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Fulltext Psychometric properties of the malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a sample of Malaysian adults attending a health care facility

Subramaniam K, Low WY, Chinna K, Chin KF, Krishnaswamy S

Malays J Med Sci, 2017 Aug;24(4):64-73.
PMID: 28951691 MyJurnal DOI: 10.21315/mjms2017.24.4.8

OBJECTIVE: This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults.
METHOD: The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency.
RESULTS: The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit χ(2)/df = 2.129, TLI = 0.908, CFI = 0.918, RMSEA = 0.053 (90%CI = 0.048-0.058), close-fit P-value = 0.136 and satisfactory internal consistency of 0.914 for emotional eating scale, 0.819 for external eating scale and 0.856 for restrained eating scale.
DISCUSSION: The Malay version of the DEBQ is a valid instrument to study eating behaviour traits among Malaysian adults. Further research is warranted to determine if Items 14 and 27 are appropriate for the Malaysian population.
Study site: Pharmacy, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Work Ability and Its Related Factors Among Workers in Small and Medium Enterprises: Comparison Among Four ASEAN Countries

Kaewboonchoo O, Isahak M, Susilowati I, Phuong TN, Morioka I, Harncharoen K, et al.

Asia Pac J Public Health, 2016 Jul;28(5):438-49.
PMID: 27273897 DOI: 10.1177/1010539516651957

Work ability is related to many factors that might influence one's capacity to work. This study aimed to examine the work ability and its related factors among small and medium enterprises (SME) workers in 4 Association of Southeast Asian Nations (ASEAN) countries. The participants in this study included 2098 workers from food and textile industries in Indonesia, Malaysia, Thailand, and Vietnam. A cross-sectional survey of anonymous self-administrated questionnaire was designed to collect information on sociodemographic factors, work environment and ergonomic condition, musculoskeletal disorders, and work ability. Bivariate correlation coefficient and multiple linear regression analyses were used to predict the work ability. Results of this study confirm that work ability in 4 ASEAN countries was similar to that in European countries, and that the sociodemographic factors, work environment and ergonomic condition, and musculoskeletal disorder (MSD) were associated with work ability. These factors are important for considering occupational health and safety policy to promote work ability in food, textile, and other SME workers.
Access to safe legal abortion in Malaysia: women's insights and health sector response

Low WY, Tong WT, Wong YL, Jegasothy R, Choong SP

Asia Pac J Public Health, 2015 Jan;27(1):33-7.
PMID: 25452590 DOI: 10.1177/1010539514562275

Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers.
Factor Structure of Hospital Anxiety and Depression Scale in Malaysian patients with coronary artery disease

Kaur S, Zainal NZ, Low WY, Ramasamy R, Sidhu JS

Asia Pac J Public Health, 2015 May;27(4):450-60.
PMID: 24807887 DOI: 10.1177/1010539514533719

The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument used to determine the levels of anxiety and depression experienced by a patient and has been extensively used in patients with coronary artery disease (CAD). This study aimed to establish the factor structure of HADS in a Malaysian sample of 189 patients with CAD. Factor analysis of HADS using principal component analysis with varimax rotation yielded 3 factors. Confirmatory factor analysis supported the use of HADS in assessing 3 distinct dimensions of psychological distress--namely, anxiety, anhedonia, and psychomotor retardation. The HADS showed good internal consistency and was found to be a valid measure of psychological distress among Malaysian patients with CAD. However, low mean scores on the original 2 factors--that is, anxiety and depression--and also on the 2 depression subscales--anhedonia and psychomotor retardation--suggests that the recommended cutoff score to screen for psychological distress among CAD patients be reevaluated. Further research to determine the generalizability and consistency for the tridimensional structure of the HADS in Malaysia is recommended.
Trend and impact of international collaboration in clinical medicine papers published in Malaysia

Low WY, Ng KH, Kabir MA, Koh AP, Sinnasamy J

Scientometrics, 2014;98:1521-1533.
PMID: 24465065

Research collaboration is the way forward in order to improve quality and impact of its research findings. International research collaboration has resulted in international co-authorship in scientific communications and publications. This study highlights the collaborating research and authorship trend in clinical medicine in Malaysia from 2001 to 2010. Malaysian-based author affiliation in the Web of Science (Science Citation Index Expanded) and clinical medicine journals (n = 999) and articles (n = 3951) as of 30th Oct 2011 were downloaded. Types of document analyzed were articles and reviews, and impact factors (IF) in the 2010 Journal Citation Report Science Edition were taken to access the quality of the articles. The number of publications in clinical medicine increased from 4.5 % (n = 178) in 2001 to 23.9 % (n = 944) in 2010. The top three contributors in the subject categories are Pharmacology and Pharmacy (13.9 %), General and Internal Medicine (13.6 %) and Tropical Medicine (7.3 %). By journal tier system: Tier 1 (18.7 %, n = 738), Tier 2 (22.5 %, n = 888), Tier 3 (29.6 %, n = 1170), Tier 4 (27.2 %, n = 1074), and journals without IF (2.1 %, n = 81). University of Malaya was the most productive. Local collaborators accounted for 60.3 % and international collaborations 39.7 %. Articles with international collaborations appeared in journals with higher journal IFs than those without international collaboration. They were also cited more significantly than articles without international collaborations. Citations, impact factor and journal tiers were significantly associated with international collaboration in Malaysia's clinical medicine publications. Malaysia has achieved a significant number of ISI publications in clinical medicine participation in international collaboration.
Fulltext Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings

Tong SF, Low WY, Ismail SB, Trevena L, Wilcock S

Transl Androl Urol, 2013 Dec;2(4):281-90.
PMID: 26816741 DOI: 10.3978/j.issn.2223-4683.2013.09.14

BACKGROUND: Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men.
METHODS: This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated.
RESULTS: 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010).
CONCLUSIONS: Whilst sexual health inquiry should be initiated in an appropriate context, 'perceived receptivity' to sexual health inquiry significantly affected doctors' intention in initiating sexual health inquiry to their male patients. Malaysian men's health may be substantially improved by strategies that assist doctors to identify patient 'receptivity'.
A qualitative exploration of contraceptive practice and decision making of Malaysian women who had induced abortion: a case study

Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R

Asia Pac J Public Health, 2014 Sep;26(5):536-45.
PMID: 24368749 DOI: 10.1177/1010539513514434

This study explores contraceptive practice and decision making of women who have experienced abortion in Malaysia. In-depth interviews were carried out with 31 women who had abortions. Women in this study did adopt some method of modern contraception prior their abortion episodes. However, challenges to use a method consistently were experiences and fear of side effects, contraceptive failure, partner's influence, lack of confidence, and cost. The decision to adopt contraception was theirs but the types of contraceptive methods to adopt were influenced by their spouses/partners. The women wanted to use modern contraception but were faced with challenges that hampered its use. More proactive contraceptive promotion is needed to educate people on the array of contraceptive methods available and made accessible to them, to correct misconceptions on safety of modern contraception, to increase men's involvement in contraceptive choices, and to encourage consistent contraceptive use to prevent unintended pregnancies.
Determinants of health-related quality of life in psoriasis patients in Malaysia

Nyunt WW, Low WY, Ismail R, Sockalingam S, Min AK

Asia Pac J Public Health, 2015 Mar;27(2):NP662-73.
PMID: 23858523 DOI: 10.1177/1010539513492561

Psoriasis is a chronic dermatological disorder that has a negative impact on quality of life (QoL). This hospital-based cross-sectional study determined factors associated with health-related QoL (HRQoL) impairment in adult psoriasis patients. HRQoL was assessed using the Dermatology Life Quality Index (DLQI). Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). A total of 223 patients, aged 18 to 83 years, were recruited. For 67 (30%) patients, psoriasis had very large to extremely large effect on their life (DLQI score = 11-30). The median DLQI score was 7 (interquartile range = 7). Factors significantly associated with severe impact on HRQoL (DLQI ≥ 10) were disease severity, single status, working status, sports activities, nail dystrophy, exposed area involvement, itch, disturbed sleep, stress, and infection. The factor predictive of severe impact of psoriasis on HRQoL was disease severity. A holistic approach in the management, including psychosocial issues, is absolutely crucial for the optimal care of psoriasis patients.

Study site: Universiti Malaya Medical Centre (UMMC)
Psychometric properties of the self-report Malay version of the Pediatric Quality of Life (PedsQLTM) 4.0 Generic Core Scales among multiethnic Malaysian adolescents

Ainuddin HA, Loh SY, Chinna K, Low WY, Roslani AC

J Child Health Care, 2015 Jun;19(2):229-38.
PMID: 24154841 DOI: 10.1177/1367493513504834

Adolescence is the potential period for growth and optimal functioning, but developmental issues like time of transition from childhood to adulthood will create stress and affect the adolescent's quality of life (QOL). However, there is a lack of research tool for measuring adolescent's QOL in Malaysia. The aim of the study was to determine the validity and reliability of the self-report Malay version of the pediatric QOL (PedsQL™) 4.0 Generic Core Scales in assessing the QOL of Malaysian adolescents. A cross-sectional study design using the 23-item self-report Malay version of the PedsQL 4.0 Generic Core Scales was administered on a convenient cluster sampling (n = 297 adolescent) from a secondary school. The internal consistency reliability had Cronbach's α values ranging from .70 to .89. Factor analysis reported a six-factor structure via principal axis factor analysis. In conclusion, the self-report Malay version of the pediatric QOL 4.0 Generic Core Scales is a reliable and valid tool to measure the QOL of multiethnic Malaysian adolescents.
Fulltext Exploring pregnancy termination experiences and needs among Malaysian women: a qualitative study

Tong WT, Low WY, Wong YL, Choong SP, Jegasothy R

BMC Public Health, 2012;12:743.
PMID: 22950371 DOI: 10.1186/1471-2458-12-743

Malaysia has relatively liberal abortion laws in that they permit abortions for both physical and mental health cases. However, abortion remains a taboo subject. The stagnating contraceptive prevalence rate combined with the plunging fertility rate suggests that abortion might be occurring clandestinely. This qualitative study aimed to explore the experiences of women and their needs with regard to abortion.
Fulltext Knowledge, attitudes and practices among people with chronic hepatitis B attending a hepatology clinic in Malaysia: a cross sectional study

Mohamed R, Ng CJ, Tong WT, Abidin SZ, Wong LP, Low WY

BMC Public Health, 2012;12:601.
PMID: 22856889 DOI: 10.1186/1471-2458-12-601

BACKGROUND: Hepatitis B (HBV) is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors.
METHODS: This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV.
RESULTS: The response rate was 89% (n = 483/543). Participants had a mean age of 46.3 (±14.7) years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8) years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0-19). Participants aged 30-39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5%) were embarrassed to reveal their diagnosis to the public but most of them (93.6%) would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6%) did not share dining utensils and the majority (93.2%) believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV.
CONCLUSION: The findings highlight the stigma and misconceptions that still exist among the HBV patients. More patient and public education about HBV and its prevention are essential to increase awareness and to demystify the disease.
Study site: Hepatology clinic, University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Fulltext Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle

Tong SF, Low WY, Ismail SB, Trevena L, Willcock S

BMC Fam Pract, 2011;12:29.
PMID: 21569395 DOI: 10.1186/1471-2296-12-29

BACKGROUND: Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour.
METHODS: A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview.
RESULTS: The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's overall health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia.
CONCLUSIONS: The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.
Uncovering the experiences and needs of patients with chronic hepatitis B infection at diagnosis: a qualitative study

Ng CJ, Low WY, Wong LP, Sudin MR, Mohamed R

Asia Pac J Public Health, 2013 Jan;25(1):32-40.
PMID: 21807630 DOI: 10.1177/1010539511413258

Patients with hepatitis B face uncertainty at diagnosis. Information and support they receive at the early stage of the disease determine their adherence to follow up and treatment. This study aimed to explore the experiences and needs of patients with hepatitis B at diagnosis. A qualitative methodology was used. Nine focus groups (n = 44) were conducted to explore patients' feelings and reaction to the diagnosis, encounters with health care professionals, and their needs. The transcribed data were analyzed using a thematic approach. Most patients were not prepared for the diagnosis and many felt anxious and distressed. This was attributed to poor patients' knowledge, doctor's emphasis on disease complications, and associated stigma. Information about the disease was lacking and patients wanted to know more about the mode of transmission, natural progression of the disease, complications, and treatment options. There was a feeling of "passivity" among patients because there was often no active treatment available at diagnosis. This resulted in patients defaulting surveillance visits and missing the opportunity to start antiviral treatment. Therefore, there is an urgent need to provide sufficient information and education about hepatitis B to newly diagnosed patients, break "bad news" to patients with sensitivity, address their emotional needs, and emphasize on the rationale and importance of surveillance and treatment. This may entail public awareness campaign, implementation of pretest and posttest counseling, and educating doctors on how to communicate the diagnosis and management to patients accurately and sensitively.
Quality of life of multiethnic adolescents living with a parent with cancer

Ainuddin HA, Loh SY, Low WY, Sapihis M, Roslani AC

Asian Pac J Cancer Prev, 2012;13(12):6289-94.
PMID: 23464447

BACKGROUND: Research evidence suggests a debilitating impact of the diagnosis of cancer on the quality of life of the afflicted individuals, their spouses and their families. However, relatively few studies have been carried out on the impact on the QOL of adolescents living with parents diagnosed with cancer. This paper presents a sub- analysis on the impact of parental cancer (colorectal, breast and lung) on adolescents.
MATERIALS AND METHODS: This is a cross-sectional study on adolescents aged 13-18 years old. Upon ethical clearance obtained from UMMC Medical Ethics Committee, patients with colorectal, breast or lung cancer and their adolescent children were recruited from the Clinical Oncology Unit of University of Malaya Medical Centre. Respondents who gave consent completed a demographic questionnaire and the Pediatric Quality of Life Inventory, via the post, email, home visit or meetings at the clinics.
RESULTS: 95 adolescents from 50 families responded, giving a response rate of 88 percent. The adolescent's mean age was 16 years (ranging between 13-18 years). Adolescents with parental cancer had the lowest mean score in emotional functioning (p<0.05). Male adolescents had significantly higher quality of life overall and in physical functioning compared to female adolescents. Adolescents with a father with cancer had better school functioning compared to adolescents whose mothers had cancer. Families with household income of RM 5000 and above have significantly better quality of life compared to families with lower household income.
CONCLUSIONS: Adolescent sons and daughters of parents with a cancer diagnosis show lowered QOL, particularly with reference to emotional functioning and school performance. Addressing the needs of this young group has been slow and warrants special attention. Revisiting the risk and resilience factors of adolescents might also inform tailored programs to address the needs of this neglected adolescent population.
The triad of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome: findings from a multi-ethnic Asian men study (The Subang Men's Health Study)

Tan WS, Ng CJ, Khoo EM, Low WY, Tan HM

Aging Male, 2011 Dec;14(4):231-6.
PMID: 22115177 DOI: 10.3109/13685538.2011.597463

The etiology of erectile dysfunction (ED) is multi-factorial. This paper examines the association between ED, testosterone deficiency syndrome (TDS) and metabolic syndrome (MS) in Malaysian men in an urban setting. One thousand and forty-six men aged ≥ 40 years from Subang Jaya, Malaysia were randomly selected from an electoral-roll list. The men completed questionnaires that included: socio-demographic data, self-reported medical problems and the International Index of erectile function (IIEF-5). Physical examination and the following biochemical tests were performed: lipid profile, fasting blood glucose (FBG) and total testosterone. The response rate was 62.8% and the mean age of men was 55.8 ± 8.4 (41-93) years. Ethnic distribution was Chinese, 48.9%; Malay, 34.5%; Indian, 14.8%. The prevalence of moderate-severe ED was 20.0%, while 16.1% of men had TDS (< 10.4 nmol/L) and 31.3% of men had MS. Indian and Malay men were significantly more likely to have ED (p = 0.001), TDS (p < 0.001) and MS (p < 0.001) than the Chinese. Multivariate regression analysis showed that elevated blood pressure, elevated FBG, low high-density lipoprotein and heart disease were predictors of ED while all MS components were independently associated with TDS. Malay and Indian men have a higher disease burden compared to Chinese men and were more likely to suffer with ED, TDS and MS. MS components were closely related to TDS and ED.
Fulltext Physician's intention to initiate health check-up discussions with men: a qualitative study

Tong SF, Low WY, Ismail SB, Trevena L, Willcock S

Fam Pract, 2011 Jun;28(3):307-16.
PMID: 21115986 DOI: 10.1093/fampra/cmq101

BACKGROUND: Although prevalent in primary care settings, men's health issues are rarely discussed. Yet, primary care doctors (PCDs) are well positioned to offer health check-ups during consultations.
OBJECTIVES: This study aims to develop a substantive theory to explain the process of decision making by which PCDs engage men in discussing health check-ups.
METHODS: Grounded theory method was adopted. Data source was from 14 in-depth interviews and 8 focus group discussions conducted with a semi-structured guide. Interviews were recorded and transcribed verbatim for analysis. Initial open coding captured the concepts of processes from the data, followed by selective and theoretical coding to saturate the core category. Constant comparative method was used throughout the process to allow emergence of the theory.
RESULTS: Fifty-two PCDs from private and public settings were interviewed. PCDs engaged male patients in health check-ups when they associated high medical importance with the relevant issues. The decision to engage men also depended on perceived chances of success in negotiations about health check-ups. A high chance of success, associated with minimal negotiation effort, is associated with men being most receptive to health check-ups. When doctors feel the importance of a particular health issue, they place less emphasis on their perceived men's receptivity to discuss that health issue in their intention to engage them in discussing it.
CONCLUSIONS: Engaging male patients in appropriate health check-up activities requires a series of actions and decisions by the PCDs. The decision to engage the patient depends on the perceived balance between the receptivity of male patients and the medical importance of the issues in mind.
Factors contributing to utilization of health care services in Malaysia: a population-based study

Krishnaswamy S, Subramaniam K, Low WY, Aziz JA, Indran T, Ramachandran P, et al.

Asia Pac J Public Health, 2009 Oct;21(4):442-50.
PMID: 19783559 DOI: 10.1177/1010539509345862

This paper examines the factors contributing to the under utilisation of health care services in the Malaysian population.
Effect of treating lower urinary tract symptoms on anxiety, depression and psychiatric morbidity: a one-year study

Quek KF, Razack AH, Chua CB, Low WY, Loh CS

Int J Urol, 2004 Oct;11(10):848-55.
PMID: 15479289

The present study aimed to evaluate the effects of treating lower urinary tract symptoms (LUTS) on anxiety, depression and psychiatric morbidity following one year of follow-up.
Correlates between risk perceptions of cervical cancer and screening practice

Wong YL, Chinna K, Mariapun J, Wong LP, Khoo EM, Low WY, et al.

Prev Med, 2013;57 Suppl:S24-6.
PMID: 23318158 DOI: 10.1016/j.ypmed.2013.01.004

OBJECTIVES: To identify the correlates between risk perceptions and cervical cancer screening among urban Malaysian women.
METHOD: A cross-sectional household survey was conducted among 231 women in Petaling Jaya city in 2007. The association of risk perceptions of cervical cancer and screening practice was analyzed using Poisson regression.
RESULTS: 56% of the respondents ever had a Pap smear test. Knowledge of signs and symptoms (aPR=1.11, 95% CI=1.03-1.19), age (aPR=1.02, 95% CI=1.01-1.03), number of pregnancies (aPR=1.06, 95% CI=1.01-1.11), marital status, education level and religion were found to be significant correlates of Pap smear screening. Respondents who were never married were less likely to have had a Pap smear. Those who had no education or primary education were less likely to have had a Pap smear compared to those with degree qualification. The prevalence of screening was significantly higher among Christians and others (aPR=1.35; 95% CI=1.01-1.81) and Buddhists (aPR=1.38; 95% CI=1.03-1.84), compared to Muslims.
CONCLUSION: Eliminating anecdotal beliefs as risks via targeted knowledge on established risk factors and culturally sensitive screening processes are strategic for increasing and sustaining uptake of Pap smear screening versus current opportunistic screening practices.
KEYWORDS: Cervical cancer; Malaysia; Pap smear; Risk perception; Screening; Targeted knowledge
Fulltext Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study

Lee PY, Khoo EM, Low WY, Lee YK, Abdullah KL, Azmi SA, et al.

Health Expect, 2016 Apr;19(2):427-36.
PMID: 25857694 DOI: 10.1111/hex.12366

BACKGROUND: Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown.
AIM: We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM).
DESIGN: We used a qualitative design and thematic approach.
SETTING: Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices.
METHOD: We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes.
RESULTS: We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand.
CONCLUSION: It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid.

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