This paper looks at some of the problems encountered when cases of abuse and injuries occur in children placed in child care in an urban community in Malaysia. It is based on the study of 37 children referred to our hospital's Child Protection Services over the past four years for injuries and incidents where the child-minders came under suspicion. They constituted 12% of the 285 children referred to the Child Protection Team during that period for evaluation of suspected child abuse. Twenty six children had experienced physical trauma. Fifty eight percent of these were young infants with cranial injuries or limb fractures but no history to explain their occurrence. Four had superficial injuries from accidents secondary to inadequate supervision. The other 11 children had been sexually abused. The perpetrators in 73% of cases were either the husbands or sons of the child-minder. Ninety five percent of the incidents occured at home-based nurseries. Prospects of any punitive measures were remote in most instances due to uncertainty about the perpetrator, or insufficient corroborative evidence required in sexual abuse cases. There were three documented cases where the family refused to lodge a police report or co-operate with investigations out of a reluctance to implicate or offend the child-minders who were mainly neighbours, relatives or friends in 58% of cases. Ninety seven percent of the facilities were unregistered, making surveillance for recurrent incidents and adherence to safety standards difficult. These incidents were almost certainly an underestimate of the problem. Training of child-care providers, improved legislation and enforcement as well as education of parents to choose suitable facilities are issues which need to be tackled.
Objective: The objective of this study was study the psychometric properties
the Malay Version of the Demoralisation Scale (DS-M) in cancer patients.
Method: This was a cross sectional study where 178 subjects were recruited
from Universiti Malaya Medical Centre (UMMC). The subjects answered
both English and Malay versions of the Demoralisation Scales, Centre for
Epidemiologic Studies Depression (CESD) Scale, Distress Thermometer and
Positive Emotion Rating Scale (PERS). Principal component factor analysis
was conducted. The internal consistency, convergent, divergent and
discriminant validity were examined.
Results: The mean score for the DS-M
of the subjects was 18.79 + 15.30 where 37.6% of the cancer patients scored >
23. The principal component analysis of DS-M yielded four-factor structures.
The Cronbach’s alpha for the scale was 0.95, and the subscales ranged
between 0.81-0.92. The Spearman’s correlation showed a good convergent
validity between DS-M and CESD (r = 0.78, p < 0.01) and Distress
Thermometer (r = 0.64, p < 0.01); and divergent validity between DS-M and
PERS (r = -.69, p < 0.01). The AUC was 0.92 (SE: 0.02, p < 0.01, 95% CI 0.88-
0.97).
Conclusion: The DS-M has good psychometric properties as a
screening tool for demoralisation in patients with cancer in Malaysia.
The number of juvenile offenders admitted to Malaysian prisons is alarming. The purpose of this paper is to determine the presence of any psychiatric disorders and their association with personal characteristics of juvenile detainees in prisons across Peninsular Malaysia.