of a sample of Malaysian children

Tan PC, Wong CL

Med J Malaya, 1969 Sep;24(1):12-7.
PMID: 4243835
Matched MeSH terms: Ethnic Groups
Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients

Daher AM, AlMashoor SA, Winn T

Qual Life Res, 2015 Apr;24(4):951-8.
PMID: 25352036 DOI: 10.1007/s11136-014-0830-5

PURPOSE: To assess the relationship between glycaemic control and quality of life (QoL) among a sample of Malaysians with type 2 diabetes mellitus.

METHODS: This study is a cross-sectional hospital-based study involving 256 patients from three major ethnic groups in Malaysia. Data about QoL were collected with the 18-item Audit of Diabetes Dependent QoL questionnaire. Other data about putative predictors of QoL including personal characteristics and disease-related factors were also collected. Hierarchical multiple linear regression was used to determine factors associated with QoL and to control for confounding variables.

RESULTS: The mean age of participants was 56.79 years. Participants were mostly women, employed and married and had attained secondary education. More than a third of the patients had a disease duration of more than 10 years, and about two-thirds had HbA1c ≥ 6.5 %. Those with desired glycaemic control had poorer QoL than those with less than desired glycaemic control moderated by the use of insulin. Hierarchical multiple linear regression showed that desired glycaemic control (HbA1c), diabetes worry, use of insulin, more than 10 years' duration of diabetes, neuropathy and retinopathy were associated with poor QoL, whereas being satisfied with waiting time for consultation was associated with better QoL.

CONCLUSIONS: The results of this study show that diabetes was associated with negative impact on quality of life. The use of insulin to achieve desired glycaemic control was particularly associated with negative impact on QoL.

Matched MeSH terms: Ethnic Groups
Fulltext Performance of the Malay Audit of Diabetes Dependent Quality of Life-18 and Associates of Quality of Life among Patients with Type 2 Diabetes Mellitus from Major Ethnic Groups of Malaysia

Daher AM, AlMashoor SH, Winn T

PLoS One, 2016;11(10):e0163701.
PMID: 27695086 DOI: 10.1371/journal.pone.0163701

INTRODUCTION: Diabetes Mellitus (DM) is notorious for its metabolic effect, acute and chronic complications and impact on Quality of Life (QoL). Successful intervention to improve QoL necessitates a valid and reliable measurement tool to identify areas of concern to patients with diabetes.
OBJECTIVES: To (1) assess the factor structure of the Malay Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) questionnaire; (2) determine the impact of DM on QoL; and (3) identify areas of concern to patients with type 2 DM from three major ethnic groups in Malaysia.
METHODS: Data was obtained from a cross sectional study involving 256 patients with type 2 DM attending the diabetes clinic of the National University of Malaysia Medical Centre. The Malay version of ADDQoL-18 survey was translated from its English version according to standard guidelines and administered by a trained research assistant. Exploratory Factor Analysis (EFA) with oblimin rotation was used to determine factor structure of the data. Confirmatory Factor Analysis (CFA) was used to confirm the factor structure. Hierarchical liner regression was used to determine factors associated with QoL.
RESULTS: Unforced factor solution yielded two factors for the whole sample. Forced one factor solution was ascertained for the whole sample and for each ethnic group. Loadings ranged between 0.588 and 0.949. Reliability coefficients were all higher than 0.955. CFA showed that the two factor model had better fit statistics. QoL was associated with the use of insulin and desired glycaemic control, longer diabetes duration, worry about diabetes, and diabetes complications.
CONCLUSIONS: The Malay ADDQoL-18 is a valid tool to be used among patients with diabetes from different ethnic groups in Malaysia. The use of insulin to achieve desired glycaemic control had more negative impact on QoL than the use of tablets and/or dietary changes.

Matched MeSH terms: Ethnic Groups
Anterior tooth trauma in eleven-year-old South African children

Hargreaves JA, Matejka JM, Cleaton-Jones PE, Williams S

ASDC J Dent Child, 1995 Sep-Oct;62(5):353-5.
PMID: 8550926

Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.

Matched MeSH terms: Ethnic Groups
Fulltext What do men want from a health screening mobile app? A qualitative study

Teo CH, Ng CJ, White A

PLoS One, 2017;12(1):e0169435.
PMID: 28060953 DOI: 10.1371/journal.pone.0169435

There is a lack of mobile app which aims to improve health screening uptake developed for men. As part of the study to develop an effective mobile app to increase health screening uptake in men, we conducted a needs assessment to find out what do men want from a health screening mobile app. In-depth interviews and focus group discussions were conducted with 31 men from a banking institution in Kuala Lumpur. The participants were purposely sampled according to their job position, age, ethnicity and screening status. The recruitment was stopped once data saturation was achieved. The audio-recorded interviews were transcribed verbatim and analyzed using thematic approach. Three themes emerged from the analysis and they were: content, feature and dissemination. In terms of the content, men wanted the app to provide information regarding health screening and functions that can assess their health; which must be personalized to them and are trustable. The app must have user-friendly features in terms of information delivery, ease of use, attention allocation and social connectivity. For dissemination, men proposed that advertisements, recommendations by health professionals, providing incentive and integrating the app as into existing systems may help to increase the dissemination of the app. This study identified important factors that need to be considered when developing a mobile app to improve health screening uptake. Future studies on mobile app development should elicit users' preference and need in terms of its content, features and dissemination strategies to improve the acceptability and the chance of successful implementation.

Matched MeSH terms: Ethnic Groups
Rhinitis-chronica-tropica: clinical, radiological, histopathological, therapeutic and ethnological studies on Chinese, Indians, Malays and 'others'

Werner R

Med J Malaysia, 1973 Mar;27(3):159-72.
PMID: 4268918
Matched MeSH terms: Ethnic Groups
Structural identification of haemoglobin E in Malayan ethnic groups

Blackwell RQ, Lie-Injo LE, Weng MI

Trop Geogr Med, 1971 Sep;23(3):294-5.
PMID: 5099000
Matched MeSH terms: Ethnic Groups
Pepidase B variants among the Semai, Temuan, Semelai, and Jakun groups of West Malaysian Orang Asli

Welch QB

Hum. Hered., 1973;23(5):482-6.
PMID: 4785876
Matched MeSH terms: Ethnic Groups
Hepatitis B antigen in Kuala Lumpur blood donors

Kamath S, How VJ, Lam SK, Duraisamy G, Lopez CG, Welch Q

Southeast Asian J. Trop. Med. Public Health, 1973 Jun;4(2):159-64.
PMID: 4749067
Matched MeSH terms: Ethnic Groups
Fulltext Burden of Systemic Lupus Erythematosus on Work Productivity and Daily Living Activity: A Cross-Sectional Study Among Malaysian Multi-Ethnic Cohort

Abu Bakar F, Sazliyana Shaharir S, Mohd R, Mohamed Said MS, Rajalingham S, Wei Yen K

Arch Rheumatol, 2020 Jun;35(2):205-213.
PMID: 32851369 DOI: 10.46497/ArchRheumatol.2020.7405

Objectives: This study aims to assess the self-reported work productivity and activity daily living (ADL) impairment among Malaysian patients with systemic lupus erythematosus (SLE) and to examine their associated factors.
Patients and methods: This cross-sectional study included 167 SLE patients (21 males, 146 females; mean age 38.2±9.8 years; range, 20 to 60 years) recruited from the outpatient Rheumatology and Nephrology clinics. Face-to-face interviews were conducted to record patients' socio- demographics (age, sex, ethnicity, marital status, and occupation) and SLE disease characteristics (system involvement, age onset, and presence of organ damage). Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K). Short form 36 (SF-36) was used to determine health-related quality of life (HRQoL) while Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the four domains of absenteeism, presenteeism, overall work productivity, and non-work related ADL impairment. Univariate analyses and multivariable regression analysis examined the association of demographic variables, SLE disease characteristics, and activity with reduced HRQoL and WPAI scores.
Results: The majority of the patients were Malays (59.3%), followed by Chinese (34.7%) and Indian (3.6%) patients. More than two-thirds of the patients reported some degree of impairment in their work productivity and ADL due to the disease. The absenteeism rate was 10.4% in the past one week and their indirect costs were 2,875.17 Malaysian ringgits (US $701.22) in the past seven days. Significant predictors of higher work productivity and ADL impairment scores were higher disease activity, more frequent SLE flares, lupus nephritis, and hematological involvement of SLE. Patients with higher work productivity and ADL impairment scores were also strongly associated with poor QoL. No ethnic disparities of work productivity and ADL impairment were found.
Conclusion: Systemic lupus erythematosus significantly affected the overall productivity in work and non-work related activity in our Malaysian multi-ethnic cohort and both impairments were significantly associated with poor QoL.

Matched MeSH terms: Ethnic Groups

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