Method: This was a cross-sectional study with universal sampling conducted between July and October 2017. A total of 146 patients with asthma aged 18 years and older in a primary care clinic in Putrajaya, Malaysia were recruited. Logistic regressions were used for statistical analysis to examine the association between improper MDI techniques and their related factors.
Results: The majority (83%) of respondents were female with a median age of 37 (IQR = 30.75-49.25) years, and the median duration of asthma of 20 (IQR = 10-30) years. An improper MDI technique was observed in 100 (71.9%) patients. The most frequently missed step was exhaling gently and fully before inhalation (51.4%). Respondents who were not on an MDI preventer (adjusted OR: 2.487, 95% CI: 1.121-5.519, p = 0 .025) or had used an MDI 5 years or fewer (adjusted OR: 3.369, 95% CI: 1.425-7.964, p = 0.006) were more likely to employ an improper MDI technique.
Conclusion: There was a high proportion of improper MDI techniques among patients with asthma. Patients not using an MDI preventer or who had used an MDI less than 5 years were at higher risk of improper MDI technique.
METHODS: This was a qualitative study utilising the constructivist grounded theory approach. A total of 31 individuals aged 30 years and above from the community were sampled purposively. Eight interviews and six focus groups were involved, using a semi-structured topic guide.
RESULTS: A conceptual framework was developed to explain the public's decision-making process on health check participation for CVD prevention. The intention to participate in health checks was influenced by the interplay between perceived relevance and the individual's readiness to face the outcome of health checks. Health checks were deemed relevant if people perceived themselves to be at risk of CVD and there was an advantage in knowing their cardiovascular status. People were ready to face the outcome of health checks if they wanted to know the results and were prepared to deal with the subsequent management. The decision to participate in health checks was also influenced by external factors such as the views of significant others, and the accessibility and availability of resources including time and finances.
CONCLUSIONS: The intention to screen for CVD is motivated by two internal factors: the perceived relevance of the disease and readiness to face screening outcomes. Strategies targeting the internal decision-making process may prove to be key in improving the uptake of screening.
METHODS: This was a cross sectional survey using mall intercept interviews. It was carried out in a hypermarket surrounded by housing estates with a population of varying socioeconomic backgrounds. Inclusion criteria were Malaysian nationality and age 30 years and older. The validated CVD health check questionnaire was used to assess participants' intention and the determinants that influenced their intention to undergo CVD health checks.
RESULTS: A total of 413 participants were recruited. The median age of the participants was 45 years (IQR 17 years) and 60% of them were female. Participants indicated they were likely (45.0%) or very likely (38.7%) to undergo CVD health checks while 16.2% were not sure, unlikely or very unlikely to undergo health checks. Using ordinal regression analysis, perception of benefits, drawbacks of CVD health checks, perception of external barriers and readiness to handle outcomes following CVD health checks were the significant determinants of individuals' intention to undergo CVD health checks.
CONCLUSIONS: To improve individuals' participation in CVD health checks, we need to develop strategies to address their perception of benefits and drawbacks of CVD health checks, the perceived external barriers and their readiness to handle outcomes following CVD health checks.
METHODS: The concepts and items were developed based on findings from our prior exploratory qualitative study on factors influencing individuals' intention to undergo CVD health checks. Content validity of the questionnaire was assessed by a panel of six experts and the item-level content validity index (I-CVI) was determined. After pretesting the questionnaire was pilot tested to check reliability of the items. Exploratory factor analysis was used to test for dimensionality using a sample of 240 participants.
RESULTS: The finalized questionnaire consists of 36 items, covering nine concepts. The I-CVI for all items was satisfactory with values ranging from 0.83 to 1.00. The exploratory factor analysis showed that the number of factors extracted was consistent with the theoretical concepts. Correlations values between items ranged from 0.30 to 0.85 and all the factor loadings were more than 0.40, indicating satisfactory structural validity. All concepts showed good internal consistency, Cronbach's alpha values ranged 0.66-0.85.
CONCLUSIONS: The determinants for CVD health check questionnaire has good content and structural validity, and its reliability was established. It can be used to assess determinants influencing individuals' intention to undergo CVD health checks.
METHODS: This was a cross-sectional survey using mall intercept interviews. Malaysians aged ≥30 years without known CVD were recruited. They were asked for their intention to undergo CVD health checks and associated factors. The factors included seven internal factors that were related to individuals' attitude, perception and preparedness for CVD health checks and two external factors that were related to external resources. Hierarchical ordinal regression analysis was used to evaluate the importance of the factors on intention to undergo CVD health checks, for men and women separately.
RESULTS: 397 participants were recruited, 60% were women. For men, internal factors explained 31.6% of the variances in likeliness and 9.6% of the timeline to undergo CVD health checks, with 1.2% and 1.8% added respectively when external factors were sequentially included. For women, internal factors explained 18.9% and 22.1% of the variances, with 3.1% and 4.2% added with inclusion of the external factors. In men, perceived drawbacks of health checks was a significant negative factor associated with likeliness to undergo CVD health checks (coefficient = -1.093; 95%CI:-1.592 to -0.594), and timeline for checks (coefficient = -0.533; 95%CI:-0.975 to -0.091). In women, readiness to handle outcomes following health checks was significantly associated with likeliness to undergo the checks (coefficient = 0.575; 95%CI: 0.063 to 1.087), and timeline for checks (coefficient = 0.645; 95%CI: 0.162 to 1.128). Both external factors 1) influence by significant others (coefficient = 0.406; 95%CI: 0.013 to 0.800) and 2) external barriers (coefficient = -0.440; 95%CI:-0.869 to -0.011) were also significantly associated with likeliness to undergo CVD health checks in women.
CONCLUSIONS: Both men and women were influenced by internal factors in their intention to undergo CVD health checks, and women were also influenced by external factors. Interventions to encourage CVD health checks need to focus on internal factors and be gender sensitive.
METHODS: This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers.
RESULTS: The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952-9.368), being Malay (OR = 4.414, 95% CI: 1.18-16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587-4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454-9.276) had a significantly positive association with CAM use among postpartum mothers.
CONCLUSIONS: The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.
METHODS: We searched the reference lists of included studies from four electronic databases (PubMed, CINAHL, Scopus and Google Scholar) from inception until November 2020. We included pre-post, quasiexperimental and case-control studies, as well as randomised controlled trials (RCTs) that discussed medical play using the TBH concept as an intervention. Studies that involved sick patients and used interventions unlike the TBH were excluded. We assessed the quality of the included studies using the Cochrane Collaboration's 'Risk of bias' tool.
RESULTS: Ten studies were included in this systematic review. Five specifically investigated the TBH method, while the others involved the same concept of medical play. Only three studies were RCTs. All of the studies report more than one outcome-mostly positive outcomes. Two report lower anxiety levels after intervention. Two found better healthcare knowledge, with one reporting increased feelings of happiness regarding visiting a doctor. Two studies found no change in anxiety or feelings, while another two found increased levels of fear and lowered mood after the medical play (which involved real medical equipment).
CONCLUSIONS: The practice of TBH has mostly positive outcomes, with lower anxiety levels and improved healthcare knowledge. Its effectiveness should be verified in future studies using a more robust methodology.
PROSPERO REGISTRATION NUMBER: CRD42019106355.
METHOD: A cross-sectional study was conducted among participants aged > 18 years with asthma who attended five primary health clinics in Malaysia. Systematic random sampling was employed with a final sample of 550 participants. The questionnaires included the validated Malay version of Health Literacy Scale (HLS) and asthma control questionnaire (ACQ). Statistical analysis was done using SPSS version 25. Multiple logistic regression was performed to determine the determinants for limited health literacy.
RESULTS: The participants mean age of the participants was 48 (SD15.4) years. Most of the participants were women (64%) and of Malay ethnicity (51.1%). Nearly half had a secondary level of education, n = 112, (45.8%). Mean duration of asthma diagnosis is 20.6 (SD 15.9) years. More than half (62.5%) had a family history of asthma. About half (50.9%) had uncontrolled asthma, with 87.3% self-rated themselves as having controlled asthma. About a third (29.1%) received education on of asthma action plan, but only 7.1% of these owned a written version an asthma action plan. Limited health literacy accounts for 60.5% of the participants. The significant determinants for limited health literacy included lower educational attainment (p