A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
Customer satisfaction is one of the main priority to any service provider. It indicates process and quality involved in delivering of services. However, satisfaction level varies from one service to another. In Indonesia, satisfaction study is seldom done on Posyandu activity. This study tries to understanding this issue. A cross sectional study was conducted on Posyandu services located in urban and rural areas of South Sumatera, Indonesia from November 2005 until January 2006 with 125 respondents in urban area and 123 respondents in rural area using multi stages random sampling. Data was collected via structured questionnaires using SERVQUAL score method based on five dimensions : tangible, reliability, responsiveness, assurance and empathy. The results showed that the proportion of satisfied customers was higher at 74% particularly in the rural area. Satisfied respondents were significantly associated with age, education, income and distance to Posyandu services. The most satisfying dimension were tangible and reliability especially in the urban area, but not for responsive and empathy dimension. Overall, the mean SERVQUAL score of all dimension was higher for the urban as compared to the rural area, implying that customer perceptions are much better from what was expected.
Responsive and empathy dimension were the main barrier affecting customer satisfaction. Staff development efforts such as training, refreshing and others form of organizational development strategies, therefore, need to be incorporated into its current managerial practice in order to improve the health services delivery and increase customers' satisfaction.
The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).
This study determined the association between nutritional status and the use of protease inhibitors (PI)
containing regimen among HIV-infected children receiving treatment at the referral centres in Klang
Valley. A total of 95 children currently on antiretroviral (ARV) therapy, aged one to eighteen years, were recruited using purposive sampling. Demographic data, anthropometric measurements, medical history, were collected using a structured questionnaire. Serum micronutrients levels and lipid profile were also examined using blood samples. Mean age was 8.8 3.9 years and 44.2% were on PI. Age ( 2 = 10.351, p = .006), weight-for-age ( 2 = 6.567, p = .010), serum selenium ( 2 = 4.225, p = .040) and HDL-C ( 2 = 7.539, p = .006) were significantly associated with the use of PI. Fewer children on PI were deficient in selenium as compared to those not on PI. On the contrary, more children on PI were underweight and had low HDL-C. The use of PI was found to have both positive and negative effects with better selenium level but poorer HDL-C level and weight status.
Background: Most PTSD screening tools for children and adolescents have been validated in Western contexts which is not necessarily generalizable to non-western cultures. Therefore, the objective of this cross-sectional study was to determine the psychometric properties of the Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) within a Malaysian population. Methods: Eighty-five adolescents aged 13- to 14-years-old completed the CPTS-RI, Harvard Trauma Questionnaire (HTQ) and Hopkins Symptom Checklist scale (HSCL). Results: Results showed a good internal consistency for the overall scale (α =.92), for the subscale -re-experience, avoidance and arousal subscales (α = .89, α = .73, α = .56 respectively) and for different gender groups and ethnicity. CPTS-RI demonstrated good construct and divergent validity, and showed good concurrent validity with the use of HTQ and HSCL as the criterion measure. Conclusion: Findings suggest that CPTS-RI is a valid and reliable instrument to assess PTSD symptoms among Malaysian adolescents.
The report describes a pilot study of cognitive-behavioural social skills program conducted on primary school children in Kelantan, Malaysia. Designs: Uncontrolled pre- and post- single design study. Methods: Children aged 9 - 11 referred by school teachers for behavioural problems were put into Petersen’s Stop-Think-Do cognitive-behavioural social skills program for 6 sessions delivered by a clinical psychologist. Main outcome measure was Goodman’s Strengths and Difficulties Questionnaires; to assess child’s emotional and behavioural functioning rated by parents and children themselves. Results: The results showed positive short-term effects of the program at improving some aspects of children’s psychological functioning, however they are not significant. Findings are limited to several issues including subjects’ drop-out, problems in generalizing learnt behaviour, and the use of single outcome measure. Conclusion: Whilst the program could possibly improve children behavioural functioning more dramatically, the implementation of such program in school setting must be organized in full collaboration and assistance from the parents and school administrators.
Objective: This study explored the stress and coping strategies among retired people in Malaysia. Methods: In-depth interviews were conducted with 36 elderly Malaysian subjects. This protocol was approved by the Ethics Committee of the Management and Science University. The data obtained were sorted into various categories. Results: A total number of 36 retired elderly people participated in this study. The majority of them were in the age group of 55-59 years old, females, Malay and married. The majority defined stress as pressure or tension. Financial difficulties, family and work problems were the main causes of stress in the majority. Also, the majority of respondents mentioned that they coped with stress by sharing problems with others, by resting and relaxing, and/or by doing housework during their free time. A few of them coped with stress by hanging out with friends, going shopping,
doing photography, travelling, going fishing, and doing sports. Conclusion: Financial difficulties, family and work problems were the main causes of stress among elderly people. They coped with stress by sharing problems with others, resting and relaxing, and/or doing housework during their free time.
Objective: This interventional study was aimed to investigate the effects of dark chocolate
consumption on anxiety, depression, and stress (ADS) among trainee nurses. Methods: A
parallel and open-label experimental study was conducted. Of the 128 nurses enrolled, only 47 participated in the intervention study (mean age = 20.32 years; ranging from 19 to 22 years old). They were randomly assigned to an intervention group (IG, n = 25) or a control group (CG, n = 22). The IG consumed dark chocolate and CG ingested mineral water for 3 consecutive days. The validated Malay Hospital Anxiety and Depression Scale (HADS) and Depression, Anxiety and Stress Scale (DASS-21) were utilised for measuring ADS levels. Data were analysed descriptively and score comparisons were conducted using non-parametric tests. Results: No significant differences between IG and CG in ADS scores were detected at baseline (all p > 0.05). At post-consumption, ADS score were significantly reduced in IG (all p < 0.01) compared with CG (all p < 0.05). Larger effect sizes among these respondents had also revealed that there were mood-elevating effects of dark chocolate consumption. Conclusion: This study has discovered that 3-day consumption of dark chocolate may alleviate ADS status among trainee nurses suggesting that dark chocolate may have a more prominent role in improving emotional and mood generally. Further investigations are however warranted to confirm this finding.
Objective: In the process of growing, adolescents experience stress either good or bad depending on how they cope. School training further adds to this stressful situation. It is noteworthy that persistent over stress will impair students’ academic achievement, personal and professional development. This preliminary study is meant to obtain initial data on the stress prevalence, stressors, and coping strategies among secondary school children in Malaysia. Data gained from this preliminary study provides valuable data for subsequence research in the future. Methods: This is a cross-sectional study involving 100 secondary school students from a Malaysian government secondary school. The validated Malay version 12-item General Health Questionnaire (GHQ-12), Soalselidik Stressor Sekolah Menengah (SSSM) and Malay version of Brief COPE were used to identify stress level, stressors, and coping strategies. Results: A number of 90 (90%) students participated in this study. The prevalence of stress among secondary school students was 26.1%. It was found that the main stressors were related to academic. The top five coping strategies were religion, positive reinterpretation, active coping, planning, and use of instrumental support. Conclusion: The prevalence of stress among secondary school students in a Malaysian
stressor among the students. The most frequent coping strategies being used by the students were positive coping strategies.
Background Despite country’s tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the school personnel is alarming.
Objective To determine the prevalence of smoking and to examine the determinants of smoking behaviour among the secondary school teachers in Bangladesh.
Methods A two-stage cluster sampling was used with a selection of schools on Probability Proportional to Enrolment (PPE) size followed by stratified random sampling of government and private schools and then all the teachers present on the day of the survey were selected for the study. The 66-item questionnaire included smoking behaviour, knowledge, attitude, second-hand smoking, tobacco free school policy, cessation, media advertisement and curriculum related topics. Seven additional questions were included to assess the socio-demographic characteristics of the teachers. Data analysis was performed using SPSS 17 software. A total of 60 schools were selected with school response rate of 98.3%. An anonymous self-administered questionnaire was filled in by all teachers present at the day of the survey. The sample consisted of 559 teachers with response rate of 99.5%.
Results The prevalence of smoking was 17% (95% CI: 14%, 20.4). About half of the teachers (48.4%) smoke daily followed by 25.3% smoke 1-2 days in last 30 days. The mean duration smoking of was 13.7(95% CI: 11.6, 15.9) years. Logistic regression analysis revealed that male teachers smoke 37.46(95% CI: 5.078, 276.432) times higher than their female counterparts. The graduate teachers were 2.179(95% 1.209, 3.926) times more likely to be smoke than master’s degree holder teachers. Smoking by friends appeared to be the strongest predictor for teachers smoking behaviour (OR 4.789, 95% CI: 1.757, 13.050). However, no statistically significant association was found between type of school, second-hand smoking and curriculum related factors and smoking behaviour of the teachers (p>0.05).
Conclusions Prevalence of smoking among the teachers is high in Bangladesh. Effective smoking prevention program should take into account within the dominant of socio-environmental influence to reduce smoking behaviour. The school curriculum items had less impact in preventing smoking behaviour.
Introduction Elderly are often associated with multiple social and health problems. Family members are important in helping them doing their daily activities. For elderly diabetics, family support has a role in diabetes management and glucose control. The aim of this study is to explore the perceptions of elderly diabetics regarding the role of family support on their glucose control.
Methods This qualitative technique was a part of the study on glucose control and its associated factors among elderly diabetics. It was conducted from February until May 2009 in Kulim. Ten respondents were purposively sampled based on their glucose control. HbA1c 6.5% or less was considered as good glucose control. In depth interview, using semi-structured interview guide was used in this study. The conversation had been taped, transcribed to verbatim and analyzed manually using thematic analysis.
Results All ten respondents perceived that family support did not play a role on their glucose control. They believed that self-awareness and self-determination were important to control the glucose level. Those with good glucose control practiced healthy diet, and not affected by food prepared by their family members compared to those with poor glucose control. However, both groups claimed that, they did not receive much advice from their family members and no special food was prepared for them. Conclusions Elderly diabetics should be motivated on self-determination and focusing on good glucose control. Health education should be given to patients and their family members to increase their diabetes knowledge especially on useful advice and proper food preparation. It could motivate the elderly diabetics to control their glucose level.
Introduction Children with cerebral palsy (CP) are often prescribed Rehabilitation and Seating Systems (RSS) to assist in daily activities, posture improvement and prevention of muscular-skeletal complications. In Sarawak, a special project to produce RSS was started under a partnership of a Japanese physiotherapist, health department and the community using local material.Aim To document the RSS project and to determine usefulness and costaffordability of these systems for cerebral palsy children and their families.
Methods The details of RSS manufactured were retrieved from the clinic notes and secretary file. Parents of children who received the seating systems between July 2004 and September 2008 were invited to complete a 5-point Global Parental Perception Questionnaire (GPPQ) between December 2008 and January 2009.
Results 277 RSS were manufactured between July 2004 and February 2011 (which included modified wheel chair, wooden chair, corner chair, buggy chair and standing frame), and used by children all over Sarawak. Parents of 73 children who used the seating systems completed the 5-points GPPQ. Ten families required full sponsorship. Children spent more time sitting up and brought outdoor more often after the systems became available. Majority of parents reported positive experience in their children with sitting ability, smiles, interaction with people, learning skills and easiness of doing physiotherapy. No change was noted with passing of motion drooling / oral secretion. Most parents agreed that the cost was affordable and worth paying.
Conclusions A community based initiative to manufacture RSS by using locally available material and skill, at affordable price for the parents was feasible and useful for the family/children with CP.
A literate and numerate population is the goal of any modern industrialized society. Literacy and mathematics skills carry the means by which children are equipped for the education processes on which their future will depend. Deaf and hard of hearing students' reading and mathematics skills are lower than that of others due to their inability. Before enhancing their literacy and mathematics skills, their standard of literacy and mathematics skills should first be identified. For this reason, the Malaysian Ministry of Education initiated the Literacy and Numeracy Screening (LINUS) program in 2009. However, problems arose in the assessment method of LINUS screening for these students since the LINUS screening method does not accommodate these students' situation and needs. Therefore, the researchers introduced internet-based Literacy and Mathematics Assessment (iLiMA) prototype that can overcome those problems. In the iLiMA prototype, sign language instruction video is used to standardize the assessment method in order to ensure that non-bias assessment could be established. The methodology used to develop this system is the Evolutionary Process Model - Prototype. The iLiMA prototype usability was assessed with the Computer System Usability Questionnaire (CSUQ) and conducted by using web-based survey method. The results indicate that the iLiMA prototype is usable and teachers are satisfied with it. Finally, the iLiMA prototype which had the potential to accommodate deaf and hard of hearing students to get a standardized and non-bias literacy and mathematics assessment was developed.
Introduction : Major flooding that occurred in Segamat District at the end of 2006 and early 2007 was a natural disaster that has left impact on physical and mental well-being of the victims. The aim of this study is to see the impact of the major flooding to the mental health of the health staff in Segamat District.
Methodology : Cross sectional study was conducted among Segamat health staffs who were involved in the major floods. Structured questionnaire was used to assess the mental health status of the victims. Result : There were 119 health staffs from the district health office, Hospital Segamat, dental clinic and Community Nursing School were interviewed in this study. A total of 6.7% respondents claimed to have stress related symptoms with women were more effected than men. Nurses and married respondents were found to be more stressful in this study.
Conclusion : Based on findings, therefore, top management has to pay more attention to the welfare of the health staff, directly or indirectly, in particular on the psychological aspect. By giving emphasis on continuous in-service training and counseling as well as other relevant support, stress-related symptoms could be minimized which in turn lead to higher individual productivity.
This study aims to determine the prevalence of lower urinary tract symptoms (LUTS) and level of awareness among male outpatients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A questionnaire consisting of demographic data, questions related to knowledge, attitude and practice on BPH and the International Prostate Symptom Score (IPSS) was used for this study. Uroflowmetry and bladder scan were used to evaluate the function of the urinary tract and severity of BPH. Urine dipstick was done for glycosuria, proteinuria and haematuria. A total of 220 respondents were surveyed. The prevalence of moderately and severely symptomatic LUTS was 42.7%. The most commonly reported LUTS were nocturia (78.2%), frequency (58.2%) and incomplete emptying (44.6%). The prevalence of glycosuria, proteinuria and haematuria were 23.6%, 11.4% and 1.8% respectively. There was a significant association between increasing age with the severity of LUTS (p=0.005). Out of 102 respondents with voided urine volume greater than 150 mL, there was a significant decrease in maximum (Qmax) (p=0.039) and average (Qave) urine flow rates with every 10 years increase of age (p=0.001). The majority of respondents (59.5%) have heard of BPH before. Over 78.2% of the respondents would seek medical attention if they have LUTS with 15.9% saying they would seek traditional treatment. In conclusion, the prevalence of LUTS was high and the level of awareness was satisfactory.
Study site: surgical and medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
A survey was conducted to assess dental caries experience and oral health related behaviour among Malaysian Territorial Army (TA) personnel. This cross-sectional study involved 284 personnel covering their socio-demography, oral hygiene habits and related behaviour and past utilization of dental services pattern. Dental caries were assessed using DMFT index. Caries prevalence was very high (97.2%; DMFT 8.15±5.36). Untreated decay (DT) was 3.67 (±3.15) and missing teeth (MT) 2.90 (±3.73). However, few were treated teeth (FT) at only 1.58 (±2.02). Almost everyone (98.2%) claimed they brushed their teeth at least once daily and 80% used fluoridated toothpaste. However, very few participants used dental floss (11.3%) while majority (60.2%) did not know about flossing. More than 70% were current smokers. Only 13.7% were regular attendees with the majority (86.3%) visiting the dentist only when they had dental problems. The most common reason (49.7%) for their last dental visit was related to presence of symptoms and few were (27.4%) for prevention. Symptomatic attendees are significantly more likely to have more severe caries experience than preventive oriented individuals (p=0.003). These findings support the importance of promoting preventive oral health utilization behaviour among army personnel.
Several studies on job stress have been conducted among nurses, teachers, clerks, lecturers, laboratory technicians, petroleum and automotive workers and the calculated prevalences ranged from 20-35%; associated factors identified include high job demand, low job control and poor social support. Thus, the aim of the present study was to determine the prevalence and associated factors of stress in dental healthcare workers of an institution of higher learning in Kelantan. A cross-sectional study of the prevalence and associated factors of stress in 54 dental healthcare workers of an institution of higher learning in Kelantan [response rate of 63.5 percent] was conducted in March 2006. The Malay version of the validated Depression, Anxiety and Stress Scale and Karasek’s Job Content Questionnaire were used as research instruments in this study. Informed consents were obtained from all participants. The prevalence of stress was 22.2%. One (1.9%) staff member experienced severe stress whilst 20.4% experienced mild to moderate stress. After controlling for age, sex, marital status and duration of work, psychological job demand (adj. b 0.61, 95% CI 0.21, 1.00, p=0.003), toxic exposures (adj. b 1.41, 95% CI 0.47, 2.35, p=0.004) and overtime work (adj. b 5.67, 95% CI - 1.18, 10.16, p=0.015) were directly associated with reported stress in dental healthcare workers. High psychological job demand, increased toxic exposures at work and increased overtime work were significantly associated with stress in dental healthcare workers. These findings can be used to guide preventive measures to reduce stress in dental healthcare settings.
The aims of the study were to investigate patient satisfaction and perceived psychosocial benefit from orthodontic treatment and to relate them to factors ajfecting treatment duration and treatment standards. A total of 130 patients (mean age I5 years) who had just completed full fixed appliance therapy (removable appliance) filled questionnaires. There was high proportion of satisfaction with dentofacial appearance (98.5 %), alignment of teeth (100 %), improved mastication (99.2%) and cleaning of teeth (98.5%). About 89.2% would recommend orthodontic treatment to their friends. All surveyed were satisfied with the services provided by the orthodontic staff and kw patients were dissatisfied with the length of each appointment (3.] %), number of appointments (l.5%) and total treatment time (5.4%). The main dissatisfaction appeared to be the long waiting time to be treated during their appointments (10%}. The mean duration of treatment to complete two-arch fixed appliance was I 7.6 months (S.D. 6.8 months) and 89.2% of cases were completed within 24 months. Treatment duration was also associated with pre-treatment ovemet (r=0.23 5), ovetjet d%rence_h·om pre-treatment to post-treatment 0·=0.204} and number of extractions (r=0.305}. Multmle linear regression anahtsis of duration of treatment with these factors accounted for about 7.8% ofthe variability.
Study site: Dental clinic, Kota Kinabalu, Sabah, Malaysia
Introduction: Each year, more than 20 million people are injured and 1.17 million are killed due to road
traffi c accidents. Developing countries account for over 85% of the deaths, and close to 90% of the disability caused by road traffi c crashes worldwide. The objectives of this study were to determine the knowledge, attitudes and practice and the factors infl uencing university students in Malaysia concerning road traffic accident. Materials and Methods: This study was conducted among the students of Management and Science University, Malaysia. The questionnaire was distributed randomly to the students of the Faculty of Health and Life Sciences. Data was analyzed using SPSS version 13, T-test and ANOVA. Results: The total number of 109 students with the mean age of 20.94±1.89 years participated in this study. Approximately 39 (35.7%) of the participant had been involved in one or more than one road traffi c accident. About 93.6% of them were very strongly/strongly convinced of seat belts importance. Multivariate analysis using the multiple linear regression method showed that age and attitude were signifi cantly associated with the exposure to the accident. Conclusion: The study participants had moderate knowledge about road traffic regulations and most of them mentioned that high speed, drivers’ lack of awareness about traffi c regulation and laws, and drivers’ non-compliance with traffi c rules and regulation were the most important cause of road traffic accidents. Almost all students were very strongly/strongly convinced of seatbelts importance. Age and attitude were signifi cantly associated with the exposure to the accident.
Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate.
Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire.
Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score.
Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.