Breast self-examination (BSE) is recommended globally as one of the methods in early detection of breast cancer. Little is known about nurses screening behavior related to BSE. A cross-sectional study was conducted to examine the knowledge, attitude and practice of Breast Self Examination (BSE) among nurses. A self-administered questionnaire was sent to a total of 114 nurses working in Obstetrics & Gynaecology wards and clinics of two tertiary hospitals. Among the 114 participants, 111(97.4%) practiced BSE. The mean age of the participants was 34.97(±9.104) years. The mean score of knowledge was 11.07(±1.020) and 81.1% had high knowledge of BSE. Majority (98.2%) of respondents showed good attitude towards BSE. Barriers was found to be a significant predictor and self confidence proved to be an influencing factor on BSE performance. Despite practicing BSE, the number of nurses that examined their breast monthly was only 35.1%. Age, working experience and marital status showed no significant relationship with knowledge and practice of BSE. However, BSE taught during their undergraduate programme was found to have a significant relationship with practice of BSE. Majority of nurses in this study were not complying with MOH recommendation for BSE in terms of frequency. Thus, intervention strategies should focus on educating nurses on performing BSE monthly, in accordance with the Ministry of Health guidelines. This is important as nurses play a primary role in promoting health behaviors in BSE practice and breast cancer awareness among women in this country.
Breast cancer is one of the most frequently encountered malignancies among young females in Malaysia, which accounts for 30.4% of newly diagnosed cancers. All women at or above the age of 20 are considered at risk of developing breast cancer. This is a cross-sectional study. The study was conducted in a private medical university in Malaysia during year 2012. Two hundred students were recruited in this study using universal sampling. Data collection was done using a selfadministration questionnaire. Chi-square test was used to assess the association between the practice of breast selfexamination and socio-demographic variables. Only 19.5% of the study sample has sufficient knowledge about BSE which is acquired mostly from local media. Having a family history of malignancy other than breast cancer seems to be the only significant variable associated with knowledge about BSE (P=0.002). Other variables such as demographic data, menstrual history and social history were also tested, but found to be not significant. Frequent community-based awareness programs are needed so that all women can know and practice BSE, which in turn helps to alert the women to any abnormal changes in the breasts so that they will be able to seek medical advice immediately.
The attitudes shown by community towards the mentally ill patient can have implications for recovery. To gather robust evidence regarding community attitudes towards people with mental illness, a data collection is required. A cross sectional study was carried out to examine the community attitudes towards the mentally ill patients and its associated factors in Tampoi Town, Johor among 347 respondents. This study was conducted from June 2012 to June 2013. Community Attitudes towards the Mentally Ill questionnaire was used to examine public attitudes towards the mentally ill patients. Another questionnaire was used to determine media influence and history or experience with the mentally ill patients was administered by a researcher. The community in this town had a positive attitude towards the mentally ill patients. Benevolence attitude which represent the positive attitude has the highest mean score [37.13 (4.18)]. Social Restrictiveness attitude which represent the negative attitude has the lowest mean score [25.42 (4.82)]. Results indicated that race, educational level and previous experience with the mentally ill patients had a significant association with community attitudes towards the mentally ill patients. Meanwhile, age, gender, religion, occupation, income and media have no association with community attitudes towards the mentally ill patients. These results are expected to help the related parties in conducting various comprehensive and holistic programs or campaign. Specifically, medical social worker should be more sensitive to the public attitude toward the mentally ill patients so that they could recognize the contributing factors on negative attitudes and prevent them.
Substantial studies reported musculoskeletal disorders among the working population in the developed country, however, a limited number of studies were conducted in Malaysia. The objective of this cross sectional study was to determine the physical activity risk factors for low back pain among automotive workers in Selangor. Modified Risk Factors Questionnaire (RFQ) was used to assess physical activity with the occurrence of low back pain. The significant physical activities associated with the 12 months point prevalence are lifting weight (
Introduction: It is estimated that 4.9 million people worldwide died in 2000 as a result of their addiction to nicotine, about half of them prematurely. This huge death toll is rising rapidly, especially in low and middle income countries where most of the world’s 1.2 billion tobacco users live.
Objectives: This study aimed to determine (i) the prevalence of smoking among the community aged 18 and above in Terengganu state, and (ii) the relationship between smoking and age, sex, educational level, family and peer influence.
Methods: A cross-sectional study design was used in this study and data was collected using a standardised pre-tested structured questionnaire.
Results: The overall mean age of the respondents was 38.9 (95% CI= 37.7 – 40.2) years. The majority of the respondents were Malays (99.1%). Of the 653 respondents, 32.2% and 23.6% were ever and current smokers respectively. Of this, 211 ever smokers, 199 (94.3%) were males and only 12 (5.7%) were females. The prevalence of ever and current smokers for males was 73.2% and 53.7% respectively compared to the females (3.1% and 2.1% respectively). There was a significant association between smoking status and sex (p<0.001). The prevalence of ever smokers was lowest amongst respondents with college or university educational level. However, for current smokers, those with college or university education had the highest prevalence. The overall mean initiation age of ever smokers was 19.7 years (95% CI = 18.8 – 20.7). The mean initiation age for the males (19. 1 years) was significantly lower compared to 29.8 years for the females (p<0.001). The mean duration of smoking for the current smokers was 21.6 (95% CI= 19.1 – 24) years. There was also no significant difference in the mean duration of current smoking for males compared to the females (p = 0.5). The majority (93.4%) of the ever smokers started either because their friends asked them to try or they were trying for fun. The quit ratio was 27%.
Conclusion : The prevalence of ever and current smokers in males is very high (73.2% and 53.7% respectively) compared with the females (3.1% and 2.1% respectively). The mean initiation age for the males (19.1 years) was significantly lower compared to 29.8 years for the females (p<0.001). Key words: Smoking, prevalence, initiation age, duration, Terengganu state
Introduction: Nasopharyngeal Carcinoma (NPC) is the second most common cancer among men in Malaysia. Establishing local data will help to improve the treatment strategies and lower the anxiety and depression level among NPC patients. Our aim was to compare the level of symptoms of anxiety and depression and the coping strategies employed between NPC and cancer-free patients. Methods: A comparative cross-sectional study with universal sampling was conducted on 22 NPC patients and 30 cancer-free patients from the Oncology and Radiotherapy Department and Ear, Nose and Throat clinic of Hospital Kuala Lumpur (HKL) between 12 to 29 May 2008. In this study, the symptoms of depression and anxiety were obtained by using the Hospital Anxiety and Depression Scale (HADS) while Brief COPE questionnaire was used to understand patients’ coping strategies. Results: The prevalence of NPC was higher in the Chinese, men, aged between 40 and 59 years, and those from the lower income group. The levels of anxiety and depression symptoms were found to be higher in the NPC group as compared to the cancer-free group. However, only the level of depression was found significantly related to the NPC group (p=0.002). This study also found that the two comparison groups were
using different types of coping strategies. The NPC patients mainly used ‘acceptance’ as their coping strategy while the comparative group most often used ‘religion’. Among the types of coping strategies reported by the patients, ‘use of instrumental support’ type was found to be associated with a lower level of anxiety (p = 0.035) and ‘humour’ type was associated with lower depressive symptoms (p = 0.269). On the contrary, ‘selfblame’ type was associated with both anxiety (p =0.0001) and depression (p = 0.001) symptoms. In addition, patients with different gender, ethnicity, educational levels, and
monthly income were also found to have significant differences in their levels of anxiety and depression as well as type of coping strategies. Conclusions: NPC patients had higher anxiety and depression levels as compared to the comparative group. Different socio-demographic backgrounds and different types of coping strategies had an influence on patients resulting in different levels of anxiety and depression.
Study site: ENT clinic, Hospital Kuala Lumpur, Malaysia
Objective: This study was conducted to determine prevalence and factors associated with obesity in Selangor, Malaysia. Methods: A population-based cross-sectional study was conducted in all districts of Selangor State. All individuals, 15 years and above in the selected households, were included. A pre-tested structured questionnaire was used to collect the data. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. Statistical analysis was performed using Stata 8.2 taking into account the complex survey design. Results: The overall mean age of the 2219 respondents was 36.6(95% CI 35.7 – 37.6) years. There was no significant difference in the mean age of the males and females (p=0.697). The majority of the respondents were Malays (52.9%), followed by Chinese (30.9%), Indians (15.4%) and
other races (0.9%). The overall mean BMI was 24.1 kg/m2 (95% CI=23.8- 24.4). The overall prevalence of obesity was 12.2% (95% CI 10.6%, 14.0%). There was no significant difference in the prevalence of obesity in the males compared to females (p>0.05). The prevalence of obesity increased with age up to the ages of 40-59 years and then decreased after 60 years. The highest prevalence of obesity was in the 40-59 years age groups in both sexes. The overall prevalence of obesity was significantly higher amongst the Malays (15.2%) compared to the Indians (11.6%) and Chinese (7.3%). Multivariate logistic regression analysis showed that only age and ethnicity were associated with obesity. Sex and educational level were not associated with obesity.
Introduction: Women are exposed to stress such as working full time while still being responsible for the family and house.
Objective: The objective of this study was to determine the prevalence of depressive symptoms among adult women in Selangor, and to determine the potential risk factors associated with depression.
Method: A community based cross sectional study was conducted in all districts of Selangor state, Malaysia in July 2004. Multi stage stratified proportionate to size sampling method was used to collect data. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depressive symptoms among the respondents. All respondents aged 20 to 59 years old in the selected households were interviewed.
Results: Out of 1032 women, 972 agreed to participate in this study, giving a response rate of 94.2%. The mean age of the respondents was 37.91 ± 10.91. Majority were Malays (54.9%), married (83.8%) and had secondary education (54.5%). The results showed that the prevalence of depressive symptoms was 8.3% in Selangor. Race, religion, education level, history of having a miscarriage within the last 6 months and history of difficulty in getting pregnant were significantly associated with depressive symptoms (p<0.05). Women with history of a miscarriage within the last 6 months and absence of formal education were potential risk factors for depressive symptoms (OR, CI = 2.576 (1.165-5.696), p<0.01 and OR, CI = 5.766 (1.949-17.053), p < 0.01).
Conclusion: Depressive symptoms among adult women in Selangor was 8.3% and was associated with race, religion, education, history of miscarriage and difficulty in getting pregnant. The main potential risk factors were having a miscarriage within the last 6 months and absence of formal education.
Keywords: Depressive symptoms, Prevalence and Risk Factors, Selangor Women
The aim of the study was to acquire background information on computer literacy among schizophrenia patients in Kota Bharu, Malaysia, prior to the introduction of a computerised cognitive remediation programme in the local setting.
Method: Fifty consenting consecutive patients with schizophrenia attending the Universiti Sains Malaysia Hospital psychiatric clinic were surveyed using the Computer Literacy Scale (CLS), a scale designed to specifically look at their level of computer knowledge, confidence and attitude towards computers.
Results: The majority of the patients studied have had schizophrenia for 5 years or less. While the majority of them have used computers befoie, about half had a poor level of knowledge, although they showed reasonable confidence and a positive attitude towards computers. Few played computer games.
Conclusions: Implementation of a computerised cognitive remediation programme in the Malaysian setting has a promising potential based on the results of this study but the programme needs to be adapted in light of the negative attitudes towards the use of games.
Study site: Psychiatric clinc, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Lumbar puncture (LP) is an important procedure both for diagnostic and therapeutic purposes. In Kelantan, Malaysia, on many occasions consent for this procedure is not granted by patients or guardians. The aim of this study was to find out the factors that influence the decision to grant or refuse the consent for LP. This was a cross-sectional study in which 86 parents (who agreed or refused to give consent for LP on their child) were interviewed by using a standard questionnaire. A scoring system was used to assess their knowledge about the purpose and technique of the procedure. Consent for LP was granted in 23 and refused in 27 children. The refusal rate was significantly higher when family members other than parents made the decision. The factors which did not play a statistically significant role in decision-making included: age of the child and parents; gender of the patient; number of children in the family; patient's birth order among the siblings; place of residence; monthly income of the family; parents' level of education; and number of days after admission when LP was requested. The factors that positively influenced the decision to give consent included knowledge about the purpose of LP and underlying disease. In order to receive positive consent for LP it is concluded that the parents/guardians and other family members who may influence the decision-making should be explained the role of LP in (1) making diagnosis and (2) choosing right antibiotics for treatment. They should also be informed about the side-effects of antibiotics, which may be used unnecessarily in unconfirmed cases of central nervous system infections.
The two vital aspects of treatment for patients with tha-lassaemia are regular blood transfusions and iron chela-tion therapy. Unfortunately, the use of blood transfu-sions exposes these patients to the risks of acquiring transfusion related viral infections such as hepatitis C. Patients who acquire the hepatitis C virus (HCV) may develop chronic hepatitis and later on hepatocellular carcinoma. Hence, patients with thalassaemia should be regularly screened for the presence of HCV. We report here the results of a cross-sectional study conducted in a typical day-care centre for thalassaemics at the Hospital Universiti Kebangsaan Malaysia, involving 85 multiply transfused patients. We found that 19 patients (22.4%) were seropositive for HCV and two of them had positive HCV-RNA. Those who had started receiv-ing their transfusions before 1995, i.e. the year routine screening for HCV amongst blood donors were com-menced, and those who received transfusions 2-4 week-ly had a significantly higher risk of acquiring HCV infection.
Objective: In Malaysia, opioid abuse is an acknowledged problem with severe health and economic repercussions. Until recently, drug addicts were mainly criminalised and forcefully rehabilitated in correctional facilities. However, the high relapse rates of this approach, coupled with the high rates of blood borne infections among drug users, led to increasing acceptance of a healthcare-based approach in the rehabilitation of drug addicts. Methadone was among the medications introduced as substitution maintenance therapy in 2005 and Universiti Malaya Medical Centre (UMMC) is a centre for MMT. This study aimed to determine the effects of MMT on quality of life in patients here. Methods: The sample was 46 patients who attended the Psychiatric outpatient clinic in fill in UMMC. The instrument used to assess quality of life was the WHOQOL-BREF. Results: The study design was cross-sectional with retrospective elements. Baseline QOL scores were obtained from case records and follow-up scores from the month of September 2007. Statistically significant improvements in all four domains of WHOQOL-BREF were found. Physical: p
Study site: Psychiatric outpatient clinic, Universiti Malaya Medical Centre (UMMC
Objective: This study aims to determine the quality of life (QOL) of Malaysian women based on their physical and mental scores and correlates with age and cervical disease severity. Methods: This is a cross-sectional study from Nov 2006 till Dec 2007 from participating
Gynecology-Oncology outpatient and in patient’s wards. QOL interviews used the SF-36 questionnaires. Main domains were the Physical Composite Scores (PCS) and the Mental Composite Scores (MCS). Results: A total of 396 participated in the study. Mean respondents age were 53.31 ± 11.21 years, educated till secondary level (39.4%), Malays (44.2%) with mean marriage duration of 27.73 ± 12.12 years. Among pre-invasive diseases, the cervical intra epithelial neoplasia (CIN) 1 was the highest in percentage of cases
(8.1%). Among invasive cancer, stage 1 cancer was highest (31.1%), followed with stage 2 (28.3%), stage 3 (7.3%) and stage 4 cancers (5.8%). PCS scores are highest among the pre-invasive and stage 1 cancer (F=4.357; p
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Objective: A study was conducted at the Universiti Kebangsaan Malaysia Medical Center (UKMMC) adult psychiatric clinic from June 2006 to December 2006. The aim was to assess the rate of the metabolic syndrome in a group of outpatients with mood disorders and schizophrenia and also to determine the relationship of this condition with sociodemographic factors and psychiatric illness characteristics.
Methods: A total of 51 subjects agree to participate of which 100 were approached. The International Diabetes Federation (IDF)(2005) criteria are used for the diagnosis of metabolic syndrome and Diagnostic Statistical Manual Version IV (DSM-IV) criteria are used to made psychiatric diaognosis.
Results: The prevalence of metabolic syndrome was found to be 37.2% and was significantly higher amongst mood disorders patient. However the metabolic syndrome is not associated with the anti psychotic therapy (p=0.41).
Conclusion: This study suggests that it is important for the psychiatrist to monitor metabolic syndrome in any of their patients.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Objective: The aim of this study was to identify depression among HIVinfected patients attending Infectious Disease Clinic in University Malaya Medical Centre (UMMC). Methods: This is a cross sectional study on HIVinfected patients attending Infectious Disease Clinic, UMMC. Those who fulfilled inclusion criteria were recruited and interviewed. Sociodemographic characteristics and clinical conditions such as mode of transmission, year of diagnosis, CD4+ counts, drug treatment and clinical stage were collected. The patients were then subjected to self-administered questionnaires, Patient Health Questionnaire, (PHQ-9) and Hospital Anxiety & Depression Scale (HADS). Results: 89 patients were recruited. Scores from PHQ9 showed 32% of depression rate while scores from HADS showed 19% of depression rate among the respondents. Non-self financial supporter, nonalcoholic drinkers and females were more likely to be depressed (P
Cross-sectional studies on infant feeding practices in Malaysia have shown that even though there is a high percentage of initial breastfeeding, there is also a very rapid fall-off of full breastfeeding to be replaced by mixed feeding or full formula feeding. This paper gives the findings of a study conducted on 148 mothers who had just delivered their babies at the Maternity Hospital, Kuala Lumpur. 56 of these mothers were followed up to identify the feeding practices up to 6 months of the infant's life. Just after delivery, 83 .1% of the 148 motftrs had indicated interest to breasffeed either fully or partially. However, in the 56 mothers followed up later, 15 (26.7%) babies were not breasffed or breasffed for less than 1 week and only 15 (26.5%) were breasffed at least 6 months. Several factors affect breastfeeding rate amongst these mothers. Breastfeeding rate was significantly higher and longer amongst the Malays and least and shortest amongst the Chinese. The number of Malay mothers breastfeeding less than 1 week was 2 out of 24 (8.3%) whereas the number of Chinese mothers was 10 out of 19 (52.6%). Similarly, the number of Malay mothers breastfeeding beyond 3 months was 16 out of 24 (67.7%) and Chinese mothers only 4 out of 19 (21.0%). Other important factors are the type of initial feeding and the onset of initial formula feeding. Out of 26 babies initiated on breastmilk as the first feed, 12 were breasffed for at least 6 months whereas 8 of the 18 started on formulas were not breasffed at all or for less than 7 days and only one breastfed for at least 6 months. Similarly, out of 27 babies given formula feeding in the first 2 days, 15 were not breasffed at all or for less than 1 week and only 3 breasffed at least 6 months. This suggests the importance of early mixed feeding in the rapid decline of breastfeeding. The employment status of the mother and the family income do not seem to affect the breastfeeding rate and its duration for the baby.
The objective of the study is to investigate the extent of preventive and promotive health care in the ambulatory management of paediatric gastroenteritis in an incompletely immunised child using the simulated patient methodology. Only 44% of doctors explained to the fathers the nature of their child's ailment. 75% of clinicians prescribed oral rehydration solution but only 4% met the Gold Standard. The questionnaire survey showed that doctors rated immunisation as a very important health message to disseminate to all parents. But only 3% of doctors in the study advised parents to complete each child's immunisation once he is well. The extent of preventive and promotive health care in ambulatory paediatric practice in the Klang Valley is very low. (Copied from article).
Patient satisfaction plays a crucial role in ensuring utilization of healthcare services, continuity of care, and compliance towards treatment. Thus, this study aimed at determining the level of patient satisfaction with the services provided by the UKMMC primary care clinic. A descriptive cross-sectional study involving 317 patients attending the clinic from February to March 2011 was carried out. They were selected through systematic random sampling. Using a validated self-administered Patient Satisfaction Questionnaire-46 (PSQ-46) in English and Malay versions, general satisfaction and satisfactions with five different subscales (doctors, nurses, accessibility, facilities and appointment) were assessed. A majority of the patients (93.1%) were generally satisfied with the overall services. Among the five subscales, patients were most satisfied with the doctors (96.5%), but only 35.6% of the patients were satisfied with the facilities. The proportions of patients who were satisfied with other subscales were: 86.1% (appointment), 82.0% (nurses) and 68.1% (accessibility). There was a significant association between each of the subscales and the general satisfaction (p
Dental caries is the main oral health problem in hearing-impaired (HI) children and remains the most neglected need. The present study aimed to determine caries prevalence and treatment needs in HI children and the association with salivary parameters. A cross-sectional study was conducted on 63 HI children aged between 7-14 years who attended a special school for the deaf. Clinical oral examination was done and salivary parameters (resting flow rate and resting pH) were measured. Caries experience was charted using the index of decay-filled teeth (dft) and Decay-Missing-Filled Teeth (DMFT) for primary and permanent dentition respectively. Data were analysed using SPSS version 12.0. The mean age was 11.5 (SD 2.39) years and 53.8% were female. Dental caries prevalence was 88.0% (95% Cl: 73.0, 100.0) in primary dentition and 85.0% (95% Cl: 73.0, 96.0) in permanent dentition. The mean dft was 6.1 (SD 4.14) and the mean DMFT was 4.9 (SD 3.28). The mean resting flow rate was 0.14 (SD 0.08) ml/min while mean pH was 6.8 (SD 0.79). Both pit and fissure sealants and restorations were the highest (83.1%) treatment needs. Only 3.1% of the children did not require any treatment. There were no significant association between both salivary flow rate and salivary pH with caries experience in the primary (p=0.342, p=0.610 respectively) and permanent (p= 0.99, p=0.70 respectively) teeth. In conclusion, children with HI have high caries prevalence and unmet need for dental treatments. Salivary pH and resting flow rate of the children were not associated with their caries experience.
Clinical psychology is a specialised field of professional psychology that is much needed with regards to the treatment of mental disorders, behaviour problems and learning difficulties. The field of clinical psychology has been integrated into the health system, especially the mental health and education system, in many western countries. In Malaysia, clinical psychology is still a new concept and has yet to be accepted into the medical and health systems in Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 59-6660 general. This preliminary study looks at the awareness of 199 medical and health sciences professional with regards to clinical psychology. Results of this survey found that only 13.6% of the respondents demonstrated basic knowledge of what clinical psychology is. The awareness of clinical psychology as a clinical profession, and its benefits within the health system is still very much lacking among medical and health sciences professionals. The need to improve awareness of clinical psychology as a clinical profession as well as a health science discipline is very important as clinical psychology services are able to contribute to more holistic treatment of health problems in Malaysia.Implications of this study includes the need for the awareness of clinical psychology to be improved.