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  1. Fulltext Comparison of Fluvoxamine alone, Fluvoxamine and cognitive psychotherapy and psychotherapy alone in the treatment of panic disorder in Kelantan--implications for management by family doctors
    Azhar MZ
    Med J Malaysia, 2000 Dec;55(4):402-8.
    PMID: 11221150
    This paper reports the result of a brief therapy attempt at treating panic in a busy outpatient psychiatric clinic. The patients were cases of panic referred from the various outpatient clinics within the hospital complex. The patients were divided into three groups at random using one of three modalities of treatment, i.e. cognitive behaviour therapy (CBT), CBT and Fluvoxamine (FVX), and FVX alone. The therapy was aimed for a maximum of nine sessions after which the patients were to be discharged. There were 14 patients in each group. The results show that all the groups were similar in the severity and scores pre treatment but after the different types of treatment there was a significant difference among them. The FVX alone group, showed significant improvement from the pretreatment levels but did not show as much improvement as the other groups and the mean score was only 9.07 after nine sessions. The best group was the CBT in combination with FVX. This indicates that the best way to treat panic is to combine drug treatment and psychological treatment. It is also shown from the study that the combination group requires less FVX than the FVX alone group. This finding has implications for the treatment of panic at the family physician clinic.

    Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia
    Matched MeSH terms: Hospitals, University
  2. Fulltext A case control study on factors that influence depression among the elderly in Kuala Lumpur Hospital and Universiti Kebangsaan Malaysia Hospital
    Salimah O, Rahmah MA, Rosdinom R, Azhar SS
    Med J Malaysia, 2008 Dec;63(5):395-400.
    PMID: 19803299 MyJurnal
    Depressive illness is common among the aged population. A case control study was conducted, focusing on risk factors influencing depression among the elderly. This study involved 130 elderly patients diagnosed to have depressive illness from the psychiatric clinics of Kuala Lumpur Hospital (HKL) and Universiti Kebangsaan Malaysia Hospital (HUKM). Another group of 130 elderly patients with no history of depressive illness were recruited from the medical specialist clinics. The majority of cases were female (75.4%), aged 60-74 years (92.3%) and from Chinese ethnic group (59.2%). Non-Malay elderly has three times risk (AOR 2.537, 95% CI 1.439-4.471) of suffering the depressive illness compared to the Malay elderly, the elderly with chronic health problems are more likely to be depressed compared to those who do not suffer from any chronic illness (p trend <0.001). Other risk factors identified were family history of depression with four times risk (AOR 4.225, 95% CI 2.017-8.848) and lower social support with eight times risk (AOR 7.949, 95% CI 2.588-24.417). Social support is not only important in encouraging the elderly to practice healthy life style but proven to influence the risk of getting depression among them. Hence, it is very crucial that the elderly is given total attention, respect and love from all parties to ensure prosperity and meaningfulness in life.
    Matched MeSH terms: Hospitals, University
  3. Fulltext Factors affecting outpatients’ satisfactionat at University Kebangsaan Malaysia Medical Centre (UKMMC)
    Hasyimah, R., Aniza, I., Ahmad Taufik, J., Jamsiah, M., Azimatun Noor, A.
    Malaysian Journal of Public Health Medicine, 2014;14(2):77-85.
    MyJurnal
    The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
    Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  4. Fulltext Psychometric evaluation of the malay version of the impact of weight on quality of life-lite (IWQOL-LITE) questionnaire
    Mohd Rizal Abdul Manaf, Ahmad Fareed Abdul Rahman Aniza Ismail, Sharifa Ezat Wan Puteh, Azimatunnoor Aizuddin
    Int J Public Health Res, 2018;8(1):950-955.
    MyJurnal
    Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups.
    Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability.
    Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains.
    Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.
    Matched MeSH terms: Hospitals, University
  5. Fulltext Probable carpal tunnel syndrome and its coping strategies among clinical dental support staff in Hospital Universiti Sains Malaysia
    Nurfarah Wahidah Mohd Nor Rasid, Nurul Syafiqah Noh, Munirah Mohd Adnan, Azizah Yusoff
    Archives of Orofacial Sciences, 2016;11(2):31-38.
    MyJurnal
    Prolonged work with highly repetitious flexion and extension of the wrist and forceful grip task were shown to increase the risk of developing carpal tunnel syndrome (CTS) among dental personnel. The present study was carried out to determine the prevalence, risk factors and coping strategies of probable CTS among clinical dental support staff in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted and a set of questionnaire consisting of socio-demographic status, work-related and psychosocial risk factors and coping strategies was distributed. Ninety-five clinical dental support staff completed and returned the questionnaire with a response rate of 80.5%. The prevalence of probable CTS was 38.9%, with the highest prevalence was found among dental surgery assistants (40.5%) followed by dental technologists (29.7%). There was no significant association between work-related or psychosocial risk factors with probable CTS (p>0.05). Most of the respondents with symptoms of CTS chose religion as the coping mechanism; mean 7.11 (SD 1.13). Awareness training should be emphasized among clinical dental support staff on the prevention of CTS.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  6. An evaluation of the agreement between three peak flow meters: Wright's, Miniwright's, and Pocket, when used in children
    Deng CT, Azizi BH
    J Asthma, 1996;33(2):125-30.
    PMID: 8609100 DOI: 10.3109/02770909609054541
    Three peak flow meters (PFM), Wright's, Miniwright's II (MPFM), and Pocket, were evaluated in 50 children in a pediatric outpatient clinic. It was found that there was close agreement between the Pocket and the MPFM as shown by an intraclass correlation (rho) of 0.95. Less agreement was noted between the MPFM and the Pocket, respectively, with the Wright's. It was also noted that the coefficient of correlation (r) was not a suitable test for agreement in this study. Both the Pocket and the MPFM also read higher than the Wright's. We conclude that children should be monitored using the same type of peak flow meter.
    Study site: Pediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  7. Fulltext Psychiatric out-patient's perspectives on medication information given by doctors
    Hatta Sidi, Marhani Midin, Azlin Baharudin
    ASEAN Journal of Psychiatry, 2008;9(1):48-51.
    MyJurnal
    Objective: To investigate patient’s perceived satisfaction and adequacy of information given by doctors on prescribed drugs in an outpatient psychiatric setting.
    Methods: The sampling was done consecutively with a target sample size of 200 patients. A simple questionnaire that was developed with 10 close-ended questions and yes or no answers was administered by the interviewing team. This questionnaire assessed patients' knowledge on prescribed medications and their perception on the adequacy of information given.
    Results: More than 80% of the patients were informed regarding the reasons, timing to take medication(s), duration of drug treatment and type of prescribed drugs. Half of them were informed regarding the side effect profiles of their prescribed medications. Majority of them (80%) were satisfied with the information given despite only 49% of the patients being given adequate information on their medications.
    Conclusion: Patients who are adequately informed about their medications are more significantly satisfied than those inadequately informed. (χ2=4.085, p<0.05).
    Key words: perceived satisfaction, adequacy of information, prescribed psychotropic drug
    Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  8. Fulltext Metabolic syndrome in psychiatric patients with primary psychotic and mood disorders
    Abdul Hamid Abdul Rahman, Holifa Saheera Asmara, Hatta Sidi, Azlin Baharudin
    ASEAN Journal of Psychiatry, 2009;10(2):127-134.
    MyJurnal
    Objective: A study was conducted at the Universiti Kebangsaan Malaysia Medical Center (UKMMC) adult psychiatric clinic from June 2006 to December 2006. The aim was to assess the rate of the metabolic syndrome in a group of outpatients with mood disorders and schizophrenia and also to determine the relationship of this condition with sociodemographic factors and psychiatric illness characteristics.
    Methods: A total of 51 subjects agree to participate of which 100 were approached. The International Diabetes Federation (IDF)(2005) criteria are used for the diagnosis of metabolic syndrome and Diagnostic Statistical Manual Version IV (DSM-IV) criteria are used to made psychiatric diaognosis.
    Results: The prevalence of metabolic syndrome was found to be 37.2% and was significantly higher amongst mood disorders patient. However the metabolic syndrome is not associated with the anti psychotic therapy (p=0.41).
    Conclusion: This study suggests that it is important for the psychiatrist to monitor metabolic syndrome in any of their patients.
    Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  9. Fulltext National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur
    Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A
    Asian Pac J Cancer Prev, 2013;14(5):2991-9.
    PMID: 23803068
    BACKGROUND: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves.
    MATERIALS AND METHODS: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique.
    RESULTS: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%.
    CONCLUSIONS: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.
    Study site: O&G clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  10. Fulltext Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification
    Rizal AM, Aljunid SM, Normalina M, Hanom AF, Chuah KL, Suzainah Y, et al.
    Med J Malaysia, 2003 Aug;58(3):380-6.
    PMID: 14750378
    A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE.
    Matched MeSH terms: Hospitals, University/economics
  11. Fulltext Breast self examination: to do or not to do?
    Leelavathi, M., Yasmin, S.A.K., Gomez, P.A., Aznida, F.A.A.
    Medicine & Health, 2006;1(1):1-4.
    MyJurnal
    This is a retrospective descriptive study done to look at common presentation and method of detection of breast cancer. A total of 366 case records of patients attending the Breast and Endocrine Clinic at Hospital Kuala Lumpur were reviewed. The peak age of breast cancer presentation was 40 to 49 years (39.6%). Most (81.4%) patients presented with a lump in the breast and the lump was mainly self-detected (97.3%). The mean tumour diameter on presentation was 4.7± 3 cm. Medical staff detected the disease in 1.6% cases and 1.1% of cases were detected by mammogram. Most women detected the lump themselves, suggesting that Breast Self Examination (BSE) can be used for detection of the disease in places where there is cost and availability constrains for mammogram. Early detection with BSE can possibly offer better treatment options and quality of life despite the evidence that it does not reduce the mortality due to breast cancer.
     
    Study site: Breast and Endocrine Clinic at Hospital Kuala Lumpur
    Matched MeSH terms: Hospitals, University
  12. Fulltext A comparative study between honey and povidone iodine as dressing solution for Wagner type II diabetic foot ulcers
    Shukrimi A, Sulaiman AR, Halim AY, Azril A
    Med J Malaysia, 2008 Mar;63(1):44-6.
    PMID: 18935732 MyJurnal
    Honey dressing has been used to promote wound healing for years but scanty scientific studies did not provide enough evidences to justify it benefits in the treatment of diabetic foot ulcers. We conducted a prospective study to compare the effect of honey dressing for Wagner's grade-II diabetic foot ulcers with controlled dressing group (povidone iodine followed by normal saline). Surgical debridement and appropriate antibiotics were prescribed in all patients. There were 30 patients age between 31 to 65-years-old (mean of 52.1 years). The mean healing time in the standard dressing group was 15.4 days (range 9-36 days) compared to 14.4 days (range 7-26 days) in the honey group (p < 0.005). In conclusion, ulcer healing was not significantly different in both study groups. Honey dressing is a safe alternative dressing for Wagner grade-II diabetic foot ulcers.
    Matched MeSH terms: Hospitals, University
  13. Fulltext 'I can’t pray' - The spiritual needs of Malaysian Muslim patients suffering from depression
    Ahmad Nabil, M.R., Saini, S.M., Sharip, S., Nasrin, N., Bahari, R.
    International Medical Journal Malaysia, 2016;15(1):103-109.
    MyJurnal
    Introduction: The mainstay of treatment of depression relies on pharmacological and psychological treatments. On top of that, evidence also recognizes the vital role of spirituality for human wellness which leads to growing interest in its utilization to treat depression. However, research on spirituality among Muslims in relation to depression is relatively scarce. The aim of this study is to explore the understanding of spirituality among Muslim patients with depression, and to explore their spiritual needs.
    Methods: This is a qualitative study conducted on 10 depressed Muslim patients at the UKM Medical Centre. Purposive sampling was done to ensure diversity of subjects. Individual in-depth interviews were conducted using semi-structured questionnaire guidelines. The data were transcribed verbatim and analysed using a thematic approach.
    Result: Out of 10 patients, almost all of them expressed spiritual needs. Two major themes emerged in relation to the spiritual needs which are (i) religious needs; need for worship, religious knowledge and guidance, religious reminders, and (ii) existential needs; need for calmness, sensitivity and empathy, self-discipline, certainty, hope , physical help, ventilate and meaning of illness. These needs are essential for patients during the time of crisis.
    Conclusion: The majority of patients expressed spiritual needs which are required during the process of recovery and this provides an opportunity to incorporate spiritual approaches in the treatment of depression. However, more studies are needed to demonstrate its scientific basis and to design an effective psycho-spiritual treatment modality so that the ‘holistic’ or ‘biopsychosocial-spiritual’ treatment can be integrated by health care professionals to those in need.
    Study site: hospital database at the department of psychiatry (in-patient and outpatient), Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  14. Clinical depression while caring for loved ones with breast cancer
    Nik Jaafar NR, Selamat Din SH, Mohamed Saini S, Ahmad SN, Midin M, Sidi H, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S52-9.
    PMID: 23706655 DOI: 10.1016/j.comppsych.2013.03.003
    The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.

    Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia
    Matched MeSH terms: Hospitals, University
  15. Prolonged writing task: comparison of electromyographic analysis of upper trapezius muscle in subjects with or without neck pain
    Leonard JH, Kok KS, Ayiesha R, Das S, Roslizawati N, Vikram M, et al.
    Clin Ter, 2010;161(1):29-33.
    PMID: 20393675
    Work related musculoskeletal disorders represent a serious public health problem as it is a leading cause for disability and absenteeism in workers. The main purpose of the present quasi-experimental study was to compare the muscle activity of the upper trapezius in subjects with neck pain and compare it to those of normal subjects.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Hospitals, University
  16. Understanding of Coronavirus Disease 2019 (COVID-19) and the practice of preventive measures among doctors and nurses in a university teaching hospital- A cross-sectional study
    Ng BH, Low HJ, Nik Nuratiqah NA, Faisal AH, Soo CI, Periyasamy P, et al.
    Med J Malaysia, 2021 07;76(4):454-460.
    PMID: 34305104
    INTRODUCTION: Knowledge and adequate practice of preventive measures among health care workers (HCWs) are important to reduce the risk of COVID-19 transmission.

    METHODS: A cross-sectional study was conducted among doctors and nurses in the medical department in Pusat Perubatan Universiti Kebangsaan Malaysia between November 18, 2020 and December 18, 2020 during the third wave of COVID-19 epidemic in Malaysia. We studied the knowledge and practice of preventive measures of COVID-19 among doctors and nurses in the COVID-19 or sudden acute respiratory infection (SARI) wards and general medical wards. Data was collected using a validated self-designed google form online-questionnaire.

    RESULTS: A total of 407 subjects completed the study and 80.8% were females; 55.8% were aged between 30-39 years; 46.4% were medical doctors. The main source of COVID-19 knowledge was the Ministry of Health Malaysia (MOH) website (35.1%). Majority (97%) had sufficient knowledge and 82% practiced proper preventive measures. Doctors had a higher mean knowledge score compared to nurses (p < 0.001). HCWs working in COVID-19 or SARI wards scored higher in knowledge questions compared to those in the general medical wards (p = 0.020). Nurses practiced better preventive measures (p < 0.001). Good knowledge could not be predicted based on professions (OR: 0.222, 95% CI: 0.048 - 1.028, p = 0.054). Majority were unable to recall the proper steps of donning (85.8%) and doffing (98.5%).

    CONCLUSIONS: Although majority had good knowledge and practiced proper preventive measures, there was a poor recall in donning and doffing steps regardless of place of practice. The MOH website is a useful platform for tailored continuous medical education and regular updates on COVID-19. Regular training and retraining on donning and doffing of PPE is needed to bridge this gap.

    Matched MeSH terms: Hospitals, University/statistics & numerical data
  17. Fulltext Low-glycaemic index diet to improve dietary intake among women with gestational diabetes mellitus
    Nor Azlin, M.I., Zalilah, M.S., Farhanah, A.S., Barakatun Nisak, M.Y.
    Pertanika Journal of Science & Technology, 2017;25(107):31-42.
    MyJurnal
    This study examines the effect of a low glycaemic index (LGI) intervention to improve dietary intake among women with Gestational Diabetes Mellitus (GDM). Women with GDM were randomised to receive either a low GI intervention (LGI; n = 20) or standard nutrition therapy (SNT; n = 20) for a 4-week period. Food Frequency Questionnaire (FFQ) and Three-Day Diet Record assessed the dietary intake and food choices. Dietary intake and food choices of the participants were comparable at baseline. At the end of the study, energy, protein, fat and carbohydrate were reduced in both groups (p < 0.05). In the LGI group, fibre and calcium intake was higher compared with SNT group. More participants in
    the LGI group consumed rice from the low GI varieties, the whole grain breads and the low GI biscuits (p<0.05) compared with participants in the SNT group. The diet GI reduced significantly in the LGI group (50 ± 9 units) compared with the SNT group (57 ± 6) (p < 0.05). Findings showed low GI dietary intervention improved the dietary intake of women with GDM.
    Keywords: Carbohydrate, dietary intake, Gestational Diabetes Mellitus, low glycaemic index
    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  18. Information needs of family members of critically ill patients in intensive care unit of a tertiary hospital
    Noor Siah AA, Ho SE, Jafaar MZ, Choy YC, Das S, Ismail SM, et al.
    Clin Ter, 2012;163(1):63-7.
    PMID: 22362236
    BACKGROUND AND AIMS. The experience in intensive care unit (ICU) has created an intense emotional situation both to patients and their family members. The aim of this study was to determine the family members information needs of critically ill patients in ICU.

    MATERIALS AND METHODS:
    A descriptive cross-sectional study was conducted on 200 family members of patients admitted in ICU. A face to face interview was conducted and a self-report questionnaire of the Critical Care Family Needs Inventory (CCFNI) was used.

    RESULTS:
    Findings reported CCFNI five sub-attributes that ranked from highest to lowest included: support (mean 39.13 ± 6.189); proximity (mean 27.17 ± 3.384); information (mean 24.25 ± 3.093); assurance (mean 22.67 ± 1.862) and comfort (mean 16.24 ± 2.776). There were no significant differences in needs between family members with different gender (p >0.05). However, there were significant differences in support needs between family members with admission to ICU with (t=-2.111; p <0.05). There were significant differences in assurance needs (F=3.542; p <0.05) and information needs (F=3.681; p <0.05) between family members with age. There were no significant differences in needs between family members with different education level (p >0.05) whereas assurance needs were significant differences with education level of (F=3.542; p <0.05).

    CONCLUSION:
    The results suggest that family members perceived support and proximity as the most crucial need. Comfort need was viewed as least important. Although this study was conducted in a tertiary hospital, the findings could still provide insight for nurses to improve the delivery of care to patients and family members.
    Matched MeSH terms: Hospitals, University
  19. Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia
    Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al.
    Dement Geriatr Cogn Disord, 2009;27(3):247-53.
    PMID: 19246909 DOI: 10.1159/000203888
    BACKGROUND/AIMS: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics).
    METHODS: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves.
    RESULTS: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders.
    CONCLUSION: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.
    Study site: Community, neurology and dementia outpatient clinics, Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Hospitals, University
  20. Fulltext Medication-related issues associated with adherence to long-term tyrosine kinase inhibitors for controlling chronic myeloid leukemia: a qualitative study
    Tan BK, Tan SB, Chen LC, Chang KM, Chua SS, Balashanker S, et al.
    Patient Prefer Adherence, 2017;11:1027-1034.
    PMID: 28652712 DOI: 10.2147/PPA.S132894
    PURPOSE: Poor adherence to tyrosine kinase inhibitors (TKIs) could compromise the control of chronic myeloid leukemia (CML) and contributes to poorer survival. Little is known about how medication-related issues affect CML patients' adherence to TKI therapy in Malaysia. This qualitative study aimed to explore these issues.

    PATIENTS AND METHODS: Individual face-to-face, semistructured interviews were conducted at the hematology outpatient clinics of two medical centers in Malaysia from August 2015 to January 2016. CML patients aged ≥18 years who were prescribed a TKI were invited to participate in the study. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.

    RESULTS: Four themes were identified from 18 interviews: 1) concerns about adverse reactions to TKIs, 2) personal beliefs regarding the use of TKIs, 3) mismanagement of TKIs in daily lives, and 4) financial burden in accessing treatment. Participants skipped their TKIs due to ineffective emesis control measures and perceived wastage of medication from vomiting. Participants also modified their TKI therapy due to fear of potential harm from long-term use, and stopped taking their TKIs based on belief in curative claims of traditional medicines and misconception about therapeutic effects of TKIs. Difficulty in integrating the dosing requirements of TKIs into daily lives led to unintentional skipping of doses, as well as the risk of toxicities from inappropriate dosing intervals or food interactions. Furthermore, financial constraints also resulted in delayed initiation of TKIs, missed clinic appointments, and treatment interruptions.

    CONCLUSION: Malaysian CML patients encountered a range of medication-related issues leading to a complex pattern of nonadherence to TKI therapy. Further studies should investigate whether regular contact with patients to improve understanding of treatment rationale, to elicit and address patients' concerns about adverse reactions, and to empower patients with skills to self-manage their medications might promote better adherence to TKIs and improve CML patients' outcome.

    Study site: hematology outpatient clinics of Ampang Hospital (AH) and University Malaya Medical Centre (UMMC) in Malaysia
    Matched MeSH terms: Hospitals, University
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