Adolescents are known to obtain information regarding sexual and reproductive health from a variety of sources and not just during formal lessons in schools. This cross-sectional descriptive study was carried out to determine the source of information on sexual and reproductive health among Form four secondary schools girls in the Klang Valley as well as parents’ relationship profile. A total of 520 secondary school girls were recruited for the study. In this study, the source of information on puberty and sexual topics were categorized as follows: first level of importance - mothers, second level of importance - siblings, third level of importance - fathers, fourth level of importance - friends, fifth level of importance - teachers and sixth level of importance - books/internet. A majority of respondents agreed that their mothers were the first level of importance they sought for information on puberty (74.8%) and sexual topics (53.8%). Thirty nine point three percent (39.3%) of respondents reported it was very easy to have a dialogue with their mothers while only 10.0% of the respondents said it was very easy to have a dialogue with their fathers. While this was the case, only 6.3% of the respondents reported discussing sex-related matter with their mothers.
Introduction: There is increasing awareness of the contribution of perceived social support (PSS) to emotional and physical well-being. Numerous scales measuring PSS have been developed, including the widely used Multidimensional Scale of Perceived Social Support (MSPSS). The psychometric properties of the MSPSS have been demonstrated in diverse samples, however mostly are conducted in English. Malay is the official languange in Malaysia, and this study was conducted to provide evidence of the validity and reliability of a Malay version MSPSS (MSPSS-M) suited for our population.
Methods: This is a cross sectional study. The socio-demographic and clinical information of the selected patients from psychiatric outpatient clinic over a 3-month period, were obtained via pre-designed questionnaire, interviews and medical records. Assessment of psychiatric symptoms and social support were measured by various instruments including the Brief Psychiatric Rating Scale (BPRS-E), Depressive, Anxiety and Stress Scale (DASS) and MSPSS-M.
Results: Data were reported for 228 psychiatric outpatients with the mean age of 40.3 years old. The 3-factor structure of the MSPSS-M (significant others, family, and friends) fitted the data well. The MSPSS-M showed good internal consistency (Cronbach α of 0.89) and validity. The scores of the total subscales for MSPSS-M were negatively correlated with the depression subscale in DASS (P < 0.05). BPRS was negatively correlated with significant others (P < 0.01) compared to the other two subscales in MSPSS-M.
Conclusions: The Malay version MSPSS (MSPSS-M) is a psychometrically valid instrument with high internal consistency, which is useful in assessing perceived social support in Malaysian population.
Study site: psychiatric clinic, University Malaya
Medical Center (UMMC)
Objective: Transition of people with cognitive impairment to nursing home is often an option when their disease progresses and their needs become too complex. The aim of this study was to identify the needs of people with cognitive impairment living in nursing homes and factors associated with higher level of needs.
Methods: A cross sectional survey involving 110 respondents with cognitive impairment aged ≥60 was carried out. Respondents were assessed using the Short Mini Mental State Examination (SMMSE), Camberwell Assessment of Needs for Elderly (CANE), Barthel Index (BI), Friendship Scale (FS), and Geriatric Depression Scale (GDS).
Results: Respondents with cognitive impairment had a mean of 2.81 (SD=3.72) for unmet needs and 11.95 (SD=3.14) for the met needs, with higher mean suggesting a better outcome measure. The most frequent unmet needs were intimate relationships (66.40%), company (40.00%), and daytime activity (34.50%). Unmet needs were significantly associated with depression, social isolation, and cognitive impairment.
Conclusion: Most of the needs of people with cognitive impairment in nursing homes were fulfilled, except in social area. Therefore, attention should be given in improving the care system, which emphasizes collaboration between people with cognitive impairment, family members, community, and government in helping to reduce the risk of loneliness in those with cognitive impairment.
The evaluation of mental health among older adults has become increasingly important in health and social science. Although this has been studied in developed countries, there are also issues for emerging countries, which have aging populations. The aims of this study were to determine the prevalence of loneliness/social isolation and late-life depression among older adults with cognitive impairment living in institutional care. Methods: A cross sectional survey involving residents of four government nursing homes in West Malaysia was carried out. All residents aged 60 years old and above with cognitive impairment were included in the study. Participants were assessed by the Short Mini Mental State Examination (SMMSE), Friendship Scale (FS) and Geriatric Depression Scale (GDS). Results: The prevalence of depression and loneliness/social isolation were 85.5% and 95.5% respectively. Depression was strongly associated with age, education attainment, financial conditions, health, cognitive impairment and loneliness/social isolation. Loneliness/social isolation was strongly associated to depression and relationship satisfaction with children. Conclusion: There was high prevalence of depression and loneliness/social isolation among older adults with cognitive impairment living in institutional care. Depression and loneliness/social isolation are interrelated and influence each other and these problems need to be addressed to improve their quality of life.
Device, Questionnaire & Scale: Mini Mental State Examination (MMSE-12); Friendship Scale (FS); Geriatric Depression Scale (GDS-15)
Smoking among rural adolescents in Malaysia is on the rise with a significant difference seen between urban and rural youths. Therefore, this study was carried out to determine a predictive model of smoking among the rural-school adolescents population in Malacca, Malaysia. An unmatched case-control study was conducted in 2010 involving 484 cases and 444 controls of Form Two students in Malacca, Malaysia, using cluster sampling. Smoking was the dependent factor of this study while the independent factors were individual, family, school and environment. Data were obtained through a self-administered questionnaire. The response rate of the study was 100% whereas the smoking prevalence was 20.9%. Binary logistic regression was used to determine the smoking predictive model. Strong predictors of smoking behaviour were: influenced by artistes who smoke (Adjusted OR=8.67, 95% CI 5.53-13.58); the male gender (Adjusted OR=6.7, 95% CI 4.14-10.83); Muslim (Adjusted OR=4.46, 95% CI 2.36-8.44); and the belief that smoking is not dangerous when the teacher is seen smoking as well (Adjusted OR=3.95, 95% CI 2.19-7.10). Other predictors were: being offered cigarettes by friends (Adjusted OR=2.81, 95% CI 1.79-4.42); the belief that smoking will relax the mind (Adjusted OR=2.45, 95% CI 1.33-4.51); having friends who smoke (Adjusted OR=2.32, 95% CI 1.29-4.81); forced by friends to smoke (Adjusted OR=2.17, 95% CI 1.15-4.12); have heard of the national No-Smoking Campaign (Adjusted OR=1.89, 95% CI 1.06-3.37); have problems with the school management (Adjusted OR=1.75, 95% CI 1.07-2.88); parental consent to watch sexual activities, drug use or violence on television or at the cinema (Adjusted OR=1.73, 95% CI 1.06-2.83); and have lunch in school (Adjusted OR=1.58, 95% CI 1.04-2.41). This paper ends with the recognition of the need for intervention in dismantling the predictors that can lead to the development of smoking among Malaysian adolescents in rural schools. of different pathological entities.
The objectives were to assess the prevalence, severity, the psychological and social impacts of fluorosis among school children and their parents in the Kuala Pilah area, Negeri Sembilan, Malaysia. Methods: A convenience sample of 431 students aged 16-17 years old from 3 secondary schools in Kuala Pilah, Negeri Sembilan were selected. The students were assessed for presence of dental fluorosis using Dean’s Index and to assess impacts. Questionnaires were administered to all the dental fluorosis students and selected matched students with no fluorosis. They constituted a control group for the case control study. Questionnaires were sent to the parents of dental fluorosis and control non fluorosis cases. Results: The prevalence of dental fluorosis was 27.8%; 82% of the fluorosis cases were questionable to mild and 18% moderate to severe fluorosis. 16.1% of students with dental fluorosis and 8.5% of non-fluorosis students had psychological impacts. 12.8% of the parents of children with fluorosis reported that their child had an impact. More girls with fluorosis (35.7%) had psychological impacts compared than boys (25.0%). In the 16.1% of fluorosis cases who had psychological impacts, difficulty smiling and showing teeth, affected 35.7% of girls and 25 % of boys. The percentage of students with dental fluorosis who had psychological impacts on carrying out school work was 2.7%, and 3.6% had impacts related to going out with friends. Conclusions: There were considerable psychological impacts on smiling and showing teeth among Malaysian teenagers with dental fluorosis and some of their parents were concerned about the fluorosis. But the impacts were mild and do not have a major impact on students’ lives. Dental fluorosis is not aesthetically displeasing to most subjects but does have psychological and social impacts on a small percentage with fluorosis.
The objective of this study was to evaluate consumers' perceptions regarding "modern medicines" in Penang, Malaysia. To conduct this exploratory study, qualitative techniques were used. Consumers more than 19 years of age and could speak English, who had visited a pharmacy in the last 30 days, were included from the four major areas of Penang. Eighteen interviews were conducted until the point of saturation. The interviews were audio-taped and then transcribed verbatim for thematic content analysis. Many consumers correctly identified the major characteristics and properties of modern medicines; however, others raised doubts regarding the safety, quality and efficacy of "modern medicines". There were many misconceptions such as "all modern medicines can cause dependence", traditional medicines are completely "free of side-effects" and "Western medicines cure while Chinese medicines don't". Color was also considered a strong determinant of the safety and characteristics of a medicine. Regarding consumers' "medicine information seeking behavior", many consumers would seek information from doctors and pharmacists; however, there were others, who would look for books, or get it from the internet and friends. Of concern many consumers emphasized that while "self-searching for drug information" they would only look for side-effects. Misconceptions regarding medicine-taking behavior, medicine use and compliance were also identified. Though several consumers complied with the medicine-taking instructions, many reported that they would stop taking medicines, once they feel better. Though many consumers correctly identified the characteristics of "modern medicines", misconceptions regarding "medicine information sources and "medicine-taking behavior" were rampant. The situation demands corrective actions including community-oriented educational campaigns to improve "medicine use" in the society.
Use of instruments or questionnaires in different cultural settings without proper validation can result in inaccurate results. Issues like reliability, validity, feasibility and acceptability should be considered in the use of an instrument. The study aims to determine the usefulness of the CIS-R Malay version in detecting common mental health problems specifically to establish the validity. The CIS-R instrument (PROQSY* format) was translated through the back translation process into Malay. Inter rater reliability was established for raters who were medical students. Cases and controls for the study were psychiatric in patients, out patient and relatives or friends accompanying the patients to the clinic or visiting the inpatients. The Malay version of CIS-R was administered to all cases and controls. All cases and controls involved in the study were rated by psychiatrists for psychiatric morbidity using the SCID as a guideline. Specificity and sensitivity of the CIS-R to the assessment by the psychiatrist were determined. The Malay version of CIS-R showed 100% sensitivity and 96.15% specificity at a cut off score of 9. The CIS-R can be a useful instrument for clinical and research use in the Malaysian population for diagnosing common mental disorders like depression and anxiety.
Globally, HIV/AIDS-related stigma and discriminatory attitudes deter the effectiveness of HIV prevention and care programs. This study investigated the general public's perceptions about HIV/AIDS-related stigma and discrimination towards people living with or affected by HIV/AIDS in order to understand the root of HIV/AIDS-related stigma and discriminatory attitudes. Study was carried out using qualitative focus group discussions (FGD). An interview guide with semi-structured questions was used. Participants were members of the public in Malaysia. Purposive sampling was adopted for recruitment of participants. A total 14 focus group discussions (n = 74) was carried out between March and July 2008. HIV/AIDS-related stigma and discrimination towards people living with HIV/AIDS (PLWHA) was profound. Key factors affecting discriminatory attitudes included high-risk taking behavior, individuals related to stigmatized identities, sources of HIV infection, stage of the disease, and relationship with an infected person. Other factors that influence attitudes toward PLWHA include ethnicity and urban-rural locality. Malay participants were less likely than other ethnic groups to perceive no stigmatization if their spouses were HIV positive. HIV/AIDS-related stigma and discrimination were stronger among participants in rural settings. The differences indicate attitudes toward PLWHA are influenced by cultural differences.
BACKGROUND:
Illicit cigarette consumption has increased worldwide. It is important to understand this problem thoroughly.
OBJECTIVES:
To investigate behaviours and factors associated with illicit cigarette consumption in southern Thailand.
DESIGN:
A survey and qualitative study were conducted in a border province in southern Thailand next to Malaysia. A modified snowballing technique was used to recruit 300 illicit and 150 non-illicit cigarette smokers. A questionnaire was used to interview subjects. Illicit cigarette packs were obtained in order to identify their characteristics. Bivariate and multivariate logistic regression was used for data analysis.
RESULTS:
Smoking of illicit cigarettes has become accepted in the communities. They were available in supermarkets and vendor shops. Friends and other illicit smokers known by illicit cigarette smokers were an important source of information for access to illicit cigarette products. The main factors associated with smoking illicit cigarettes, compared with smoking non-illicit cigarettes, were younger age, higher education and higher average monthly expenditure on cigarettes (most illicit smokers smoked illicit cigarettes (average price per packet = 33 THB (US$1.1), while most non-illicit smokers smoked hand-rolled cigarettes (average price per packet = 7 THB (US$0.2)) and knowledge of other illicit cigarette smokers. The low price of illicit cigarettes was the main reason for their use. Selling strategies included sale of singles, sale in shops and direct sale through social networking.
CONCLUSIONS:
Illicit cigarette consumption has become more acceptable especially among young adult smokers. Age and extent of social networks are important factors associated with smoking illicit cigarettes.
KEYWORDS:
Smoking behaviour; border province; cessation; cigarette consumption; global health; hand-rolled/RYO tobacco; health services; illegal tobacco products; illicit cigarette