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In Search for a Sustainable and Equitable Long-Term Care for Malaysia

Yunus RM, Johar H, Katiman D

J Aging Soc Policy, 2023 Nov 02;35(6):743-755.
PMID: 35290173 DOI: 10.1080/08959420.2022.2049575

Like many other countries across the globe, Malaysia is rapidly graying. It is projected that older adults will comprise 10-15% of the country's total population in the next decade. Despite the surge in chronic diseases and a rise in dependency in daily living activities among Malaysian elders, formal support and long-term care services (LTC) have not been adequately developed. The existing tax-funded health care system - currently under huge financial strain - has no systematic or comprehensive LTC provision in place. This paper highlights the need for sustainable and equitable LTC services in Malaysia while drawing insight from existing LTC provision and financing arrangements in neighboring countries. It offers several recommendations to move forward in LTC planning using an approach that is unique to the Malaysian context.
Tumour Lysis Syndrome: a Rare Complication of Trans-Arterial Chemo-Embolisation with Doxorubicin Beads for Hepatocellular Carcinoma

Katiman D, Manikam J, Goh KL, Abdullah BJ, Mahadeva S

J Gastrointest Cancer, 2012 Sep;43 Suppl 1:S187-90.
PMID: 22692948 DOI: 10.1007/s12029-012-9373-6
Fulltext Caregiver burden among informal caregivers in the largest specialized palliative care unit in Malaysia: a cross sectional study

Ahmad Zubaidi ZS, Ariffin F, Oun CTC, Katiman D

BMC Palliat Care, 2020 Dec 08;19(1):186.
PMID: 33292214 DOI: 10.1186/s12904-020-00691-1

BACKGROUND: Informal caregivers (IC) are often overshadowed by the attention required by the terminally ill. This study aims to reveal the estimated proportion of caregiver burden, psychological manifestations and factors associated with caregiver burden among IC in the largest specialized Palliative Care Unit (PCU) in Malaysia.
METHODS: This was a cross-sectional study involving IC attending a PCU. Caregiver burden and psychological manifestations were measured using previously translated and validated Zarit Burden Interview and DASS-21 questionnaires respectively. Two hundred forty-nine samples were selected for analysis.
RESULT: The mean ZBI score was 23.33 ± 13.7. About half of the population 118(47.4%) was found to experienced caregiver burden whereby majority have mild to moderate burden 90(36.1%). The most common psychological manifestation among IC is anxiety 74(29.7%) followed by depression 51(20.4%) and stress 46(18.5%). Multiple logistic regression demonstrated that women who are IC to patients with non-malignancy were less likely to experience caregiver burden. IC who were highly educated and spent more than 14 h per day caregiving were at least twice likely to experience caregiver burden. Finally, those with symptoms of depression and anxiety were three times more likely to suffer from caregiver burden.
CONCLUSION: Caregiver burden among IC to palliative patients is prevalent in this population. IC who are men, educated, caregiving for patients with malignancy, long hours of caregiving and have symptoms of depression and anxiety are at risk of developing caregiver burden. Targeted screening should be implemented and IC well-being should be given more emphasis in local policies.
Fulltext A survey on the initial management of spontaneous pneumothorax

Ismail T, Anshar MF, How SH, Hashim CW, Mohamad WH, Katiman D

Med J Malaysia, 2010 Sep;65(3):187-91.
PMID: 21939165

Spontaneous pneumothorax (SP) is a common medical condition but continues to be a frequent management problem among doctors. Despite the availability of guidelines on management of SP, studies have shown that the compliance with the guidelines is low. The various treatment options available in treating this condition further confuse doctors on the right approach in managing SP. The objective of this study is to investigate the awareness of the availability of these existing guidelines and to investigate how the doctors involved in the initial management of SP would manage this condition. A self completed questionnaire which included three case scenarios were distributed among doctors in two teaching university hospitals and two large Ministry of Health hospitals. This study showed that there is a lack of awareness of the existing guidelines even among the senior doctors and there is a variation in the initial management of SP. Therefore a locally produced guideline may be beneficial to standardise and improve the management of SP.