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Fulltext Quality of Life and Associated Factors among Primary Care Asian Patients with Type 2 Diabetes Mellitus

Dhillon H, Nordin RB, Ramadas A

Int J Environ Res Public Health, 2019 09 23;16(19).
PMID: 31547629 DOI: 10.3390/ijerph16193561

Diabetes complications, medication adherence, and psychosocial well-being have been associated with quality of life (QOL) among several Western and Asian populations with diabetes, however, there is little evidence substantiating these relationships among Malaysia's unique and diverse population. Therefore, a cross-sectional study was conducted in a Malaysian public primary care clinic among 150 patients diagnosed with type 2 diabetes mellitus (T2DM). Structured and validated questionnaires were used to investigate the associations between demographic, clinical, and psychological factors with QOL of the study participants. Approximately three-quarters of patients had a good-excellent QOL. Diabetes-related variables that were significantly associated with poor QOL scores included insulin containing treatment regimens, poor glycemic control, inactive lifestyle, retinopathy, neuropathy, abnormal psychosocial well-being, higher diabetes complication severity, and nonadherence (p < 0.05). The main predictors of a good-excellent QOL were HbA1c ≤ 6.5% (aOR = 20.78, 95% CI = 2.5175.9, p = 0.005), normal anxiety levels (aOR = 5.73, 95% CI = 1.8-18.5, p = 0.004), medication adherence (aOR = 3.35, 95% CI = 1.3-8.7, p = 0.012), and an aDCSI score of one and two as compared to those greater than or equal to four (aOR = 7.78, 95% CI = 1.5-39.2, p = 0.013 and aOR = 8.23, 95% CI = 2.1-32.8, p = 0.003), respectively. Medication adherence has also been found to be an effect modifier of relationships between HbA1c, depression, anxiety, disease severity, and QOL. These predictors of QOL are important factors to consider when managing patients with T2DM.
Self-care actions taken for vasomotor symptoms by some postmenopausal Kelantanese women

Dhillon HK, Singh HJ, Mahmood NM, Ghaffar NA

Climacteric, 2008;11(6):518-24.
PMID: 18991079 DOI: 10.1080/13697130802491031

OBJECTIVE:
Documentation of self-care actions for vasomotor complaints by some postmenopausal women in Kelantan.

METHODS:
A semi-structured questionnaire was administered to 326 naturally menopausal women to determine the prevalence and types of self-care actions taken for vasomotor complaints.

RESULTS:
Fractionally more women took self-care actions for night sweats than hot flushes. The choice of self-care action depended upon the area of residence and the educational level. The most common action taken for night sweats was to sleep either in an air-conditioned room or under a ceiling fan. About one-quarter of the complainants used hormone replacement therapy, the majority of who were urban-living and with secondary education. Only a small fraction used traditional remedies.

CONCLUSION:
A large proportion of women complaining of vasomotor complaints took self-care actions and the choice of self-care actions depended on the area of residence and educational level. The use of modern remedies and less of the traditional remedies was more common amongst the more affluent and educated women than women in rural areas who either did nothing or resorted to the more simple type of self-care actions. Contrary to our expectations, the use of traditional remedies was low.
Total parenteral nutrition (TPN) and steroid usage in the management of hyperemesis gravidarum

Subramaniam R, Soh EB, Dhillon HK, Abidin HZ

Aust N Z J Obstet Gynaecol, 1998 Aug;38(3):339-41.
PMID: 9761170
The perceptions of Australian oncologists about cognitive changes in cancer survivors

Smidt K, Mackenzie L, Dhillon H, Vardy J, Lewis J, Loh SY

Support Care Cancer, 2016 11;24(11):4679-87.
PMID: 27320905 DOI: 10.1007/s00520-016-3315-y

OBJECTIVE: Cancer-related cognitive changes (CRCC) can have a profound impact on a cancer survivor's quality of life. However, cancer survivors frequently report receiving limited information about their experience of CRCC from their oncology specialists. This qualitative study aimed to explore the perceptions of oncology specialists regarding CRCC and the potential for their views to influence their decisions about patient care.
METHODS: Thirteen medical oncologists and five radiation oncologists currently practising in Australia participated in this study. Data collection involved individual semi-structured interviews via telephone. Data were audio-recorded, transcribed verbatim and analysed using a thematic approach.
RESULTS: Four key themes emerged: (1) beliefs about the impact of priming on cancer survivors' perceived cognitive function, (2) perceptions of who is more likely to raise concerns of cognitive change, (3) uncertainty of how to best manage CRCC, and (4) the perceived role of oncologists in the management of CRCC.
CONCLUSIONS: CRCC and its impact on the cancer survivor's journey have been under-addressed by oncology specialists, and they are uncertain of potential management strategies. With cancer survival rates increasing, there is a need for specific interventions and management guidelines addressing CRCC and their effects on cancer survivors. Future exploration should focus on the survivor as central to their care and holistic approaches to CRCC management involving all members of the multidisciplinary team.