Displaying publications 101 - 120 of 780 in total

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  1. Fulltext Biochemical effects of statins on lipid parameters among newly diagnosed dyslipidaemia subjects in primary care
    Meor Fairuz Rizal Meor Anuar Shuhaili, Intan Nureslyna Samsudin, Chew Boon How, Hejar Abdul Rahman, Johnson Stanslas, Shariful Hasan, et al.
    Malaysian Journal of Medicine and Health Sciences, 2018;14(1):7-14.
    MyJurnal
    Introduction: Statins have several pleiotropic effects including its primary effect of lipid lowering that is important to prevent cardiovascular disease (CVD). Subjects often have heterogeneous responses to statin. This study aims to determine the biochemical effects of statins on lipid parameters among newly diagnosed dyslipidaemia subjects.
    Methods: This was a prospective observational study involving 118 newly diagnosed adults with dyslipidaemia from three government health clinics in Selangor, Malaysia. Biochemical analyses including fasting lipid profile [triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and apolipoproteins (apoA1, apoB) were taken at baseline and follow-up after a month on statin.
    Results: Majority of subjects (61.9%) were prescribed with lovastatin, with the rest on simvastatin. At baseline, the median values for all lipid profile parameters (TC, LDL-C, HDL-C) and non-conventional lipid parameters (LDL-C:HDL-C ratio, non-HDL-C, TC:HDL-C ratio, apoB:apoA1 ratio) were deranged except for TG and apoA1. On follow up, all parameters showed median values within the reference range except for HDL-C, non-HDL-C and TC:HDL-C ratio. There was significant difference in the effect of statins on lipid parameters including predictors of cardiovascular risk, simvastatin having better effects.
    Conclusions: Different statins have varying effects on lipid parameters. Simvastatin showed significantly better effects compared to lovastatin. Non-HDL value should be included in the standard lipid profile report given its ease of use and implementation as it’s both a marker of coronary artery disease (CAD) risk stratification as well as an established determinant of goal attainment during therapy.
    Matched MeSH terms: Ambulatory Care Facilities
  2. Assessment of newly developed real-time human respiration carbon dioxide measurement device for management of asthma outside of hospital
    Singh OP, Ahmed IB, Malarvili MB
    Technol Health Care, 2018;26(5):785-794.
    PMID: 30124456 DOI: 10.3233/THC-181288
    BACKGROUND: Assessment of asthma outside of the hospital using a patient independent device is highly in demand due to the limitation of existing devices, which are manual and unreliable if patients are not cooperative.

    OBJECTIVE: The study aims to verify the use of newly developed human respiration, carbon dioxide (CO2) measurement device for the management of asthma outside of the hospital.

    METHOD: The data were collected from 60 subjects aged between 18-35 years via convenience sampling method reported in UTM Health Center using the device. Furthermore, the data were normalized and analyzed using descriptive statistics, t-test, and area (Az) under receiver operating characteristic curve (ROC).

    RESULT: Findings revealed that the normalized mean values of end-tidal carbon dioxide (EtCO2), Hjorth Activity (HA), and respiratory rate (RR) were lower in asthmatic compared with healthy subjects with minimum deviation from the mean. In addition, each parameter was found to significantly differ statistically for asthma and non-asthma with p< 0.05. Furthermore, the Az shows the strong association for the screening of asthma and non-asthma with an average of 0.71 (95% CI: 0.57-0.83), 0.77 (95% CI: 0.64-0.90), and 0.83 (95% CI: 0.73-0.94) for RR, EtCO2, and HA, respectively.

    CONCLUSIONS: This study demonstrates that the newly developed handheld human respiration CO2 measurement device may possibly be used as an effort-independent asthma management method outside of the hospital.
    Matched MeSH terms: Ambulatory Care Facilities
  3. Fulltext Researchers journey in conducting interview on breastfeeding experience among Malay mothers
    Siti Mariam Muda, Nurul Akma Jamil
    International Journal of Care Scholars, 2018;1(2):34-36.
    MyJurnal
    In Malaysia, breastfeeding was dominantly practiced among Malay whose deeply believe in Islam and any decision should abide by Islamic teachings. Existing literature appear to have limited evidence on Malay mothers’ interpretation and construction of this practice. The decision to breastfeed was believed to be influenced by social and cultural context. Therefore, in order to explore life experience of breastfeeding mothers on their beliefs related to religious and sociocultural, qualitative study design was used. A minimal guidance of phenomenological approach adopted as the methodological framework. Semi structured interviews were carried out among 15 mothers whose were recruited from four Maternal and Child Health Clinic in Kuantan using purposive sampling. The experience of researchers thorough out their journey will be shared in terms of challenges; barriers and solution to overcome the concerned that exist while conducting in-depth interview session.
    Matched MeSH terms: Ambulatory Care Facilities
  4. Fulltext Late antenatal booking and its predictors in Lundu district of Sarawak, Malaysia
    Jiee SF, Safii R, Hazmi H
    Int J Public Health Res, 2018;8(2):956-964.
    MyJurnal
    INTRODUCTION: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
    METHODS: This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
    RESULTS: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
    CONCLUSION: Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
    Study site: Maternal and Child Health Clinics, Lundu, Sarawak, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  5. Fulltext Iodine deficiency disorders among pregnant women in Sarawak, Malaysia
    Lim KK, Chan YY, Mahmud NA, Ismail H, Tan BC, Chua BK, et al.
    Int J Public Health Res, 2018;8(2):980-986.
    MyJurnal
    Introduction Iodine deficiency disorders (IDD) during pregnancy may impair the neurological development of the fetus. The aim of this study is to determine the iodine status among pregnant women (PW) in Sarawak after introduction of mandatory universal salt iodisation (USI) for seven years.
    Methods A total of 508 first trimester PW attending government Maternal and Child Health Care clinics in all 11 divisions in Sarawak between 1st April and 15th June 2015 were recruited. Urine samples were obtained and analysed for urinary iodine concentration (UIC) using the modified Sandell-Kolthoff reaction method. For pregnant women, an adequate iodine intake was defined as a median UIC between 150-249 µg/L according to the WHO/UNICEF/ICCIDD’s criterion. For further analyses, the 11 divisions were then combined into 3 regions, namely Northern (Miri, Bintulu, Limbang), Central (Kapit, Mukah, Sibu, Sarikei, Betong) and Southern (Kota Samarahan, Kuching, Sri Aman).
    Results TThe median UIC of the PW in Sarawak was 105.6 µg/L, indicating iodine deficiency. A total of 330 (65.0%) PW had UIC<150 µg/L. In terms of urinary iodine levels by region, the median UIC in Northern, Central and Southern regions were 136.3 µg/L, 85.5 µg/L and 97.4 µg/L respectively. The differences in median UIC between regions were significant. In addition, the Northern region (p = 0.001), Malay/Melanau ethnicity (p = 0.015) and parous parity (p = 0.014) were significantly associated with higher median UIC. No significant association was found for locality, age nor gravida.
    Conclusions This study indicates inadequate iodine status among PW in Sarawak despite seven years of mandatory USI. In fact, the majority of PW appear not to be protected against IDD and its consequences. In future, a comprehensive study should be carried out to determine the levels of iodine in salt at the retail outlets, villages and households in Sarawak.
    Keywords Iodine deficiency disorders - Pregnant women - Mandatory USI - Sarawak
    Matched MeSH terms: Ambulatory Care Facilities
  6. Fulltext Premature ejaculation and quality of life among men attending Klinik Kesihatan Jaya Gading, Kuantan
    Harun Z, Ahmad S
    Int J Public Health Res, 2018;8(1):878-874.
    MyJurnal
    Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
    Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
    Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
    Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
    recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
    Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
    Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  7. Fulltext Barriers in obtaining primary health care services from public clinics by non-citizen labors in Malaysia
    Maryam Sohrabi, Ahmad Farid Osman, Makmor Tumin
    Malaysian Journal of Medical Research, 2018;2(1):52-60.
    MyJurnal
    Non-citizen labors in the country have been found to face difficulties in accessing healthcare services. The study seeks to investigate the existence of barriers in accessing primary healthcare services by non-citizen labors in Malaysia. This study was conducted on 323 non-citizen labors residing in the urban areas of Malaysia, particularly of Johor Bahru and Klang Valley from May to September 2017. Relevant information regarding the personal barriers (language, preference for physician's gender, difficulty taking leave from work), structural barriers (availability of public clinic in residential area, travel time to the public clinic,physician's knowledge and skill) and financial barriers (insurance coverage, fear of losing daily income,transportation costs) on using primary healthcare services at public clinics were obtained. The result of the analysis revealed that the barriers cited by non-citizens to seek primary healthcare in Malaysia were lack of medical insurance protection (75.1%), non-availability of a public clinic in the residential area (38.7%), not receiving the needed or wanted services (21.3%), long travel time to the nearest public clinic (17.3%), language (10.2% of respondents), negative perception about the doctors' knowledge and skills (9.9%), difficulty taking leave (7.8%), fear of losing daily income (7.7%), high transportation cost (3.7%) and different doctor gender preference (2.5%). Therefore, barriers to access healthcare services among noncitizens exist in Malaysia.
    Matched MeSH terms: Ambulatory Care Facilities
  8. Fulltext Usefulness of newly acquired commercial dengue NSI antigen test kit for early detection of dengue in a general practice clinic in Batu Gajah, Perak
    Chan, S.C., Teoh, L.C.
    Asian Journal of Medicine and Health Sciences, 2018;1(1):1-8.
    MyJurnal
    The non-structural protein 1 (NS1) of the dengue viral genome has been found useful for diagnosis of acute dengue infections, being detected from one day and up to 18 days post onset of symptoms (1). Rapid Dengue NS1 antigen test was made available in commercial test kits for private clinics in Perak in 2014. This study aimed to determine the use usefulness of dengue NS1 test kits in suspected dengue cases in a general practice clinic in Perak and the period in which positive test results were obtained after the onset of symptoms. Clinic records of all suspected dengue cases seen in the ten months from October 2014 to July 2015 were traced. Patients’ demographic characteristics, presenting symptoms and the use of One Step Dengue NS1 Antigen test (Avo Diagnostics) were analyzed using SPSS version 17. Seventy one suspected dengue fever cases were seen in the study period, the highest number in July 2015 (25%). Majority were Chinese (80%), female (63%), and aged 40 years and above (51%). Most patients presented with fever (99%), body-ache (51%), gastrointestinal symptoms (51%) and headache (44%). Dengue NS1 antigen test was done in 94% of the suspected cases with 61% testing positive. The majority of the cases presenting one day to five days after onset of symptoms tested positive i.e. 59% (1 day), 90% (2 days), 54% (3-4 days) and 89% (5 days). Using dengue NS1 antigen test, positive results can be obtained as early as one day after the onset of symptoms. This test is a useful tool to aid primary care physicians detect dengue fever early.
    Matched MeSH terms: Ambulatory Care Facilities
  9. Fulltext Prevalence and related factors of depression among healthcare personnel at primary healthcare centers
    Eusof Izzudin MP, Al–Bedri A, Subramaniam V, Matthews P, Cheong AT
    Malaysian Journal of Medicine and Health Sciences, 2018;14(Special 2):32-36.
    MyJurnal
    Depressive disorders are common. As compared to the general population, healthcare personnel are hypothesized to have an above than average risk to develop this condition. The aim of this study is to assess the prevalence of this condition and its contributing factors amongst primary healthcare personnel.
    Methods: A cross-sectional study was conducted by universally sampling 179 primary healthcare personnel at nine primary healthcare centers across Kuala Lumpur and Selangor in May 2015. Depressive symptoms were screened using self-administered Patient Health Questionnaire-9 (PHQ-9) questionnaire. Socio-demographic and work profile data were also assessed.
    Results: 92.7% of the 179 personnel agreed to participate. Near half of the respondents were staff nurses (49%), followed by doctors (22%), assistant medical officers (10%), attendants (10%) and the remaining were pharmacists, dieticians, and laboratory technicians (9%). Depression was found to be present in 38% of the participants with one-third found to have moderate to severe depression. Bivariate analysis show that males (p=0.043), assistant medical officers (p=0.048), and working more than 10 hours per day (p=0.019) are significant risk factors. Further analysis by logistic regression shows that working more than 10 hours per day increases the odds of depression by 3.1 (OR 3.1, 95% CI 1.1-8.7, p=0.03).
    Conclusions: A high prevalence of depression was found within the healthcare personnel population at the primary healthcare centres studied. Being a male, employed as an assistant medical officer, and, prolonged hours at the workplace is a significant risk factor for depression.
    Matched MeSH terms: Ambulatory Care Facilities
  10. Fulltext Mobility and fear of falls measuring tools to predict falls risk among malaysian community dwelling older adults. [Abstract]
    Ajit Singh DK, Ng ES, Ng CP, Ab Rahman NNA, Pannir Selvam SB
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):225-226.
    MyJurnal DOI: 10.17576/JSKM-2018-35
    Falls is a global health issue among older adults. Identifying measuring tools that can predict falls risk among older adults can assist in early falls risk detection and prevention. Best measuring tools that can predict falls risk among Malaysian community dwelling older adults is not known. The objective of our study was to determine if Timed Up and Go (TUG) test and Activities-Specific Balance Confidence (ABC) scale could be used as a falls risk predictor tools among Malaysian community dwelling older adults. Hundred and six (n = 106) community dwelling older adults who were attending Klinik Kesihatan Cheras participated in this cross sectional study. Falls incidence in the past one year was obtained from the participants. TUG test was performed and ABC scale was administered. Data was analysed using binomial logistic regression and receiver operating curves (ROC). The cut off values identified for TUG test and ABC scale were 9.02 seconds (area under the curve, AUC was 0.711; 95% CI 0.577-0.844) and 82.81% (area under the curve, AUC was 0.682; 95% CI 0.562-0.802) respectively. Hence, older adults with a score of above 9.02 seconds for TUG test and a score of below 82.81% for ABC scale were noted to have a higher risk of falls. Results of this study demonstrated that both TUG test (p < 0.001) and ABC scale (p < 0.01) were significant predictors of falls risk. Our study results indicated that both mobility (TUG test) and fear of falls (ABC scale) measuring tools, with the present cut off values can be used to identify community dwelling older adults who are at a higher risk of falls. Identifying older adults with higher risk of falls can assist the health professionals to optimise falls prevention and management approaches.
    Matched MeSH terms: Ambulatory Care Facilities
  11. Fulltext Factors contributing towards high-risk situations in drug relapse. [Faktor-faktor penyumbang kecenderungan situasi berisiko tinggi dalam kalangan penagih dadah berulang di Malaysia]
    Hadijah B, Wan Shahrazad Wan S, Fauziah I, Norulhuda Sarnon K
    Jurnal Psikologi Malaysia, 2018;32(2):26-41.
    The scenario of drug addiction is a chain of threats to individual, families and communities. This is shown through the increasing statistics in addiction relapse causing epidemic to communities. The effects of drug relapse affect individual’s health with problems of comorbidity, psychopathology and psychosocial. After 40 years, Malaysia undertook various efforts in treatment and rehabilitation programs, but these efforts do not indicate success. This situation has led to the study of various factors that contribute towards high-risk situations in drug relapse. Hence this study aims to identify intrapersonal factors consisting of motivation to change and coping strategy as mediator of high-risk situations for drug relapse, which include negative emotions, interpersonal conflict and social pressure. This study employed a cross sectional design which utilized questionnaires administered to 600 clients in the Cure & Care Clinic, Malaysia. The questionnaires used were The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), Brief COPE and the tendency of high risk situation for drug relapse scale. Data were analyzed using multiple regression analysis and PROCESS for SPSS. Results showed significant influences of intrapersonal factors and coping strategies towards high-risk situations for drug relapse. In addition, coping strategy mediated the relationship between motivation to change and the tendency of high-risk situations for drug relapse. These findings should be taken into account in establishing treatment and rehabilitation programs for drug relapse in Malaysia.
    Keywords: motivation to change, coping strategy, addiction relapse, high risk situations, mediator
    Matched MeSH terms: Ambulatory Care Facilities
  12. Fulltext Patient appointment compliance at UKM optometry. [Kepatuhan temujanji oleh pesakit di klinik optometri UKM]
    Hairol MI, Arif N, Mohd Shariffudin SH
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):103-108.
    MyJurnal
    Patient’s appointment compliance refers to the willingness and ability of a patient to attend to their scheduled clinical appointment. Failure to do so have various consequences, especially so for a teaching clinic such as the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM). The percentage of appoinment compliance at the Optometry Clinic was analysed from September to December 2015. Compliance rate was categorised based on clinic type and session, and on patient’s gender and ethnicity. Attendance compliance was around 60% for the Primary Care Clinic. It increased to 70% for patients with vision problems who where referred to specialty clinics i.e. Low Vision and Paediatric Clinics. Clinic day and session did not influence compliance significanly (p > 0.05). Patient’s gender and ethnicity did not influence compliance significantly as well but those of Indian ethnicity consistently showed the lowest appointment compliance rates. A protocol should be developed to increase the rate of patients’ appoinment compliance. This would then maximise productivity of students and clinic staff and optimise the clinic’s resources. The cost of each clinical session could be informed to the patients, even when the cost is not borne by them.
    Keywords: Appointment compliance; Optometry Clinic; appointments; clinical teaching and learning; public health
    Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  13. Fulltext Relationship between serum methadone concentration and cold pressor pain sensitivity in patients undergoing methadone maintenance therapy
    Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, et al.
    Iran J Pharm Res, 2018;17(Suppl):8-16.
    PMID: 29796025
    Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose. Serum methadone concentrations were measured using the Methadone ELISA kit and classified into two categories: < 400 ng/mL and ≥ 400 ng/mL. Eighty-eight patients (59.9%) had trough concentrations of < 400 ng/mL and 40.1% had trough concentrations of ≥ 400 ng/mL. There were significant effects of SMC on the cold pressor pain threshold (p = 0.019). Patients with concentrations < 400 ng/mL had significantly higher (almost 60% higher) cold pressor pain threshold (adjusted mean (95% CI) = 30.15 (24.29, 36.01) s) compared to those with concentrations of ≥ 400 ng/mL (18.93 (11.77, 26.08) seconds). There was also a 20% difference in pain tolerance, and 6% difference in cold pressor pain intensity score, neither of which were significant statistically (p > 0.05). Our results suggest an association of trough methadone concentration with the cold pressor pain threshold among opioid dependent patients on MMT. It would be useful to study the mechanisms underlying this association to help managing pain in such a population.
    Study site: Psychiatric Clinic, Hospital Universiti Sains Malaysia (HUSM); Psychiatric Clinic, Hospital Raja Perempuan Zainab II; and eight other government MMT clinics in Kelantan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  14. Fulltext Patient's decision to disclose the use of traditional and complementary medicine to medical doctor: a descriptive phenomenology study
    Kelak JA, Cheah WL, Safii R
    Evid Based Complement Alternat Med, 2018;2018:4735234.
    PMID: 29636778 DOI: 10.1155/2018/4735234
    Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients.
    Study site: Klinik kesihatan, Kuching, Sarawak, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  15. Fulltext Diabetes self-care and its associated factors among elderly diabetes in primary care
    Ishak NH, Mohd Yusoff SS, Rahman RA, Kadir AA
    J Taibah Univ Med Sci, 2017 Dec;12(6):504-511.
    PMID: 31435286 DOI: 10.1016/j.jtumed.2017.03.008
    OBJECTIVES: Diabetes is a primarily self-manageable condition. Healthcare professionals usually offer education, treatment, and support, but patients themselves are responsible for the daily management of their condition. Increasing the effectiveness of self-management support may have a considerable impact on health care, especially for elderly people. The aim of this study was to describe diabetes self-care among elderly diabetics and to determine its associated factors.
    METHODS: This report describes a cross-sectional study involving 143 elderly diabetes patients in the outpatient department of the Hospital Universiti Sains Malaysia (HUSM). Self-care activities assessed in this study included dietary control, physical activity, self-monitoring of blood glucose, medication adherence, and situational related adherence behaviour, all of which were obtained using the validated Malay Elderly Diabetes Self-Care Questionnaire (MEDSCaQ).
    RESULTS: The mean (±SD) age of the subjects was 67.9 (±5.4) years old. A majority was Malay, with a mean HbA1c of 8.4 (±1.9). The mean diabetes self-care score was 26.5 (±8.0). Factors with a positive impact on diabetes self-care included being non-Malay (β = 5.275, p = 0.002), having family as care givers (β = 8.995, p = 0.004), having a higher level of family support (β = 0.159, p = 0.042), and possessing acceptable (β = 4.375, p = 0.001) or good knowledge of diabetes (β = 5.893, p = 0.004). The presence of neuropathy negatively impacted self-care, while diabetes nephropathy had a positive impact on self care (β = -4.053, p = 0.003).
    CONCLUSIONS: Elderly individuals with type 2 diabetes in HUSM have a moderate score of diabetes self-care practice based on the MEDSCaQ. Determinants for good diabetes self-care include race, social support, having care-takers during periods of illness, diabetes knowledge, and diabetic microvascular complications.
    Study site: outpatient department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  16. Addressing unmet needs of patients with chronic diseases: Impact of the VISIT website during consultations
    Lee YK, Ng CJ, Low WY
    J Eval Clin Pract, 2017 Dec;23(6):1281-1288.
    PMID: 28585242 DOI: 10.1111/jep.12777
    RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations.
    METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT)). Doctors accessed this information via the electronic medical records before consultations. Individual in-depth interviews were then conducted with patients and doctors on the website's impact on consultations. Interviews were transcribed verbatim and analysed thematically.
    RESULTS: The average age (years) was 65.7 for patients (n = 8) and 35.7 for doctors (n = 7). Patients in the study entered between 1 to 6 items in the website. From postconsultation interviews, we found that the website impacted the consultation in 5 ways: (1) It facilitated patients to communicate their full agenda to doctors; (2) it helped address unmet patient needs as it gave them opportunity to raise other issues besides their chronic condition; (3) it facilitated rapport between doctor and patient; (4) it facilitated doctors to organize their consultation around the concerns the patient had listed; and (5) it disrupted the doctor's usual consultation style if the list of concerns was lengthy.
    CONCLUSIONS: Integrating patient concerns into electronic health records helped to facilitate patient-centred consultations. Doctors found this information useful but felt uneasy if the agenda list was too long or too complex. Areas for future studies include training doctors to manage complex agendas and formal evaluation of the VISIT tool.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  17. Assessment of the level of knowledge of colorectal cancer among public at outpatient clinics in Serdang Hospital: a survey based study
    Pan Y, Chieng CY, Haris AAH, Ang SY
    Med J Malaysia, 2017 12;72(6):338-344.
    PMID: 29308770 MyJurnal
    OBJECTIVES: Colorectal cancer (CRC) is one of the most common gastrointestinal cancers in the world. In the Asia- Pacific region, it is the fastest emerging gastrointestinal cancer. Level of awareness on CRC warning signs and risk factors in the rural population of Malaysia is reported of very low. The aim of this study was to assess the level of knowledge of CRC among the public at medical outpatient clinics in Serdang Hospital. The association between sociodemographic factors with level of knowledge among the respondents was further studied.

    STUDY DESIGN: A study was conducted among the non-CRC patients' relatives accompanying their relatives to the medical outpatient clinics in Serdang Hospital from 1st April to 31st August 2016. The study was carried out with cluster sampling method.

    METHODS: The respondents were assessed using validated and modified Cancer Awareness Measures (CAM) questionnaire consists of three parts which are knowledge on warning signs, knowledge on risk factors and sociodemographic factors. All data were analysed using IBM SPSS Statistics 21.0.

    RESULTS: Altogether 308 subjects completed the questionnaires. It was shown high percentage of good knowledge for warning signs and risk factors of CRC among the respondents. A significant association between age groups and level of income with level of knowledge on warning signs was observed.

    CONCLUSIONS: The level of knowledge of CRC among the general public in Serdang Hospital was sufficient. The respondents with higher income or younger age had higher level of knowledge regarding CRC.

    Matched MeSH terms: Ambulatory Care Facilities*
  18. Fulltext Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia
    Jalal TMT, Abdullah S, Wahab FA, Dir S, Naing NN
    Malays J Med Sci, 2017 Dec;24(6):75-82.
    PMID: 29379389 DOI: 10.21315/mjms2017.24.6.9
    Background: One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia.
    Methods: A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment.
    Results: Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study.
    Conclusion: Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.
    Matched MeSH terms: Ambulatory Care Facilities
  19. Fulltext Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia
    Rashid A, Mohd R
    Reprod Health, 2017 Nov 02;14(1):144.
    PMID: 29096646 DOI: 10.1186/s12978-017-0404-4
    BACKGROUND: Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support.
    METHODS: This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support.
    RESULTS: The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%).
    CONCLUSIONS: Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.
    Study site: Antenatal clinics (klinik kesihatan), Pulau Pinang, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  20. An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model
    Toh LS, Lai PSM, Othman S, Wong KT, Low BY, Anderson C
    Res Social Adm Pharm, 2017 11;13(6):1142-1150.
    PMID: 27780658 DOI: 10.1016/j.sapharm.2016.10.004
    OBJECTIVES: This study describes the perspective of patients, nurses, pharmacists, doctors and policy makers to identify the level of collaboration and the areas for improvement to achieve inter-professional collaboration between doctors, nurses, pharmacists and policy makers in a primary care clinic.

    METHODS: Patients (n = 20), Nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) from a primary care were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis informed by constant comparison.

    RESULTS: Patients, doctors, nurses, pharmacists and policy makers were eager for pharmacists to be more proactive in creating health awareness and conducting osteoporosis screening at the primary care clinic via inter-professional collaboration. These findings were further examined using the D'Amour's structural model of collaboration which encompasses four main themes: shared goals and visions, internalization, formalization and governance. This model supports our data which highlights a lack of understanding of the pharmacists' role among the doctors, nurses, policy makers and pharmacists themselves. There is also a lack of governance and formalization, that fosters consensus, leadership, protocol and information exchange. Nonetheless, the stakeholders trust that pharmacists have sufficient knowledge to contribute to the screening of osteoporosis. Our primary care clinic can be described as developing towards an inter-professional collaboration in managing osteoporosis but is still in its early stages.

    CONCLUSIONS: Inter-professional collaboration in osteoporosis management at the primary care level is beginning to be practised. Efforts extending to awareness and acceptance towards the pharmacists' role will be crucial for a successful change.
    Matched MeSH terms: Ambulatory Care Facilities
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