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Fulltext The association between polyunsaturated fatty acids and depression among Iranian postgraduate students in Malaysia

Yary T, Aazami S

Lipids Health Dis, 2011;10:151.
PMID: 21864357 DOI: 10.1186/1476-511X-10-151

The incidence of depression is expected to increase over the next 20 years, and many people will have to deal with it. It has been reported that up to 40% of university students experience levels of depression. Several negative consequences are associated with depression symptoms, such as memory impairment, suicide, and substance abuse. Recently, researchers have been studying possible associations between depression and polyunsaturated fatty acids (PUFAs), which may modify depression symptoms. The aim of the present study was to find an association between PUFA levels and depression among Iranian postgraduate students in Malaysia.
Fulltext Reliability and validity testing of the healthcare provider-patient communication instrument: a pilot study in a Malaysian primary care setting

Nor Azmaniza A, Shamsuddin K, Aazami S

Malaysian Journal of Public Health Medicine, 2014;14(2):12-20.
MyJurnal

There is a growing interest in research on satisfaction with healthcare provider (HCP) and HCP- patient communication as a measure of healthcare quality of HCP’s communication competency. However, many communication assessments were not comprehensive measures and are not entirely accurate in measuring what is supposed to be measured. This study aimed at assessing the validity and reliability of a newly developed HCP-PC instrument in a Malaysian primary care setting. The HCP-PC instrument was developed using items adapted from existing instruments as well as self-developed items. A pilot study involving 277 clients of an outpatient clinic was conducted in HKL using the proposed instrument which was distributed immediately after face to face consultation. The content validity and Cronbach alpha reliability were assessed. Factor analysis constructed 3 components, exchanging information (EI), socioemotional behaviour (SB) and communication style (CS). All items loaded on the corresponding component with factor loading ≥0.6, suggesting that all items in the respective component are measuring the same direction. PCA of the final 30 items explain 61.98% of the total variance with 6.66%, 47.18% and 8.13% explained by EI, SB and CS respectively. Component-based reliability show strong internal consistency with Cronbach alpha, αEI= 0.92, αSB= 0.96 and αCS= 0.70. The pilot study supported the instrument validity and reliability after initial tests. However, further study needs to be done to confirm its construct validity to help establish a valid and reliable HCP-PC instrument for measuring patient satisfaction with HCP-PC that can be used in primary care setting.

Study site: outpatient clinic was conducted in HKL
Fulltext Examining behavioural coping strategies as mediators between work-family conflict and psychological distress

Aazami S, Shamsuddin K, Akmal S

ScientificWorldJournal, 2015;2015:343075.
PMID: 25695097 DOI: 10.1155/2015/343075

We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.
Fulltext Malay version of the family satisfaction scale: validity and reliability among Malaysian working women

Aazami S, Shamsuddin K, Akmal S

Int J Public Health Res, 2015;5(2):606-612.
MyJurnal

Introduction Family satisfaction is referred to the extent in which family members feel happy and fulfilled with each other. However, there has been lack of evidences on the family satisfaction scale within the Malaysian context. Therefore, the aim of this study was to assess validity of the Malay version of the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers to bring family satisfaction in line with the different field of studies.
Methods This study was conducted among 567 Malaysian working women. Data were collected using self-administrated questionnaires. This study conducted exploratory and confirmatory factor analysis, convergent validity and internal consistency using Cronbach’s alpha.
Results The findings of this study support the uni-dimensionality of the Malay version of the family satisfaction scale. The 10 items of the scale account for 68.1% of the total variance and the un-rotated factor loadings ranged from 0.76 to 0.87. Confirmatory factor analysis was run and supported the structure of family satisfaction scale. The results of confirmatory factor analysis using AMOS 21 in the current study reported the following indices: RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity (average variance extracted= 0.65) and the internal consistency (Cronbach’s alpha= 0.94) of this construct were adequately supported.
Conclusions The findings support the factor structure, convergent validity and the internal consistency of the examined construct. Therefore, Malay version of the family satisfaction scale is a valid and reliable instrument among Malaysian working women.
Dietary intake of magnesium may modulate depression

Yary T, Aazami S, Soleimannejad K

Biol Trace Elem Res, 2013 Mar;151(3):324-9.
PMID: 23238611 DOI: 10.1007/s12011-012-9568-5

Depressive symptoms are frequent in students and may lead to countless problems. Several hypotheses associate magnesium with depression because of the presence of this mineral in several enzymes, hormones, and neurotransmitters, which may play a key role in the pathological pathways of depression. The aim of this study was to assess whether magnesium intake could modulate depressive symptoms. A cross-sectional study was conducted on a convenience sample of 402 Iranian postgraduate students studying in Malaysia to assess the relationship between magnesium intake and depressive symptoms. The mean age of the participants was 32.54 ± 6.22 years. The results of the study demonstrated an inverse relationship between magnesium intake and depressive symptoms, which persisted even after adjustments for sex, age, body mass index, monthly expenses, close friends, living on campus, smoking (current and former), education, physical activity, and marital status.
Fulltext Work-family conflict and sleep disturbance: the Malaysian working women study

Aazami S, Mozafari M, Shamsuddin K, Akmal S

Ind Health, 2016;54(1):50-7.
PMID: 26423332 DOI: 10.2486/indhealth.2015-0086

This study aimed at assessing effect of the four dimensions of work-family conflicts (strain and time-based work interference into family and family interference into work) on sleep disturbance in Malaysian working women. This cross-sectional study was conducted among 325 Malaysian married working women. Multiple-stage simple random sampling method was used to recruit women from public service departments of Malaysia. Self-administrated questionnaires were used to measure the study variables and data were analyzed using SPSS version 21. We found that high level of the four dimensions of work-family conflicts significantly increase sleep disturbance. Our analyses also revealed an age-dependent effect of the work-family conflict on sleep disturbance. Women in their 20 to 30 yr old suffer from sleep disturbance due to high level of time-based and strain-based work-interference into family. However, the quality of sleep among women aged 30-39 were affected by strain-based family-interference into work. Finally, women older than 40 yr had significantly disturbed sleep due to strain-based work-interference into family as well as time-based family interference into work. Our findings showed that sleep quality of working women might be disturbed by experiencing high level of work-family conflict. However, the effects of inter-role conflicts on sleep varied among different age groups.
Fulltext The Relationship Between Job Satisfaction and Psychological/Physical Health among Malaysian Working Women

Aazami S, Shamsuddin K, Akmal S, Azami G

Malays J Med Sci, 2015 Jul-Aug;22(4):40-6.
PMID: 26715907 MyJurnal

The workplace environment has a great influence on employees' health. Job dissatisfaction has been widely recognised as a workplace stressor that can influence employees' psychological and physical health statuses. However, job satisfaction is a multi-dimensional concept, and it is necessary to investigate its different facets and their unique consequences. Therefore, the aim of this study was to assess the relationship between the nine facets of job satisfaction and psychological health and somatic complaints (i.e., sleep disorders, headache, gastro-intestinal and respiratory problems).
Fulltext Contribution of diet and major depression to incidence of acute myocardial infarction (AMI)

Yary T, Soleimannejad K, Abd Rahim F, Kandiah M, Aazami S, Poor SJ, et al.

Lipids Health Dis, 2010;9:133.
PMID: 21087475 DOI: 10.1186/1476-511X-9-133

BACKGROUND: Despite significant improvements in the treatment of coronary heart disease (CHD), it is still a major cause of mortality and morbidity among the Iranian population. Epidemiological studies have documented that risk factors including smoking and the biochemical profile are responsible for the development of acute myocardial infarction (AMI). Psychological factors have been discussed as potential risk factors for coronary heart disease. Among emotional factors, depression correlates with coronary heart disease, particularly myocardial infarction.
METHODS: This case-control study was conducted on 120 cases (69 males and 51 females) of acute myocardial infarction (AMI) and 120 controls, with a mean age of 62.48 ± 15.39 years. Cases and controls were matched by age, residence and sex.
RESULTS: The results revealed that severe depression was independently associated with the risk of AMI (P = 0.025, OR = 2.6, 95% CI 1.1-5.8). The analysis of variables indicated that risk factors for developing depression were unmarried, low levels of polyunsaturated fatty acids (PUFAs), total dietary fiber (TDF) and carbohydrates. The levels of these dietary factors were lowest in severely depressed patients compared to those categorised as moderate or mild cases. Furthermore, severely depressed subjects were associated with higher levels of total cholesterol, high systolic blood pressure (SBP) and WHR. Age, income, a family history of coronary heart disease, education level, sex, employment and smoking were not associated with severe depression.
CONCLUSION: The present study demonstrated that severe depression symptoms are independent risk factors for AMI. Furthermore, severe depression was associated with an unhealthy diet and AMI risk factors.
Study site: Mostafa Hospital, Ilam Province, Iran
Validation of the Iranian/Persian Version of the Perceived Therapeutic Efficacy Scale for Type 2 Diabetes

Azami G, Lam SK, Shariff-Ghazali S, Said SM, Aazami S, Mozafari M, et al.

Arch Iran Med, 2018 08 01;21(8):356-361.
PMID: 30113857

BACKGROUND: The theory if self-efficacy is the central concept of social cognitive theory with emphasis on the constructs of efficacy expectation, outcome expectation. Efficacy expectation is defined as the person's confidence to carry out a specific behavior. Outcome expectation is beliefs that carrying out a specific behavior will lead to a specific outcome. While the benefit of measuring outcome expectations has been established, there has been no large scale within the Iranian context. The purpose of this study is to examine the reliability-validity of the Persian version of the Perceived Therapeutic Efficacy Scale (PTES).
METHODS: This study was conducted among 160 patients with type 2 diabetes mellitus (T2DM) using a self-administered instrument measuring outcome expectation. We used a methodological study design to assess the validity and reliability of the translated Persian version of the instrument.
RESULTS: The findings of the present study support the uni-dimensionality of the Persian version of the instrument. The 10 items of the scale account for 73.54% of the total variance and the un-rotated factor loadings ranged from 0.66 to 0.93. Moreover, this study offers support for convergent validity and internal consistency of the scale.
CONCLUSION: Our study demonstrated good convergent validity, factor structure and internal consistency in a sample of 160 Iranian adults with T2DM. Therefore, the Persian version of the scale is a valid and reliable instrument and can be used in research and clinical settings.
Fulltext Behavioral interventions to improve self-management in Iranian adults with type 2 diabetes: a systematic review and meta-analysis

Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S

J Diabetes Metab Disord, 2018 Dec;17(2):365-380.
PMID: 30918872 DOI: 10.1007/s40200-018-0376-0

PURPOSE: The aim of this study was to systematically-review published experimental studies to determine the effectiveness of behavioral interventions on self-management in Iranian adults with type 2 diabetes.
METHOD: Pub Med, Web of Science, Science Direct, Ovid Medline, EBSCO, ProQuest, Google Scholar, and the Scientific Information Database (SID) were searched for English and Persian language studies published between 2009 and 2017. The primary outcome of this review was to assess the effects of behavioral interventions on glycosylated hemoglobin. Changes in the blood pressure, Lipid profiles, BMI, Self-efficacy, knowledge, attitude, practice, Self-care behaviors, social support, anxiety, and depression were the secondary outcomes.
RESULTS: Comprehensive search procedures resulted in twenty-three experimental studies with 2208 participants. Eleven studies were included in the Meta-analysis. Compared with the control group, behavioral interventions significantly lower glycosylated hemoglobin -0.61% (95% CI -0.80, -0.41). To explore the effects of the study intervention (regarding what aspects of the intervention are most effective), we then conducted a stratified analysis for HbA1c. Larger effects were found in interventions with a longer duration and higher intensity, delivered in the group format, interventions offered to individuals with higher baseline HbA1c, and interventions delivered by a multidisciplinary team. Moreover, behavioral interventions were effective in improving blood glucose, lipid profiles, knowledge, attitude, practice, self-efficacy, quality of life, and self-care.
CONCLUSION: In line with other behavioral studies, our study shows that behavioral interventions improve self-management in Iranian adults with type 2 diabetes.
Fulltext Effect of a Nurse-Led Diabetes Self-Management Education Program on Glycosylated Hemoglobin among Adults with Type 2 Diabetes

Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S, Mozafari M, et al.

J Diabetes Res, 2018;2018:4930157.
PMID: 30225268 DOI: 10.1155/2018/4930157

In recent years, great emphasis has been placed on the role of nonpharmacological self-management in the care of patients with diabetes. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors was designed. One hundred forty-two adults with type 2 diabetes were randomized to receive either usual diabetes care (control group) or usual care plus a nurse-led diabetes self-management education (intervention group). Duration of the intervention was 12 weeks. The primary outcome was glycosylated hemoglobin (HbA1c values). Secondary outcomes were changes in blood pressure, body weight, lipid profiles, self-efficacy (efficacy expectation and outcome expectation), self-management behaviors, quality of life, social support, and depression. Outcome measures were assessed at baseline and at 12-week and 24-week postrandomizations. Patients in the intervention group showed significant improvement in HbA1c, blood pressure, body weight, efficacy expectation, outcome expectation, and diabetes self-management behaviors. The beneficial effect of a nurse-led intervention continued to accrue beyond the end of the trial resulting in sustained improvements in clinical, lifestyle, and psychosocial outcomes. This trial is registered with IRCT2016062528627N1.

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