Displaying publications 81 - 100 of 119 in total

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  1. Nicholas Pang, Jiann Lin Loo
    MyJurnal
    Introduction: Global health awareness is sorely lacking in medical curricula and the general public, leading to increasing apathy and decreased levels of volunteerism. Much knowledge about pertinent global health issues is sequestered with academicians and researchers, with little public trickle down. The aim of the study was to increase awareness among Sabahan public about global health issues and promote discussion. Methods: A global health film club was established at community level and discussions about issues and potential individual action points was conducted. Films were screened every month in both UMS and Palliative Care Center Sabah. Global health issues ranging from First World manipulation of HIV/AIDS medication prices, deregulation of medical devices industries, heroin addiction, ADHD drug abuse, and stigma in psychiatry were covered. Public participants’ responses were collected qualitatively. Results: The films largely were well received by participants, with most participants prefer-ring the expose-type films over the more narrative approaches. Films spurred discussion about how foreign or global issues were related to local level, for example unscrupulous sale of medical devices in Malaysian populations and abuse of sleeping medications from local health providers. Also each film screening vastly increased participants’ awareness of pertinent issues, and spurred them to evangelise about said issues to others and take small actions. Conclusion: Global health is a somewhat neglected part of medical and community curricula. Lack of awareness about global health issues reduces the public’s capacity for collective action in exerting pressure on stakeholders, governments, and civil society in taking action. It is hoped such regular global health film screenings at local level brings literacy on urgent public health issues to the people for whom it matters most – the communities where ad-verse global health consequences eventually arise.
    Matched MeSH terms: Palliative Care
  2. Tan SB, Lee YL, Tan SN, Ng TY, Teo YT, Lim PK, et al.
    J Hosp Palliat Nurs, 2020 10;22(5):407-414.
    PMID: 32898385 DOI: 10.1097/NJH.0000000000000678
    Palliative care providers find meaning in their work, even though stress, burnout, and compassion fatigue can be a concern. In this study, we aimed to explore the experiences of well-being of palliative care providers in Malaysia. Data collected using semistructured interviews were thematically analyzed. Eighteen palliative care providers participated: 9 doctors and 9 nurses. Five subthemes were generated: (1) values and strengths, (2) coping and work-life balance, (3) social support and spirituality, (4) passion and satisfaction, and (5) learning, growth, and transformation. These subthemes were further categorized into 2 themes: resilience and reward. The results may inform the development of interventions in the promotion and sustenance of well-being of palliative care providers.
    Matched MeSH terms: Palliative Care
  3. Tan CE, Md Radzniwan R, Khairani O, Ednin H
    Malays Fam Physician, 2011;6(1):26-28.
    PMID: 25606216 MyJurnal
    A 7-year-old boy with a diagnosis of advanced medulloblastoma refractory to treatment was discharged from hospital for further palliative care at home. During this short and eventful period, the child developed spinal cord compression with progressive weakness of upper and lower limbs, neck pain, faecal and urinary incontinence. This case highlights the important roles of a primary care doctor in the provision of palliative care for a child in the community.
    Matched MeSH terms: Palliative Care
  4. Bradley, Sani SFA, Shafiqah ASS, Collins SM, Hugtenburg RP, Rashid HAA, et al.
    Appl Radiat Isot, 2018 Aug;138:65-72.
    PMID: 28427834 DOI: 10.1016/j.apradiso.2017.04.019
    Using tailor-made sub-mm dimension doped-silica fibres, thermoluminescent dosimetric studies have been performed for α-emitting sources of 223RaCl2 (the basis of the Bayer Healthcare product Xofigo®). The use of 223RaCl2 in the palliative treatment of bone metastases resulting from late-stage castration-resistant prostate cancer focuses on its favourable uptake in metabolically active bone metastases. Such treatment benefits from the high linear energy transfer (LET) and associated short path length (<100µm) of the α-particles emitted by 223Ra and its decay progeny. In seeking to provide for in vitro dosimetry of the α-particles originating from the 223Ra decay series, investigation has been made of the TL yield of various forms of Ge-doped SiO2 fibres, including photonic crystal fibre (PCF) collapsed, PCF uncollapsed, flat and single-mode fibres. Irradiations of the fibres were performed at the UK National Physical Laboratory (NPL). Notable features are the considerable sensitivity of the dosimeters and an effective atomic number Zeff approaching that of bone, the glass fibres offering the added advantage of being able to be placed directly into liquid. The outcome of present research is expected to inform development of doped fibre dosimeters of versatile utility, including for applications as detailed herein.
    Matched MeSH terms: Palliative Care
  5. Khairidzan, M.K., Normalina, M., Ismail, M.A., Siraj, H., Nor Azlin, I.M., Zainol, R., et al.
    MyJurnal
    We present a case of a 45-year-old female who presented with blurring of right vision associated with constitutional symptoms. Examinations revealed right optic disc swelling with inferior exudative retinal detachment and hepatomegaly. Gynaecological examination showed a fungating cervical mass. Histopathological reports of cone biopsy confirmed the presence of large B cell non-Hodgkin lymphoma. HIV screening was positive. A diagnosis of HIV related lymphoma was made. Chemotherapy and antiretroviral treatment were instituted. The ocular signs resolved. However, the patient could not tolerate the side effects of medical therapy and opted for palliative treatment.
    Matched MeSH terms: Palliative Care
  6. Taufiq Hidayat, Zahoor Iqbal, Ariffin Nasir, Norsarwany Mohamad, Fahisham Taib
    MyJurnal
    Food is considered as a social responsibility of caregivers to their children. It has cultural connotation for all races notwithstanding their background and religious belief; that social responsibility should not be separated even in terminally ill patients. We recorded a case scenario of a terminally ill child who faced difficult end of life with inability to take oral fluids or food due to mechanical obstruction of duodenum by the pelvic rhabdomyosarcoma. From cultural context, the physical act of giving food and fluids to a sick person is considered “a display of one’s affection”. It is understandable that, once the dying phase has reached, and the body starts to shut down, administering fluids may not be useful despite it is deemed necessary from cultural point of view. This case illustrates an ethical dilemma in managing a child with end stage metastatic disease with multiple systemic complications, compounded with futility of medical care and complex social circumstances. It is quite challenging for physicians and relatives to provide good end of life care to patients in palliative care setting. Ensuring good quality of care, quality of life and quality of death are paramount to avoid suffering and distress among the patients and family members.
    Matched MeSH terms: Palliative Care
  7. Alwi M, Mood MC
    Interv Cardiol Clin, 2013 Jan;2(1):93-113.
    PMID: 28581990 DOI: 10.1016/j.iccl.2012.09.011
    Stenting of patent ductus arteriosus (PDA) is an attractive alternative to the surgical aortopulmonary shunt in the palliation of cyanotic congenital heart disease. However, the diverse morphology of PDA in this setting limits its role, as stenting an overly tortuous duct may not be feasible, and in a significant number of patients, ductus-related pulmonary artery stenosis contraindicates this procedure. The major acute complications are stent migration, thrombosis, and cardiac failure. Early failure of palliation caused by in-stent stenosis is another limitation of this procedure.

    Study site: Institut Jantung Negara (IJN), Kuala Lumpur, Malaysia
    Matched MeSH terms: Palliative Care
  8. Fahisham Taib, Lee, Chee Chan
    MyJurnal
    Palliative care for life limiting conditions usually starts at birth. In neonatal period, planning,
    discussion and goal of care should focus towards improving the baby quality of life. It does not mean
    palliative care in this age group mainly as end of life care. We illustrate a complex 30 weeks baby
    who was born with genetic abnormality complicated with intracranial bleeding and acute myeloid
    leukaemia. There were various ethical issues related to the approach of death and dying infant and
    psychosocial challenges surrounding the case.
    Matched MeSH terms: Palliative Care
  9. Nies YH, Ali AM, Abdullah N, Islahudin F, Shah NM
    Patient Prefer Adherence, 2018;12:1955-1964.
    PMID: 30319245 DOI: 10.2147/PPA.S168638
    Purpose: The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia.
    Participants and methods: Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews.
    Results: Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy.
    Conclusion: Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.

    Study site: two tertiary care hospitals in Malaysia as well as the National Cancer Society Malaysia.

    Matched MeSH terms: Palliative Care
  10. Yip YY, Hwong WY, McCarthy SA, Hassan Chin AA, Woon YL
    J Palliat Care, 2023 Apr;38(2):111-125.
    PMID: 36464769 DOI: 10.1177/08258597221143195
    Background: Addressing timely community palliative care integration is prioritized due to the increased burden of noncommunicable diseases. Objectives: To compare referral-to-death duration among palliative cancer and noncancer patients and to determine its associated factors in a Malaysian community palliative care center. Methods: This retrospective cohort study included decedents referred to a Malaysian community palliative care center between January 2017 and December 2019. Referral-to-death is the interval between the date of community palliative care referral and to date of death. Besides descriptive analyses, negative binomial regression analyses were conducted to identify factors associated with referral-to-death among both groups. Results: Of 4346 patients referred, 86.7% (n  =  3766) and 13.3% (n  =  580) had primary diagnoses of cancer and noncancer respectively. Median referral-to-death was 32 days (interquartile range [IQR]: 12-81) among cancer patients and 19 days (IQR: 7-78) among noncancer patients. The shortest referral-to-death among cancer patients was for liver cancer (median: 22 days; IQR: 8-58.5). Noncancer patients with dementia, heart failure, and multisystem organ failure had the shortest referral-to-death at 14 days. Among cancer patients, longer referral-to-death was associated with women compared to men (IRR: 1.26; 95% CI: 1.16-1.36) and patients 80 to 94 years old compared to those below 50 years old (IRR: 1.19; 95% CI: 1.02-1.38). Cancer patients with analgesics prescribed before or upon referral had 29% fewer palliative care days compared to no prescribing analgesics. In contrast, noncancer patients 50 to 64 years old had shorter referral-to-death compared to those below 50 years old (IRR: 0.51; 95% CI: 0.28-0.91). Conclusion: Shorter referral-to-death among noncancer patients indicated possible access inequities with delayed community palliative care integration. Factors associated with referral-to-death are considered in developing targeted approaches ensuring timely and equitable community palliative care.
    Matched MeSH terms: Palliative Care
  11. Lai CCK, Yaacub YJ, Siow YC, Baharum N
    Med J Malaysia, 2023 Nov;78(6):780-786.
    PMID: 38031221
    INTRODUCTION: Prolonged grief disorder (PGD) is a diagnosis characterised by severe, persistent and disabling grief beyond 6 months post-death of a loved one. The new text revision of DSM-5 (DSM-5-TR) approved a new diagnosis PGD on March 2022. In Malaysia, PGD is not routinely screened in healthcare settings and hence goes untreated. The aim of this study is to identify prevalence and factors related to PGD among bereaved relatives whose loved ones had access to PCU services.

    MATERIALS AND METHODS: A cross-sectional study involving bereaved individuals in Palliative Care Unit Hospital Selayang. Participants (n=175) were recruited through telephone, and a validated tool Prolonged Grief Disorder Scale (PG-13) was asked to identify PGD. Further data collected were concomitant stressors in life and support system in the bereaved individual.

    RESULTS: Prevalence of PGD was 2.9% (n=5), and subthreshold PGD was 4% (n=7). A model of multiple logistic regression calculated most of the traditional risk factors were not significant except having an increased responsibility as a single parent after passing of a spouse or loved one, had 10 times increased odds of PGD (Odds Ratios: 10.93; 95% Confidence Interval: 2.937, 40.661). Otherwise, immediate family support (80%), religion (60%) and community (40%) support were the top three coping mechanisms of our PGD cohort, although they were not significant in a multiple logistic regression model.

    CONCLUSION: Our PGD percentage may not be as high as those of other countries, but nonetheless they exist and their needs are just as important. The authors hope that this paper may create an awareness among the healthcare clinicians about PGD in our society, for a greater access of service to understand them and better public awareness.

    Matched MeSH terms: Palliative Care
  12. Biswal BM, Ruzman N, Ahmad NM, Zakaria A
    Malays J Med Sci, 2000 Jan;7(1):54-9.
    PMID: 22844216 MyJurnal
    Short course hypo-fractionated radiotherapy is a standard regime for the palliation of stage IV head and neck cancers. However few patients respond favorably and require further radiotherapy in curative intent. We have used split-course radiotherapy technique to find out this conversion rate from palliative to curative intent. This was a prospective study conducted from November 1998 to October 1999; twenty-six (26) patients with stage IV head & neck cancers were treated with a hypofractionated regime of radiotherapy. A tumor dose of 30 Gy in 10 fractions [time dose fraction (TDF) 62] over 2 weeks was delivered using a 6 MV linear accelerator. A conventional 2 field or 3 field technique was used. Patients were assessed for the regression of tumor on fifth day, tenth day of radiotherapy and 4 weeks after the completion of radiotherapy. Patients showing complete response and good partial response were allowed to receive further radiotherapy of 30 Gy in 15 fractions [TDF 49]. There were 21 males and 5 females in the study with a median age of 44 years (range 19-77 years). All patients completed the initial regime. Complete responses were observed among 14 patients (54%); partial response in 6 patients (23%), and no response was seen among 6 patients (23%). Sixteen patients (61%) were suitable for radical radiotherapy after phase-I course of the above schedule. Seventeen patients (65%) showed an improvement in the general well being with a better quality of life. One year actuarial survival was (76%), with a median survival time of 12 months. Split-course technique is a useful radiotherapy treatment in stage IV head and neck cancers to distinguish between the subset of patients who would require curative treatment and who would not.
    Matched MeSH terms: Palliative Care
  13. Beng TS, Chin LE
    J Palliat Med, 2010 Aug;13(8):1037-8.
    PMID: 20712471 DOI: 10.1089/jpm.2009.0314
    We present a case of gross lower limb edema in a 21-year-old man with an intra-abdominal malignant fibrous histiocytoma. He had a 1-month history of lower limb edema secondary to inferior vena caval obstruction. His edema failed to respond to a combination of diuretics, oral frusemide 40 mg daily and oral spironolactone 100 mg daily. Subcutaneous drainage of both lower limbs with butterfly needles was performed with minimal improvement. However, he gained significant symptomatic relief with multiple subcutaneous punctures and stoma bag drainage. A total of 12.8 L of serous fluid was drained with this simple and effective method. This is the first report of the use of this method.
    Matched MeSH terms: Palliative Care/methods*
  14. Taye GAWC
    Med J Malaysia, 2006 Oct;61(4):405-9.
    PMID: 17243516
    This survey was intended to gauge the management of pain in palliative cancer patients by the doctors in Melaka Hospital. It also sought to identify possible barriers to adequate pain management among doctors and gauge their response to the adequacy of medical school teaching on cancer pain issues. A 39 item survey was used to cover the issues involved. Overall, the doctors displayed a lack of systematic approach to cancer pain management with inadequate knowledge of analgesia handling. Medical school exposure to cancer pain issues was lacking. Formulation of accepted clinical practice guidelines and new education strategies can improve cancer pain management.
    Matched MeSH terms: Palliative Care*
  15. Lua PL, Salek S, Finlay I, Lloyd-Richards C
    Qual Life Res, 2005 Sep;14(7):1669-81.
    PMID: 16119179 DOI: 10.1007/s11136-005-2817-8
    In terminally-ill patients, effective measurement of health-related quality of life (HRQoL) needs to be done while imposing minimal burden. In an attempt to ensure that routine HRQoL assessment is simple but capable of eliciting adequate information, the McGill Quality of Life Questionnaire-Cardiff Short Form (MQOL-CSF: 8 items) was developed from its original version, the McGill Quality of Life Questionnaire (MQOL: 17 items). Psychometric properties of the MQOL-CSF were then tested in palliative care patients consisting of 55 out-patients, 48 hospice patients and 86 in-patients: The MQOL-CSF had little respondent burden (mean completion time = 3.3 min) and was evaluated as 'very clear' or 'clear' (98.2%), comprehensive (74.5%) and acceptable (96.4%). The internal consistency reliability was moderate to high (Cronbach's alpha = 0.462-0.858) and test-retest reliability (Spearman's r(s)) ranged from 0.512-0.861. Correlation was moderate to strong (0.478-0.725) between items in the short form and their analogous domains in the MQOL. Most MQOL-CSF items showed strong associations with their own domain (r(s) > or = 0.40). Scores from MQOL-CSF significantly differentiated between patients with differing haemoglobin levels (p < 0.05). Construct validity was overall supported by principal component analysis. It is concluded that the MQOL-CSF is a feasible tool with favourable psychometric properties for routine HRQoL assessment in the palliative care population.
    Study site: out-patient palliative care clinic; a hospice centre and hospital inpatient wards, United Kingdom
    Matched MeSH terms: Palliative Care*
  16. Jeremic B, Fidarova E, Sharma V, Faheem M, Ameira AA, Nasr Ben Ammar C, et al.
    Radiother Oncol, 2015 Jul;116(1):21-6.
    PMID: 26163093 DOI: 10.1016/j.radonc.2015.06.017
    To optimize palliation in incurable locally advanced non-small cell lung cancer (NSCLC), the International Atomic Energy Agency conducted a prospective randomized study (NCT00864331) comparing protracted palliative radiotherapy (RT) course with chemotherapy (CHT) followed by short-course palliative RT.
    Matched MeSH terms: Palliative Care*
  17. Syadwa AS, Anita ZB
    Med J Malaysia, 2018 08;73(4):190-196.
    PMID: 30121680 MyJurnal
    AIM: Symptomatic relief following palliative radiotherapy for advanced cancers may take a few weeks up to a few months to achieve. Thus, accurate prognostication is important to avoid harm to these patients with limited lifespan. We conducted a retrospective cohort study to determine the median survival and 30-day mortality (30-DM) and factors associated with these parameters in our centre.

    METHODS: Data from 585 eligible patients who received palliative radiotherapy between January 2012 and December 2014 were analysed. Median overall survival was calculated from the commencement of first fraction of the last course of radiotherapy to date of death or when censored. 30-DM was calculated as the proportion of patients who died within 30 days from treatment start date. Kaplan-Meier survival analysis was used to estimate survival. Chi-square test and logistic regression was used to assess the impact of potential prognostic factors on median survival and 30-DM.

    RESULTS: The most common diagnoses were lung and breast cancers and most common irradiated sites were bone and brain. Median survival and 30-DM were 97 days and 22.7% respectively. Primary cancer, age, treatment course, performance status, systemic treatment post radiotherapy and intended radiotherapy treatment completed had an impact on median survival whereas mainly the latter three factors had an impact on 30-DM.

    CONCLUSION: Median survival and factors affecting both survival and 30-DM in our study are comparable to others. However, a 30-DM rate of 22.7% is significantly higher compared to the literature. We need to better select patients who will benefit from palliative radiotherapy in our centre.

    Matched MeSH terms: Palliative Care/methods*
  18. Chong LA, Khalid F
    Singapore Med J, 2016 Feb;57(2):77-80.
    PMID: 26893078 DOI: 10.11622/smedj.2016032
    There is increased awareness of paediatric palliative care in Malaysia, but no local published data on home care services. We aimed to describe the paediatric experience at Hospis Malaysia, a community-based palliative care provider in Malaysia.
    Matched MeSH terms: Palliative Care/organization & administration*
  19. Lua PL
    PMID: 22754943 DOI: 10.2202/1553-3840.1369
    Although the popularity of complementary indigenous Malay therapies (CIMT) in general healthcare is undeniable in the Malaysian context today, their usage within the palliative care scenarios remains unexplored. Our study was specifically embarked to determine CIMT’s usage pattern, reasons, attitudes, beliefs, perceptions and health-related quality of life (HRQoL) differences (users vs. non-users) in a sample of hospice-based palliative patients in Selangor, Malaysia. From the 39 consenting patients (mean age = 56 years; female = 56.4 percent; Malay = 53.8 percent), 38.5 percent were users of CIMT. Dried medicinal roots, herbs and sea cucumber products were the most preferred types of CIMT (53.3 percent). The most common reason cited for usage was because these were "easier and simpler to be administered" (46.7 percent). Although users' attitudes, beliefs and perceptions were more favourable than the non-users, between 30.0-73.3 percent of users remained unsure or had no knowledge regarding CIMT. They also exhibited significantly poorer Physical Symptoms than the non-users (p=0.006), a probable motive for seeking CIMT in the first place. Despite the small sample size, the findings provided some insight into the role of CIMT especially with regard to usage trends and overall well-being among the terminally-ill, of which healthcare professionals should constantly be vigilant of amidst their routine care responsibilities.
    Matched MeSH terms: Palliative Care/methods*
  20. Haranal M, Mood MC, Leong MC, Febrianti Z, Abdul Latiff H, Samion H, et al.
    Interact Cardiovasc Thorac Surg, 2020 08 01;31(2):221-227.
    PMID: 32437520 DOI: 10.1093/icvts/ivaa069
    OBJECTIVES: This study aims to review our institutional experience of ductal stenting (DS) on the growth of pulmonary arteries (PAs) and surgical outcomes of PA reconstruction in this subset of patients.

    METHODS: This is a retrospective study done in neonates and infants up to 3 months of age with duct-dependent pulmonary circulation who underwent DS from January 2014 to December 2015. Post-stenting PA growth, surgical outcomes of PA reconstruction, post-surgical re-interventions, morbidity and mortality were analysed.

    RESULTS: During the study period, 46 patients underwent successful DS, of whom 38 underwent presurgery catheterization and definite surgery. There was significant growth of PAs in these patients. Biventricular repair was done in 31 patients while 7 had univentricular palliation. Left PA augmentation was required in 13 patients, and 10 required central PA augmentation during surgery. The mean follow-up period post-surgery was 4.5 ± 1.5 years. No significant postoperative complications were seen. No early or follow-up post-surgery mortality was seen. Four patients required re-interventions in the form of left PA stenting based on the echocardiography or computed tomography evidence of significant stenosis.

    CONCLUSIONS: DS provides good short-term palliation and the growth of PAs. However, a significant number of stented patients require reparative procedure on PAs at the time of surgical intervention. Acquired changes in the PAs following DS may be the reason for reintervention following PA reconstruction.

    Matched MeSH terms: Palliative Care/methods*
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