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Fulltext Assessing the unmet needs among caregivers of children with disabilities at the community-based rehabilitation centres in Selangor

Suriati, S., Sharifah Zainiyah, S.Y., Lye, M.S., Norlijah, O.

Malaysian Journal of Public Health Medicine, 2011;11(2):32-40.
MyJurnal

Caregivers may experience the need for information, social support, a range of services and financial support in caring for children with disabilities. However, some of these needs are unmet. This study aims to determine the perceived unmet needs among caregivers of children with disabilities at the Community-based Rehabilitation centre (CBR). A cross-sectional study was carried out among a total of 337 caregivers, who were recruited from 12 CBR centres in Selangor. The unmet needs were assessed using Family Needs Survey (FNS) questionnaire, which included six subscales of needs such as need for information, social support, community services, explaining to others, financial support and family functioning. Caregivers identified the need for information that the child might receive in the future as their greatest need (94.4%) and the least was the need for getting more counseling or help in getting a job (16.3%). The mean score for the overall unmet needs was 18.67 (SD=7.623). Out of six subscales of FNS, the need for information had the highest rating which was 98.3%, followed by need for social support (93.4%), need for community services (84.0%), need for financial support (79.9%), need for family functioning (61.8%) and need for explaining to others (46.2%). The unmet needs varied within the subscales. Therefore, more effective intervention programs are needed in community-based rehabilitation centres to match or reduce those varied unmet needs in order to allow caregivers to provide better care for their children with disabilities.

Matched MeSH terms: Counseling
Fulltext E-cigarettes: facts and legal status

Sinniah D, Khoo EJ

International e-Journal of Science, Medicine & Education, 2015;9(3):10-19.
MyJurnal

The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Longterm vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.

Matched MeSH terms: Counseling
Fulltext Trends in absenteeism rates following psychological intervention-preliminary results

Saroja KI, Ramphal KG, Kasmini K, Ainsah O, Bakar OC

Singapore Med J, 1999 May;40(5):349-51.
PMID: 10489494

To determine the relationship between absenteeism rates and psychological intervention over a 6-month period in an agency with 334 employees in Klang Valley, Malaysia, which had the highest absenteeism rates.

Matched MeSH terms: Counseling
Fulltext Implementation of MPOWER approach for tobacco control in Malaysia: findings from the Global Adult Tobacco survey (GATs)

Lim Kuang Hock, Heng Pei Pei, Muhammad Fadhli Mohd Yusoff, Teh Chien Huey, Sumarni Mohamad Ghazali, Lim Hui Li, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):144-154.
MyJurnal

Introduction: Tobacco induced illness remains a major contribution to premature death and global burden of dis- eases. The introduction of MPOWER policies by World Health Organization held the value to monitor the imple- mentation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respon- dents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.

Matched MeSH terms: Counseling
Fulltext COVID-19 Pandemic - a review and assessing higher education institution undergraduate student’s mental health

Mohd Amiruddin Mohd Kassim, Pang, Nicholas Tze Ping, Sandi James

Borneo Epidemiology Journal, 2020;1(2):0-0.
MyJurnal

Introduction: The current COVID-19 pandemic has sequelae reverberating around Malaysia, particularly in university students, as Malaysian university students are isolated in their university campuses in semi-quarantine status. This article seeks to review the existing literature on the specialized issue of university student-related psychological sequelae of COVID-19, and seeks to offer some recommendations through the process.
Methods: Existing literature demonstrates that COVID-19 has affected university students psychosocially, with the rate of anxiety and depression markedly increased. There have been significant alterations of lifestyle related to education, in accordance with the new normal, resulting in isolation and feelings of disengagement with education. Moreover, with the current uncertainties regarding their studies and possible financial depression postpandemic, the future is deeply worrying and will adversely affect their mental health.
Results: Quantitatively, recent findings indicate 33.3% of the undergraduates in a higher education institution are noted to be in stress. Therefore, multiple interventions have been implemented; a customized ultra-brief psychological module, an online tele psychiatry hotline (COVID Cares) and tele-counselling, which have received universally positive feedback.
Conclusion: In conclusion, the review demonstrates that undergraduates’ psychological health is an aspect that needs urgent attention as it is not merely limited to the fear of COVID-19, but also related to the social aspects of the pandemic. Multiple interventions have been seen to be efficacious in reducing the psychological sequelae

Matched MeSH terms: Counseling
Fulltext Sleep belief factors among Diploma students in UiTM Sabah

Nowyannie Willie D. Tamsin, Norah Tuah, Mazalan Sarahintu, Herniza Roxanne Marcus

Borneo Akademika, 2019;3(1):20-29.
MyJurnal

University students are known to have different sleeping schedules. Students’ sleep difficulties will affect their health and their performances in studies. Sleep hygiene is a collection of healthy sleep habits that can improve one’s ability to fall asleep and stay asleep. It is considered to be imperative to treat sleep disturbance especially among university students. The aim of this study is to examine the sleep beliefs among the students of UiTM Sabah based on gender and academic performance. This study was conducted on Diploma students between March and July 2018. The respondents were randomly selected from Diploma students of all faculties in UiTM Sabah: Accounting, Business Management, Public Administration, Science, Planting Industry Management, Hotel Management, and Tourism Management. This paper is based on the Sleep Belief Scale questionnaire to assess the sleep hygiene awareness. Questionnaires were distributed using online survey. Findings of this study were analyzed using SPSS statistical software. The result of findings showed that the Sleep Incompatible Behaviours (drinking coffee, taking sleep medication, smoking before sleep) is the highest contributor of the students’ sleep hygiene and therefore it affects the sleep quality. While the Sleep Wake Cycle Behaviours (going to bed & waking up always at the same hour, going to bed two hours earlier than the habitual hour) and Thoughts and Attitude to Sleep (over thinking before sleep, trying to fall asleep without having a sleep sensation)also contributed to the sleep hygiene of the students but not as high as the Sleep Incompatible Behaviours. Based on the results of the findings, the counseling department of UiTM Sabah may organise an education program to create awareness among students about the intervention and prevention strategies as well as the incorrect beliefs about sleep.

Matched MeSH terms: Counseling
Fulltext Use of Adjuvant Endocrine Therapy Among Post-Menopausal Breast Cancer Patients in Malaysia

Saiful Bahri A, Tuan Mahmood TM, Abdul-Aziz SA, Makmor-Bakry M, Mohamed Shah N

Patient Prefer Adherence, 2021;15:227-235.
PMID: 33568899 DOI: 10.2147/PPA.S293029

Context: Globally, breast cancer is the most common cancer affecting women, and adjuvant endocrine therapy (AET) is part of its treatment modality, which improves patients' outcome. However, there are concerns on side effects related to its use, which may affect treatment adherence.
Purpose: This study was conducted to explore attitude and practice on using AET among breast cancer patients in Malaysia.
Patients and Methods: Postmenopausal breast cancer patients on at least 3 months of AET attending the outpatient oncology clinic at a tertiary care hospital were interviewed. Patients underwent in-depth interviews exploring their attitude and practices while on AET using a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using thematic analysis.
Results: There were four main themes for attitude toward the use of AET: 1) benefits of using AET, 2) concerns on taking AET, 3) beliefs on alternative treatment, and 4) beliefs toward the doctor. For practice, six themes were obtained: 1) correct use of AET, 2) appointment adherence, 3) information-seeking behavior, 4) counseling services obtained, 5) experienced side effects of AET, and 6) usage of complementary and alternative medicines.
Conclusion: Several themes concerning attitude and practice of breast cancer patients receiving AET were identified, which may be addressed during treatment consultations in clinical practice.

Matched MeSH terms: Counseling
Fulltext Empowering single mothers through creative group counselling: an effective intervention to improve mental wellbeing

Rafidah Aga Mohd Jaladin, Janet Ann Fernandez, Nur Ain Sumaiyah Abdullah, Adelina Asmawi

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):192-201.
MyJurnal

Introduction: Single parent families, especially, those headed by single mothers are becoming increasingly common around the world especially in Malaysia. Single mothers generally suffer from poorer mental health, job discrimina- tion, abuse and neglect. Hence, they often experience high anxiety, depression, and stress. This calls for research to empower their mental wellbeing. The present study examined the effectiveness of creative group counselling in increasing self-compassion, and decreasing depression, anxiety and stress among single mothers. Methods: A qua- si experimental pre-test post-test design was employed in the study. Research participants consisted of 36 single mothers placed in two experimental and two control groups. The instruments used were Self-Compassion Scale and Depression Anxiety and Stress Scale. A self-compassion module was developed that comprised creative therapeutic activities which was administered to the participants in the experimental groups via a 7-session group counselling programme. Participants in the control groups, on the other hand, took part in guidance activities. Semi structured in- terviews were also performed to gather feedback on the impact of the creative intervention from three single mothers. Results: Findings revealed that creative group counselling successfully increased the level of self-compassion among single mothers. Additionally, the depression, stress and anxiety scores of single mothers were lower after joining the group counselling programme. Furthermore, three themes emerged from the present study which are i) be kind to oneself; ii) mistakes are part of life; and iii) self-transformation. Conclusion: It is evident that the implementation of creative group counselling improves the mental wellbeing of single mothers.

Matched MeSH terms: Counseling
Fulltext Universiti Sains Malaysia (USM) pre-clinical medical students’ guidance and counselling needs questionnaire: a confirmatory factor analysis

Mohd Zarawi Mat Nor, Najib Majdi Yaacob

Malaysian Journal of Medicine and Health Sciences, 2020;16(3):118-123.
MyJurnal

Introduction: The USM Pre-clinical medical students’ guidance and counselling needs questionnaire (USM-MS- GCN-Q) is an English-language guidance and counselling needs questionnaire which was developed specifically for pre-clinical medical students. The aim of this study is to highlight the construct validity of USM-MSGCN-Q among pre-clinical medical students. Methods: In June 2017, a cross-sectional study on 208 pre-clinical medical students was conducted in Universiti Sains Malaysia (USM). This self-administered USM-MSGNC-Q consisted of four constructs and 20 items with a 5-point Likert scale within each item. A confirmatory factor analysis was em- ployed to test the hypothesized measurement model. Results: The final measurement model fitted the data well. The four-factor model initially consisted of 20 items however, it was reduced to 18 items with the goodness of fit indices suggesting good model fit (RMSEA 0.89, GFI .915 and ChiSq/df 2.642). Internal consistency reliability (Cronbach’s alpha) was 0.879 for self-leadership skills, 0.929 for communication skills, 0.871 for learning skills, and 0.870 for psychological coping skills. The overall Cronbach’s value was 0.922. Respective composite reliability values were 0.879,0.952,0.879 and 0.835 while the Average Variance Extracted values were 0.729, 0.911, 0.595 and 0.630. Conclusion: This study has confirmed that self-leadership, communication, learning and psychological coping skills were the components of guidance and counselling needs which influences the effectiveness of guidance and coun- selling sessions with pre-clinical medical students.

Matched MeSH terms: Counseling
Fulltext Perception of patients with type 2 diabetic mellitus towards insulin therapy

Rose A Nain, Rosalin Sulit

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):59-0.
MyJurnal

Introduction: Insulin therapy is one of the prominent treatment methods to regulate the glucose level in blood. However, there are certain patients who refuse to even begin the insulin therapy. It is importance to identify patients’ perception and their acceptance of insulin therapy. Purpose of this study is to determine the perception of patients with Type 2 diabetes mellitus towards insulin therapy. and to identify the differences in perception based on the respondents’ age, gender, occupations and educational level. Methods: This is a quantitative descriptive study and was done in one of diabetic clinic in Kota Kinabalu, involving 50 patients with Type 2 Diabetes Mellitus and was not on insulin therapy. Participants were recruited via purposive convenience sampling. Questionnaires were used as research instrument. Results: Majority of the participants (80%) have negative perceptions towards insulin ther- apy and 84% refused insulin therapy because it would interfere with their working time and routine. Acceptance of insulin therapy among the female patients (Mean = 3.0) was better than the male patients (Mean = 2.8). Patients with high educational level were more positive in accepting insulin therapy (SM > 0.5). Age and occupation factor were categorized as the strong influential factors (SM < 0.5) in determining the patients’ perception towards insulin therapy. The significant mean (mean ± SD) for gender and educational factor showed more than 0.5 hence suggests positive perception in accepting insulin therapy. While, the significant mean (mean ± SD) for age and occupation factor showed less than 0.5 thus suggests negative perception in accepting insulin therapy. Conclusion: Participants have negative perceptions towards insulin therapy and these negative perceptions may possibly deter them from receiving insulin therapy. Appropriate health education and counselling is necessary to help them change their neg- ative perceptions.

Matched MeSH terms: Counseling
Fulltext Haemoglobin Sickle D Punjab: - a case report

Rahimah A, Syahira Lazira O, Siti Hida HM, Faidatul Syazlin AH, Nur Aisyah A, Nik Hafidzah NM, et al.

Med J Malaysia, 2014 Feb;69(1):42-3.
PMID: 24814631 MyJurnal

Haemoglobin S D-Punjab is a rare compound heterozygous haemoglobinopathy characterised by the presence of two β globin gene variants: Β6(GAG→GTG) and Β121(GAA→CAA). These patients' clinical and haematological features mimic haemoglobin S disease. We describe the first case of doubly heterozygous HbSD-Punjab from Malaysia managed with regular blood transfusion at the age of one. This case highlights the propensity for occurrence of rare phenotypes within our multi-ethnic population and emphasises the importance of accurate genotyping to avoid erroneous counselling, and to plan an effective patient management strategy before complication evolves.

Matched MeSH terms: Counseling
A nationwide survey on the knowledge and attitudes of Malaysian optometry students on patients' visual experiences during cataract surgery

Tan CS, Chen AH, Au Eong KG

Ann Acad Med Singap, 2006 Feb;35(2):72-6.
PMID: 16565757

INTRODUCTION: During cataract surgery under regional (retrobulbar, peribulbar or sub- Tenon's) or topical anaesthesia, many patients experience a variety of visual sensations in their operated eye intraoperatively. Between 3% and 16.2% of patients are frightened by their intraoperative visual experiences, which may increase the risk of intraoperative complications and affect patients' satisfaction with the surgery. This study aims to determine optometry students' beliefs and knowledge of visual sensations experienced by patients during cataract surgery under regional and topical anaesthesia.
MATERIALS AND METHODS: A nationwide survey of all Malaysian optometry students using a standardised, self-administered questionnaire.
RESULTS: All 129 optometry students participated in the survey, giving a 100% response rate. Overall, 26.4% and 29.5% of the students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may experience no light perception, while 78.3% and 72.9%, respectively, thought that patients would experience light perception. Many respondents also believed that patients might experience a variety of other visual sensations. Of all respondents, 70.5% and 74.4% of students believed that patients undergoing cataract surgery under regional and topical anaesthesia, respectively, may be frightened by their visual experience and 93.0% and 85.3%, respectively, felt that preoperative counselling might help to alleviate this fear.
CONCLUSION: Many optometry students are aware that patients might encounter a variety of visual sensations during cataract surgery under local anaesthesia. A high proportion of students believe that patients may experience fear as a result of the intraoperative visual sensations and felt that preoperative counselling would be helpful.

Matched MeSH terms: Counseling
Fulltext Analysis of factors in response to rotavirus vaccination counselling in a private paediatric clinic

Kannan Kutty P, Pathmanathan G, Salleh NM

Med J Malaysia, 2010 Jun;65(2):127-32.
PMID: 23756797 MyJurnal

Rotavirus vaccine is available as an optional vaccine in Malaysia. The counselling of optional vaccines is considered an integral part of the health services offered in a private paediatric clinic. While ensuring that all babies are up-todate with their compulsory immunization, counselling of optional vaccines like the rotavirus vaccine could give parents the choice to make an informed decision on the acceptance of this vaccine. Over a period of two years, we counselled the parents regarding diarrhoea caused by rotavirus disease and the rotavirus vaccine. In this study, the factors that were significantly associated with the acceptance of the rotavirus vaccine were the gender of the baby, the mother's age, the mother's occupation, the mode of payment for the vaccine, the number of previous visits to the clinic by the parents, the number of counselling sessions given to the parents and the pre-counselling awareness or knowledge of rotavirus disease and rotavirus vaccine. It is hoped that these findings may assist busy clinicians in their continuous efforts to provide health education and vaccination counselling to the parents of their patients.

Matched MeSH terms: Counseling
The effect of medical education and counselling on treatment adherence and disease severity in patients with acne vulgaris: a non-randomised interventional study

Ling WY, Loo CH, Nurul Shafaril Niza MA, Tan JL, Norazlima MA, Tan WC

Med J Malaysia, 2023 May;78(3):263-269.
PMID: 37271834

INTRODUCTION: Acne vulgaris (AV) is a common inflammatory skin disease affecting adolescents and young adults. It affects one's self-esteem and social relationship. In addition, poor adherence to treatment can cause poor treatment response and disease recurrence. This study aims to determine the effectiveness of medical education and counselling on treatment adherence and disease severity.
METHODS: This is a non-randomised interventional study with age- and treatment- matched control conducted in a tertiary dermatology clinic from July 2021 to June 2022. Patients in the intervention group received a 10 min video presentation on acne, followed by treatment counselling. The adherence rate was determined objectively (pill counting and tube weighing) and subjectively (ECOB questionnaire). The disease severity was assessed using the Comprehensive Acne Severity Scale (CASS) and Global Acne Grading System (GAGS).
RESULTS: A total of 100 patients completed the 12-week study. With intervention, patients have better adherence to topical medication (5% benzoyl peroxide gel: 71% vs 57.9%, p= 0.031; 0.05% tretinoin cream: 58.7% vs 45.4%, p= 0.044) at week 12. However, the intervention program did not improve adherence to oral medication. Overall, with intervention, a significantly higher percentage of improvement in disease severity was noted (47.3% vs. 39.1%, p=0.044). Nonadherence to treatment was attributed mostly to forgetfulness in 54% of the patients, followed by a busy lifestyle (41%) and little knowledge of acne (26%).
CONCLUSION: Patients have significantly better adherence to topical medication with education and counselling. Better adherence to treatment leads to more remarkable disease improvement.

Matched MeSH terms: Counseling
Topical corticosteroid counselling among Malaysian community pharmacists: a qualitative interview study

Nathan AD, Shankar PR, Sreeramareddy CT

BMC Prim Care, 2023 May 25;24(1):119.
PMID: 37231354 DOI: 10.1186/s12875-023-02071-z

BACKGROUND: Topical corticosteroids (TCS) are commonly available in community pharmacies and are used in skin conditions like atopic dermatitis and psoriasis among others. Problems such as overuse, use of potent steroids and steroid phobia have been identified in the use of TCS in the literature. The aim of the study was to obtain community pharmacists (CPs) views regarding factors influencing their counselling of patients about TCS; challenges associated, important problems, the counselling process, shared care with other healthcare professionals, and explore further the findings from the questionnaire-based study.
METHODS: Seven licensed practicing community pharmacists (from the Klang Valley, Malaysia) were interviewed between 23rd September to 14th November 2021. These were CPs participating in the questionnaire study who agreed to be interviewed. NVIVO 11 software was used for data analysis. Codes and themes were generated and agreed on by the researchers.
RESULTS: The major themes identified related to the process mentioned of providing information to patients, the issues addressed by CPs during the counselling (including steroid phobia, overuse of TCS, patients asking for a specific preparation by name), less counselling support material, language barriers, lesser knowledge about certain conditions, information sources used by CPs (material provided by Ministry of Health and Malaysian Pharmacists Association, MIMS) and suggestions to strengthen the quality of counselling (specialization in skin diseases, webinars, shared care models). For patients requesting a particular preparation by name, the pharmacist will decide whether the preparation requested is suitable or suggest an alternative. Steroid phobia was seen more commonly among parents of young children and young patients. MIMS was available as a smartphone application making it easier to use. Advanced training for CPs in the management of skin conditions like that provided for diabetes mellitus can be considered.
CONCLUSIONS: Counselling was conducted while dispensing TCS in the open area of the pharmacy. Challenges to counselling were lack of time, limited counselling materials, and language barriers. Steroid phobia requires attention. Initiatives to strengthen counselling were mentioned by respondents and appear feasible. Further research covering the entire country is required.

Matched MeSH terms: Counseling
Efficacy of mHealth and education-led peer counseling for patients with hypertension and coronary artery disease in Pakistan: study protocol for a double-blinded pragmatic randomized-controlled trial with factorial design

Arshed M, Zakar R, Umer MF, Kiran M, Ullah N, Iftikhar G, et al.

Trials, 2023 Jul 10;24(1):448.
PMID: 37424031 DOI: 10.1186/s13063-023-07472-0

BACKGROUND: Hypertension is a highly relevant public health challenge. Digital interventions may support improving adherence to anti-hypertensive medications and alter health behavior. Therefore, this protocol describes a study that aims to assess the effectiveness of mHealth and educational support through peer counseling (Ed-counselling) to control blood pressure in hypertensive patients when compared to standard care.
METHODS: We chose a double-blinded pragmatic randomized-controlled with factorial design for this investigation. The trial is going to recruit 1648 hypertensive patients with coronary artery disease at the age of 21 to 70 years. All participants will already be on anti-hypertensive medication and own a smartphone. They will be randomized into four groups with each having 412 participants. The first group will only receive standard care; while the second group, in addition to standard care, will receive monthly Ed-counselling (educational booklets with animated infographics and peer counseling); the third group will receive daily written and voice reminders and an education-led video once weekly together with standard care; while the fourth one gets both interventions given to second and third groups respectively. All groups will be followed-up for 1 year (0, 6, and 12 months). The primary outcome will be the change in systolic blood pressure while secondary outcomes include health-related quality of life and changes in medication adherence. For measuring changes in systolic blood pressure (SBP) and adherence scores difference at 0, 6, and 12 months between and within the group, parametric (ANOVA/repeated measure ANOVA) and non-parametric tests (Kruskal-Wallis test/Friedman test) will be used. By using the general estimating equation (GEE) with negative binomial regression, at 12 months, the covariates affecting primary and secondary outcomes will be determined and controlled. The analysis will be intention-to-treat. All the outcomes will be analyzed at 0, 6, and 12 months; however, the final analysis will be at 12 months from baseline.
DISCUSSION: Besides adding up to existing evidence in the literature on the subject, our designed modules using mHealth technology can help in reducing hypertension-related morbidity and mortality in developing countries.

Matched MeSH terms: Counseling
Fulltext Impact of community pharmacy-based educational intervention on patients with hypertension in Western Nepal

Sharma S, Kc B, Alrasheedy AA, Kaundinnyayana A, Khanal A

Australas Med J, 2014;7(7):304-13.
PMID: 25157270 DOI: 10.4066/AMJ.2014.2133

BACKGROUND: There is a paucity of data regarding the feasibility and impact of community pharmacy-based educational interventions on the management of chronic diseases in developing countries.
AIMS: The aim of this study was to establish the feasibility, and to investigate the impact, of community pharmacy-based educational intervention on knowledge, practice, and disease management of patients with hypertension in Western Nepal.
METHOD: A single-cohort pre-/post-intervention study was conducted from August 2012 to April 2013. The participants included in the study were patients diagnosed with hypertension attending a pharmacist-led hypertension clinic. The educational intervention was conducted by pharmacists, was individualised, and consisted of three counselling sessions over a period of six months. The patients' knowledge of hypertension, their practice of lifestyle modification and non-pharmacological approaches concerning hypertension management, and blood pressure were assessed at baseline and again after nine months by using a pre-validated questionnaire.
RESULTS: Fifty patients met the inclusion criteria and were enrolled in the study. The median (IQR) knowledge score changed from 6 (4) to 13 (0) after the intervention (p<0.01) with the median (IQR) practice score changing from 7 (4) to 16 (2) (p<0.01). The mean (SD) systolic BP changed from 150.1 (7.8) to 137.7 (9.9) (p<0.01) and the mean (SD) diastolic BP from 104 (9.5) to 94.5 (7.8) after the intervention (p< 0.01).
CONCLUSION: A simple, educational intervention by community pharmacists had improved patients' disease knowledge, practice, and management of their hypertension. Evidence suggests Nepalese community pharmacists need could play an important role in the management of chronic diseases like hypertension through simple interventions such as providing educational support for patients.

Matched MeSH terms: Counseling
Fulltext Surgical Management of Bulky Mediastinal Metastases in Follicular Thyroid Carcinoma

Adwin Z, Nur A, Suhaimi S, Rahman R

Oman Med J, 2016 Jan;31(1):69-72.
PMID: 26816570 DOI: 10.5001/omj.2016.13

Follicular thyroid adenoma and carcinoma are very common. Benign and malignant lesions are usually indistinguishable from cytology alone and often require confirmatory resection. The spread of follicular carcinoma is usually hematogenous and is treated with surgery and adjuvant radioactive iodine. Very rarely, metastases occur in the mediastinum. Patients usually present with severe compressive symptoms. With proper treatment and follow-up, the prognosis for these type of thyroid malignancies is excellent. In the case presented here, our patient presented to the Universiti Kebangsaan Malaysia Medical Center with a progressively enlarging anterior neck swelling. The swelling had started 10 years before his presentation. We diagnosed him with an advanced thyroid malignancy with bulky mediastinal metastases. After extensive investigations and counseling, we chose to treat the patient with tumor excision and mediastinal metastases resection. Typically, mediastinal resection involves the removal of the sternum and use of an acrylic implant to recreate the sternum. In this case, the sternum and ribs were removed with subsequent myocutaneous flap coverage for the wound defect. Our experience represents an alternative treatment option in cases where implant use is unsuitable.

Matched MeSH terms: Counseling
Outcome of chemotherapy counseling by pharmacists on psychological effects and self esteem among oncology patients in a Government Hospital in Malaysia

Ummavathy P, Sherina MS, Rampal L, Siti Irma Fadhilah I

Med J Malaysia, 2015 Jun;70(3):131-41.
PMID: 26248774 MyJurnal

INTRODUCTION: Chemotherapy is the most common form of treatment among cancer patients. It is also known to cause many physical and psychological side-effects.
OBJECTIVE: This study developed, implemented and evaluated the outcome of a chemotherapy counseling module among oncology patients by pharmacists based on their psychological effects (depression, anxiety) and selfesteem.
METHODS: A randomized, single blind, placebo controlled study was conducted among 162 patients undergoing chemotherapy in a government hospital in Malaysia.
INTERVENTION: Counseling sessions were conducted using the 'Managing Patients on Chemotherapy' module for oncology patients undergoing chemotherapy at each treatment cycle.
OUTCOME: The outcome of repetitive chemotherapy counseling using the module was determined at baseline, first follow-up, second follow-up and third follow-up.
RESULTS: The findings revealed that there was significant improvement in the intervention group as compared to the control group with large effect size on depression (p = 0.001, partial η(2) = 0.394), anxiety (p = 0.001, partial η(2) = 0.232) and self-esteem (p = 0.001, partial η(2) = 0.541).
CONCLUSION: Repetitive counseling using the 'Managing Patients on Chemotherapy' module was found to be effective in improving psychological effects and self-esteem among patients undergoing chemotherapy.

Matched MeSH terms: Counseling
Effectiveness of a developed module in improving quality of life among breast cancer patients undergoing chemotherapy at Institut Kanser Negara

Suhasinee S, Sherina MS, Lekhraj R, Kulanthayan KCM, Ismail SIF, Ummavathy P

Med J Malaysia, 2025 Jan;80(1):72-80.
PMID: 39812432

INTRODUCTION: Cancer is one of the leading causes of morbidity and mortality worldwide. Breast cancer risk has risen due to lifestyle choices and genetic factors. Women with breast cancer symptoms experience lower quality of life (QoL), particularly in psychological and physical domains, compared to healthy women. Several studies reveal that poor QoL among breast cancer patients increases the risk of psychological distress. This study aimed to develop, implement, and evaluate the effectiveness of a counselling module in improving the QoL among breast cancer patients undergoing chemotherapy at the Institut Kanser Negara (IKN).
MATERIALS AND METHODS: A single-blinded Randomized Controlled Clinical Trial was conducted at the IKN between January 2023 and June 2023. The estimated sample size was 120 participants. A sequential numbering system assigned a unique identifier to each participant until a total of 120 participants were recruited, with 60 participants in both the intervention and control groups. The intervention group received chemotherapy counselling using a newly developed module. QoL and depression were assessed at multiple time points using a validated questionnaire. Data were analysed using SPSS version 26, with independent tests and two-way repeated measures ANOVA. A p-value < 0.05 was considered significant, and partial eta squared was used to measure effect size.
RESULT: Overall, in age distribution, the intervention group had the highest percentage of participants in the 41-60 years category (40.0%), whereas the control group had the highest percentage of participants aged ≥61 years (38.3%). The counselling module was effective in improving QoL and depression among participants at baseline and for three consecutive follow-ups following interventions. The QoL showed improvement in all four domains in the intervention group, which were Physical Health (p < 0.001), Psychological (p < 0.001), Social Relationship (p < 0.001), and Environment (p = 0.001). There was also a moderate effect reduction on depression (p < 0.001).
CONCLUSION: The newly developed counselling module was effective in improving the QoL and depression among breast cancer patients. Repetitive counselling sessions by pharmacists, which were conducted during the module implementation, played a key role in ensuring the well-being of breast cancer patients throughout the treatment journey.

Matched MeSH terms: Counseling

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