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Caregiver burden among caregivers of individuals with severe mental illness: testing the moderation and mediation models of resilience

Mulud ZA, McCarthy G

Arch Psychiatr Nurs, 2017 Feb;31(1):24-30.
PMID: 28104054 DOI: 10.1016/j.apnu.2016.07.019

The association between the socio-demographic characteristics of caregivers, such as gender and caregiver burden, is well documented; however, the process underlying this relationship is poorly understood. Based on the stress process model, we designed a cross-sectional study to examine the mediating and moderating effect of resilience on the relationship between gender and caregiver burden. Caregivers of individuals with severe mental illness (n=201) were recruited in two psychiatric outpatient clinics in Malaysia. The relationship between the gender of the caregiver and caregiver burden was mediated by resilience, thus supporting the stress process model. The findings from the present research contribute to the growing evidence of the interaction between socio-demographic variables of caregivers and resilience, and caregiver burden.

Study site:Two clinics in West Malaysia Clinic A is located in the Klang administrative district, while clinic B is underthe Petaling administrative district
Factors associated with different types of hip fractures among elderly patients a tertiary hospital in Pahang: A retrospective cross-sectional study

Mohd Yusoff R, Mulud ZA, Mohammadnezhad M

Med J Malaysia, 2024 Mar;79(Suppl 1):117-121.
PMID: 38555895

INTRODUCTION: Hip fractures, predominantly due to decreased bone density and falls, significantly impact elderly health, disproportionately affecting women and placing a strain on healthcare resources. This study aims to conduct an indepth epidemiological analysis of hip fracture incidence among the elderly in Pahang, Malaysia, to inform better healthcare strategies.
MATERIALS AND METHODS: In this retrospective study, medical records of patients admitted with hip fractures between 2019 and 2021 at Hospital Sultan Haji Ahmad Shah (HoSHAS) in Pahang were analyzed. Data on sociodemographic characteristics, nature of trauma, fracture types, and comorbidities were collected and examined using descriptive and inferential statistics.
RESULTS: Among 3856 Orthopaedic Department admissions at HoSHAS (2019-2021), 296 hip fracture cases were identified, predominantly in women (71.3%), Malay ethnicity (75.3%), and aged 71-80 (38.5%). Intertrochanteric femur fractures were prevalent (62.8%). Unintentional falls accounted for 94.9% of cases. Logistic regression showed age and gender as significant predictors of femoral neck fractures. Specifically, Chinese seniors were 1.96 times more likely, and women over 65 were 1.95 times more likely to suffer these fractures. Notably, the absence of comorbidities increased the risk by 3.41 times (p < 0.05).
CONCLUSION: With increased longevity among Malaysian citizen, the number of hip fracture cases are growing and leading to other health-related problems such as disability, depression, and cardiovascular. Various preventive interventions for osteoporosis and falls should be implemented to reduce the incidence of hip fractures among older adults.
Research on the application effect of cognitive stimulation therapy in patients with Alzheimer's disease based on expert consultation and semistructured interviews

Shuzhen L, Hongyan G, Wei W, Ruiying W, Mulud ZA

J Popul Ther Clin Pharmacol, 2022;29(4):e97-e106.
PMID: 36441056 DOI: 10.47750/jptcp.2022.991

The awareness and utilization of psychological therapies for Alzheimer's disease have increased significantly in recent years. Limitations on the utilization of pharmacological therapy for Alzheimer's disease in China have corresponded with this surge in greater studies in the field. For individuals who have Alzheimer's disease, cognitive stimulation therapy (CST) is a quick self-help that is founded on the theories of quality and cognitive functioning. People with Alzheimer's disease often participate in cognitive behavioral programs; however, their expense has never been studied. Being part of a meta-analysis, we analyze the application effectiveness of a CST program that is based on recent research for Alzheimer's disease patients. A CST group therapy was given to 91 Alzheimer's patients, who resided in healthcare settings or the general public, multiple times per week for 8 weeks; the other 70 people with Alzheimer's disease got a medical therapy. Costs were computed, and resource utilization was tracked for 8 weeks both before and after the therapy. It was determined by a value study. In the value study, cognition and quality of life were the major and tertiary outcomes, respectively. Contours of cost-effectiveness and acceptance were drawn. It was driven based on expert consultation and semistructured interviews. In Alzheimer's disease, CST improves intelligence and standard of living, and there was no difference in implementation expenditures between the categories. Regarding both outcome metrics, there is a significant chance that CST seems to be more expensive than conventional therapy within realistic expectations. The efficacy of CST for Alzheimer's patients is superior to conventional treatment, and it could be the greater value. The outcomes contrast well with pharmacological studies for Alzheimer's. Many people with Alzheimer's disease may benefit significantly from CST groups.
Effects of multidisciplinary collaborative nursing combined with cognitive stimulation therapy on cognitive function, quality of life, and daily activities in patients with Alzheimer's disease

Shuzhen L, Wei W, Hongyan G, Ruiying W, Mulud ZA

J Popul Ther Clin Pharmacol, 2022;29(4):e86-e96.
PMID: 36441055 DOI: 10.47750/jptcp.2022.990

Alzheimer's disease (AD) is a neurodegenerative condition that disrupts neuropsychological activity and hinders the development of mental capacity. Efficient AD therapy is a major challenge in biological studies. Alzheimer's condition cannot be cured with any particular medication. The purpose of this study is to investigate the impact of multidisciplinary collaborative nursing and cognitive stimulation therapy (MCN- CST) on daily activities, quality of life, and cognitive performance in AD patients. The inclusion/exclusion method is initially used to gather information about AD patients. Control and investigative teams were formed with its own set of functions. The control group gets a regular course of treatment, whereas, the investigation group receives MCN-CST. To ensure that our study is as practical and useful, we compare our findings to existing nursing approaches. The ANOVA and Chi-Square tests are used to assess the conditions of Alzheimer's patients. There was a scientifically significant improvement in the overall level of their medical condition after implementing MCN-CST. Nursing protocols developed MCN-CST is beneficial in improving patients' quality of life, cognitive function, and daily activities. It is encouraged to do intensive research using many samples drawn from a wider range of people.
The impact of novel coronavirus (2019-nCoV) pandemic movement control order (MCO) on dengue cases in Peninsular Malaysia

Rahim MH, Dom NC, Ismail SNS, Mulud ZA, Abdullah S, Pradhan B

One Health, 2021 Jun;12:100222.
PMID: 33553566 DOI: 10.1016/j.onehlt.2021.100222

This study has highlighted the trend of recently-reported dengue cases after the implementation of the Movement Control Orders (MCOs) caused due to COVID-19 pandemic in Malaysia. The researchers used the dengue surveillance data published by the Malaysian Ministry of Health during the 3 phases of MCO (which ranged between 17th March 2020 and 28th April 2020) was used for determining the cumulative number of dengue patients. Thereafter, the dengue cases were mapped using the Geographical Information System (GIS). The results indicated that during the 42 days of MCO in Peninsular Malaysia, 11,242 total cases of dengue were reported. The daily trend of the dengue cases showed a decrease from 7268 cases that occurred before the MCOs to 4662 dengue cases that occurred during the initial 14 days of the COVID-19 pandemic (i.e., MCO I), to 3075 cases occurring during the MCO II and 3505 dengue cases noted during MCO III. The central peninsular region showed a maximal decrease in new dengue cases (52.62%), followed by the northern peninsular region (1.89%); eastern coastal region (1.25%) and the southern peninsular region (1.14%) during the initial MCO implementation. However, an increase in the new dengue cases was noted during the MCO III period, wherein all states showed an increase in the new dengue cases as compared during MCO II. The decrease in the pattern was not solely based on the MCO, hence, further investigation is necessary after considering different influencing factors. These results have important implication for future large-scale risk assessment, planning and hazard mitigation on dengue management.
Fulltext Trauma Informed Interventions to Reduce Seclusion, Restraint and Restrictive Practices Amongst Staff Caring for Children and Adolescents with Challenging Behaviours: A Systematic Review

Kelly P, Saab MM, Hurley EJ, Heffernan S, Goodwin J, Mulud ZA, et al.

J Child Adolesc Trauma, 2023 Sep;16(3):629-647.
PMID: 37593061 DOI: 10.1007/s40653-023-00524-2

Engaging with children and adolescents in mental health settings who are exhibiting behaviours that challenge can often result in the use of seclusion, restraint and coercive practices. It is recognised that more therapeutic ways to engage this population are needed, adopting trauma informed interventions may provide a solution. The aim of this systematic review is to synthesize the evidence in relation to the effect of trauma-informed interventions on coercive practices in child and adolescent residential settings. The review is guided by elements of the Cochrane Handbook for Systematic Reviews of Interventions and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) checklist. Results were synthesized and reported narratively. Nine studies met the eligibility criteria for this review. There was a lack of homogeneity amongst the studies. The trauma-informed interventions used were typically multi-faceted, underpinned by a variety of approaches and sought to bring about changes to clinical practice. Most studies (n = 8) reported significant reductions in the use of restrictive practices following the implementation of a trauma informed approach. The use of a trauma-informed approach, underpinned by an organisational change or implementation strategy, have the potential to reduce coercive practices with children and adolescents. However, the included interventions were insufficiently described to draw strong conclusions.