Displaying all 17 publications

  1. Kueh, Yee Cheng, Tony Morris, Aziz-Al-Safi Ismail
    The present study aimed to examine the levels of diabetes knowledge, attitudes, self-management and
    quality of life (QoL) between two countries with different cultural and language backgrounds. Data
    collection was conducted in two hospitals in Melbourne, Australia, and a hospital in Kelantan, Malaysia.
    Participants with type 2 diabetes mellitus (T2DM) were asked to complete four questionnaires, measuring
    diabetes knowledge, attitudes, self-management, and QoL. The differences between the samples were
    examined using chi-square and independent samples t-tests. The variables of gender and type of treatment
    (using insulin or not using insulin for treatment) based on groups were analysed using one-way ANOVA.
    All analyses were conducted using SPSS 22.0. The results highlighted some similarities and differences
    between the Australia-based sample and the Malaysia-based sample. In general, the Australia-based
    participants scored significantly higher in diabetes knowledge and reported more regular self-management
    of T2DM in exercise, blood glucose testing and foot care. The Australia-based sample also scored higher
    on attitudes compared to the Malaysia-based participants. On the other hand, Malaysia-based participants
    reported a lower level of impacts of T2DM on QoL. There was no significant difference between selfmanagement
    of T2DM in terms of diet and satisfaction as an aspect of QoL related to living with diabetes
    between the two samples. The present study highlighted the levels of diabetes knowledge, attitudes,
    self-management, and QoL among Australia-based
    and Malaysia-based people with T2DM.
  2. Dariah Mohd Yusoff, Junaiti Yusof, Kueh, Yee Cheng
    Patients with chronic diseases such as diabetes, hypertension and cardiovascular diseases are known as
    high-risk groups for developing chronic kidney disease (CKD). Adequate related knowledge among them
    helps to increase their awareness towards CKD and adapt healthy attitude and practices for CKD
    prevention, which will result in better health outcomes. This study aimed to identify the patients'
    knowledge, attitude, and practices (KAP) towards the risks for CKD. This cross-sectional study used a selfadministered
    survey questionnaire on 103 adult male and female patients at four general surgical and
    medical wards in a teaching hospital using convenient sampling method. The data were computed using
    STATA version 12. Data on KAP were obtained through the Chronic Kidney Disease Screening Index
    questionnaire. The majority of respondents had poor knowledge (69.9%, n=72), but most of them had good
    attitude (68.9%, n=71) and good practices (88.3%, n=91) towards the risk of CKD. Significant associations
    were indicated between education level, occupation and monthly family income with knowledge (p-value <
    0.05). Significant associations were also indicated between age, sex, marital status and occupation with
    their attitude (p-value < 0.05). Meanwhile, marital status was found to be significantly associated with the
    practices towards the risk for CKD (p-value=0.008).
    Poor knowledge on the risk of getting CKD among hospitalized adults in this study implied the need for
    improvement in the public understanding towards the risk for CKD.
  3. Chin, Chee Kee, Dariah Mohd Yusoff, Kueh, Yee Cheng
    Blood donation is important for lives saving and the need is unceasing. However, the shortage of blood supply
    is a common issue. While the public is the main source of blood donation, it is unknown whether they are
    aware about it. This study was carried out to determine the public's knowledge, perceptions and barriers
    towards blood donation. Atotal of 384 male and female respondents were conveniently selected to participate
    in this study. Data was collected through self-administered questionnaire and analyzed with SPSS software
    version 22.0. Most of the respondents (60.9%) had never donated blood but their knowledge towards blood
    donation was high (79.9%). Some misconceptions were indicated among respondents. Afraid of the needle
    prick, pain or discomfort were the top barriers among non-donors respondents (45.3%). The majority of the
    respondents believed that blood donation is a practice or selfless concern for the well-being of others (98.7%).
    A significant relationship was indicated between age and level of education with status of blood donation
  4. Das, Priscilla, Naing, Nyi Nyi, Nadiah Wan-Arfah, Noorjan, K.O.N., Kueh, Yee Cheng, Rasalingam, Kantha
    Astrocytic gliomas are the most common primary brain tumours that originated from human glial cells. The tumours rely upon endothelial progenitor cells (EPCs) for neoangiogenesis. This study aimed to investigate the association between tissue resident EPCs in a brain tumour and normal adjacent tissue in relation to age and grade of astrocytic glioma. Astrocytic glioma patients (n=22), grade I to grade IV were consented from Hospital Universiti Sains Malaysia. Brain tumour tissue and normal adjacent brain tissue samples were obtained from each patient during surgery. The EPCs were stained with CD133+ and VEGFR-2+ markers. The tissue residents EPCs for each sample were determined using the immunofluorescence microscopy method. The age of the patients increased by disease severity in the following order (Grade I: 21.33±20.79 years) < (Grade II: 46.50±0.707 years) < (Grade III: 47.38±11.95 years) < (Grade IV: 48.44 ±10.66 years). The EPCs in brain tumour correlated significantly with the age of the patients with positive correlation (Spearman’s rho correlation test, r=0.52; p=0.013). The tissue resident EPCs in the brain tumour (median=0.40, IqR=0.59) were significantly higher compared with the adjacent normal brain (median=0.067, IqR=0.29) (Wilcoxon Signed-Rank Test, Z stat=-3.587, p
  5. Kueh YC, Morris T, Ismail AA
    Psychol Health Med, 2017 02;22(2):138-144.
    PMID: 26851120
    We examined the effect of diabetes knowledge and attitudes on self-management and quality of life (QoL) of people with type 2 diabetes mellitus (T2DM). We employed a cross-sectional study design. A total of 137 female and 129 male participants with T2DM completed the diabetes knowledge scale (DKN), Diabetes Integration Scale-19 (ATT19), Summary of Diabetes Self-care Activities (SDSCA) scale, and Diabetes Quality of Life (DQoL) scale, measuring diabetes knowledge, attitudes, self-management, and QoL respectively. The SDSCA scale measures diet, exercise, blood glucose monitoring, and foot care. The DQoL scale measures satisfaction and impact of QoL. An initial path model that tested the inter-relationships of the study variables was first identified based on previous research. Then, the path model was tested using Mplus 7.3. In the final model, diabetes knowledge was a significant predictor of attitudes and self-management in terms of blood glucose monitoring and foot care. Attitudes was a significant predictor of impact of QoL. Self-management in terms of blood glucose monitoring was a significant predictor of impact of QoL and diet was a significant predictor of satisfaction and impact of QoL. Exercise and foot care aspects of Self-management were significant predictors of satisfaction and impact of QoL respectively. The final model showed a good fit to the data: RMSEA = .045 (90% CI: .009, .071; Clfit = .601), CFI = .950, SRMR = .058. The findings suggest a theoretical basis to direct the development of appropriate health programs and interventions for improving QoL in people with T2DM and warrant replication in diverse samples.
  6. Chew KS, Kueh YC, Abdul Aziz A
    BMC Med Educ, 2017 Mar 21;17(1):58.
    PMID: 28320367 DOI: 10.1186/s12909-017-0897-0
    BACKGROUND: Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making.

    METHODS: This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format.

    RESULTS: For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6.

    CONCLUSION: The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

  7. Kueh YC, Morris T, Borkoles E, Shee H
    PMID: 26286395 DOI: 10.1186/s12955-015-0303-8
    Quality of life (QoL) is an important aspect of wellbeing for people with chronic conditions like type 2 diabetes, making it a noteworthy outcome. Knowledge about diabetes, attitudes, and self-management of diabetes are key factors that might directly or indirectly impact QoL. However, little is known about the inter-relationships between diabetes knowledge, attitudes, self-management and QoL among people with type 2 diabetes mellitus (T2DM). The aim of this study was to examine a model describing the relationship between diabetes knowledge, attitudes, self-management, and QoL of people with T2DM that is based on previous research linking pairs of these variables.
  8. Lim BC, Kueh YC, Arifin WN, Ng KH
    Objective: To determine the factor structure of the Health Promoting Behaviours (HPB) component of Health Promoting Lifestyle Profile-II among undergraduate students in Universiti Sains Malaysia (USM) by confirmatory factor analysis (CFA).
    Methods: A cross sectional study was conducted among undergraduate students. The data was collected in the USM campus using a proportionate cluster sampling method. The HPB questionnaire was handed to students in the lecture hall and collected immediately when the lecture finished. CFA was conducted using robust maximum likelihood estimation due to violation of multivariate normality assumption. A three-factor model was tested for measurement model validity and construct validity.
    Results: A total of 788 students participated in the study. CFA of a 21-item, three-factor model yielded an adequate goodness-of-fit values. The measurement model also showed a good convergent and discriminant validity after model re-specification.
    Conclusion: The health promoting behaviours scale was proven to have a valid measurement model and reliable constructs. It was deemed suitable for use to measure the health promoting behaviours components of a healthy lifestyle among Malaysian undergraduate students. It was recommended to further conduct cross-validation studies in other Malaysian public universities to provide additional empirical evidence to support its use.
  9. Lim BC, Kueh YC, Arifin WN, Ng KH
    Malays J Med Sci, 2016 Jul;23(4):33-45.
    PMID: 27660543 MyJurnal DOI: 10.21315/mjms2016.23.4.5
    Heart disease knowledge is an important concept for health education, yet there is lack of evidence on proper validated instruments used to measure levels of heart disease knowledge in the Malaysian context.
  10. Kuan G, Morris T, Kueh YC, Terry PC
    Front Psychol, 2018;9:14.
    PMID: 29459837 DOI: 10.3389/fpsyg.2018.00014
    Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14,F2,62= 5.03,p= 0.01, η2= 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for performance in other fine motor skills.
  11. Kueh YC, Abdullah N, Kuan G, Morris T, Naing NN
    Front Psychol, 2018;9:1096.
    PMID: 30018580 DOI: 10.3389/fpsyg.2018.01096
    Measurement equivalence is often assumed across comparison groups, a pervasive problem related to many self-report instruments. Measurement equivalence, also known as measurement invariance, implies that a measure has the same meaning across different groups of people. In this study, we aimed to examine the measurement and structural invariance among gender of the Malay version of the Physical Activity and Leisure Motivation Scale for Youth (PALMS-Y-M). Seven-hundred-and-eighty-three secondary school students (female = 57.3%, male = 42.7%) with mean age 14.5 years (standard deviation = 1.25) from Kota Bharu, Malaysia, volunteered to participate in this study and completed the PALMS-Y-M, consisting of 28 items with seven subscales. We conducted the confirmatory factor analysis (CFA) and invariance tests on the seven motives of the PALMS-Y-M model. The hypothesized model consisted of 28 observed items and seven latent variables. We used estimator robust to maximum likelihood, MLR to examine the hypothesized measurement and structural invariance. Measurement invariance was tested for three different levels. We first established the configural invariance model, then we compared the metric invariance model and the scalar invariance model with the less restrictive model. Then structural invariance was tested for factor variance, covariance, and means. Findings provided evidence for full measurement and structural invariance of the PALMS-Y-M in males and females. The final CFA model fit the data well for males [comparative fit index (CFI) = 0.922, root mean square error of approximation (RMSEA) = 0.048, standardized root mean residual (SRMR) = 0.050] and females (CFI = 0.922, RMSEA = 0.047, SRMR = 0.053). When invariance of both factor loadings and item intercepts holds in PALMS-Y-M, underlying factors consisting of different motives for participating in PA can be meaningfully compared across gender. Accurate and valid measurement of PALMS-Y-M across comparison groups is crucial for future research that involves examining motives to physical activity in different genders and other socio-cultural variables.
  12. Baharuddin IH, Arifin WN, Kueh YC, Rahman NA
    Malays J Med Sci, 2018 May;25(3):111-119.
    PMID: 30899192 DOI: 10.21315/mjms2018.25.3.11
    Background: Many questionnaires have been developed to measure dental anxiety and fear. Among them is the Index of Dental Anxiety and Fear Scale (IDAF-4C+), which consists of a dental anxiety and fear module (IDAF-4C), a phobia module (IDAF-P) and a stimulus module (IDAF-S). The objective of this research was to report the adaptation and validation of the IDAF-4C+ for Malaysian secondary school children.

    Methods: This was a cross-sectional validation study. The original English version of the IDAF-4C+ was translated into Malay, back-translated, and then sent for content validation via an expert validation and face validation by the target student population. Three hundred and seventy questionnaires were then distributed among 16-year-old school children. Confirmatory factor analysis (CFA) was conducted for the IDAF-4C module using a bootstrapped maximum likelihood estimator. Spearman's rank correlation was used to assess the relationship between the IDAF-S and IDAF-4C modules. Intraclass correlation (ICC) was used to determine the stability of the IDAF-S and IDAF-4C modules, while kappa values were used for the IDAF-P module.

    Results: The response rate was 86.5% for CFA and 76.9% for stability. CFA showed the existence of only one factor with a reliability estimate of 0.921, obtained via Raykov's procedure. All items in the IDAF-S module were significantly correlated with the IDAF-4C module (P < 0.001). The IDAF-S and IDAF-4C modules were stable, as determined via a two-way mixed model with absolute agreement, a single measure and a Case 3 ICC (A, 1). The IDAF-P module showed satisfactory stability, as assessed via kappa values.

    Conclusion: The Malay version of the IDAF-4C+ is valid and reliable in measuring dental anxiety and fear among Malaysian secondary school children.

  13. Chai S, Kueh YC, Yaacob NM, Kuan G
    Malays J Med Sci, 2019 Jan;26(1):115-124.
    PMID: 30914899 DOI: 10.21315/mjms2019.26.1.11
    Background: Understanding the individual aspirations of exercise participation is important for promoting physical activity. However, there is a lack of evidence to validate a measurement instrument for exercise-based goal content among Malaysian populations. The purpose of this study was to determine the validity and reliability of the Malay version of the Goal Content in Exercise Questionnaire (GCEQ) for a sample of Malaysian undergraduates.

    Methods: The original English version of the GCEQ underwent forward and backward translation into the Malay language. A cross-sectional study was conducted. The finalised Malay version was administered to 674 undergraduate students at the Health Campus of the Universiti Sains Malaysia (USM) with a mean age of 20.27 years (SD = 1.35 years). Confirmatory factor analysis (CFA) was conducted for the psychometric evaluation.

    Results: The measurement model consisted of 20 observed items and five latent factors. CFA demonstrated adequate fit to the data: comparative fit index = 0.929; standardised root mean square residual = 0.052; root mean square error of approximation = 0.061 (90% CI = 0.056, 0.067). The composite reliability coefficients for the five latent factors ranged from 0.777 to 0.851. All the correlations between the factors were less than 0.85, so discriminant validity was achieved.

    Conclusion: The findings suggested that the Malay version of the GCEQ is valid and reliable for assessing goal content in the exercise context of undergraduates at the Health Campus, USM.

  14. Tai ELM, Kueh YC, Wan Hitam WH, Wong TY, Shatriah I
    PLoS ONE, 2018;13(2):e0191434.
    PMID: 29389952 DOI: 10.1371/journal.pone.0191434
    PURPOSE: Childhood obesity is associated with adult cardiometabolic disease. We postulate that the underlying microvascular dysfunction begins in childhood. We thus aimed to compare retinal vascular parameters between obese and non-obese children.

    METHODS: This was a cross-sectional study involving 166 children aged 6 to 12 years old in Malaysia. Ocular examination, biometry, retinal photography, blood pressure and body mass index measurement were performed. Participants were divided into two groups; obese and non-obese. Retinal vascular parameters were measured using validated software.

    RESULTS: Mean age was 9.58 years. Approximately 51.2% were obese. Obese children had significantly narrower retinal arteriolar caliber (F(1,159) = 6.862, p = 0.010), lower arteriovenous ratio (F(1,159) = 17.412, p < 0.001), higher venular fractal dimension (F(1,159) = 4.313, p = 0.039) and higher venular curvature tortuosity (F(1,158) = 5.166, p = 0.024) than non-obese children, after adjustment for age, gender, blood pressure and axial length.

    CONCLUSIONS: Obese children have abnormal retinal vascular geometry. These findings suggest that childhood obesity is characterized by early microvascular abnormalities that precede development of overt disease. Further research is warranted to determine if these parameters represent viable biomarkers for risk stratification in obesity.

  15. Liu KT, Kueh YC, Arifin WN, Kim Y, Kuan G
    Front Psychol, 2018;9:2402.
    PMID: 30618907 DOI: 10.3389/fpsyg.2018.02402
    This study's purpose was to examine the structural relationship of the transtheoretical model (TTM) and the amount of physical activity (PA) among undergraduate students in health and medicine at Universiti Sains Malaysia. A cross-sectional study was carried out among students who took part in the co-curricular program. Co-curricular program includes activities that take place outside of the regular lectures or tutorials in the University. Students recruited through purposive sampling were informed that their participation was entirely voluntarily. Those interested completed the self-administered questionnaire, which consisted of the decisional balance, processes of change, self-efficacy, stages of change scales, and Godin leisure-time exercise questionnaire. Data were analyzed using Mplus version 8 for descriptive statistics and structural equation modeling analysis for inferential statistics. A total of 562 students participated in the study. The majority of the students was female (79.0%) and Malay (73.3%) and average of exercise sessions per week was 2.62, with a mean of 43.37 min per exercise session. The final structural model fit the data well based on several fit indices (SRMR = 0.046, RMSEA (CI: 90%) = 0.061 (0.045, 0.078), RMSEA p = 0.130). The model showed that stages of change significantly affected self-efficacy (p < 0.001), pros (benefits of exercise; p < 0.001), cons (barriers to exercise; p = 0.022), and processes of change (p < 0.001). The model also showed significant inter-relationships among the TTM constructs and supported seven hypotheses. Among all the variables examined, only processes of change significantly affected PA (p < 0.001). However, stages of change (p < 0.001) and pros (p =< 0.001) had significant indirect effects on PA via processes of change. The findings support that individuals' stages of change affect their self-efficacy level, or the ability to make positive and negative decisions and perform behavior accordingly. The study confirms that making correct decisions and taking action accordingly can increase PA levels.
  16. Kuan G, Abdullah N, Kueh YC, Ismail M, Shafei MN, Morris T
    Malays J Med Sci, 2019 Jan;26(1):138-146.
    PMID: 30914901 DOI: 10.21315/mjms2019.26.1.13
    Background: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia.

    Methods: The participants were university students at USM's Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS).

    Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities.

    Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.

  17. Vadivelu S, Ma ZF, Ong EW, Hassan N, Nik Hassan NFH, Syed Abdul Aziz SH, et al.
    Dig Dis, 2019;37(2):100-107.
    PMID: 30384376 DOI: 10.1159/000494386
    BACKGROUND: Gastroesophageal Reflux Disease Questionnaire (GERDQ) and Quality of Life in Reflux and Dyspepsia Questionnaire (QOLRAD) are reliable tools for evaluation of GERD.

    AIM: We aimed to test validity and reliability of Malay language translations of GERDQ and QOLRAD in a primary care setting.

    METHODS: The questionnaires were first translated into the Malay language (GERDQ-M and QOLRAD-M). Patients from primary care clinics with suspected GERD were recruited to complete GERDQ-M, QOLRAD-M, and Malay-translated 36-item short-form health survey (SF-36 or SF-36-M), and underwent endoscopy and 24-h pH-impedance test.

    RESULTS: A total of 104 (mean age 47.1 years, women 51.9%) participants were enrolled. The sensitivity and specificity for GERDQ-M cut-off score ≥8 were 90.2 and 77.4%, respectively. Based on this cut-off score, 54.7% had a high probability of GERD diagnosis. GERD-M score ≥8 vs. < 8 was associated with erosive esophagitis (p < 0.001), hiatus hernia (p = 0.03), greater DeMeester score (p = 0.001), and Zerbib scores for acid refluxes (p < 0.001) but not non-acid refluxes (p = 0.1). Mean total scores of QOLRAD-M and SF-36-M were correlated (r = 0.74, p < 0.001). GERDQ-M ≥8, erosive esophagitis, and DeMeester ≥14.72 were associated with impaired QOLRAD-M in all domains (all p < 0.02) but this was not seen with SF-36.

    CONCLUSIONS: GERDQ-M and QOLRAD-M are valid and reliable tools applicable in a primary care setting.

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