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  1. Syed FNN, Zakaria MH, Bujang JS, Christianus A
    Int J Food Sci, 2021;2021:8825970.
    PMID: 33553420 DOI: 10.1155/2021/8825970
    Several aquatic macrophytes such as Colocasia esculenta, Eleocharis dulcis, Nelumbo nucifera, Sagittaria sagittifolia, Trapa bispinosa, and Typha angustifolia possessed carbohydrate mainly in their storage and reproductive parts. Starch morphology, total starch, and amylose content of these six freshwater plant species were determined. Their functional properties, i.e., starch crystallinity, thermal properties, and rheological behaviour were assessed. Large starch granules were in N. nucifera rhizome (>15 μm), medium-sized was N. nucifera seed (8-18 μm), while the rest of the starches were small starch granules (<8 μm). Shapes of the starch granules varied from oval and irregular with centric hilum to elongated granules with the eccentric hilum. Eleocharis dulcis corm starch had significantly higher total starch content (90.87%), followed by corms of C. esculenta (82.35%) and S. sagittifolia (71.71%). Nelumbo nucifera seed starch had significantly higher amylose content (71.45%), followed by T. angustifolia pollen (36.47%). In comparison, the waxy starch was in N. nucifera rhizome (7.63%), T. bispinosa seed (8.83%), C. esculenta corm (10.61%), and T. angustifolia rhizome (13.51%). Higher resistant starch was observed mostly in rhizomes of N. nucifera (39.34%)>T. angustifolia (37.19%) and corm parts of E. dulcis (37.41%)>S. sagittifolia (35.09%) compared to seed and pollen starches. The XRD profiles of macrophytes starches displayed in all the corms and N. nucifera seed had A-type crystallinity. The T. bispinosa seed had CA-type, whereas the rest of the starches exhibited CB-type crystallinity. Waxy starches of C. esculenta corm had higher relative crystallinity (36.91%) and viscosity (46.2 mPa s) than regular starches. Based on thermal properties, high-amylose of N. nucifera seed and T. angustifolia pollen resulted in higher gelatinization enthalpy (19.93 and 18.66 J g-1, respectively). Starch properties showed equally good potential as commercial starches in starch-based food production based on their starch properties and functionality.
  2. Ji X, Guo X, Soh KL, Japar S, He L
    Nurs Health Sci, 2024 Jun;26(2):e13113.
    PMID: 38566439 DOI: 10.1111/nhs.13113
    Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.
  3. Soh KL, Soh KG, Japar S, Raman RA, Davidson PM
    J Clin Nurs, 2011 Mar;20(5-6):733-42.
    PMID: 21320202 DOI: 10.1111/j.1365-2702.2010.03579.x
    This study sought to determine the strategies, methods and frequency of oral care provided for mechanically ventilated patients in Malaysian intensive care units. The study also described nurses' attitudes to providing oral care and their knowledge of the mode of transmission of ventilator-associated pneumonia.
  4. Soh KL, Soh KG, Ahmad Z, Abdul Raman R, Japar S
    Contemp Nurse, 2008 Dec;31(1):86-93.
    PMID: 19117504
    The Intensive Care Unit (ICU) is a therapeutic place for monitoring critically ill patients. However, it is a stressful area for the patients and it is causing them great anxiety. Previous studies have identified three groups of stressors in ICU namely; physical, psychological and environmental. The aims of this study were to determine the ICU stressors as experienced by patients and to determine the level of stressors felt by patients in ICU. A cross sectional study was done on 70 patients from two tertiary hospitals in Malaysia. A face-to-face interview with structured questionnaire was used for patients. Data collection occurred from 15 December 2006 to 31 January 2007. The five major ICU stressors perceived by patients were pain, being stuck with needles, boredom, missing their spouses and being too hot/cold. The ICU physical stressors were the major items ranked by post ICU patients. The findings from this study provided a set of baseline information to the health care providers, particularly ICU nurses in Malaysia, with which to provide better care for the patients in ICU.
  5. Ong SL, Abdullah KL, Danaee M, Soh KL, Soh KG, Japar S
    J Reprod Infant Psychol, 2019 04;37(2):193-205.
    PMID: 30480464 DOI: 10.1080/02646838.2018.1540861
    OBJECTIVE: This study aims to determine maternal stress and anxiety as perceived by mothers whose premature infants were admitted to the neonatal intensive care unit (NICU) and to identify maternal stress and its relationship with maternal and infant characteristics and anxiety.

    BACKGROUND: Vulnerable premature infants commonly require special care in the NICUs. In most cases, prolonged hospitalization results in stress and anxiety for the mothers.

    METHODS: A non-probability convenience survey was used in a public hospital, with 180 mothers completing the 26-item Perceived Stress Scale (PSS) and a 40-item State-Trait Anxiety Inventory (STAI).

    RESULTS: 56.5% of mothers had high levels of stress, 85.5% of mothers had a high level of state-anxiety and 67.8% of mothers had a high level of trait-anxiety. The stress experienced by these mothers had a significant relationship with anxiety, and was found to be associated with state and trait anxiety levels, but not with maternal and infant characteristics.

    CONCLUSION: Mothers in this setting revealed high levels of stress and anxiety during their premature infants' NICU admission. An immediate interventional programme focusing on relieving mothers' anxiety and stress is needed to prevent maternal stress and anxiety at an early stage.

  6. Leong OS, Ghazali S, Hussin EOD, Lam SK, Japar S, Geok SK, et al.
    Br J Community Nurs, 2020 Feb 02;25(2):84-90.
    PMID: 32040358 DOI: 10.12968/bjcn.2020.25.2.84
    With the older population increasing worldwide, depressive disorder in this cohort is a serious public health problem that contributes to increased healthcare costs and mortality. This study aimed to determine the prevalence of depression among older adults in Malaysia who attended a daycare centre and to identify the relationship between depression and demographic factors. A cross-sectional study was conducted with 159 older adults recruited following screening for mental capacity. The Malay Geriatric Depression Scale questionnaire was distributed among the participants to obtain descriptive data on the symptoms of depression. Some 59.1% of the participants experienced depression. The most common factors associated with depression were being divorced, low education levels and low income. The findings indicate the need to revise and re-evaluate the activities and programmes in daycare centres for older adults in order to objectively cater to their physical and emotional needs.
  7. Lee SY, Soh KL, Japar S, Ong SL, Soh KG, Tsujita Y
    Belitung Nurs J, 2021;7(5):361-369.
    PMID: 37496510 DOI: 10.33546/bnj.1682
    BACKGROUND: The transition process of migration to work abroad can be challenging and, depending on how it is handled, can impact the job satisfaction level of these foreign-educated nurses. A clear understanding of migrant nurses' job satisfaction is critical for effective translation of nursing practice across the health systems and cultures.

    OBJECTIVE: This study examined the job satisfaction of the foreign-educated nurses in Malaysia, which includes the job satisfaction dimensions and the significant difference between sociodemographic status and job satisfaction.

    METHODS: A cross-sectional survey of 102 foreign-educated nurses working in private hospitals, clinics, hemodialysis centers, nursing homes, and private homes in Malaysia was conducted from September 2017 to March 2018. Data were collected using a structured questionnaire. Descriptive statistics, Mann-Whitney U, and Kruskal Wallis tests were used to analyze the data.

    RESULTS: The study revealed that the participants had a median satisfaction score of 22 (IQR = 19 to 24). Serving the sick and needy and participants' self-respect were the highest satisfaction dimensions among the participants (Median = 3, IQR = 3 to 3). Moreover, the job satisfaction was significantly higher for registered foreign-educated nurses (mean rank = 62.5) than for unregistered foreign-educated nurses (mean rank = 48.65) when working in other countries (p = 0.02). Indian nurses (mean rank = 60.36) also expressed higher satisfaction in terms of working in other countries than Filipino nurses (mean rank = 46.88; p = 0.02). In addition, positive relationships with colleagues and superiors led to higher satisfaction among Indian nurses (mean rank = 61.02) than among Filipino nurses (mean rank = 47.24; p = 0.04). The job satisfaction of male foreign-educated nurses was significantly higher than their female counterparts in terms of self-respect, relationship with fellow nurses and superiors, working in other countries, career development, and ease of finding employment (p < 0.05).

    CONCLUSION: The overall job satisfaction among the foreign-educated nurses in Malaysia is high, mainly when serving the sick and needy, and their degree of self-respect. Understanding job satisfaction among foreign-educated nurses in Malaysia enables the management team to develop effective strategies for addressing nursing shortages and improving the quality of patient care.

  8. Ong SL, Soh KL, Hussin EOD, Japar S, Soh KG, Vorasiha P, et al.
    Belitung Nurs J, 2022;8(2):93-100.
    PMID: 37521892 DOI: 10.33546/bnj.1872
    BACKGROUND: As Quality of Life (QoL) becomes progressively vital in health care services, its importance in mother and child health is of no exception too. Quality of life among mothers with a premature newborn is an issue that has led to growing concerns in the health care system. Yet, despite the knowledge about mother's QoL being essential to family-centered planning on prematurity integrated healthcare, current evidence has been scant.

    OBJECTIVE: To examine factors related to the QoL of mothers having preterm newborns hospitalized in the neonatal critical unit.

    METHODS: A non-probability convenience survey was used in a public hospital in Malaysia, covering 180 mothers whose preterm newborns were hospitalized into level III Neonatal Intensive Care Unit (NICU) through the completion of a 26-questions survey of the World Health Organization Quality of Life (WHOQOL-BREF) and the 26-questions of Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU). The data were analyzed using descriptive statistics, bivariate analysis, and Pearson correlation coefficients.

    RESULT: The mean scores for mothers' quality of life were (M = 3.67, SD = 0.73) and maternal stress (M = 3.03, SD = 0.90) out of 5. A mother's occupation was found to be the only factor associated with the quality of life among mothers who have preterm newborns admitted to the NICU. Furthermore, maternal role change was found to have a moderate negative relationship with the quality of life (r = 0.310, p = 0.05).

    CONCLUSION: The findings of this study revealed that the main factors contributing to the mother's QoL during their preterm newborns' NICU admission were role change-related stress. Thus, to maintain a better QoL among this group of mothers during this traumatic period, a special nursing intervention program must be implemented immediately, right after the preterm newborns' admission, to relieve the mothers' stress which has been proven to have a direct effect on the mothers' QoL. The study results will alert healthcare providers, particularly neonatal nurses, on the need to support mothers psychologically in terms of role change. This is to ensure a better quality of life among mothers whose newborns were admitted to the NICU.

  9. Japar S, Ong SL, Muhamed Z, Fukunaga K, Kobayashi T, Imachi H, et al.
    Diabetes Metab Syndr, 2022 Nov;16(11):102655.
    PMID: 36323181 DOI: 10.1016/j.dsx.2022.102655
    BACKGROUND AND AIMS: To assess the level of diabetes knowledge and its association with diabetes self-management practices during Ramadan fasting among patients with type 2 diabetes (T2D).

    METHODS: A cross-sectional study was conducted involving a sample of Malaysian patients with T2D. Patients aged 18 years and above, and attending an outpatient diabetic unit of a government hospital were recruited between February and April 2021. A self-administered questionnaire was utilized to assess diabetes knowledge and diabetes self-management practices.

    RESULTS: A total of 306 participants completed the questionnaire. Most of them were females (54.2%) and above 55 years old (75.1%). Resultantly, knowledge of diabetes was considered average among 52% of the participants. Only 9.5% of them avoided the consumption of sweet foods during iftar. Practicing late suhoor (p = 0.012) and self-monitoring of blood glucose (SMBG) (p = 0.026) during Ramadan were significantly associated with a better diabetes knowledge score. Education level (p = 0.000), working status (p = 0.030), and monthly income (p = 0.000) were significantly associated with participants' knowledge level of diabetes. A higher proportion (72.2%) of the participants completed fasting for a month during Ramadan 2020. Meanwhile, hypoglycemia was the main reason (38.8%) for incomplete fasting.

    CONCLUSIONS: These findings reflect the need to improve patients' knowledge of diabetes and diabetes self-management practices, especially during Ramadan. Such objectives could be achieved by considering the associated factors identified in this study.

  10. Ong MF, Soh KL, Saimon R, Saidi HI, Tiong IK, Myint WW, et al.
    J Adv Nurs, 2024 Apr 12.
    PMID: 38606809 DOI: 10.1111/jan.16190
    AIMS: To evaluate factors associated with fall protection motivation to engage in fall preventive behaviour among rural community-dwelling older adults aged 55 and above using the protection motivation theory scale.

    DESIGN: A cross-sectional study.

    METHODS: The study was conducted in a healthcare clinic in Malaysia, using multistage random sampling from November 2021 to January 2022. Three hundred seventy-five older adults aged 55 and older were included in the final analysis. There were 31 items in the final PMT scale. The analysis was performed within the whole population and grouped into 'faller' and 'non-faller', employing IBM SPSS version 26.0 for descriptive, independent t-test, chi-square, bivariate correlation and linear regressions.

    RESULTS: A total of 375 older participants were included in the study. Fallers (n = 82) and non-fallers (n = 293) show statistically significant differences in the characteristics of ethnicity, assistive device users, self-rating of intention and participation in previous fall prevention programmes. The multiple linear regression model revealed fear, coping appraisal and an interaction effect of fear with coping appraisal predicting fall protection motivation among older adults in rural communities.

    CONCLUSION: Findings from this study demonstrated that coping appraisal and fear predict the protection motivation of older adults in rural communities. Older adults without a history of falls and attaining higher education had better responses in coping appraisal, contributing to a reduction in perceived rewards and improving protection motivation. Conversely, older adults from lower education backgrounds tend to have higher non-preventive behaviours, leading to a decline in fall protection motivation.

    IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: These results contribute important information to nurses working with older adults with inadequate health literacy in rural communities, especially when planning and designing fall prevention interventions. The findings would benefit all nurses, healthcare providers, researchers and academicians who provide care for older adults.

    PATIENT OR PUBLIC CONTRIBUTION: Participants were briefed about the study, and their consent was obtained. They were only required to answer the questionnaire through interviews. Older individuals aged fifty-five and above in rural communities at the healthcare clinic who could read, write or understand Malay or English were included. Those who were suffering from mental health problems and refused to participate in the study were excluded from the study. Their personal information remained classified and not recorded in the database during the data entry or analysis.

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